Science Vs - Coronavirus Outbreak: How Scared Should You Be?

Episode Date: January 31, 2020

A new virus showed up in China late last year, and it’s making its way to other countries too. So what do scientists know about the virus so far? And how worried should we be? To find out we talk to infectious disease researchers Dr. Kristian Andersen and Dr. Catharine Paules, physician Dr. Hui, and director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci. We did an episode on a *fictional* pandemic, which you can find here: https://gimletmedia.com/shows/science-vs/49hok3/pandemic  Check out the full transcript here: https://bit.ly/2S7JwXN Selected references: The WHO and the CDC are maintaining information centers that update regularly: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 and https://www.cdc.gov/coronavirus/index.html  Scientific journals The Lancet and the New England Journal of Medicine have taken down the paywall for papers related to the outbreak: https://www.thelancet.com/coronavirus and https://www.nejm.org/coronavirus  This episode was produced by Wendy Zukerman, Meryl Horn, Rose Rimler and Michelle Dang. We’re edited by Blythe Terrell and Caitlin Kenney. Fact checking by Lexi Krupp. Mix and sound design by Sam Bair. Music written by Peter Leonard, Emma Munger, and Bobby Lord. A big thanks to Dr. Paul Delamater, Dr. Vittoria Colizza, and Shan Li. Recording assistance from Margot Wohl and Randy Scott Carroll. Translation by Yuan Xue, John Deng, and Chiung H Chuang. And special thanks to Bobby Lord, the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology and what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. It's season three of The Joy of Why, and I still have a lot of questions.

Like, what is this thing we call time? Why does altruism exist? And where is Jan 11? I'm here, astrophysicist and co-host, ready for anything. That's right, I'm bringing inuckerman, and you're listening to Science Verses from Gimlet. every other Thursday, starting February 1st. Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. We are on a break. We were on a break.

Working on new episodes for our next season. That was until we started hearing about this new virus infecting people in China, with the number of cases going up and up. There are nearly 300 confirmed cases. 830 confirmed cases. Now heading towards 3,000. More than 4,500 have been infected. China has gone into full-blown crisis mode,

building new hospitals, closing schools and shutting down transport between cities, effectively putting millions of people under lockdown. The country has quarantined multiple cities. The streets are deserted. Shops are shut. It is cut off from the rest of the world. But still, there are cases showing up around the world. Cases confirmed in Japan, South Korea and Thailand. In Europe.

Australia to the United States. Right now, though, the vast majority of infected people are in China. As of January 30th, that's today, Chinese officials have reported almost 10,000 confirmed cases and more than 200 people have died. The head of the World Health Organization has just raised the alert level. I'm declaring a public health emergency of international concern. The head of the World Health Organization has just raised the alert level. I'm declaring a public health emergency of international concern.

Today on the show, we're going to ground zero to talk to a doctor in China who's treating patients now. We'll also talk to researchers who are tracing this virus back to its source and trying to figure out how bad this whole thing might get. A few months ago, we did an episode about a fictionalized pandemic where things got pretty bad. Will this be anything like that? And finally, we'll hear from the man who is advising the president about this outbreak. We have only five minutes, Wendy. Five minutes. Was that the president in the room? Well, I can't tell you who it was.

To start, let's head to ground zero. Wuhan, the city in China where this virus broke out. Dr. Hui is a doctor in Zhennan Hospital at Wuhan University, and he's seen the outbreak grow from its earliest days. Normally, Dr. Hui works in the allergy department, but early in January, he got a call from his boss saying, you're needed elsewhere. On January 3rd, I got a phone call from the director of our department. He said the medical service team had told us to send help to stop the virus spreading.

At the time, I had no idea what I was going to get involved with. That night, I was actually pretty nervous, mainly because I had no idea what I was getting myself into or what I can do to help or where I'll be sent to help. The next day, he went to the hospital. And because the people there were so worried about how dangerous this disease could be, Dr. Hui had to bundle himself into what he calls a full-body antivirus suit. It basically looks like a space suit. I'm hooded with this hat, and then I'll be covered from head to toe in an antivirus suit. And there's a zipper, which also has a hoodie on top. Finally, finishing up with an oral mask and face mask to cover up my whole face.

His first shift at the hospital was pretty calm. But then, in mid-January, things took a turn. It's winter over there, and Dr. Kwei remembers that it was really cold outside, and infected people were lining up at the hospital. Some were really sick, and they didn't have enough beds at the hospital. Most of the patients were seated or waiting outside of the hallway, standing. I felt overwhelmed and stressed, since I couldn't take care of many patients immediately. The disease that's infecting people is a kind of virus called a coronavirus. It's a family of related viruses and not all of them are deadly.

In fact, according to the CDC, most people have been infected with a coronavirus at some point in their lives. They typically give you just like a runny nose or a cough. Mild symptoms. But this virus, it's new. Science didn't know about it before. For now, scientists are calling it 2019-nCoV, the novel coronavirus. And yeah, some of the patients infected,

they are also experiencing pretty mild symptoms. But the patients that Dr. Hui is seeing, they have high fevers. Some have chest and muscle pain. Some have difficulty breathing. Dr. Hui remembers a patient that he saw one night.

I remember a more severe case, one that made a huge impression on me, was one case from before Chinese New Year, around January 15th or 16th. I was working a day shift. This patient was very fragile, and she came in carried by her family to the hospital. She had so little spirit left in her that she couldn't even lift her head up. She just seemed very fragile. She was sent to emergency care, and he thinks she survived, but he's not sure.

We were totally unaware of the seriousness at the time and how many people would be infected. Currently, the fatality rate of the virus is estimated to be between two to four percent. That means some two in every hundred people who get infected and get treatment are dying. That doesn't mean that 2% of those who are infected will die, because that number doesn't include people who get sick, have a bit of a cough, maybe feel lousy, but don't seek treatment. This is all unfolding in real time, though, and there's still a lot we don't know. So leaving the hospital, our next question, where did this virus come from? There's a lot of reports pinning it to a wet market in Wuhan, a place where they sell seafood alongside porcupines and foxes and snakes and other animals.

But then it became clear that some of the earliest patients had never been to that market, leaving the question, where did this virus come from and just how long has it been infecting people for? Well, really early in this outbreak, Chinese researchers worked out the genetic code of this coronavirus and they uploaded it into an international database. They keep adding samples from other patients. So now scientists in China and all over the world are using these sequences to unravel where this virus came from and when it first emerged. And one of the first things they did

was to compare this virus's genetic code with other nasty viruses, ones that we already know about. And bam, they found something. This virus was really similar to a virus found in bats. So we think that's bats. That's Christian Andersen, the director of infectious disease genomics at Scripps Research Institute. He's one of the scientists who's been researching the origins of this virus.

And, you know, bats probably don't get sick from this virus, right? So the virus gets to infect bats and just sort of hang out there. So this virus is hanging out in bats, maybe for a while. How did it jump to humans? Well, it might not have been a direct jump. Like with SARS, which was another coronavirus that emerged in 2002 and killed around 900 people. Well, that disease started in bats as well.

But it had what's called an intermediate host, a middle animal that it infected first. Christian talked to producer Meryl Horne about it. We know from SARS, for example, that there was an intermediate host, as it's called. There were civets. What's a civet? I think it's like a cat- civets. What's a civet? I think it's like a cat-like. I'm Googling it now.

Oh, it is. Yeah, it's kind of like a cat, a very long spotted cat. It's pretty cute, actually. Okay, very cool. Yeah. Yeah, so we think something similar probably happened with this coronavirus too, right? For this virus, if there was an intermediate host, we don't know what it was. An early paper suggested it might have been snakes, but Christian doesn't think that's right. We also don't know how this virus got from one of those animals into us. At this stage,

we really don't know. It's possible the animals were simply just there and, you know, droppings or whatever around the animals, people could get into contact with that. They could be traded in the market. They could be consumed for food. But Christian told us that it's not surprising that this happened. When you have animals, including humans, all living next to each other, a virus has a lot of chances of leaping from one creature to another.

It happened with Ebola, bird flu, even the bubonic plague. OK, so next question. When did this virus make the jump? There's this idea out there that the virus has been around for a while, simmering away, infecting people before the word got out. Is that true? Well, here's how scientists like Christian are finding out. First, they take all those samples of the viruses from different patients, you know, the ones that have been uploaded to the database, and they compare them

to each other. And what you're going to see, because viruses change slightly over time, is that you're going to see that the viruses are going to be slightly different between different patients. You see, viruses are mutating all the time. It's not necessarily dangerous mutations. Sometimes they're just changing. So the idea is that if a virus has been around for a while, it will have accumulated lots of different tweaks to its genetic code. There'd be lots of versions of it out there. But if the virus is really new, it would look pretty

much the same in every patient who has it. And that's what Christian found here. He looked at the genetic code of the virus found in 27 patients, and they were all really similar. Other researchers found the same thing. So this means that this virus, it probably emerged really recently. And what we can show is that it happened somewhere around mid-November to early December. Based on this early research, it looks like this virus was first born maybe in November.

China told the World Health Organization about it on December 31st. So this idea that the disease was simmering away for ages before we knew about it, Christian says no. Based on the genetic data, we can show that that's not what was going on. It really was picked up very, very rapidly. After the break, how contagious is this new virus? And if someone near you is infected, what should you do? Welcome back. Today we're looking into what we know about this new coronavirus that showed up in China late last year

and has since been found in at least 18 other countries. In the US, five people who recently visited China were diagnosed with this virus. And on January 30th, we heard that the husband of one of those people is now also infected. It's the first case of human-to-human transmission in the US. And while this is very much a moving target, since the outbreak, scientists have been scrambling to understand this virus. So our next big question is how is this spreading and how contagious is it? For that, we went to Dr. Catherine Paulus. She's an infectious disease expert. Catherine used to

work at the National Institutes of Health, and she's now at Penn State Health in Pennsylvania. If we started to have cases here at the hospital, I would be on the front lines of this. And what's happening in your hospital right now? Right now, we're preparing for, I think, a very real possibility that we may see one of these cases or even more than that here. One of the initial fears about this virus was that it would survive floating around in the air. That is, it would be airborne. If true, it would mean that you could get infected from someone just breathing near you. Some other viruses act like this. So for measles, for example, if you walk into a room where someone with measles has been,

even within two hours, you could potentially get infected. Oh, wow. But Catherine says that other similar coronaviruses that we know about, they mostly don't spread through the air. She thinks this disease is spreading a different way. So most coronaviruses are spread through droplets. Somebody coughs or sneezes, they form a respiratory droplet and that comes in contact with someone, their eyes, they breathe it in, they touch their mouth, something like that. With droplet transmission, the droplets fall pretty quickly. They're not hanging out in the air for you to breathe it in. They touch their mouth, something like that. With droplet transmission, the droplets fall pretty quickly.

They're not hanging out in the air for you to breathe them in. So that is how we are assuming that this is spread, but we don't have the full information yet. So can you give me a little more details, given this is unfolding? Why do scientists think that currently this is just spread through droplets? Like what are the clues that you're using to get that information? That most of the cases so far have been very close contacts if they've been spread outside of China. So for example, there have been a couple reported instances of human to human transmission in other countries besides China. So places like Germany and Vietnam. So a traveler had gone there and they came back and they spread it to somebody. But those cases were in very close contact with

the person that was sick. They were staying in the same hotel room, touching the same things. If something is airborne, you would have 10, 20 people potentially infected that wouldn't be close contacts. And that's not what we're seeing. So can someone spread this before they start getting symptoms? That's a question that everyone would like to know the answer to. So there's been some reports coming out about that, that there are potentially people that have spread this before they're experiencing symptoms. But we are still learning a lot more about these cases to see what might be going on. Most respiratory viruses are the most contagious when people are having symptoms.

You know, even if one person spreads it when they're asymptomatic, the majority of people are not going to. So for every person who is sick, on average, how many people will they spread it to? So that gets into a concept called a basic reproduction number or an R-naught value. And that value sort of tells us how many people someone could potentially spread the virus to. So for example, if you had an R-naught value that was less than one, an outbreak would die out because each person is not able to spread to one additional person. Once you get above one, an outbreak can sustain itself. The virus will continue to exist. It won't die off on its own. So what they've reported on this

is a range between 1.5 and 3, but with a lot of uncertainty about those numbers. So if you look at it in isolation, one person could potentially have the ability to spread to one and a half to three other people. As a comparison, when scientists look at this number for the flu, it's about 1.3. And for measles, the R value is roughly 15. Yeah, measles is bogus contagious. So this new coronavirus, scientists are currently thinking it's between 1.5 and 3. So now just moving on to what people should be doing about this. If you live in China, you know, should you be wearing a mask? We're seeing a lot of people with masks. Do they actually work? We don't know how well they work, but I expect that they provide some protection.

So at the very least, they probably keep people from touching their mouth after they've, you know, maybe touched something that somebody's coughed on or something along those lines. But Catherine says where we go wrong is that we slip our grubby fingers under the mask when we eat, when we scratch our face, and the virus can sneak in that way. Yeah, it's totally defeating the purpose of the mask. It probably provides some protection, but it shouldn't be relied on by people that that's going to protect them definitively. And don't use the mask to substitute for other ways to prevent infection, like good hand washing and not being in contact with people that are sick. Have there been studies that literally show when you wash your hands, it reduces the risk of infection. Absolutely. Absolutely. I think washing your hands is the number one most important thing you can do to prevent infection.

Who would have thought that your best weapon in the battle against an outbreak is a humble bar of soap? When do you think this will end? I think that the next two weeks will give us a lot more information about whether this will be contained primarily in China or whether this will become a global epidemic. And Catherine told us that for now, this doesn't seem as scary as some of us might be thinking. So I actually went into infectious disease because I saw the movie Outbreak when I was like 11-year-old. So I don't think this is going to be Outbreak, but I do watch these respiratory viruses very closely because they certainly have the potential to spread and make a lot of people very sick.

Right. And speaking of outbreak and worst case scenarios, just a couple of months ago, we created our own worst case scenario pandemic episode. And you've listened to it. And I was just wondering, you know, how are things panning out differently in this case? Yeah, that was terrifying. I listened to that. And that was a very terrifying outbreak that you created. I think the good things that we know already, one of the first things you said in that podcast was that every person was infecting 10 more. I certainly don't think that's happening with this virus. And another thing you had mentioned was the mortality rate, which I believe was 40%. I certainly don't think we're anywhere near those numbers. So, you know, I think those things are reassuring and we just need to watch and see how the next couple of weeks shape up and how well this virus is able to be controlled moving forward. There was one last person that we really wanted to hear from about this outbreak because it's his job to advise the president of

the United States about what's going on. Yeah, thanks. Hello. Hey, Anthony Fauci. Hold on one second. Just hang on. OK. I'll be finished in five minutes. We have only five minutes, Wendy. Five minutes. I hear you. Sorry. Was that the President in the room?

Well, I can't tell you who it was, but... What's up? Anthony is the head of the National Institute of Allergy and Infectious Diseases. We had him on the show a few months ago to talk about our pandemic episode. And I know you've been talking to the president, as you do, about these issues. What did you tell him about this virus? Wendy, I can't tell you anything I tell the president of the United States. I'm sorry.

We had a very long meeting. How worried are you right now? When you say worry, I mean, I don't worry. I either get prepared or I do something about it. I think from the standpoint of the American public, should they be frightened? No. Is this a serious situation? Yes. Certainly in China, it is. But right now, the risk in the United States is low. That could change. You know, we need to be prepared for the worst. The worst would be if we started to see this virus passing on to lots of people who haven't been in China, because that would open up the possibility of this virus really taking off internationally.

Now, so far, there's been just a few reports of this, including one in the US that we just heard about today on January 30th. A woman was in Wuhan when she returned to her home near Chicago and she passed the virus on to her husband. We asked Anthony if this new case was concerning. We would have liked to have not seen that, but it's not surprising that we have seen that. The thing you need to do when that happens is what the CDC is doing and the state and local health authorities are doing.

They've identified the person, they're isolating them, and they will now do contact tracing on that person's contacts. Contact tracing is when researchers get in touch with the people that someone who is infected has been around to see if they've spread the disease. And do we know if the husband has infected anyone else? We don't know that right now, and that's the

reason why the CDC is doing contact tracing. Meanwhile, China has taken some pretty extreme steps to try to stop more and more cases of the disease coming out. Some cities that have been hit the hardest are basically in lockdown, with citizens unable to leave. Well, you know, I think it's unprecedented, as a matter of fact. Will it work? People ask me, do I think it's going to work? And my answer, honestly, I really don't know. I mean, I have seen people do restrictions on social interactions and travel, but never to this magnitude where they've essentially locked down 45 million people. So that could work. I don't know. I mean, because there's no precedent, no benchmark for this to compare it to this degree of shutting down of transportation and citizens in a country.

Do you think that if there was an outbreak in, say, New York, you know, Wuhan's a little bit bigger than New York, would there ever be a lockdown in the same way? I would doubt it very, very much. I cannot imagine that New York or Los Angeles or San Francisco could be locked down like that. I would be stunned and very surprised if that were the case. With making a vaccine for a coronavirus, how long might it take? Well, we've already started. We could probably have a vaccine that we could start using anywhere, you know, from a year to a year and a half. It's going to take at least a year to have that. And by then, do you think the peak of this outbreak will be over?

No, I'd have to say I don't know, Wendy. I think it is too early in the outbreak to make any conclusion about where this is going. Absolutely. It's too early. We can't say that this is mild or that it's, you know, under control. We don't know. It's still evolving. It's still evolving. There are over 7,000 cases now, up from 6,000 yesterday, up from 4,000 the day before. Given what we know about, I guess, the pattern of what happened with SARS. Wendy, I love you. You're wonderful. But I'm telling you six different ways we cannot predict. We can't. This is an evolving situation. It could go either way. It could taper out like SARS, or it could take off in a very, very widespread way. And that's the truth. Wendy, I got to go.

Thank you so much. Thank you so much. Bye. Okay, so we don't know how bad this will get and the research is still very much in flux. But here are some things that we think we do know about this virus. Right now, it's killing roughly 2% to 4% of people who are infected and go to get treated. We think it's mainly spreading through coughing and touching. So if the virus makes it to your area, one of the best things you can do to protect yourself

is to wash your hands, which I guess we should all be doing anyway. So far, the virus has been pretty contained in China with relatively few cases outside. This is all evolving, and science is doing its best to keep up. That's Science Versus. So we'll be back with a brand new season in March, in March.

But in the meantime, we have some special treats for you. We made a playlist of all of our favourite episodes. So if you want to tell your friends about Science Versus and where to start, you can send them to this playlist. Or if you just want to see what are some of our favorite episodes, head to www.sciencevs.show.com. And we also started making mini versions of our episodes for when, you know, you just want to swing one back. Search for Shots of Science Versus, Shots of Science Versus, and you can listen for free on Spotify. This episode was produced by me, Wendy Zuckerman, Meryl Horn,

Rose Rimler, and Michelle Dang. We're edited by Blythe Terrell and Caitlin Kenny. Fact-checking by Lexi Krupp. Mix and sound design by Sam Baer. Music written by Peter Leonard, Emma Munger, Thank you. and Chi-Yung Shuang. A special thanks to Bobby Lord, the Zuckerman family and Joseph Lavelle Wilson. I'm Wendy Zuckerman. Back to you next time.