The Joe Rogan Experience - #1439 - Michael Osterholm

Episode Date: March 10, 2020

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

All right. Here we go. So what you said when you sat down was absolutely perfect, that the timing could not have been better. Well, tell everybody what you do, Michael. Well, thank you. I'm, for a black, for a better term, a medical detective. I've spent my whole career tracking infectious diseases down, trying to stop them, trying to understand where they come from so we can make sure they don't happen in the first place. But most of all, trying to respond to situations just like this. Just like this.

And just off the bat, how serious is this? Is this something that we need to be terrified of or is this overblown or how do you stand on this? Well, first of all, you have to understand the timing of it in the sense that it's just beginning. And so in terms of what hurt, pain, suffering, death has happened so far is really just beginning. This is going to unfold for months to come yet. And that's, I think, what people don't quite yet understand. What we saw in China, I'm convinced,

as are many of my colleagues, as soon as they release all of these social distances, these mandated stay-at-home, haven't left your home in weeks and weeks kind of thing, when they go back to work, they're on planes, trains, subways, buses, crowded spaces, manufacturing plants, even China is going to come back again. And so this really is acting like an influenza virus, something that transmits very, very easily through the air. We now have data to show that you're infectious before you even get sick. And in some cases, quite highly infectious, just breathing is all that you need to do. So from this perspective, I can understand why people would say, well, wait a minute, flu kills a lot more itself every year than this does. And I remind people, this is just the beginning. Probably the best guess that we

have right now on what limited data we have is say, this is going to be at least 10 to 15 times worse than the worst seasonal flu year we see. 10 to 15 times worse in terms of fatalities? Yeah, yeah, and just illness. In fact, I just brought some numbers. We conservatively estimate that this could require 48 million hospitalizations, 96 million cases actually occurring, over 480,000 deaths that can occur over the next three to seven months with this situation. So this is not one to take lightly. And I think that's what I can understand if you say there's only been 10 deaths or 20 deaths or 50 deaths. Just remember, two weeks ago, we were talking about almost no cases in the United States. And now that we're testing for it

and watching the spread as it's unfolding, those numbers are going up astronomically. Three weeks ago, Italy was just living life just fine. Now they're literally in a virtual shutdown in the northern parts of Italy. And that's the challenge with an infectious disease like this. It can spread very quickly, and it also can affect people. I think maybe to put this into modern terms, because this is something we think of often when we think of, you know, pre-antibiotic days, the old-time medicine. We have an employee at our Center for Infectious Disease Research and Policy at the University of Minnesota, and she has a dear friend who lives in Milan, Italy, and she works at a hospital there. And she texted us to this employee of ours last night.

And this was an email that came out yesterday from one of their physicians in Milan at the largest hospital there. He said, I just got a very disturbing message from a cardiologist at one of the Milan's largest hospitals. They're deciding who they have to let die. They aren't screening the staff anymore because they need all hands on deck and they have very small areas of the hospital dedicated to non-COVID patients where they still screen doctors. Everybody else is dedicated to COVID patients. So even if they're positive, meaning that they're sick, but they don't have a severe cough or fever, then they have to work.

He says that they're seeing an alarming number of cases in the 40-something age range. And these are horrible cases. So we need to stop thinking that this is only an old person's disease. This is what's going to unfold, not just in Wuhan, it's unfolding in Milan, it's unfolding here in Seattle. And this is what's going to continue to rollingly unfold throughout the world. Yeah, where did this rumor come from that it's an old person's disease? Is it just because the majority of the people that have died from it so far have been older? Yes.

In fact, that's the primary risk factor for dying is being old and then having certain underlying health problems. For example, in China, those men over the age of 70 who also smoked, 8 to 10 percent of them died. Sixty-five percent of older Chinese men smoke. to 10% of them died. 65% of older Chinese men smoke. The case fatality rate or the percentage of people who die in women in that same age group was only about 2%. In that case, very few women smoke. Now, the challenge we have is that that's the Chinese data. But there are a series of risk factors that we worry about that if they overlay on this disease are going to cause bad outcomes. And we happen to be right at ground zero for one of the major ones here in this country, and that's obesity.

We know that obesity is just like smoking in terms of its ability to really cause severe life-threatening disease. And 45% of our population today over the age of 45 in this country are obese or severely obese, and there's men and women. So one of the concerns we have is we're going to see more of these, what I guess I would call very serious and life-threatening cases occur in our country because of a different set of risk factors than we saw in China. Now, you mentioned that there's some sort of an incubation period before people become sick, they're still contagious. What is this incubation period and how do we know about it? When we call something an incubation period,

we're talking about from the time you and I got exposed, meaning I was in a room breathing the air that somebody else who was infected with the virus was expelling out, I breathed it in. How long from that time period until the time period that you get sick? And what is that? That's what we call the incubation period. So that's when case numbers can double or triple in every so many days. In this case, it's about four days. So, and we actually have data there from people who are exposed one time or one time only. And we know when they were exposed, where they were exposed,

and how soon do they get sick afterwards. So the chauffeur in the car where an individual was sick or showing symptoms, then the chauffeur gets it four where an individual was sick or showing symptoms, then the chauffeur gets it four days later. You know, they were there one time and one time only. And if the chauffeur does not show any symptoms, he's still contagious. He could also be contagious too. And that's one of the things that's challenging here is you and I might get exposed to somebody who is totally asymptomatic, no symptoms. That virus would appear, well, that's not a very strong virus. But in fact, when it infects us, it could kill us. So we've seen cases of fatal disease that were exposed to people that had minor symptoms themselves. Wow. And this is what's unfolding

here. And this is where I think is such an important, and I said, why the timing is so important? Because, you know, Joe, we've really got to get information out to the public. There is so much misinformation right now. And, you know, we, we've really got to get information out to the public. There is so much misinformation right now. And, you know, we're going to be in this for a while. This is not going to happen overnight. And I worry. I keep telling people we're handling this like it's a corona blizzard, you know, two or three days. We're back to normal.

This is a coronavirus winter. And we're going to have the next three months or more, six months or more that are going to be like this. And, you know, so far this thing has been unfolding exactly as we predicted it. We and our center put out a piece on January 20th and said this is going to spread worldwide. At the time people said, ah, no, it's just China. We put out a piece the first week of February and said this is going to pop probably the last week of February, first week of March. Because what happens is it has what's called an R-naught or a doubling time of these every

four days. So it of these every four days. So it increases doubling every four days. So if you go from two to four to eight to 16, it takes a while to build up. But when you start going from 500 to 1,000 to 2,000 to 4,000, that's what we're seeing happen in places like Italy. We're beginning to see it in some ways up in Seattle. It's what happened in China. And when people are confronted with that, suddenly this low-risk phenomenon that everybody talks about isn't so low anymore. And that's what we need to prepare people for. Now, what can be done? What can the average person do? I see people walking around with

masks on, wearing gloves. Is that nonsense? Largely, yes. First of all, let's step back. The primary mechanism for transmission is just the respiratory route. It's just breathing. In studies in Germany, which just have been published literally in the last 24 hours, they actually followed a group of people who had been exposed to somebody at an automobile manufacturing plant. And then they had nine people that with this exposure said, if you have any symptoms at all, contact us. We want to follow up. And they all agreed. that with this exposure, he said, if you have any symptoms at all, contact us. We want to follow up. And they all agreed. Well, they got infected. And so in the very first hours, just feeling bad, sore throat, they went in and sampled their throats, their saliva, their nose for virus.

They did blood. They did stool. They did urine. And they found that at that very moment, when they first got sick, they had incredibly high levels of virus, sometimes 10,000 times that we saw with SARS in their throats, meaning they were infectious at that point already and they hadn't even had symptoms yet of really any nature. They weren't coughing yet. And that's where we're concerned because that's the kind of transmission it's, you know, I always have said trying to stop influenza virus transmission, like trying to stop the wind, you know, we've never had anything successfully do that other than vaccine and we don't have a vaccine here. So what's happening is that people in public spaces are getting infected. And the way you need to address that is, unfortunately, if you're older, over 55, you have some underlying health problems, which unfortunately a lot of Americans do. We have

obesity. Then right now, you don't want to be in large public spaces and trying to potentially get infected. So you can take care of that part. As far as what can public health do, we can talk about this. We're not going to have a vaccine anytime soon. That's happy talk. We can close schools. One of the big challenges we have right now, if we close schools, what do we accomplish? In influenza virus, when we close schools during outbreaks, because it turns out kids get infected in school and they're like little virus reactors. You know, they come home and they transmit it to mom and dad and brothers and sisters. And so we close school sometimes. Christmas breaks are always great for kind of putting the dampening effect on flu. In this case,

kids are not getting sick very often at all, which is one of the really good news features of this disease. In China, only 2.1 percent of the cases are under 18, 19 years of age. Why is that? You know, we don't completely know. And I'm going to come to that in a second because they're getting infected, it turns out. One study showed that they still get infected with the virus, but they don't get sick. And we have that happen. There's a disease called infectious hepatitis, hepatitis A, where we have outbreaks in daycares. And the way we know we have

an outbreak is because it's transmitted through the stool, fecal-oral. His mom and dad and the daycare providers all get sick. And the kids, those symptoms, we go in and test the kids, they're all positive. So some diseases will manifest primarily when you're an adult, but not as a child. This one appears to be the same. So do we close schools or not if we're not really spreading the disease? Because it turns out that if we close schools, a recent study done showed that 38% of nurses today in this country who are working in the medical care area have kids in school. And if suddenly we're closing schools for two or three months, who's going to take care of those kids? One-fourth of the American population has no sick leave.

If we close schools, they don't get paid if they have to stay home. So when you ask what can we do, we have to really be thoughtful about what we do. Are we doing more harm than good by closing schools, for example, even though everybody will say, oh, we've got to do everything we can? Or do we just tell people, you know, it's going to be limiting your contact as much as you can, and that's really about what we can do. And limiting the contact, is that really going to help? It does because it's like putting rods in a reaction. If you don't have as much close contact, you can not transmit as much. If I'm sitting in a room with 100 people and we're kind of sharing air, the transmission is remarkable.

Right here off the coast of California, you've got your cruise ship. Cruise ships are notorious for recirculating air inside the inner cabins. We've had a number of outbreaks. That's why they're having these outbreaks on cruise ships? Yeah, and then you leave them on there. I think the cruelest human experiment we've done in a long time with humans is leave them on these ships, get them off right away. Should they get them off right away?

Oh, absolutely. And what should they do with them? Well, they can put them in quarantines of some kind if they want and follow up on them. But you're guaranteed they're all going to keep getting infected day after day. It seems like we're not really prepared for something like this, although the CDC has been telling us for a long time that we should

be. You know, we are not prepared at all, in the sense. You know, I wrote the book Deadliest Enemies that was published in 2017. Thank you. Thank you. Thank you. Go get it.

No. Panic. In Chapter 13, the title of the chapter was SARS and MERS, a harbinger of things to come. You know, we predicted this. And then I wrote a chapter on there what a flu pandemic would look like if it emerged in China. And if you read it, it's exactly what's happened. The supply chains went down. China locked down the country. It spread to other countries, people all pointed

fingers. And, you know, it's the kind of thing where we hear it and hear it, but we don't get prepared. You know, five years ago, I gave a talk at the Mayo Clinic. First time I talked about this, I've talked many times afterwards, and I showed a slide of Puerto Rico, a picture of Puerto Rico, and then I showed the map. And then I showed a picture of a building in Puerto Rico, a nondescript building. And I said, this is our next big disaster. It turns out that 85% of all the world's production of IV bags, the saline that we need desperately, were made in these plants in Puerto Rico. And all we needed was one Category 5 hurricane to come through and take it out. Maria came through a year and a half ago, and the world went into a major crisis with a shortage of IV bags. Now, that was so obvious

that was going to happen, and yet we don't prepare. That's so foolish. I know, I agree. And that's what, hopefully, this is a wake-up call. The business community, I hope, will wake up. You know, one of the other things we're doing right now, Joe, this is really, one of the things that has me most concerned about this whole situation is our group has been studying for the last year and a half with support from the Walton Family Foundation looking at critical drug shortages. It turns out that we identified 153 drugs in this country that people need right now or they die. I mean it's on the crash card. It's acute critical drugs. 100 percent of them are generic.

All of them basically are made offshore of the United States and a 100% of them are generic. All of them basically are made offshore of the United States. And a large part of them are made in China and India. And at this point, we have shortages anyway every day, just before this crisis happened. Now these supply chains have gone down. Our group is actively helping the United States government try to figure out, you know, where they can get these drugs. Now, just think of this. If I came to you and said the Defense Department was going to outsource all its munitions production to China, you'd look at me and say, come on. You know what? The U.S. Defense Department has no more access to these drugs than anybody else. They are beholden to China for these drugs. 690,000 Americans have end-stage renal disease right now. Most of their

primary drugs are coming from China. And now with the shutdown and what's happening with this, and this is what I talked about in the book, why I was so concerned, because we are at risk. So even this situation as it unfolds, it's not just about what the virus does to you. It's about what the entire system is rigged up to be and what this virus does once it gets into it. Jesus. You're making me nervous. Well, but that's before we get done here. system is rigged up to be and what this virus does once it gets into it. Jesus. You're making me nervous. Well, but that's before we get done here. We're going to talk about what we can do to get people not nervous because this is- What? It's too late.

No, no, no. What I mean is we're going to bring you around to take, you know, my job is not to scare you out of your wits. It's to scare you into your wits. What can we do about it? Sorry. Let me ask you something about sauna use. One of the things that I read was that if you are in contact, that 20 minutes in a sauna, in a really hot sauna, is very good for killing some of the virus. Is that bullshit? Yes. Jesus Christ, these people. Yeah, there was some sauna facts thing that was being pushed around that it's great for flu and all sorts of infectious diseases.

Actually, it's great for you. I mean it makes you feel good, but we don't have any evidence it makes any difference in infectious disease. Why is – so it doesn't have any impact at all? The idea was that the breathing in of the very hot air, 180-degree air for 20 minutes will kill some of the virus. See, if that temperature of 180-degree air got really into your lungs, your lungs would be fried. You'd be dead. Well, where does it go? So what happens is just from the time you breathe it in and what you mix it with the air there,

it's kind of like taking a cup of hot water and putting it into a bathtub of cold water. And so what happens by the time you get done, it's not that hot. of a cold water. And so what happens by the time you get done, it's not that hot. And so in this case, your lungs couldn't stand even 110 to 20 degree heat without causing real severe damage. And so it doesn't kill the virus at all. So the virus would have to be like just in your mouth or something like that. Even then, no? No, no. Jesus, Michael. That's unfortunate because that was exciting. I was reading that. I was like, wow. Don't stop using the sauna.

It's a good thing to use for your skin and everything else. But, yeah, but it's not going to help you with this one. So how does it cool the air down? What's happening? It's going right into your lungs, right? Well, basically it's a mixture of – when you breathe out, you don't breathe all the air out. Okay? I mean that would – that would almost be dead.

You couldn't do the tidal volume. So what happens is every breath. What are you saying? In other words, you have so much air in your lungs already. When you breathe out, you breathe just a little bit of it out. And each time you bring more in and out. And so when this mixes in, the hot air like that or the very cold air. You know, in Minnesota, when you're 45 below zero, we have the same problem.

We don't freeze our lungs. Okay. You know, when we, when you're 45 below zero, we have the same problem. We don't freeze our lungs, okay? You know, when we breathe in, it may feel cold. And so it's just there's so much in there that it mixes with the other air, and it ultimately doesn't – the temperature of your lungs don't change. Even if you're doing, like, some crazy deep breathing exercises where you slowly exhale all the air out until there's nothing left and then breathe it all the way in?

I'm giving you my best shot at it. It's not going to make much difference. Sorry. I've always wondered that about people that are in Alberta, and it's like 50 degrees below zero. How do they do that? Yeah. Well, we do it all the time in Minnesota. Well, we don't anymore in Minnesota.

It's getting warmer there every winter. Part of the problem, right? Yeah. We surely know what cold air is like. All right. Well, so much for that myth. Myth number two. Well, I don for that myth. Myth number two, well, I don't say myth,

I should say rumor, was that this was something from some sort of a biological weapons thing that was leaked, right? Because Wuhan is some area, a part of China, that they actually do work on biological weapons. And we've heard that loud and clear. And let me just give a little bit background of more of my career. Back in the early 1990s, I got very involved in the whole area of biodefense and bioterrorism, biowarfare. It turned out I was involved with helping to interview and get information from some of the Russian bioweaponers after the wall fell and Russia collapsed. We had all these experts coming out who'd been spending their whole lives making bioweapons. And it became very clear to me this was really a serious challenge. And as part of my work, I spent a lot of time in this area. And I actually, through a series of serendipitous events,

became a personal advisor to His Majesty King Hussein of Jordan before he died on this topic. I got really into it. I wrote a book that was published in 9-11 of 2000 called Living Terror is What Our Country Needs to Know, the five-to-coming bioterrorist catastrophe. And I think I bought eight of the 12 copies that were sold that year afterwards. And then when 9-11 happened, of course, then it became really prominent. And then I went on to serve on a group here in the United States that was basically the National Science Advisory Board on biosecurity safety issues. So I've had a lot of experience in this area. And so I bring that to the table and I tell you, there is no evidence whatsoever that this is a bioweapon or that it was accidentally released from the Wuhan lab.

Today, with the genetics we have on these viruses and how we can do testing, we can almost date them, almost like carbon testing. You know, so radiocarbon, you want to know how old a block is or something like that. This thing clearly jumped from an animal species probably the third week of November to humans. And pangolins, you know, these scaly anteater-like animals, are a very good source because we have coronaviruses just like those in these animals and it got into a human so you know we've surely had a lot of challenges with that but i don't believe that there's any evidence linking those two one an intentional release and that or an accidental release or that it's an engineered bug it's not my friend duncan and i did a show back in 2012 ish somewhere around there with um uh sci-, where we went to the CDC in Galveston,

and we talked to them about that very thing. And they said the real concern, the real concern is just actual diseases. It's not man-made diseases. It's just naturally occurring diseases. That's exactly it. I mean, look, you know, we could not have crafted a virus like this to do what it's doing. I mean, we don't have the creative imagination or the skill set. If somebody said, okay, I want to find a virus that will take out a lot of people, okay? Mother Nature does it so much better than we could ever do it. And, you know, whether it was Ebola, whether it's this one or it's antibiotic resistance, any of these things, I mean, you know, you and I were talking earlier about the potential for chronic wasting disease to be a problem for humans. You know, Mother Nature is doing it pretty well on her own.

The chronic wasting one really scares me because there's so many people that have a vested interest in dismissing it. I had our good friend Doug Duren on the podcast with, I don't remember the gentleman that he brought with him. Brian Richards. Thank you. Brian Richards, who explained the science behind it. who explain the science behind it. And there are so many people that are dismissing this because either they enjoy deer hunting or they want captive cervids to be something that are still

something that could be released on private property because people grow and breed deer and then sell them to ranchers who want deer on their properties, particularly large deer. And, I mean, guys that i have talked to that are dismissing it i can see the chain of events that they want it to be not a concern but if you see what it's doing to deer it's terrifying it's 100 fatal um the the dna exists on plants for years they they leak it out of their saliva. They leave traces of it everywhere.

And in Doug's area, there's somewhere near there that's like 50% infection rate. That's right. Listen, I think this is really a significant challenge. I was involved back in the 1990s and into the 1980s when mad cow first emerged in England. And at the time was asked to give an assessment when this was all, this bovine spongiform encephalopathy and other prions. These prions are what causes disease. And, you know, people wanted to dismiss it that people weren't going to get sick. Well, then we realized 10 years later all these human cases started to show up

that were from those exposures 10 years before. And it took a while before those prions obviously changed in the cattle to get to the point where they'd infect humans. Well, the same thing is happening with deer. If you look back on the deer population that were infected 30 years ago, and you look at it today, the prions are constantly changing. They're mutating. They're new strains. And they're getting more human-like all the time. And one of the things our center is doing is working on that very issue of trying to help people understand that the studies that were done 15 or 20 years ago looking at how infectious these might be for humans were really well done. They were good.

But they had different strains. And over time, these strains are looking to be more and more like they could infect humans or they could even infect cattle, which would be another huge challenge if that happened. And so I think your point's a really good one. And we know today that there are probably at least 17,000 deer that were consumed in the past year that were actually positive for this prion and people went ahead and ate them anyway. So I worry about that too. That's terrifying. So these people have these prions in their system now, but then currently they're not making the jump to cause, what is it, Jakob's-Kreutzfeldt disease? Yeah, Kreutzfeldt-Jakob disease, which is one. Yeah, it's kind of a – we don't know that humans are getting infected.

One of the challenges is we don't have a test unless you die, and then that's a heck of a way to have to get a test or something. Okay. So one of the challenges is you don't know this until you actually show up with the signs and symptoms. And so one of the things that we're looking at carefully is doing surveillance or disease detection among people that might present with this. If it's going to happen, I suspect the naturally occurring prion-related diseases, Leitz-Kreutz-Holt-Jakobus disease you just mentioned, occurs typically in older people over 70. If you suddenly start seeing a 40-year-old

or a 50-year-old or 60-year-olds even with this disease, then you got to start thinking what else is going on. And so that'll help us detect it in cases. But then we've already failed. You know, then we've had 10 years worth of transmission or more potentially before we get the first human cases like we did with mad cow. And so our message has been right now, hunting is really important. It is a very important part of our society. Frankly, it's the way we manage deer herds, thank God. It's a huge economic boon for running the kinds of DNRs, et cetera, we have. We balance the back, as you know, from sportsmen on these licenses. And so we don't want to stop hunting, but we've got to make sure that we, and make sure that people aren't getting infected. And one of the things that our

group at the University of Minnesota is working on is tests now that are almost like point of detection tests. So if you shoot an animal, could you know very quickly that it's positive or not? And then you'd know not to process that animal or eat it. And that's what we need to get at. Well, not only that, the prions, what's terrifying is how invulnerable they are, how ridiculously vigorous they are. Exactly. You can boil them at a thousand degree temperature for hours and hours and they're fine. That's right.

When they're sanitizing medical equipment that they've used on mad cow patients or whether it's cows or humans with these prions, they've been able to do it three times. So try to sterilize these things. The sterilization process, what is the temperature that they do it for? Well, they do it both temperature and pressure, but it's in the hundreds of degrees and it's under high pressure. And I've actually been involved with several cases where these very equipment you're talking about were accidentally used on somebody who had Creutzfeldt-Jakob disease. They had to landfill it.

They couldn't even sterilize it. That's what's insane. Like, you can't kill these things. It's pretty hard. That's why, you know, we want to make sure that if you're eating deer cervids right now that we have to make sure they're tested. And I think the other point you raised is a good one. We've been very concerned about the movement of this disease by cervid farming.

We've had far too many examples, and Doug has shared that with you, just the extent to which we see state by state by state slowly getting picked off because somebody moved a trophy deer from state A to state B, and it was infected and it got out, or others got out of the pens, and then it infects locals. Now, has that made the jump to bison or elk or any of those other animals yet? Not yet. It's several kinds of deer, as you know, but not those. Mule deer so far. There has been some cases in the West. It's primarily whitetails, right? Exactly. Yeah. And

then there's been a deer in Korea, a type of deer there, and one in the Scandinavian countries. One? Yeah. I mean, different kinds of deer types that are in the Scandinavian countries. One? Yeah. I mean, different kinds of deer types that are there. Yeah, yeah. So the one we worry about right now is getting into the caribou in northern Canada. Right now, the range of the deer that are infected in the provinces of Canada is right budding up next to caribou.

And of course, if you're not a hunter, you wouldn't know this, but caribou, obviously, the herds are remarkable, unlike, you know, white tails, which that matter elk. If you got it into caribou, it would likely spread very quickly. And as you know, the native populations, caribou are key. They're key to their livelihood. So you wouldn't want to see it get in the caribou. Now, I didn't even know that it was in Canada. What parts of Canada has it been?

Throughout a number of provinces. I think there's four provinces now it's in. And again, it's spreading. It's the same phenomena that a combination of a deer movement with cervid farming, and then once it's in an area, it'll keep migrating a bit and a bit as these animals move somewhere. But, you know, as we know, deer don't fly 4,000 miles every season. So it's not that kind of movement. If we're going to see a big movement, it's humans are doing it.

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

But I think the tide is changing. More and more people are sensitive to it. They want to have access to testing quickly. But if it's going to take you a month and have to get the test back, you know what it is about processing. Is it that long? Well, in some cases, they get so busy because, you know, unlike laboratory testing for an entire year where I do one 12th in January, one 12th in February, et cetera, et cetera.

You know, deer season typically is very concentrated in just a couple of weeks to a month in the fall. And so the problem is all the animals come in at that time. So your lab capacity has to handle that huge surge all at one time. And so sometimes it takes a while to get it back. So these hunters just hope they don't take a bite during that time. Yeah. And we hope that these prions don't ultimately infect people and jump. And, but if they do, you know, I worry what will happen to deer hunting as we know it, because probably a lot of people will, you know, not continue. And we need that desperately for herd management. I mean, it's the way we do it. Well,

what they're doing in Doug's area is they're actively trying to eliminate a lot of deer and try to drastically lower the numbers, particularly of bucks, which I guess they wander more. Yep, they do. It's all really scary stuff because if they do make the jump to humans, I mean, it has made the jump to, I believe, mice. Is that the case? Well, what happened was originally it didn't. And so that was some of the data that was used to support, ah, it's not a problem. Now, these what we call humanized mice or mice that are basically much more like a human, we're now seeing that jump occurring. And these new strains,

see the strains that again were around 20 years ago are not the same ones today because as these prions continue to pass from animal to animal to animal, they go through these little minor mutations. And they're getting more and more and more like what a human transmissible prion might look like. So in these mice studies now that are really made to mimic a human, we're starting to see that jump. Yeah, and folks, if you've never seen a deer with CWD, you should go and Google it because it's terrifying. The idea that that could make that jump to human beings and people pouring saliva out of their mouths and their whole body just wasted away to skin and

bones. Right. That's what we're looking at. I mean, that's why it's called chronic wasting disease because the animals literally waste away. We actually have a major resource center on our website, free of charge, open, and it's all on chronic wasting disease. If people want to go there, it's www.cidrap.umn.edu, and you can go there and all these pictures. Can you repeat that again? What is it again? www.cidrapRAP. Yep. Just Center for Infectious Disease Research and Policy. CIDRAP. Dot U-M-N dot E-D-U.

Dot U-M-N dot E-D-U. And we have a lot of information. There it is. That's it. You got it right there. That's it. Yep. And we've got a lot of information on there also about coronaviruses.

We have a whole resource center just for the coronaviruses too. Novel coronavirus. There you go. coronavirus. There you go. So for the average person that is sitting around reading these articles that say, don't worry, or reading these articles that say this is the end of humanity, what could these people do? Like what could they do and what do they do if they get infected? Well, first of all, neither of those kind of articles are correct. And we have to make sure that we get that message out to people that it's there. We need straight talk right now. You know, and part of it is it's so hard to hear from people

who suppose experts, what's this going to happen or not happen? You know, and let me just give you an example, because we've heard a lot about, well, it's going to go away with the coronavirus with the seasons. Okay, when it warms up, it'll go away. Well, you know, the other coronaviruses that we have that we've had to worry about was SARS, which appeared in 2003 in China. And when that came out of China in February 2003, it took us a little while to figure out that these people really aren't that infectious till day five or six of their illness. And then they really crash and burn, and many of them would die. But what we did was basically, by knowing that, identify these cases in their context quickly. And so if they had symptoms, brought them in, put them in these isolation rooms so

they wouldn't infect anybody else. And it took until June to bring that under control. That had nothing to do with the seasons. MERS, which is another coronavirus that's in the Middle East, it's in the Arabian Peninsula, the natural reservoir for that is camels. In China, and by the way, SARS, it was palm civets, and we, a type of animal food, the rodent, that we got out of the markets there.

In the Arabian Peninsula, we're not going to euthanize 1.7 camels, you know, to try to get rid of MERS. And there, it's 110 degrees out, and this virus is transmitted fine, thank you. I mean, it goes from animals to people, it goes in the hospitals. There's no evidence that's seasonal there. So that's a good myth to expose right away. This is not something that's going to cure up when it gets warm. You know, if it does, it won't be because there's a model for it. What will it be? Because how does something like SARS run through a population and then stop being around anymore? Well, it wouldn't have, but we had good public health and we had,

you know, the same kind of transmission we're seeing with this coronavirus where you're infectious before you ever get sick, where you're highly infectious. Remember with SARS? Now, you didn't really get infectious until you're in six days of illness, and you knew that you were in trouble. And then you could isolate you. And we didn't understand that at first, and the virus transmitted. So that's why SARS stopped. MERS stops because we don't get rid of the camel, so it keeps hitting humans day after day. But then when they go to the hospital, we no longer allow those individuals to transmit to others in the hospital because we do what we call good infection control. As soon as they get there, they're in special rooms with special masks and all this kind of thing. And so in that regard, these coronaviruses

can be stopped. This one's not. As I said at the top of the program, this is like trying to stop the wind. Influenza transmission, you never hear anybody saying in a bad seasonal flu year, you know, we're going to stop this one. If you don't have a vaccine that works, you don't. It's just breathing. That's all it is. So what's the best case scenario here? Well, I think as I laid out to you before, you know, this could be 10 times worse than a really bad seasonal flu year. And I'll grant you it will hit, you know,

primarily the older population and those with underlying health problems. But as I mentioned also, you know, we have a lot of people who have other risk factors, obesity, high blood pressure is another risk factor where you can have a really bad outcome with this. And so we don't quite know what it's going to do yet. I think, you know, we've been right on the mark predicting where it's going to be to today. I think from here on out, I can tell you it's going to stay around for months. It's not going to go away tomorrow. We've got to stop thinking about if we just get through tomorrow, that's it. So we're going to close schools.

We're going to tell people not to go into public. We're going to cancel big events. How long are we prepared to do that? What are we going to do? We have to ask ourselves that. I think the big thing is eventually enough people get infected where it will be like putting reactors in the rods, you know, rods in the reaction, I should say, and then that stops it by itself. How so? Because if two of the three of us in this room were immune right now to it because we had it and recovered and had protection because of natural protection, then I couldn't transmit to anybody.

So that's what's going to happen. If you get enough people who get infected, ultimately, then it will slow down and stop transmission that way. But that's a heck of a price to pay to get there. Is it safe to say that we're fairly fortunate that this isn't something like the Spanish flu or something that's really ruthlessly deadly? Well, that's where I think we have to be really careful. Just to back up, about 0.1% of people who get seasonal flu die. In grand shits, mostly older or younger people, okay? That's one out of 1,000. With this one right now in China, we're seeing between 2% and 3% of the people die, and some say, well, that's way too high. It's not going to be that high. It's going to be lower.

But again, and they say that because we didn't pick up all the milder illnesses, okay. But on the other hand, we have a lot of additional people in countries like ours that have even more risk factors for having bad outcomes in China. And so Spanish flu, the one you mentioned, 1918, that was about a 3 to 3.2% case fatality rate. Now, it did preferentially impact 18 to 25-year-olds. They were the hardest-hit group. Why was that? Well, you know, it has to do with your immune response again. We think that what happened is

when this virus got into you, it created what we call a cytokine storm, which is an antibody response in your body that's out of control. And it basically, you destroy yourself. And it sets this thing up to trigger it off. So the healthier people had the more adverse reaction to it. Exactly. Or the other group that has had a real challenge with that are pregnant women. And pregnant women have a very unique issue. One is, of course, they have some constriction of their lungs just by the very physical mass. But also their immune system is really at a heightened state at that point. There's a part of that immune system and that woman says, this is not all me. Get rid of this. It's like a rejection of a graft. And the other part saying, this is the most precious

cargo I'll ever carry. You know, I got to make sure I don't lose it. And when that virus got in between those two, it started again, that same kind of cytokine storm. Now, the thing that concerns us about this, what we saw in 1918, I mentioned just 3 plus percent. This one could be as high as 2 percent. So it's somewhere between a really bad flu year at 0.1 percent, and it could be as high up here, you know, getting closer to 1918-like. 18 like. And that's the numbers I just gave you a few minutes ago from the American Hospital Association of, you know, 480,000 deaths here in this country over the next 6 to 12 months. What can someone do to shore up their immune system while this is all going on? Well, a couple things. First of all, just being as healthy as you can be, you know, wait,

wait. You know, I'm getting up there right now where it becomes more and more of a challenge to stay in good shape. The more you can do to do that, something you know all about is keeping in shape is really important. Second thing is if you're on medications, like for high blood pressure, don't miss them. Take those drugs because they're really important, even though they may not appear simple. You don't have any symptoms of high blood pressure or something like that. And then I think just getting sleep and eating a healthy diet and that's about what we can do today to help get you prepared for this. Is there anything else one could do like maybe IV vitamin drips or anything that's going to really boost your system? No, you know, when you look at all the things that might be there, and I'm happy and willing

to accept any and all that might help, but we don't really have any data that those substantially impact on your immune system to make it that much better. Is that the case because not that many people do it, though? No, actually, there's been studies. Yeah it been studied? Yeah, it's been studied. And it's been studied. I mean, a good example is, you know, and I was one of those people that thought, boy, this is a great thing. Probiotics, you know, things. It turns out that we've studied this with regard to antibiotic resistance and does it help your gut, et cetera. And it turns out that the probiotic users were no different than the non-probiotic users. In terms of recovery from antibiotics?

No. And the issue of if you're going to kind of compete out the bad bugs, so by getting the good, healthy gut flora, the bugs there, you would actually reduce the chance of picking up a bad bug. And it turned out there was no difference. But how would they do a study like that? The only way I think they would do a study like that accurately is infect someone that is the same person, like have the same person with no probiotics and then have them with probiotics. And the studies that have been done are very close to that. But what they did is they used two different groups of people. Those people used probiotics. This group did not. Right. And then they looked at all their illnesses and they got stool samples on everybody.

How large is the group? I don't have the numbers in front of me. They're pretty sizable because I was disappointed. I mean I was taking some myself. Yeah. Yeah. So, I mean, I think – but I think the key message here is that we're going to get through this. But right now, we do have some real challenges before us.

What we can't tell people is it's all safe. Every time I hear people say the risk is low right now, it reminds me of what would happen if there was this huge low-pressure system five days off the coast, the Gulf, and there was 90-degree water between that system and the beach, and there was no wind shears in the northern hemisphere that's likely going to knock it off. But we tell the people standing on the beach that day, we have low risk of anything. Well, we know five days from now it's coming. And so what we need to do is help this American population or the world for that matter, understand we're going to be in some hurt for the next few months. And we have got to get better prepared. How are we going to work? Where are we going to work? We can't stop working. We need our lights on. We need

health care. We need food. So a bunch of things people should do that's going to boost their immune system that we know of, right? Like get sleep. Drastically lower your alcohol intake. Drink a lot of water. Take vitamins. Those kind of things. Things that are going to keep your body healthy. Yep.

That's, you nailed it. So in that sense, sauna will help you a little bit because it does. Well, it relaxes you. Relaxes you. It also boosts up your heat shock proteins. Now, if you're in Minnesota, we'd say there's a two-part requirement of that. You got to go from the sauna to the ice water, back to the sauna. You got to do both. Yeah. People love that, right? We do it all the time. Well, the Russians invented that, right? The banya. Yeah. Yeah. Does that, have you ever done that? I have.

My son and daughter have a beautiful lake place up in northern Wisconsin. They got a sauna like literally 12 feet from the lake. And there's a spring right there. So in the wintertime, the lake actually stays open. So we go right from the sauna and the hot tub right to the water and back. Oh, wow. Even when it's frozen? Oh, yeah. Because it's not frozen right there where the spring is. So you literally can go right from the sauna and the hot tub right to the water and back. Oh, wow. Even when it's frozen? Oh, yeah.

Because it's not frozen right there where the spring is. So you literally can go right into it. And then you run right back into the hot tub. That's when you sleep well. When you've done a couple of those rounds, you sleep really well. Yeah. Yeah, I would imagine. Your body's freaking out.

Yeah, I love the sauna, but I haven't had any opportunity to jump into a lake right afterwards. Okay. Well, we'll have to. Just not any lake. You've got to have an ice-covered lake. Yes. Yeah, yeah love the sauna, but I haven't had any opportunity to jump into a lake right afterwards. Okay, well, we'll have to – just not any lake. You've got to have an ice-covered lake. Yes. Yeah, yeah. Real cold. Then you've got to – yeah.

That's the real feeling. Yeah. Well, what else can people do in terms of all this hand sanitizer jazz and masks? Is that all? Yeah. The hand sanitizers actually are a great thing for stopping a lot of infectious diseases. They actually are really good. They're good for your hands, you know, in terms of the skin. They kill the bad bugs. But the whole issue of using your hands touching your face that people all concentrate on.

Yes. The data is actually very weak that this kind of virus is going to be transmitted that way. So I wouldn't tell you to stop using hand sanitizers, but don't think it's going to have a big impact on this bug. Do you see that viral video that's going around, that woman who was giving the address at the behest of the White House? And she tells people not to touch their face and then immediately licks her finger and turns the page. Yeah, I saw that.

Well, why is she telling people not to touch their faces? Because, you know, well, the thought was is that there are receptors around your eye right here that actually for this virus could get in and then get into your body. And, you know, the data we have on this is so sparse to say that that's the case. I think the primary thing about hand washing is legitimate. But one of the things people want to do something, they want to be able to feel like they're doing something. And so we tell them, wash your hands often to prevent this disease. And I feel like we're not being really honest with the people. That the data, and we've looked at this very carefully, really is about just breathing air. And that's a hard thing to stop.

So keep doing the hand washing, but don't think that that's going to stop this disease. But you asked about the masks. It's going to stop other stuff. Yes, the masks. There's two kinds. Basically, the surgical mask, which just fits over. And the reason it's called a surgical mask is because it's loose fitting, just fits, you know, kind of ties behind you. It was worn by surgeons so that they don't cough or drip into your wound. And it was never made to protect you from bugs coming in. So those little spaces

on the sides, that's not a problem if I'm breathing into the cloth right in front of my nose. But in terms of the air coming in on the side, they're not effective at all. So people wear them, they look like they're doing something, they're not. Now, if you are sick, they may help a little bit from you transmitting because if you cough, then you cough right into that cloth and some of it will embed in there and not get out around. The other one, though, is called an N95 respirator. But for all intents and purposes, it looks like a mask. It's just tight face fitting. It has a seal even at the nose, et cetera.

That's an apocalypse mask. It could be. I don't know what those are, but that could be. I'm just saying that that's how I look at it. Okay, okay. Well, actually, we use them all the time in health care all the time. And actually about 90% of them are used in industry. So when they're grinding things or asbestos, et cetera, they don't breathe in all these parts.

So if we have one of those, that'll do something. They're very effective. They're very effective. The problem is we have a big shortage. Right now we have hospitals that are down to just a couple days' worth of these masks, the respirators, and it's because we don't stockpile anything in this country. You know, we don't have – hospitals don't have the money to do that. Those preppers right now are so excited. Yeah.

All the preppers across the country. I knew it. I knew the day would come. Yeah, well, they are. They are. Bottled peaches and – Well, and, you know, but this is really important because how healthcare workers go is how the country, I think, will see where we're going. You know, there have been over 4,000 health care workers in China who were infected, many of them on their job.

And a number of them died. And if in this country we have a real challenge delivering health care because we're overwhelmed, and then we have health care workers picking up the, like we talked about the group in Milan, and we don't have the protection for them. I really believe that's when the public will say, wait a minute, what's going on here? And that's where I think the challenge. So we really have to protect our healthcare workers. They are the frontline people. And the biggest problem we have is a lot of these cases need intensive care medicine, which we only have a limited number of beds for. But this is really sophisticated medicine.

So when one of those people get infected, a doctor or nurse working intensive care, it's not like you just took out another soldier. You took out a special forces person. You just can't bring somebody in from family practice or wherever and put them in there. And so we've got to protect these workers. And I'm really concerned that that's one of the areas we've not done. Nobody stockpiles. We have no capacity to make lots of them all of a sudden. Prior to this event, the hospital purchasing agent would go online, click a button, send me 5,000 of these, and it would be there the next morning.

me 5,000 of these and it would be there the next morning. Has anyone contacted you before this or since in particular and asked for your advice as to how they can better prepare? All the time. Like in terms of like the president? The president hasn't, but I know a number of the people who are working in the White House. And they've contacted you? Oh, yeah.

Well, you know, I've served roles in the last five presidential administrations. I worked for two Republican governors, two Democratic governors. I do appreciate one, Independent Rassler. I worked for two when he was governor, Jesse. Oh, that's right. to private and the public health army. And so I actually served as a science envoy for this administration in the State Department last year, you know, I'm still in my full-time job at the university. And so I've never been, I mean, I'm there to give the best advice I can. And so I've talked to a lot of these people there at the CDC, at Health and Human Services, etc. So yeah, we've given a lot of advice. And do you think there's anything that you could do now that could help them make sure that we don't have these shortages of masks and shortages of medicine and IV bags and something that could be done to – I mean, you – obviously, you've laid out all these problems. And you laid it out in your book here that people can buy right now. Go pick it up on Amazon, right? Is there an audio version of it as well? There is.

All right. Do you read it? The book? Yes. The audio version? You know, I have. I don't know. I don't read it myself. No, there's actually a really good voice. It's not mine. Oh, it should be you, man. That drives me crazy. Someone else does it. Yeah. No, you know, this is the challenge we have is today in this environment, everything is just in time delivery. I mean look at – I mean you go online and whatever place you're ordering from, Amazon or wherever, you expect it there the next day. Yeah.

People forget that we don't have that capacity today to suddenly make lots of things. So right now, all the mass manufacturers in North America are working 110 percent time. Now, all the mask manufacturers in North America are working 110 percent time. But if they were trying to fill all the orders they've gotten just in the last few weeks, it would take them years and years with the capacity they have. And you can't go build these new machines to make masks overnight. So this is something that should be set in advance of anything like this, any pandemic happening, like long in advance, we should be prepared. You know, think about the issue with defense. You know, we prepare all the time well in advance.

We don't build an aircraft carrier at the moment we think we're going to go to battle. We look at what all do we need. We don't do that in public health. We've tried. And so, you know what, stockpiling 500 million of these N95s would have been the difference between night and day. And when you look at the price of one of those versus one airplane, not even close. If you look at the things like that, it's like these medications. Think about our own defense department.

Employees are at risk of running out of these critical drugs because they get them from China. I mean, what a vulnerability. So what we need to do is take a step back after. We can start now, but we're not going to fix it now, is to say, what are the key things that we should do? Vaccines. If we had been serious about this, we might very well have had a coronavirus vaccine that whether it worked specifically for this strain, whether it worked for SARS or MERS, but right after SARS happened in 2003, everybody was hot on a new vaccine.

And then when it went away, the interest weighed. Is it something like the flu where, you know, sometimes when they come up with a flu vaccine, it doesn't necessarily address the current strain? Yeah, it could be. And that's where a coronavirus family vaccine may not match up right here now, but it could. And the flu one, you've really hit an important point. There's one where, you know, we do have an imperfect vaccine, but it still does a lot of good. You know, if 50% of the people are protected, that's a heck of a lot better than zero. If we had a vaccine right now that 50% of the people could be protected against this virus, man, think of all the lives we'd save. So the bottom line message is we can't wait until the crisis to fix these things.

You know what? We spend about 0.0001% on public health compared to our defense department. And yet look how vulnerable. It's the bugs. It's not a war. It's not a missile. It's bringing down the world economy right now. It's a darn virus.

And so this is where I think, and that's what I tried to say in my book, was all about that. I went into what we needed to do. In fact, I hate it when people come up and say, we're screwed. You know, my whole bottom line is, well, what are you going to do about it then? And that's what I laid out a whole plan in here, like these vaccines, like the stockpiles of masks. You know, we should have a plan in place already. What are we going to do with our schools when they close? Are we going to really close schools? Let's not try to make this on the fly. You know,

I just mentioned if we close schools, we are going to really hurt some people. And people may die in health care facilities, hospitals, because we don't have enough nurses or health care workers. Why have to make that decision all of a sudden? We could have planned for that a long time ago. And so I think hopefully this is a wake-up call because nobody, I think, really believed this. I got to tell you, the market today, as you know, on this particular day crashed badly. And I think that up till 10 days ago, the market didn't even think this was a possibility. They just, if you look at it, it was flying high. On Friday, I did a briefing for over 400 major financial investors around the world. And you know how I'm talking to you right now. I'm not trying to be scary.

I'm just trying to tell the facts and make sure people understand it. The questions I got from these people almost remind me of a six-year-old who was afraid to have to go through a dark hallway. to have to go through a dark hallway. You know, and I thought, I actually said to friends and colleagues Friday night, I said, you know what, Monday's market's not going to look good because I could hear the fear in these people. Okay, well, we shouldn't be there. We should be, what are we going to do? We have a problem.

You know, it's like a forest fire, whatever. We got a problem. What are we going to do about it? Financially, how are we going to get through this? You know, where are we going to go with it? No plans again. It's caught everybody by surprise. I mean you were one of the few people that wanted to deal with this issue.

We set this up several weeks ago. You guys saw it coming. And I think that's where the country hasn't seen it. Now they're getting it. Well, I'm paranoid. Well, I seek the advice of experts whenever possible and uh what what i was seeing was that there was a lot of weird um misinformation and conflicting information a lot of people saying don't worry and a lot of people that were terrified i'm like okay i got

to talk to an expert and luckily you were willing to sit down with us and and help us out well and you know and the other thing i think that you that I – maybe it's a function of age. But straight talk is so important today. I'm so tired of having people say to me, oh, if you tell them this stuff, they're going to panic. And I say, well, what's panic? Have you seen anybody ride in the streets yet? Have you seen cars turned over, smashed? Have you seen people hurting themselves over this issue?

They're concerned. But they want legitimate information. And so what you need to do is just tell them the truth. And we have many experiences like that. A few years ago, when I was at the state health department in Minnesota, we had a big outbreak of meningitis, a type of brain infection, bacterial brain infection. And a number of high school students were very sick. All of a sudden, in one day, they were in a hospital. And this community of 20-some thousand people were on edge. And so we had a big town meeting. Several thousand people showed up.

And I addressed them and gave them everything I knew about meningitis, what we're going to do about it, et cetera. And then towards the end of the talk, I said, and I just need to let you know, about one out of every seven cases of this dies. And people looked at me and said, why did you tell them that? And I said, because they needed to know it. Two days later, one of them died them that? And I said, because they needed to know it. Two days later, one of them died. Wow. And you know what?

Everybody in town was terribly sad, very emotional, but they all said, we knew it. We knew it. You told us. Right. We knew it. Right. And then they got on with dealing with it. We vaccinated the whole town.

20,000 people we vaccinated in one weekend for this bacterial meningitis. But it was because they had faith in us because we told them the truth. And we said what we know and what we didn't know. And so that's what we need to do here. We need to just have straight talk. Don't tell them it's low risk. That's like the hurricane, okay? You know, I would be really bad at you if I thought you were a hurricane forecaster and you knew this was coming, but you kept telling me, oh, it's low risk. Don't worry about it. Right. Yeah. Once it hit. Yeah. So that's what we need to do today is just say this is going to be challenging. And we're going to get through it, though. We are going to get through it. I hope this wakes people up

to the value of vaccines, too. There's so many wackos out there that think that vaccines are, you know, a scam or they're dangerous or it's, there's so many people out there that won't vaccinate their children. I know. And that's one, you know, one of your best shows you ever did was Peter Hotos. He's a dear friend of mine.

I do too. He's a dear friend of mine, as you. And he is one of the champions out there on this very issue. I couldn't agree with you more. I think that's really an important point that we've got to get this idea. These vaccines can be life-saving. If we had one right now, think how different the situation would be in the world right now. It would be radically different. But you see the measles making a comeback and directly attributed to a lack of vaccines. You know what? And it's not only

the vaccines themselves, but it's the prioritization of vaccines. I mean, you know, one of the real tragic stories right now in Africa is we are just finally bringing to a close this outbreak of Ebola in the Democratic Republic of the Congo, far northeast part of the Congo. You know, 20-some-thousand or 2,800 people have died from this, okay? Bad. It's been going on for almost two years. And everybody talks about that, and I understand why. Ebola is a challenge. And I understand why. Ebola is a challenge. But do you know that during that same time period, over 7,000 kids in that same area have died from measles? Because everybody was preoccupied trying to deal with for what you do say about vaccines, because people listen to you, and we need every positive voice, because we have so many crazy voices out there right now that are so paranoid and delusional, and they want

it all to be a conspiracy. There's been an amazing medical innovation in human culture, and that's vaccines. It's amazing what it's done. And have there been adverse effects on people? Of course. Everything. Everything that's vaccines. It's amazing what it's done. And have there been adverse effects on people? Of course, everything. Everything that people do, there's some people that are going to react in a bad way. It doesn't mean it's not a positive thing. And there's a reason why the cases of polio are so tiny. There's a reason why smallpox went away. It's because of vaccines. Absolutely. And you know, that's one of the challenges, you know, today between the anti-science misinformation that's out there.

But then when they don't see it. Yes. And the reason they don't see it is because we did vaccinate until we get enough people not vaccinated. And then look what happened. There's a famous photo of two twins from the early 20th century. One of them has smallpox and one of them was vaccinated. Have you seen that photo? I have, I have, I have.

It's a black and white photo. It's very telling. Jamie will find it because people need to see it. That is the difference, folks. Yep, yep, yep. There it is right there. That's it right there. That's the one.

One kid whose body is just devastated by what looks like pebbles glued to his skin all over his body, his face, his hands, and then his brother right next to him with nothing. And you know what's really important to note here is that in that body, all those things are very painful, but what's going on inside the body is equally bad. Yeah. And so you're exactly right. I couldn't agree with you more that, you know, this is really an important point. Yeah. Diseases are terrifying. They're really right. I couldn't agree with you more that this is really an important point.

Diseases are terrifying. They're really terrifying. And when something like this can be prevented and the reason why people don't do it is because they're paranoid of vaccines and they get that information from some wacko website or some person who really has no business talking about it, whether it's the people out there that think it causes diseases or that it's a government plot or that it's a medical scam because it's just trying to raise money. It's just all of it. All of it's very, very disturbing. But it's a part of people.

The human beings, for whatever reason, there's a percentage of us that lean towards conspiratorial thinking and they lean towards thinking that there's some sort of a plot against them or the government's against them. And it's just, you've got to listen to the medical experts. You know, and I hope that if there's any good to come out of this terrible coronavirus situation is that there's a wake up call. If we'd had a vaccine for this or one that even worked partially, think how different we'd be. And you know what? We got other ones coming like this. We have to use our creative imagination. You know, as I said in the book, the chapter on

coronaviruses, the title is SARS and MERS, a harbinger of things to come. I mean, we can use our creative imagination to say we should be funding these things almost like we pay for our fire department. Imagine if we had to go out and buy a fire truck when the 911 call came in. Yes. We need to do it now. It's kind of disturbing that it's Chapter 13, though. I know. It was.

Well, actually, would you do me a favor? You're going to really be like this. Okay. Open up to Chapter 13. Okay? Okay. And when you look at – it's towards the end there. I'm just trying to find it's towards the end there.

Read the quote that goes with it. Okay. 125. Okay. So every chapter started not with just a title but a quote. And I think you'll find this one quite interesting. Bile Terror Opening Pandora's box. That's not the chapter.

That's not it? Yes, chapter 13. You're close. There it is. Okay, read the quote. SARS and MERS, a harbinger of things to come. Look at the quote underneath it. I'm going to need glasses. These make me look smarter.

Rudyard Kipling. And the dawn comes up like thunder water. China crossed the bay. China. China. Did you put that in there because you really thought that a lot of this stuff was going to come out of China or was that just because it's a great quote? Exactly. No.

This is exactly what we're talking about. Why China? Because they have this incredibly large population, 2 billion. They've got this food supply that is largely wildlife that comes into these markets where there's this incredible contact between people and these animals. And the crowded nature of that society. I mean, I think one of the things that surprises people when they go to China, 15 million population cities are common over there. I mean, we think of the United States, we think of LA and New York, and that's big, okay? Over there, I mean, in Wuhan, a city of 15 million, the entire metropolitan area is 60 million.

And so you have people crowded so closely together that if you add in the bugs coming from these animals and then the potential for this kind of contact where it spreads quickly, China has been a bacterial and viral soup vessel for a long time. That's, again, why we have to protect ourselves here because a bug anywhere in the world today can be a bug everywhere tomorrow. Right. And particularly when you're dealing with a massive number like these kind of cities. So these – they call them wet markets? Yep. Wet markets, yep.

So that's what it is a lot of it is wildlife? Oh, it's incredible. You know, I've hunted my life. You know've hunted my life. I love to fly fish. I love the outdoors. Okay. I could never have imagined the animals. I've spent time in these markets. I remember one day spending a day in the Bangkok Thailand market, and it was about a mile by a mile and a half wild big. I mean, in these tight aisles. Every animal imaginable to humans, and I swear to God, there were some out of the movies, I think, that were in there. And they're all just right on top of each other. And I actually have a picture that I show in some of my lectures.

There was a situation where there was all these chickens in a cage, 15 or 20 of them, okay, in a big wire cage. And it sat on top of a wire cage full of ferrets. And ferrets are actually an animal model from a flu standpoint that they do really well in getting infected with flu viruses. If you wanted to create the perfect experiment that no university research group would let you do is you'd put birds and ferrets like that together. And that's just common. That's just common. That's common. And so birds and ferrets together, something that's infecting the birds could jump to the ferrets or vice versa.

The ferrets could breathe it out and we could get infected. Oh, Christ. And so these markets – and I don't know what's going to happen here. But for the first time, we really saw the Chinese after this outbreak in Wuhan really start to put down some markers on what they're going to do to supervise these markets. I mean they still have to eat. But I think this is a dangerous practice where we see it. But you know what happens? Look at Africa with Ebola.

You know, bushmeat is still very important. And there's so much of the world that that's their primary food supply. And when they say bushmeat, it's basically everything. Everything from bats. We think bat was the primary source of this outbreak in West Africa, was a human bat that was consumed. They eat them all the time. Do they really? Yeah, yeah.

And some of them are pretty big bats. They're literally three feet wingspan. They're big. And so that's one of the challenges we have with China. We know that this is going to happen. It's going to occur. We think of the flu virus as the same way. And that's why we knew doing better flu vaccines.

You know, this could just as easily be a flu pandemic, the same thing like 1918. So these wet markets, they just have all these animals hanging out and some of them are still alive. Is that what it is? Many of them are alive. And then they'll actually prepare them for you right there. They basically kill them and gut them and so forth. You've got some pictures up there. Bizarre Wuhan wet market menu shows over 100 wild animals sold as food.

Link with virus unclear. Exactly. That's what it looks like in here. I'll show you the list. It's pretty amazing. Yeah. Let's see some images. Whoa.

Whoa. Look at that list. I know. Peacocks. Peacocks. People's see some images. Whoa, look at that list. I know. Peacocks. People are eating peacocks? Oh, yeah, absolutely. Deer, crocodiles, turkey, swans. Eating swans.

How dare you? Kangaroos, squirrels, snails, foxes. Foxes. And civet cats were the cause of the SARS outbreak. Ostriches. I've had that. Pretty delicious. Yep.

I'm a hypocrite. Look at me eating ostriches. Centipedes, geese, hedgehogs, goats. Jesus. So, yeah, it's a child. It's a pheasant, right? That's normal. Yeah, it's just a picture of it.

So, do we have a video of the market? I want to see what... Whoa! Look at that freaky looking salamander. Look at the size of that sucker. Big. Yep. That's a huge salamander.

I went light for you first. The pictures I was finding were dark. Yeah? Yeah. Come on. What do you got? Cages of turtles and cages of bunnies. Let's see it.

Let's see it. All right. Bam. Wow, this wet market is very strange. And these are enormous markets, right? Oh, they're huge. And the number of people in them is incredible. I mean, there are many. And where are they getting the animals from? They're getting them from the wild?

Rural area, from rural areas, yeah. And are they growing these things and farming them, or are they just catching them? Some cases, both. Some cases, both. Like a lot of the seafood today is actually being farmed. So this is really like a giant petri dish. Yeah, yeah. I mean, it's almost – wow. Fish. You're looking – that fish looks not that fresh.

Whoa, what's all that stuff? Rabbits? Rabbits. I couldn't tell you what all that is. Yeah. Jesus. But you're getting an idea. Just laying them on the ground.

If we can't stop that, we surely can try. But if we can't stop it, we need to stop the infectious diseases coming from those animals to us. Look at them all wearing masks. That's hilarious. That was, I think, with the outbreak. That might have been since the outbreak. Are those gigantic things a mollusk? What is that? What are those things? I can't tell.

Those look like giant mollusks. Yeah, they are, right? I can't tell the difference. I think you're right. They look like huge muscles. Wow. Look at those suckers behind them. Wow.

Yeah. There's a lot of people in China. They've got to eat. That's where it gets weird, right? It's like how do you tell them that they've been doing this for who knows how long? How do you tell them to stop doing it? Or is that impossible? And is it more possible to just accelerate our vaccine program and try to preemptively create something to address coronaviruses, to address various different – what other viruses are we concerned about other than coronaviruses? I think it's both. I think the next most, well, not even next, it's a co-virus you might call influenza. I mean, you know, there have been 10 influenza pandemics in the last 250 years, and each one of them was a little different, but some of them have been horribly bad.

You know, back in the 1500s even, there was a major pandemic that occurred where Spanish cities were described as almost totally depopulated. And so these viruses pop out. And that's why we need new and better flu vaccines. And we're actually working on one now, but it's still a ways off. But having those would really prevent the big calamities, meaning some of the things are going to happen. They're not good, but they're not going to bring down supply chains and threaten governments and so forth. And so I think the priority vaccines we need to get are for those diseases that we know could. Is the flu injection the most effective way or is a mist as effective? Like,

I know they do the mist up the nose. Turns out that what research we have and our group was involved with some of it, the flu mist in the nose works really well in children mostly because they haven't been infected yet themselves. They don't have any protection. And so that virus really multiplies in the nose. Remember, this virus is adapted not to multiply in your lungs because the nose is colder than the lung. And so it'll grow here. If you swallow it, it won't grow in your lungs. If you've already been infected once, then you actually have some interference in your nose. There's a little bit of once, then you actually have some interference in your nose. There's a little bit of protection there. So it works well in kids who haven't been infected

before, adults not so well. For us, the injection works best. And, you know, I'm happy to report that although I'm not happy to report, being an old man now, I can even get the high dose vaccine over age 60. So they are actually, you know, the best we have. The high dose vaccine is better? Yeah, it's better than the regular vaccine in terms of protection. When you hit a certain age? Yeah, when you get a little older, you need the higher dose because your immune system is starting to wane. You know, I'm just naturally having less. I wasn't aware that there was a low dose or a high dose.

Yeah, there's a higher dose vaccine now. Where do you get it? Like if a person is listening to this and they're like, I've never had a flu vaccine. Any doctor's office. Where do you get it? Like if a person is listening to this and they're like, I've never had a flu vaccine. Any doctor's office. And they will usually say that to you if you're over 60, you can get this vaccine.

So they'll actually do that for you. Okay. Yeah. So run out, get a vaccine. To now, it's pretty much over. The flu season is waning. I mean, if you hadn't gotten it, you should have had it a couple of months ago. Okay.

This one is waning now. We've had a bad flu season, a really bad one. But for the last couple of weeks, the numbers are coming way down. So what can a person do other than the vaccine to prevent getting the flu? That's primarily it. Again, it's an issue of who you're around. And your body's overall health. Yep. And just keep healthy as you can. And then I think the other key piece though, is if you do get the flu and you have really bad muscle aches, one of the things about real influenza is not just sniffles.

You feel like you got hit by a Mack truck. If after several days you still are really feeling bad, really bad, and you haven't seen a physician by then, you should, because that's when you get the complications occurring, the bacterial pneumonias that occur subsequent. And if you get those treated earlier than later, you can actually do a lot to keep somebody from dying. So, you know, if you don't feel a lot better in two days, I mean, if you catch it really early, you can get a medication for flu. There's actually a medication that will reduce your illness a bit. But if you're sick for more than a couple of days, it's not better.

You absolutely should see a doctor so you don't have these other complications. And what can a doctor do once you go to... Any family practitioner would know what to look for and whether or not your lungs are starting to fill up. They'll listen to your lungs to make sure you're not developing pneumonia. And what would they do for you? They would likely give you an antibiotic based on what you had because you are then... The problem with flu is it's not just the flu virus, but then you get secondary bacterial pneumonia from the damage in the lungs. And so they can prevent that. A lot of older people in particular will die from actually what we call secondary pneumonia to having had influenza. They wouldn't have gotten the pneumonia if they had not had flu, but then they do.

Now, we were talking earlier about probiotics. if they had not had flu, but then they do. Now, we were talking earlier about probiotics. Is there a benefit of probiotics once you've taken antibiotics to reflourish your gut flora? You know, that's where the studies really at this point have demonstrated that it's very temporary. In other words, if you're taking probiotics, you can get a boost initially, but it doesn't sustain itself over time. And then the natural flora comes back. I mean, the gut microbes will come back as they've been reduced.

But what I'm saying is, is it beneficial to people if they do take a probiotic after antibiotics? Because antibiotics do have a devastating effect on your flora. It kills the bad stuff, but it also kills a lot of the good stuff, right? So is it beneficial for people, once they have taken an antibiotic, to take probiotics to sort of reflourish, at least temporary? Yeah, and that's what I'm saying is that it doesn't – the data don't support that it stays.

In other words, you get a short-term boost, and it gives you some of the new good bacteria, but they don't stay around. But what if you just keep taking it? Even then, they just don't stay around. But what if you just keep taking it? Even then, they just don't stay around. Your normal gut flora will come back and take over. So the probiotics in and of themselves are not giving you that long-term boost. So you don't think there's any benefit to having even a short-term boost? Well, you know, it's again, surely I'm not going to profess to be the expert on probiotics,

but I'll tell you that the data we have doesn't show that they have a big boost and that they actually help you long-term or short-term, meaning that it makes any difference. have a disease called Clostridium difficile, which is a bad bacteria that happens when you've taken way too many antibiotics and it colonizes your gut because you don't have competing organisms there. And then you can die from this. There are treatments for that called actually fecal transplants. Yeah, I've heard of that. And that's where actually there you take it, little capsules, but it's actually... You drink it and poop. Well, purified. Purified bugs from the poop. You're right. But you take that, and that kind of is what you're talking about. That does have real benefit. And there is clear evidence that if you take those, those fecal transplants, as opposed to just probiotics as such, that that can have a major positive impact on your recovery from things like colostrum difficile infection.

And so more and more institutions now actually are doing fecal transplants, which you never thought that that would be one thing you'd do one day. But for those who've had this problem, they're life-saving. They're amazing. Maybe we should change the name. Although, on the other hand, you don't forget it if you don't forget it. Yeah, you don't forget if it's a fecal transplant. But that's what's going to be nerve-wracking

to people. Yeah, yeah. You know, once you're that sick, boy, it feels good to take it. It does, you know. Have you done it? I've never done it. I've never had a problem where I've had to, but I've known people who have been desperately sick who have taken them and have really done much better, much, much better.

I want to ask you about Lyme disease. Sure. Lyme disease is a scary one, right? And, I mean, so many of my friends on the East Coast have it. It's really terrifying that that part of the country in particular seems to be, like, really badly infected with these ticks that carry this disease. What can people do to prevent that? And what can we – there's no vaccine for Lyme disease, and I know there was at one point in time. But people were having an issue with – I mean, a good friend of mine, her dad actually got Lyme disease from the vaccine before they discontinued it.

What can someone do to sort of protect themselves? Yeah. Well, Lyme disease in and of itself is a fascinating story. I've actually been involved with it since its early discovery in the 1980s. And Minnesota, Wisconsin was a big focus of the upper Midwest. And this is a story that I think you'll find interesting is that even though it was discovered primarily in the eastern part of the United States, named after Lyme, Connecticut. It's a disease that actually probably originated in the upper Midwest.

And I tell you that because it turns out that there is a focus in northern Wisconsin and east-central Minnesota where there's Lyme disease, there's another disease called anaplasmosis, there's another disease, Babesia, et cetera, that all seem to have a similar kind of tick human deer kind of component. And back in the CCC days of the 1930s, the whitetail deer population had been virtually totally depopulated from the northeast. And so they actually trapped deer in northern Wisconsin and took them out and deposited them in New York and Connecticut and so forth. Wow. And most of those deer are actually deer that, you know, today their great-great-great-great-great-grandfather came from Wisconsin. Wow. And guess what?

When you move deer, you move ticks. involved with the study that the Wisconsin Division of Health did and a colleague of mine, the late Jeff Davis, where up in northern Wisconsin, as deer would come into the check station, they would actually measure the number of ticks that were attached to the nape of the neck, okay? And they had a thing drawn. And they asked hunters who were driving back to Madison and Milwaukee if they would be willing to check in at a station down there for just a second, and then they were going to count the ticks again. And it turned out that as the vehicles come rolling down from Highway 51 from northern Wisconsin, get on the Interstate 90-94 and go to Milwaukee or Madison, the ticks just kept falling off. By the time they got to Madison or Milwaukee, the ticks were almost all gone.

Well, guess, lo and behold, where all the Lyme disease and so forth started to show up, right along the interstate corridor. Wow. Because the ticks were coming off, and then they were getting into the local deer in that population. And so it's exactly what you said. The ticks are moving. They're moving. Okay, they've moved, and they're now infected. So I think that this Lyme disease issue is a key one. Lyme disease is really an important disease. It's real, no question about it. The challenge we have is that there's a lot of people that assume that they have chronic Lyme infection. And, you know, the data on that is just really, really not there to support that these people are chronically infected, but they do have an immune response,

likely, that occurs where it sets up this trigger. And so they're sick. They actually have something. But it's not treating it, again, for the bacteria infection. It's the fact that your own body's immune system, as we've talked about several times today, starts attacking you. I think it's a similar picture we see with chronic fatigue syndrome, same kind of thing. These people really are sick. They really do have problems. But it's not something you can treat. So when people – I have a challenge because when people take IV antibiotics at extended periods of time for Lyme disease, you know, the data – there's four different studies now that have been done where people have had what we call a double-blind placebo-controlled trial where half got the drug, half got IV, but no drug.

And it turned out all four of these studies in Lyme disease, the people who got just the placebo did just the same as the people who got the drug. And I worry that we're using antibiotics a lot there, and this is where I just mentioned earlier about clostridium difficile. We actually had a patient in Minnesota that died from the IV treatment for what was chronic Lyme disease and wouldn't have been helpful. And so we need a lot more research in this area to figure out what are these people getting? What is it that we can shut off so that they don't have this chronic Lyme disease picture, knowing that it's not actually just you've got to treat them more. Treatment's not going to help them with the antibiotics anymore.

And so I think that that's an area that we just need a lot more work in. And the numbers are growing, as you know. Yeah. So we don't know what's happening? Well, we have enough data to say your immune system is really cranked up. Right. Your immune system is, you know, just like… Reacting to something.

Yeah, it's like rheumatoid arthritis, a lot of things. You know, thank God for our immune system. It's what fights off all the bad things we have. But sometimes that immune system gets turned on too much. Yeah. And then it takes on us. Yeah. And it goes back to the coronavirus.

That's why a lot of these people are dying right now is this over-vigorous immune response. And Lyme disease is kind of that same inciting event where we have evidence now that you could be infected with the bacteria. But if we treat you, it's like every other bacteria. You can really get rid of it. But you still have this chronic illness that's occurring. And what I think is hard is that we see people who have this who are desperate to have somebody understand what they have, and they end up going to people who take real advantage of them, clinicians who charge them an arm and a leg for things that are not going to help them. And what we need is a lot more research on what is actually going on

and what kind of drugs can we use to reverse this immune system disorder. I have a friend of mine who's a UFC fighter, Jim Miller, and he's got Lyme disease, and it's pretty bad. He takes a stack of pills. I don't know what he takes every day. Yeah. What do you think someone is taking, and what benefit would they get from that? I couldn't tell. I mean, I'm not, you know, without knowing what's there.

But, again, more often than not, if he's been adequately treated, it's not that the bacteria is still growing in him like it might be for a lot of people. It's an autoimmune response. It's autoimmune, which is real. I mean, that's the other thing is I think these people just want to be legitimized and said, you know, I'm really sick. Right. And I'm not – it's not something I'm, you know, mentally ill about, whatever. But then we've got to figure out what it is that you have. So'm really sick. And it's not something I'm mentally ill about, whatever. But then we've got to figure out what it is that you have. So we really don't know.

We don't know yet. We don't know. Wow. But it's been around for so long. I know. But this is where we need a lot more research about this in terms of what is it that's making these people like this. And this is really important. And is there anything they can do to eradicate the ticks? You know, this is another thing you'll find interesting. In Minnesota, prior to the arrival of the first white men, the Native Americans burnt much of our state all the time. The prairies through much of the territory, even in northern Wisconsin, northern Minnesota, we had the classic, you know, pine forest. Firewood wiped through.

Minnesota, we had the classic, you know, pine forest, fire would wipe through. And with that, it would open up so much of the forest that you'd have a very different kind of mammals, population, deer, et cetera, et cetera. And with the suppression of fire, what's happened is we now have, instead of having these old growth forests, we have all this younger, you know, non-pine or any kind of, like the oak trees of the upper Midwest are all disappearing because oak trees need sunlight. And fire is what kept, they were very resistant to fire. And so the old oak forests and so forth would survive because of fire. Whereas today, with no fire, you know, the elms and the maples and everything else comes in and the buckthorn and all that kind of stuff and takes over. So what's happening is in our state of Minnesota is we have a really good example of this is we're losing our moose. And the big primary reason is brain worm.

Brain worm. Brain worm. It's a type of parasite that's common in white-tailed deer but causes no problems. In moose, it actually causes a brain infection and it kills them. And guess why it's happening? Because the deer range has moved farther and farther north in Minnesota. I'm sorry. It has moved farther in northern Minnesota because of lack of fire

because the forest is changing. So now where there only used to be moose, we're seeing deer and moose. And where that intersection is, we're starting to see moose develop as brain worm infection because it's from the deer. So the tick population has changed too. And it's largely due to the fire, lack of fire in many places. In the Northeast, never used to be like it was. We had fire all the time that would clear out these areas and it was just part of natural everything. So one of the challenges we have with ticks is they're here. We're not going to change how we live suburbs and trees and all of that.

Could controlled burns eliminate a lot of them? They do because what they do is they just don't eliminate the ticks, but what they do is they eliminate, for example, the white-field mice and all these different species that are important to the ticks. And then they bring in different species that will be there. So, I mean, this is a big debate in Minnesota right now. I mean, we're losing all these moose to brainworm. Ironically, the moose population is expanding dramatically in Isle Royale. Why?

Because there's no deer out there. And so they're not getting brainworm out there. So people have said, you know, we're going to lose our moose. Well, it's the deer. So fire actually has helped the moose. In areas in northern Minnesota where there's been a lot of fire, the moose population is growing because the deer are not there because exactly those mammals, those rodents and so forth are very different in burnt out areas than they are in non-burnt out areas. Well, they do control burns in some states. I had a friend who was hunting in Washington State a couple years ago,

and he said it was really weird because there's these massive fires in the distance that were actually being controlled. They do it on purpose. Yeah, which is a lot better than having the out-of-control fires where you have so much fuel. And if you haven't had a porous fire in 8,500 years in an area, the fuel in there is huge. And so actually they do that in northern Minnesota too. They're doing controlled burns. And the prairies, of course, we do control burns all the time. But the problem with the East Coast is you're dealing with a lot of these sort of almost residential areas that have all these ticks.

Yeah, you can't. And there you can't. There we have to find ways. That's where we really have to have vaccines and treatments for these diseases. We're not going to get rid of the ticks. So what we have to do is figure out, I mean, wouldn't it be incredible if we have a cocktail vaccine for, you know, Babesia, for Lyme disease, for, you know, that's what we need. Is there any kind of an animal that eats ticks? Birds, yeah, birds will eat them. But not enough.

Not enough, no, no. They're doing very well, thank you. Ticks do very well. And that's another issue. You know, for some of the larger mammals, as you know, tick predation can get so heavy, particularly in certain times of the year, that it really literally takes a lot of blood out of these large animals, even though they're so big. Yeah.

That's a lot of blood. I went down a rabbit hole the other day online, and I saw this one deer that was covered in these frisbee-sized patches of ticks. That's exactly it. They were all swollen. And they're full of blood. Oh, so disgusting. And it happens day after day. So it is a hit on them.

It's a real hit on them. Pull up a picture of that just to freak people out that are watching online. They need to see this. Yeah, yeah. It's pretty amazing. It's one of those things, though, when you talk about ticks and you talk about Lyme disease, most people, their eyes glaze over. They don't even care. It's not affecting me until someone

in your family has it. There's a guy that I know who was a former UFC fighter, Marcus Davis, who he put... His wife got Lyme disease, and he spent hundreds of thousands of dollars trying to help her and do something about it and

treatments and all these different things for it. Yeah. It's a real challenge. It's a challenge. And this is another area, again, you know, when you think of the amount of money we lose in just lost time, let alone pain and suffering, what an investment to make in this. I mean, this is the kind of thing. This is where infectious diseases really need a renaissance.

I mean, we can the kind of thing. This is where infectious diseases really need a renaissance. I mean, we can do a lot here. We pulled up a chart of the United States where they showed the areas that are affected by these ticks and what percentage of ticks carry Lyme disease they've tested. And some places in the Northeast, it's in the 60%.

Oh, exactly. Yeah, it is. It's huge. And it's growing. I mean, you understand how wildlife has changed. I mean, look at, to think that we have all these wild coyote populations in New York City now. Yes. I mean, it's amazing how animals. Every single city in the country. Yeah.

What the rats aren't doing, the coyotes are taking over. And it's a challenge. I mean, these are infectious disease issues, too. They're very real. Yeah, they have coyotes in Central Park. They do. Yeah, absolutely. They have them in the Bronx. They have them in... I mean, it's weird. It's weird to see because this is something that just didn't exist before. Look at this. Oh, there it is.

That's okay. That's okay. That's not the best I've seen, but it's gross enough. Yeah, it is. It gives you a good sense of it, though. Dan Flores, who has been a guest on the podcast before, has a great book called Coyote America that sort of details how this came to be and how these coyotes have – oh, look at that. All over that poor deer's face. Oh, look at that. Look at the eye. Look at the eye and the fawn.

Yeah. Yeah. They're disgusting. Yeah, they are. But coyotes, about how when they got rid of the wolves and they tried to do the same to the coyote, they just actually expanded their territory. They're sneaky, very clever little animals. Adaption. Yeah.

Just like microbes, adaption. Yeah. Is there anything else that we should cover? No. I mean I think – I thank you for covering this issue on infectious diseases. We can use all the help we can to get people to be aware of what's out there and what's coming and just keeping the message straight. And we're going to get through this, but at the same time, it's going to be a challenge. You know, if today you have an underlying health problem

and you're particularly over age 50, 55, I'd say avoid big crowds if you can. And that's going to be really important. And know that we're going to work on the critical drug supply to make sure that people aren't without drugs that save their lives every day. That's going to be a big challenge. One more question. How long does it take to develop a vaccine for this coronavirus? Well, you know, when I'm asked that question, I don't mean to sound glib again, but I can make a vaccine for it overnight. The question is, is it safe and effective? And that's the challenge.

We have right now questions about how do you make immunity to a coronavirus and what kind of vaccine do you have to have that brings in all the different parts of the immune system? So we don't know that yet. So some of this research is going to have to be basic to that. The second thing we have to worry about is safety. There's a condition in humans called antibody-dependent enhancement, ADE. And it turns out that if you have no antibody or an immune response, you'll get the disease. If you have a lot, you're protected. But if you have this in-between level and then you get the disease, it actually enhances the disease.

Immune response is really destructive. And then you get the disease. It actually enhances the disease immune response. It's really destructive. And in fact, there was just a couple of years ago, a major recall of dengue vaccine, a type of vaccine we use for mosquito infection in the Philippines where kids who got the vaccine actually made just a little bit of antibody. And when they got the real disease, it made them a lot sicker. And so we found with the 2003 SARS vaccine that there was an ADE component to it when we made it in animals. And so we're going to have to

really study this to be sure it's safe. And as you said earlier, you know, we can surely make mistakes. We don't, you know, we need to do everything we can not to. And so I think between getting the effectiveness and the safety data together, we're years out. I mean, maybe two years. Yeah, this is not going to happen soon. You know, it's wishful thinking. You know, every time, I mean, I go back to SARS in 2003 and look at every event, Zika, 2015, we said, oh, we'll have a vaccine for it in no time. Here we are five years later, we have no vaccine. And so this is one of the challenges we have. We have to complete the job. You know, it's like we start on something and then we forget that it's important because it kind of goes away for a while, but only to come back. And so this is part of that picture we

talked about. And this is what Peter Hotez talks a lot about. You know, we got to finish the job on these things. You know, I worry that we'll get through this situation and then people say, oh, we're done. And then we'll forget until the next one comes along. And so this is where vaccine research and development is really important. How do they test for safety? So once they come up with a potential vaccine, how do they make sure that it's safe? Well, you do it gradually. First of all, you put it into animals to see, and you know enough about them, how their immune response is, what do they do? Then you put it into a few humans, 30 humans. They volunteer willingly, knowing, to see what kind of reactions they have.

Why don't we just take really bad people that are in jail and practice on them? Well, I don't know if that's doable here in this country without their informed consent. I think Trump can fix that. If anybody, if we have a shot at doing that with any president, it's Trump. Just start with rapists. Yeah. So anyway, the bottom line, though, is that then they gradually work their way up to larger studies where, you know, if something happens one every thousand people, you have to study a lot of people before you know the chance that you might find that.

You can't do it on 30 people. So that's why it's going to take a while. And, you know, they'll test it on more and more people. And they're going as fast as they can. It's not like there's anybody dragging their feet. It's just that, you know, I jokingly say it's like if the Iowa farmer wanted to harvest his corn in half the time, it doesn't mean by planting twice as many acres he can do that. You know, plant in April, you still can't harvest until October.

That's a good point. That's what this is. It's going to take us this long to get this vaccine. Well, Michael, I appreciate you and I appreciate your time and your book, Deadliest Enemy. People can go out and buy it. And thank you for informing us. And thanks for being here. It means a lot to us.

Thank you very much. Thanks. Take care. Bye. Thank you. Bye. Can I get a picture with you? Oh, I'd love to.

I'd love to get a picture with you.