The Jordan Harbinger Show - 320: Dennis Carroll | Planning an End to the Pandemic Era
Episode Date: March 3, 2020Dennis Carroll is the former USAID director for pandemic influenza and emerging threats. He currently works with The Global Virome Project, an international initiative that seeks to proactive...ly identify, prepare for, and stop viral threats before they become pandemics. What We Discuss with Dennis Carroll: What’s the difference between an epidemic and a pandemic? Why the occurrence of a future flu epidemic is not a matter of if but when. Vaccine hesitancy (e.g., “anti-vax” hysteria) is one of the top 10 health threats in the entire world. What can we expect from — and how do we prepare for — a worst-case pandemic scenario, and how worried should we be about the current coronavirus threat? Why our incursions into wildlife populations expose humanity to greater health risks than ever before. And much more… Full show notes and resources can be found here: https://jordanharbinger.com/320 Sign up for Six-Minute Networking — our free networking and relationship development mini course — at jordanharbinger.com/course! Like this show? Please leave us a review here — even one sentence helps! Consider including your Twitter handle so we can thank you personally!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Transcript
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Welcome to the show. I'm Jordan Harbinger. As always, I'm here with my producer, Jason DeFilippo.
On the Jordan Harbinger show, we decode the stories, secrets, and skills of the world's most
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negotiation, public speaking, body language, persuasion, and more. So if you're smart and you like to
learn and improve, you'll be right at home here with us. Today, world-renowned expert on infectious
disease Dennis Carroll is here with us. We're talking about influenza, both the seasonal flu and
the big deal new and novel would-be plagues that are mostly plaguing your social media
news feeds for now. I'd love to have done this one in person, but this guy chases the flu around
the world, so maybe not. We'll discuss why our incursions into wildlife populations expose humanity
to greater health risks than ever before, and why something as mundane sounding as the flu is
in all likelihood, the next global pandemic that will kill hundreds of millions of people,
both at home and abroad. Of course, what we're doing to prepare for this and mitigate the damage,
spoiler alert, not nearly enough, and what you can do to make sure you're helping do your part
to make things better for yourself, your family, and the whole planet. If you've been watching
pandemic on Netflix, or you've been wondering what's up with the coronavirus eBolm,
and all the other headlines, this episode will set you straight.
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Now, here's Dennis Carroll.
Is it accurate to say that you travel around the world chasing the flu?
That's kind of what it seems like.
not just the flu, but largely emerging viral diseases, flu, coronaviruses, philo, you know, Ebola,
things like that, yeah.
Usually trying to anticipate the new ones like this COVID-2019, you know, where they might emerge,
trying to understand hotspots.
There are certain places that are more likely to be places of new emergent diseases.
So how to bring greater focus onto those areas and try and have a leg up on what it might
when something like this emerges.
And to the extent you can disrupt it.
Yeah, and we'll get into that.
I definitely want to talk all about that.
Why did they change the name from coronavirus to COVID 2019?
What's the deal there?
Well, I mean, it's giving it a handle, sort of like MERS or SARS.
Coronavirus is just, it's a family name.
Think of it as, you know, the Kennedy clan.
Coronavirus is like influenza is a family, which you have different varieties of influenza.
Every year we have a different influenza flu, and those names are largely denoted by letters and numbers, reflective of their sort of architecture.
So you have H1N1 or H3N2 influenza.
And then coronaviruses, when something new emerges, they try and give it a name that reflects its point of origin.
So in 2002, it was the SARS virus, a sudden acute respiratory syndrome, reflective of its type of clinical manifestation.
had the Middle East respiratory syndrome, MERS, and now you have this COVID, which is just
coronavirus infectious disease 2019. That's largely what it means.
Got it. Okay. I wasn't sure if there was something more specific or maybe even more
anecdotal about it. What do the H's and Ns mean? For us, layman, we kind of blend them all
together. Like, I've heard of H1N1, but when I see H6N4, it doesn't mean anything to me, right,
other than have I heard this a lot on the news lately?
Yeah.
Other than that, it doesn't mean anything.
It's two different structural domains within the virus that sort of speaks to certain of its functions.
And so you get different combinations of these different domains, the H domain, the N domain.
And they are constantly what are called reassorting among influences.
Influences are among what you would think of as the most promiscuous of viruses.
When you get two different influenza viruses together, they will swap genetic material.
And that's what makes them so extraordinary because that swamping of genetic material means that
they will acquire certain genetic features from other influenza viruses or they'll share
certain genetic features with other.
So some influenza viruses are very, very well equipped to infect humans.
Others are not, but when they exchange genetic material, one that previously had not been able to infect human, may now acquire that ability to infect.
But others may be incredibly lethal.
So, for instance, H5N1 that had everyone's attention 15 years ago, the avian flu virus.
And every once in a while, that virus would find an unlucky soul that it would successfully infect.
And when it infected someone, there is a 60 to 70% chance they'd die.
Very, very, very lethal.
But what had a real problem doing and still has a problem doing is efficiently infecting.
And one of the things you would be really worried about or we are worried about is that if an H5N1 virus were to co-mingle with a seasonal flu virus, which is always an efficient infector.
And if it was to commingle with it, they may swap genetic material and that H5N1 may end up picking up that part of the genetic domain within the seasonal flu virus that makes it such an efficient transmitter.
And then it would have not only efficiency and transmission, but very, very lethal in terms of its infection.
So if the highly infectious flu sort of breeds or co-mingles with the deadly flu, we end up with a massive problem.
Because right now it sounds like seasonal flu often hit or miss, maybe two billion people get infected
with it, but they get the flu, they get better, and they're fine. But if one of these super deadly
flus that so far just happens to be difficult to kill someone, or low morbidity.
Low transmissibility.
Okay.
Right. So the terms morbidity has to do with the severity of the illness, and it can be very
severe and deadly. So, again, H5N1, 60 to 70 percent.
of the people who are infected by it die, but it's very rare that someone is infected by it. It
sweeps through poultry populations. It's highly infectious within poultry, chickens, ducks,
but it doesn't have what are called receptors, sort of proteins. Because it's a respiratory
virus, they bind to your cells in your upper respiratory tract. That's so you inhale it,
and they just don't have the efficiency of binding.
The seasonal flu, very, very efficient.
And so every year, you know, you get a version of the seasonal flu that sweeps around the world infecting people.
It's very efficient.
So you always worry about something that's incredibly deadly, but it's just totally inept when it comes to infecting people, acquiring that genetic domain that the seasonal flu has.
And so if you have a really unlucky person who is infected with the seasonal flu and then becomes exposed to, say, H5N1 and gets simultaneous infection with an H5N1, then there's a real risk of in your cells the H5N1 virus replicating in your cell the same time there's an H1N1 seasonal flu virus replicating in your cell.
and they swapped genetic material.
Bingo, you're in trouble.
And you, on the global sense, not that individual,
that individual would have already had a high risk of death
because it had the H5N1,
but the people around that individual
now are vulnerable to being infected,
and then we're in deep kimchi.
Right, that makes sense, yeah, we're in deep kimchi.
Right, okay, so I misspoke before.
So what we're trying to avoid, which is impossible,
is the super deadly flu,
picking up the traits that make it highly contagious. Because right now, in the last few years,
we've seen highly contagious flus, which are a pain and, you know, kill some people, but not nearly
the amount that a highly deadly flu would kill. Is it right to say we've just been lucky enough
that some of these really, really deadly flus are really, really hard to get and have not, as of yet,
take it on the characteristics where I shake hands and get it, and then I've got a 70% chance of
dying. Exactly right. And it's a bit like going to Las Vegas and that it's an issue of probability.
So if you go to Las Vegas and you have an infinite number of slot machines and an infinite number of quarters and you throw those quarters in, you know, what's the probability of getting three cherries?
Well, having that infinite number of slot machines doesn't change the probability, but it does change the frequency with which it happens.
So what you're concerned about is that the more of these viruses you have circulating, if you start moving from just a handful to thousands or millions or trillions,
of these viruses. It's like you're moving into an infinite number of flop machines, because at some
point that changing the genetic sequences is a bit like trying to get the three cherries.
One of the goals we have in the work that we do is trying to keep the overall number of these
viruses as low as possible so that the frequency with which they acquire these three cherries
is really minimized. That makes sense. So when you're talking to
tracking and trying to prevent emerging viral threats. The emerging viral threat is not some new
disease no one's ever seen before, never heard of, and it's totally alien. It's often a mutation
on something that we already have that we just don't want to become more deadly slash more
contagious or both. No, it's really both. I mean, for the influenza family, we know that there are
There are different combinations of influenzaes out there that potentially become very deadly,
but they have the deadly feature, but they don't have the transmissibility feature.
So you're concerned about those features changing, getting highly transmissible and being deadly.
But then we also have literally tens, if not hundreds of thousands of viruses circulating in their
natural habitat.
And their natural habitat is, in fact, wildlife animals.
And they're circulating largely without consequence in wildlife animals.
Wildlife animals have learned to adapt to those viruses by and large.
And they circulate and they don't pose any issue to us because they're in wildlife.
But every once in a while, wildlife animals will become proximal to people or to livestock.
And the virus that's in that wildlife animal has an opportunity to what we call
spill over from the wildlife. The thing about viruses is that they're always sort of a Darwinian
sort of directive for all life, including humans, is diversify your ecosystems. Because if you
have only one ecosystem that you're dependent on and that ecosystem gets wiped out, then you go
extinct. And what you're always trying to do is to hedge your bets and be adaptive to as many
ecosystems as possible. So, you know, humans, Homo sapiens, originally we were limited to
parts of Africa. And then we began to migrate out and we diversified our habitats rather
remarkably. We're all over the planet. And Jeff Beez us and all that are looking to get us out
to Mars and beyond, you know, they're also trying to diversify our habitats. Viruses do the
same thing. If they are only exist in a particular species, wildlife species, and that species
moves towards extinction, then they're gone. And they're always trying to move from one animal
species to another. And so when these wildlife reservoirs for viruses bump up against another
species, that virus will test its luck and see whether or not it can further expand its
ecological niche. Humans are within that domain. And so whenever there's a chance for a virus to
jump to livestock or jump to humans, we'll give it a try. And if it successfully adapts and is able
to circulate and thrive in that ecosystem, so be it. But there is not infrequently the consequence
to that species that just got infected, the risk of severe illness and death.
That makes sense. Okay. So this, right, if that wasn't scary enough,
it gets a little scary even from here. You said in one of your talks it took humanity 400,000
years to get to a population of 1 billion, and then it took another 100 years or so to get to 7 billion,
and I'm paraphrasing, so I could have the numbers a little bit off. No, I mean, as a species,
it took us somewhere 300, 400,000 years to hit the billion mark. A hundred years ago,
there were 1.8 billion people. So in one century, 100 years, we added another 6 billion. So even if it
took us 300,000 years to hit the billion mark, we've been able to add 6 billion years in just 10
decades.
Six billion people.
Yeah, yeah, yeah.
So we're at 7.8 billion.
And by the time we get to the end of this century, we're going to be right on the age of 12 billion.
Oh, my God.
And so this is where that footprint that we have on this planet, it becomes incredibly disruptive
because as we have more people populating the earth, we're moving further and further into
ecological domains that largely had been free of human populations, but they have been rich in wildlife.
And we're now moving into areas and we're starting to interact with wildlife species
or our domestic animals are interacting with those wildlife species with increasing frequency.
And so what we've documented quite well is that over the last several decades, as this population pressure and expansion into wildlife domains for settlements, for establishing outposts, for extracting natural resources, for agricultural purposes, that more and more spillover of these long-existent but unknown viruses in animal populations, wildlife,
are making their way into domestic and human populations.
And we know that that is accelerating and intensifying.
So the events of this coronavirus, which previously existed in wildlife, spilled over into people.
We're not sure what the wildlife reservoir is at this point.
retrospectively, we'll find it.
We found very similar, genetically, very similar viruses in China.
in bats. So it could be that bats were the primary reservoir for this. But that said, as we move
further into the century, these kind of events, what we're seeing play itself out in China right now,
happen with greater frequency. So, as I've said, there's hundreds of thousands of these viruses
circulating in wildlife that have the potential to infect people. We're going to become increasingly
more familiar with what those viruses look like because spillover will happen, a little intensify.
And sometimes there'll be no consequence whatsoever.
Not all viruses make you ill, but there's a subset that will prove to be highly lethal,
such as this coronavirus.
So it's part of our future.
The 21st century is unprecedented in terms of the frequency and the intensity with which we're going
have to struggle with these issues. You'd said we can't have this type of population growth without
seeing impact at the epidemic and pandemic level. But what is an epidemic slash pandemic? How are
these different? What is the difference between a pandemic and an epidemic and a global epidemic?
Sure. Well, a global epidemic would be by definition a pandemic. Okay. So an epidemic largely means
it's a disease outbreak that is geographically limited. Think of the Ebola epidemic.
in West Africa. That was largely limited to the three primary countries, Liberia Sierra Leone
and Guinea. Even as it made its way to Dallas, it never established itself for further transmission.
So it was largely the transmission was limited in a geographic area. And it's the nature of some
of these viruses that they can't transmit that easily so that they're always going to be viruses
that will have epidemic events, but never really pose a pandemic risk.
Respiratory viruses, such as influenza and coronaviruses, however, are much more readily transmissible.
These are the two viral families that were particularly concerned about as being the source of future
pandemics. That is, it will spread around the world and pose a global risk.
The strict definition of pandemic that the World Health Organization uses is when a virus spreads and is having sustained transmission in at least two continents on the planet.
Got it. Okay. Yeah, that was a little confusing. And I thought, make sense to clear that up because I feel like the words are used interchangeably. And that's not quite correct, right?
A lot of people use them interchangeably. So an epidemic is sustained transmission in a limited geographic area.
pandemic is when a microbe, it may be a virus or it may be a bacteria,
has sustained transmission in at least two continents.
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Now, we've had flu epidemics before, and you've said in the Netflix special that I, where
I found to you, pandemic, that there will be another flu epidemic.
It's not a matter of if, but when.
and this is more scary than conventional warfare.
I know that we were talking about the flu before
and how it takes just one person to cause an outbreak
simply because one person can incubate the super contagious
with the super deadly and then spread it from there.
Why will there for sure be another flu epidemic?
What is it about the flu that makes it spectacularly dangerous
compared to other types of diseases?
Or is that just what we're seeing in the news now?
First off, influenza virus is very easily transmittable.
Once it has human-to-human transmission, we know that for every individual that gets infected,
they will infect between two and three individuals.
So it's a self-sustaining, it's a rock rolling down a hill.
Because all you have to do is sneeze, cough, and people sitting around you have a high
vulnerability of being exposed and infected.
So when you get an influenza virus that has...
the kind of genetic profile that makes it highly transmissible, it will move very quickly.
Secondly, influenza viruses, as I said, they are incredibly promiscuous and are constantly
changing their genetic profile, which means that they evolve and are able to emerge with
a whole new set of physical characteristics, which could make it lethal and transmissible.
and our body has never seen it before, doesn't recognize it in terms of the past exposure, even though we get influenza every year, our natural immunity is very much dependent on responding to things that are familiar.
So when we get infected by a particular, say, virus, if that virus comes back and infect us in the future, our immune system is primed.
That's why you use vaccines.
Vaccines are intended to prime your immune system to be able to ward off any future infection from that disease.
For instance, measles, you get a measles vaccination.
Your body is now armed that any time you see or exposed to a measle virus, your body recognizes it and essentially protects you against it.
Influenza viruses are constantly changing those, their signature, if you will.
So your body doesn't recognize what the last virus was, or the new virus is always a little different
than the last virus.
So because of that, your immune system influences are always infecting you, and you are what's
called immunologically naive.
You are vulnerable to an infection.
And when a pandemic virus, what's different about a pandemic virus from a seasonal flu virus,
seasonal flu viruses are ones that we've been exposed to. They've already had past record of infecting people,
and they will continue to circulate in the ecosystem and come back every season. And there are ones called H3N1, H1N1,
that every year they come back in some combination to cause seasonal flu. And that's what you get the vaccine against.
There's a slight variation in each of those every year that you need to get vaccinated against.
But we recognize it and you can build up a vaccine, vaccinated population to protect against the worst consequences.
A pandemic virus is one that now is totally new.
It's not circulated in the among humans before.
We get exposed to it.
And it's the first time our body has ever seen it.
We don't have natural immunity of any kind.
and we don't have a vaccine against it because we've never seen this particular virus,
so we weren't able to be forewarned and as a consequence for armed.
So a new influence of virus that is transmissible and is deadly,
that is what will then sweep around the world as a pandemic.
And there's another difference between pandemic viruses and seasonal,
that is the people that are most vulnerable.
Seasonal flu, it's elderly and the very, very young. That is, people whose natural immune system is underdeveloped as they are in children, very young children, or diminished capacity, as we find with elderly. Those people aren't able to mount a sufficient immune response, even against a somewhat familiar seasonal influenza. A brand new pandemic influence.
One we've never seen before, combinations of these H's nens, our immune system doesn't recognize it and isn't able to mount an appropriate immune response.
In fact, one of the problems with the pandemic virus is that it frequently overactivates the immune response.
And so when you look at the people who die from a pandemic virus, it's less the very old and the very, very young.
And it's the middle-aged, healthy people.
Someone like you, Jordan, that I presume is a healthy guy.
You have a healthy immune system.
What would happen if you were infected with a pandemic virus is that your immune system would get hyperactivated and it would go nuts.
And when it gets hyperactivated, it starts essentially destroying your own organs and cells.
It starts attacking everything and it just goes crazy.
There's a term for us called cytokin storm.
And we frequently see that the major cause of death for a pandemic virus is young healthy people
who've unleashed this hyperactive immune response that just is unregulatable.
Wow.
So that's terrifying because I think a lot of people go, ah, well, you know, this is going to happen
in China or India and there's going to be, it's all dirty and they're poor and they're unhealthy,
so it doesn't matter.
But no, it actually is going to affect people like us here in the Western world.
world just as much if not more because it's actually causing our own defense mechanisms against
us. Yeah. So the big difference between pandemic and seasonal influenza viruses is the healthy,
middle age are the most vulnerable for a pandemic virus. So when you talk about 50 or 100 million,
it's people who might die. It's 50 or 100 million of people in their 20s, 30s, 40s. The societal impact
above and beyond the just sheer mortality associated with it, the societal impact is just devastating.
Some people think all we have to worry about is the seasonal flu. We've kind of established that that's not true. But people will say things like, ah, massive pandemic. What are the odds? It's never happened before. But it has happened before. For example, the 1918 flu at the end of World War I, soldiers were spreading the virus. And we had, was it 50 to 100 million deaths back then?
That was 50 to 100 million deaths when the world's population was 1.8 billion.
Ah.
So think about it today.
Right.
And now we have population movement that's much more frequent.
So special pathogens and outbreaks in remote areas are like a hop, skip and a jump, one flight away from London Heathrow to Chicago O'Hare.
Absolutely.
There's like, what was it, 3,000 commercial flights passed through New York City alone every day.
So one person with an avian flu could spread it to somebody and then suddenly it's in New York within
24, 48 hours. Absolutely. Absolutely. So it's not only are there 6 billion more people on this planet than
there were in 1918, the speed with which people move around the world is staggering. You know,
when we had, there was the pandemic of 2009. That was a novel H1N1 virus that emerged in Mexico and then
swapped around the world. And you can look, there are these nice maps that show the
speed with which the virus moved out of Mexico and largely by air swapped around the world. It was first
identified in April. By the end of June, it was virtually on every continent on the planet.
Wow. That's incredibly terrifying. Fast. It's fast. So the speed with which an influenza virus can move is
staggering. Far faster than we can respond, and that's the issue is that we know that these
viruses will emerge. We know that it is inevitable. Our preparedness is really woefully lacking.
And if a 1918 virus were to emerge today, we would see the impact on numbers far greater than what we saw
not 1918. Even in 1918, when they didn't have the benefits of vaccines, you know, we didn't
have mass production of vaccines. We didn't have vaccinations at all. We didn't have antibiotics.
Many of the deaths associated with the pandemic influenza are also associated with secondary
infections from bacteria. So as you're struggling with the influenza virus, your whole system
begins to collapse, and then bacterial infections will further amplify your clinical situation.
and you'll see that maybe half of the deaths ultimately were due to bacterial infections.
Were a virus to emerge today, let's say April of 2020, similar as it emerged in 2009.
Within one year, a year later, two billion people would likely be infected.
And if it were as lethal as the 1918, which had a mortality rate of 3%, that is for every
100 people that were infected, three people of those would have died. When you've got two billion
people that are infected, 3% mortality, you're talking about hundreds of millions of people.
Oh, my God. And that virus spreads far faster than our ability to produce a vaccine.
So if people say, well, the end of this virus will merge, it'll spread, but we'll just vaccinate
and we'll be fine. We saw that even though it emerged in April of 20,
2009, despite the very best efforts of the global community to produce and mass manufacture an effective H1N1 vaccine, we didn't have production of that vaccine largely until late September, early October.
And in the United States, we didn't get our 58 millionth dose until December of 2009, when already more than a quarter of the population was in fact.
And it was well into the fall wave. By the time it spreads around the world, we're going to just begin to get enough vaccine to protect only a quarter of the world's population.
That's terrifying. And so, of course, the death toll will be much, much higher, as you mentioned, in the hundreds of millions. And that's with 3% morbidity, right? So if we have something that's like...
Mortality. Oh, is that different? Okay.
Mortality says you're dead. Morbidity says you're sick.
Ah, okay. Did not know that. That.
That's good to clarify.
So if we have something that is much deadlier than we're talking about, I mean, look,
I don't need to exaggerate this.
Hundreds of millions is already bad enough.
I guess I can move on, right?
I don't really need to like, you know, we don't need to put a cherry on that one.
In addition, you'd mention that we'll have economic and societal disruption.
So if everybody's sick and everybody's massively infectious, we're not going to have people
going to the power plant.
We're not going to have people at the wastewater treatment plant.
A lot of infrastructure is going to go down.
So people will start to die from other very preventable.
things like violence, sanitation issues, heat, cold, things like that.
Well, and they're also going to die from, you know, all the other health issues that you're
struggling with before the pandemic don't suddenly disappear. People are going to still be
struggling with normal health issues. People with chronic illnesses that may have cardiovascular
diseases or diabetes who may be, say, infected with HIV and required routine treatment
with antiretrovirals. There's a real thing.
vulnerability that the health system will collapse because the health workers are going to be sick.
And so people's ability to get access to medical care for the routine things, women who are going
to be giving birth, where are the maternity ward's going to be? This is going to be a real issue.
It's worth noting, though, that when you talk about a pandemic virus sweeping into a community,
you're talking largely what's thought of in terms of waves, that if you're in Los Angeles, that if you're in
Los Angeles right now. And if there was a pandemic happening, it doesn't happen everywhere at the same
time. And there are waves of influenza virus that will sweep across the community. And there's
typically about a two to four week period when this massive event is playing itself out. And then it's
over. I went just while I was working on the Netflix piece, I went to a local cemetery here in
Washington up on Capitol Hill. It's called the Capitol Hill. It's the Capitol Hill. And I went back in
to their records. They had burial records for 1918, and I was curious as to what that looked like.
And what you saw, when I looked in June, July, August, early September, people were dying from
tuberculosis, they were dying from dementia, whatever. And then by the end of September,
you started seeing flu deaths. By the middle of October, everything was a flu death, and the numbers were
staggering. And by the beginning of November, the flu deaths began to dramatically diminish and
normal causes of deaths were being registered as the primary cause of death. So there's this
one-month period when you're as hell. And that's where it gets really intense, because it's
a intense period when health systems are incredibly overwhelmed. And the workforce in that
period, as you just mentioned, it's going to be really challenged because of illness. So critical
life-saving, life-needed services from hospitals to police to the electric grid, telecommunications,
food transport. All of that is going to be incredibly challenged. And we know that. And then
once that wave passes, you have to build all of that up again. So part of,
when you talk about how do you prepare for a pandemic? It's not just how you mobilize the health
system to one be able to properly treat infections, but also how you protect the health workers
to be able to ensure sustained health systems for other critical issues. We also need to say,
what's our plan B for how we're going to ensure the power grid stay on? How are we going to
ensure there's food, how are we going to ensure that there's safety and security? And we have to have
that thought out beforehand. You can't make that up on the fly in the midst of a crisis of this
magnitude. Yeah, that seems like something we should have planned out ahead of time. I know a lot of
people are saying, eh, this is overblown, it's fear mongering, this is fake news, it's social media
causing a panic. What are these people right about and what are they wrong about? Well, I mean,
the big issue is that there is an element of fear mongering.
in there, which is unfortunate. The truth is that these are deadly events. So let's talk about this
coronavirus circulating in China right now and potentially on the verge of breaking out around the world.
The biggest problem you have with an event like this coronavirus, and it's the same thing that
happens during the early stages of an influenza pandemic, is that there are more questions we don't know
than we do have answers for. And in that space of known versus unknown, people start making
making up answers. And so there's a lot, as you called it fake news, there is an enormous amount
of misinformation, which is likely to play itself out. And there's a tendency that when
misinformation is spread, it tends to be the worst kind of messaging, either provoking fear
or telling people this is just not a real threat. So you have both extremes at work.
You know, what professional communicators have a responsibility, people like yourself and the newspaper, is making sure that accurate and informed information is what dominates, you know, the airwaves, the newspapers, television, everything.
And that's a challenge, how to get the right information out.
Franklin D. Roosevelt really summed it up very nicely. When he was talking about the Depression, he could have just as easily had been talking about a pandemic event, which is that you have,
nothing to fear but fear itself. Fear itself can be the most damning consequence of a pandemic.
A lot of people say things like, oh, I don't get the flu shot because it causes the flu,
or I'm afraid I'm going to get the flu because of that. Is it just confirmation bias where
people think they're getting the flu from the flu shot because they remember it happening
once somewhat in the same time frame? Well, you know, again, what's the flu shot? The flu shot is
essentially trying to prime your immune system to be able to react strongly in the same.
appropriately against a future infection from the influenza virus. So when you get the flu shot,
you get a momentary period where your immune system may start acting up a bit. So people may feel
a little uncomfortable. But it's incredibly transitory and it's very, it's an inconsequential thing.
It doesn't, you don't get the flu. You just may feel a bit uncomfortable. But that's,
it's a small price to pay when that does happen. And again, some people have that adverse effects.
Every vaccine has some kind of adverse effect.
But the reason you're using a vaccine is that the thing you're vaccinating against,
whatever the adverse effect is, it's incredibly negligible compared to the risk of what it is
that you're vaccinating yourself against.
So, you know, when people refuse to let their children get measles vaccine, I mean,
it's stunning because they have the perception that there's adverse effects associated with the measles.
vaccine. The whole issue about autism is just an absolute falsehood. For people to believe that
and then to put their children at risk for an infection as serious as measles is truly
criminal behavior. You're really putting the lives of young children at an incredible risk
of severe illness and lifelong consequences. And it's just frightening when you see that happening.
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Speaking of anti-vax lunacy, why can't we eradicate influenza like we had mostly done with the measles?
Up until, of course, people decided they were going to rub peppermint oil on their kids' forehead,
which or whatever the hell, you know.
I know vaccine hesitancy is one of the top 10 health threats in the entire world, according to the UN,
which should be scary to everyone.
Like, this thing where somebody watches YouTube and then creates one of the top 10 threats to humanity in the entire planet,
And that's really one of the dumbest things, I think, is our generation.
Yeah.
And it's really unfortunate because the dream of all of these revolutions and the information
technologies was that the opportunity to not only unite people, but to make people better
informed.
And, you know, little did people anticipate just how much a double-edged sword all of these
extraordinary advances in information technologies were going to be.
how they could be taken over by people who basically are committed to misinforming and creating
mistrust and fear for things that we should be thankful for.
We live in a time where the power of vaccination has made life a far less dangerous experience.
It's really hard to remember when, you know, in the United States, when the fear of diseases like polio swept across the country because polio was such a damning disease.
I grew up in a family.
My oldest brother had polio.
And he was crippled for his entire life.
He's still alive, but he's in his very late 70s now.
And he's paying this lingering consequence for polio survivors that he's still struggling with.
And that was for the want of a vaccine.
And when the vaccine became available in the 1950s,
absolutely extraordinary revolutionary public health breakthrough
and that anti-vaxers would throw us back into the days of polio sweeping across this country
because of their absolute belief in lives and misinformation is just stunning to me.
Why can't we eradicate influenza like we have measles?
Measels. Yeah. Yeah. One of the things I said about influenza is they're constantly mutating,
which means that developing a one vaccine to deal with all influences is incredibly difficult,
and we have not been able to develop what's called a universal vaccine. Measles, on the other hand,
genetically is very, very, very stable. And so the measles virus that circulates today is basically the
same one 50 years ago. So you develop one vaccine. It's incredibly efficacious. So it's that issue about
how changeable, how much mutations there are in the virus really determines how stable your vaccine
efficacy might be. That's one of the reasons, for instance, it's been so, so difficult to develop a
vaccine against HIV because it is constantly changing the makeup of its protein.
receptors that they have on the outside of the virus that a vaccine would recognize. Today,
it's red, tomorrow, it's green, the next day it's yellow. That just constant shifting of its genetic
signature changing structural properties of the virus itself makes vaccination incredibly,
incredibly challenging. So some viruses mutate routinely. Vaccines are really difficult. Others are
incredibly stable. Rabies virus remarkably stable. Yellow fever virus remarkably stable. But things like
influences are very, very, very, very mutagenic. People in California are worried about things like
earthquakes, but how could we prepare for a pandemic? Do we need food? Do we need water? Do we need those
breathing masks that we see people wear on airplanes? What do we do? I mean, first off, the best
prevention against infection is good hygiene. Hand-washed.
If and when, let's say this coronavirus makes its way to the United States, if it is not able to be contained in China, then handwashing and social distancing, not finding yourself going to large gatherings with people.
And then wearing an appropriate face mask makes a lot of sense. Not so much that the face masks protects you. If the virus is circulating in the air, the face mask is largely.
porous to a virus. It's much smaller than the knitting, the webbing of the face mask. But if you are
infected or if someone next you is infected, when they're sneezing and coughing and likely to
expel the virus, they're going to expel the virus in droplets of spittle or, you know, mucus. And that right
there is captured by the inside of the face mask. So someone who's infected, they will protect against
infecting other people if they have a face mask on. So if everyone wears a face mask, those who are
not infected and those who are infected, then the probability of you're getting infected by the person
next to you if they cough or sneeze will be zero, or not zero, but it's going to be greatly,
greatly reduced. And if you coupled that to very good personal hygiene, washing hands,
using sanitizers, being careful about shaking hands and exchanging interactions with people,
then, you know, you'll greatly reduce your risk of exposure and infection.
Angel, if you do get infected, you're going to greatly reduce the risk if you're acting as a further spreader of the virus.
Ah, that makes sense.
Do you have a personal stash or of emergency stuff?
Do you have, like, masks, a hazmat suit in your garage or some drugs or something like that?
I do have a face mask.
So, for instance, as you know, I just flew back from Southeast Asia.
everyone on the airplane when I flew out, when I went from Hanoi over to Bangkok and then Bangkok
out, everyone on the airplane was wearing a face mask.
Yeah, I was the only person on the plane from San Francisco to Los Angeles wearing a mask,
unfortunately.
Yeah.
So, you know, I mean, think about it.
If the person next to you was infected and they didn't have a mask, not only they say they're acting
as spreaders, if they had a mask on, then, you know, they're infected, but they don't become
the source of further spreading of that disease. So it takes a community shared effort to be able
to reduce the spreading of this virus. And so we always have to act in a way that not only is
in our self-interest, but it's in the interest of the people next to us. Waring masks, proper hygiene.
It's a community good as well as an individual good. Now, we're totally unprepared for this.
And thankfully, there are people like you who are working hard to, one,
and to help find a real solution.
I think that you probably would agree.
You're underappreciated, but I think history
will look kindly upon you for this.
How can we prevent things like this?
I mean, controlling a deadly virus,
and you said this in one of your talks,
requires moving from reactive to proactive,
because we know the virus moves from livestock
into people, and caretakers of animals
are usually, I guess, patient zero,
as you hear about in graphic novels or dramas.
Does that mean that we should be prevented?
this from transmuting from the animal to the person, like attack it when it's in the animal
population before it gets into the human population? Jordan, I'm going to hire you. You're right
on top of it. That's a great. That's exactly right. I mean, again, as I said, whatever we've seen
so far in terms of emerging viral threats, it will pale compared to what we'll see over the
course of this century. Because as I mentioned, increasing population and encroachment in wildlife
is accelerating the rate at which new emergent viruses will spill over into people.
So it's going to be more and more part of our landscape.
And so I'm part of a group that's called the Global Virone Project,
which is really trying to anticipate what the future is going to be,
looking at how these new viruses will emerge.
And rather than do what we've been doing,
which is largely waiting for a new virus,
such as this COVID-2019, then react to it.
We know that these viruses already exist and they're circulating in wildlife.
So part of a proactive stance is to go out and begin developing a comprehensive catalog
of what is circulating in wildlife.
Understand where these viruses are.
What's their geography?
What animals they're in?
Understand their proximity to livestock and to people.
and begin ranking of all these viruses, you know, which have genetic properties or genetic pedigree
that makes them potentials for future epidemic or pandemic risks.
And use that information.
Think about this viral dark matter that's circulating out there and shine a light on it.
And use this information to better inform, first and foremost, our ability to be able to,
to disrupt the spillover. It's not inevitable that these viruses move from wildlife into livestock
or wildlife into people. It's a consequence of our bringing that heightened interaction as we
expand our footprint. Let's pay attention to that. Use this information to identify where there
may be hotspots, where these viruses are circulating with an abundance in wildlife, and we see that
the interactive, potential interactive dynamics between wildlife and livestock and people is
consistent with enhancing spillover, then let's get in there and disrupt that interactive dynamic,
lower the risk of spillover, but also bring heightened surveillance to these places so that
if there is spillover, we pick it up at its very earliest moment and we stop its spread,
not once it's reached the point where it becomes a headline in the New York Times, we stop it
when it's still circulating in a market on a farm or in only one or two people.
So, you know, Albert Einstein famously said, keep doing the same thing over and over again,
and you expect a different result is the definition of madness.
As we look towards the future for future viral epidemics and pandemics,
If we keep doing what we've done in the past, which is sitting and waiting for these events to happen and then react, we're doing a disservice.
We have an opportunity to change the dynamics.
We have an opportunity to take advantage of what we know we can do, which is document, characterize what that viral dark matter looks like and use that information to better prepare, prevent, and respond to future events.
You know, it also has the added feature of possibly totally transforming how we very much think about vaccines, how we think about drugs for future viral agents, that right now we develop a vaccine against an individual virus.
There's this coronavirus emerges.
We will now, there'll be a mad rush to create a vaccine against it at the cost of hundreds of millions of not billions of dollars.
and whatever the next coronavirus emerges, it will largely that vaccine will not be effective,
so we'll scramble to develop a vaccine against the next coronavirus.
If we've documented and characterized virtually all of the coronaviruses circulating in wildlife
before they move into people, how can we use that big data, the genetic profiles that we've
developed for every one of these viruses, does it transform the kinds of questions,
researchers and scientists are asking about these viruses, can we be thinking about broad spectrum
vaccines that aren't simply effective against one virus but may be effective against multiple
members of a viral family or, as we are trying to do with the influenza virus, a universal
coronavirus vaccine. It's an opportunity. Big data can be transformative and allow us to do
things that we've never done before. So I would say the way to respond to the future is to get ahead
of the future. And I think the Global Virone Project, a global partnership to really develop this
insight, build the capacities in countries around the world to do this surveillance and better prepare
countries around the world to disrupt spillover and respond to it as rapidly as possible,
and then use the big data that you would capture in this monitoring to try.
transform the sciences around emerging viral diseases. That to me is the future.
This is all fascinating and there are so many interesting developments in this area that I think
are probably underrated and hopefully we'll get famous not because we needed them and they saved
the planet, but because we thought we didn't need them and they saved the planet. Does that make
sense? Yeah, yeah, yeah. You said something really interesting in pandemic that I think is a great
way to close the interview, which is that Rome was the center of the world 2,000 years ago and
now they're in ruins.
Can you go over that?
I think that was actually a great way
to kind of wrap this in a bow.
You know, the hardest thing we have
is perspective of it.
We don't really understand
that the world we're living in now.
One is very different
than the world that was,
and the world that will exist
in the future is very different
than the one we live in now.
We tend to get trapped
and think that what we are living in
is always was and always will be.
And we just don't
appreciate that nothing is forever. And a lot of people's resistance to doing something different
is because they're comfortable doing with what they're doing. And the matter how comfortable they get,
the fact of the matter is time marches on whatever we look at around us and think is the norm.
That will not be the case 10 years from now, 20 years from now, much less 100 or 1,000
years from now. The societies we live in today that we take for granted will be a footnote in history
500 years from now. The architecture that we surround ourselves with, they will be ruins or forgotten
a thousand years from now. When you look at ancient civilizations, they looked around the world
exactly the same way we do. They thought what they saw is exactly what always was and always will be.
and, you know, the irony of being in Rome and looking out over the Roman Forum, Rome was known as the Eternal City.
And you look at the forum and you look at it today.
And it's hard to imagine that it was the equivalent of Wall Street today.
Right, right.
We look at a bunch of rocks on the ground and we say someone stood here thousands of years ago and said,
this will never be a giant pile of stones with moss and grass rolling over it.
This is the center of the universe right now.
That's right.
So diseases are a reminder just how vulnerable we are to losing everything.
Just imagine what the world's going to be like if 500 million people in the space of six months die.
There are populations around the world that will never recover from that loss.
The world will change dramatically.
And we've seen this before.
The plagues of the 14th century, 25 to 40% of all of Europeans were wiped out.
Cities and towns were decimated and abandoned.
We don't realize just how catastrophic the black plague was in terms of putting Europe on the brink of extinction.
And that was because of an infectious disease.
We've remained as vulnerable today as Europe was 700 years ago.
And we should pay attention to those events to understand our vulnerability and to learn from
those events to figure out how we can maximize our opportunity for survival and recovery.
Dennis, thank you very much.
This is fascinating.
And I think people should be paying more attention to this.
And maybe this is the kind of thing.
We don't need to dramatize it because it is so important.
And it's being diluted with a lot of fearmongering.
But it's not that we shouldn't be afraid.
it's just that we should be afraid of the right things in order to take action in the right ways.
Yeah.
Fear is a good thing.
There's an advantage to fear sometimes.
It elevates our response to things.
But mindless fear is the most damning situation you can put yourself in.
And yes, we do say very clearly that epidemics and pandemics, it's not a question of if there will be epidemics, there will be pandemics.
It is a question of when.
But that inevitability should strike a measure of fear into our hearts.
But if we stop at being fearful, then we've missed the point.
The fear should then trigger us to act.
We should take measures, anticipate what the meaning of a future epidemic and pandemic might be,
and put in place the kind of preparations that minimize the consequences.
So fear can be the greatest trigger towards our getting our act together, but it also, for many people, immobilizes them into inaction.
And we really have to drive the equation forward.
A world prepared is a world that will thrive and live for a long time.
Dennis, thank you so, so much.
This has been fascinating, and I'm so glad we got a chance to do this.
Great, Jordan, thank you.
I appreciate it.
Great big thank you to Dennis Carroll.
We'll be linking to his stuff on the website in the show notes at Jordan Harbinger.com.
Also in the show notes, there are worksheets for each episode so you can review what you've
learned here from Dennis, and we have transcripts for each episode, and those can be found
in the show notes as well.
Super interesting show today, and I hope you agree.
It's worth noting that the hospitals and cities like New York City almost always running
at over 100% capacity.
That means if something catastrophic occurs, they will not be able to take in all the sick
in the injured, especially in a special pathogen situation. Special pathogens, by the way, are those that
are high morbidity, high mortality, are hard to treat, very contagious, and cause public panic.
Been a few of those in the media lately, if you haven't noticed. And it's not just us humans
spreading things around the world that we've caught from animals. Wild birds, one of the most
common carriers of the flu, especially, of course, the avian flu, migrate from North America to South
America and as far south as Argentina down from Canada. That can spread things fast.
When there are outbreaks, countries tend to hoard vaccines, and big pharma is not only slow to produce
new and novel treatments, but not that many folks are even working on these new treatments,
since in the past, many epidemics have mostly affected those who can't afford to pay handsomely
for treatment.
Rural hospitals are also under-resourced and often the last in line to get help in case
of a pandemic or outbreak.
I think it goes without saying that the poor are often the slowest to get health care anywhere.
So in poor areas, poor countries, these things tend to spread even faster.
And further, people can't afford to miss work, so we're going to the office contagious.
But are we just overreacting?
I mean, what about Ebola?
That was contained, right?
Well, it was a mess, and we got through it by the skin of our teeth, from what I understand,
and it's still a work in progress.
But yeah, that was contained.
Something like coronavirus, much, much more contagious.
It can affect billions of people in the same time it took Ebola to infect just 30,000 to 50,000.
We all have shared risk with this one.
So the solution is shared action.
We can't bomb, ban, or explain our way out of this one.
We need to get serious here, folks,
and I hope this episode has helped generate some awareness here today.
Thanks again for Dennis here,
and I met him through my network.
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