Today, Explained - How will coronavirus end?

Episode Date: February 6, 2020

In 2015, Dr. Vineet Menachery said a SARS-like virus could spread to humans more easily than previously believed. Now he explains what we can do to stop it. (Transcript here.) Learn more about your ad choices. Visit podcastchoices.com/adchoices

The all-new FanDuel Sportsbook and Casino is bringing you more action than ever. Want more ways to follow your faves? Check out our new player prop tracking with real-time notifications. Or how about more ways to customize your casino page with our new favorite and recently played games tabs. And to top it all off, quick and secure withdrawals. Get more everything with FanDuel Sportsbook and Casino. Gambling problem? Call 1-866-531-2600.

Visit connectsontario.ca. The coronavirus, formerly known as 2019-n-c-o-v, isn't going anywhere. Just on Wednesday, something like 70 people died from it in China. That brings the death toll to well over 500 in China, with something like 3,800 people currently in critical condition and close to 30,000 cases in total. 50 million people have been locked down, cordoned off from the rest of the world, and the rest of the world is scared. Flights are being canceled. People are stuck on a cruise ship. Japan is worried about the 2020 Olympics. There are still a lot of unknowns out there. So today on the show, we wanted to explain some things we do know.

How viruses like these are born and how they might die. To find out, I talked to Vineeth Menachery. I am a researcher at the University of Texas Medical Branch. Vineeth took some time away from his super important work at the Galveston National Lab. The Galveston National Lab works on some of the most dangerous pathogens in the world, including Ebola, coronaviruses, hanta, and a number of other important infectious diseases. We started with the origin story. In 2002 and 2003, right at the end of the year, there was a new outbreak that was reported in China and in Hong Kong of an atypical pneumonia.

And at that time, we just knew that it was a severe acute respiratory syndrome, and it quickly traveled around the world in a period of about six months, going to around the world, causing over 8,000 cases and nearly 800 deaths worldwide. It was researchers at this Hong Kong lab who first identified what was then a mystery virus. The SARS coronavirus, as it's known, had jumped from bats to humans and was proving so deadly, it was killing one in every 10 people it infected. In the aftermath of SARS, it was identified that the virus had roots in the wet markets in Southeast Asia. In a retrospective, they found that civic cats and raccoon dogs in the markets of Southeast Asia

harbored a virus that was almost identical to the SARS virus that was infecting people. So this was a major first new outbreak of the new century, and it really changed the way the world looked at infectious disease and the threat of emerging pathogens. One of the things that had been done around 2005, people had started searching for where these viruses came from, specifically this coronavirus.

So around 2005, a group had identified that there were a number of coronaviruses in bats that were very similar in the same family as SARS, but not equal to SARS at the time. What they found was that these viruses are similar, at least at the genetic level, but these viruses in bats weren't able to use the human receptor. And so at that time, the thought was that SARS was a rarity, that it maintained a rare mutation that allowed it to replicate in humans, and it had a random introduction, likely through the markets, to a human. And so you had a confluence of these two things, a rare mutation and a random introduction, that eventually started the outbreak for SARS. I come into the story around 2013 to 2015. I was a postdoc at the University of North Carolina.

We were studying viruses that were closely related to SARS. A group in Wuhan, where the outbreak is now, had identified a number of SARS-like viruses that were in bat populations in Southeast Asia. And they had actually found a number of SARS-like viruses that were in bat populations in Southeast Asia. And they had actually found a number of viruses that were much closer to the epidemic strain than had ever been found before. And so our group had actually taken the genetic sequences of those viruses and then evaluated whether those viruses could actually infect human cells. And so what we found was that there were a subset of viruses that exist

in bat populations that have the capacity to infect human cells without adaptation. And so the idea that SARS may have been a rare mutation may not actually have been true, that there may actually be viruses in bat populations that actually have the ability to jump directly into humans. Okay, so SARS is thought to be this super rare, random phenomenon, bat to market, animal to human to very, very sick human. But back in 2015, you're finding other versions of it, versions that might even go straight from bat to human and then very sick human? These viruses that we studied didn't have the ability to cause disease. And so in terms of

a virus emerging from an animal source like a bat and jumping into humans, there are about probably eight to 10 steps that are needed for that virus to be able to do that. This virus had, these viruses that we found had maybe one or two of the important key things that allowed the jump. But for the most part, these viruses wouldn't have necessarily been expected to cause an outbreak right away. But it really changed the way we looked at them. These viruses were much more capable than we originally thought. So did you know what we're seeing now in China could happen like five years ago? I wouldn't say I knew this could happen.

I think there's capacity and then there's reality. You have to have a lot of factors that line up together for a virus to emerge. We originally thought it was a rare mutation. And if it was a rare mutation, it's unlikely to happen again. I think the work that we did in 2015 argued that maybe the mutation isn't as rare as we hoped. If you had asked me five years ago, you know, in 2015, if this is what was going to happen, I don't know that I'd agree. I'd say that a novel coronavirus was possible, but maybe not likely. Vineet, the question I've really been itching to ask is, why are the bats trying to kill us?

You know, I think bats get a bad name in this. The viruses that are found in bats are often found in their digestive tract. And so the important thing to remember here is that there's a lot of bacteria and things that are in our digestive tract that don't cause us any problems. And we're not trying to kill anybody else or any other species with the viruses and the bacteria that we harbor in our guts. I think in the same way, bats harbor all of these different viruses in their digestive tract. And so they just have a unique environment that these viruses are able to thrive in. Yeah, sure, the bat cave. But just to be clear, your expert opinion here is that this coronavirus came from a bat?

I think the virus likely is derived from something in a bat. How the bat infected another species, potentially, you know, for SARS, it was a civet cat. For MERS, the MERS, the Middle East Respiratory Syndrome coronavirus, we know that the virus is found in camels. On the horizon of Saudi Arabia's Riyadh desert, camel owners are standing by their animals. The animals have come under attack for a possible link to the Middle East Respiratory Syndrome, or MERS virus. How it got from the bat

to the camels or the civic cats is not really clear. We know with viruses like Nipah that bats are a source of the virus and that they'll often pee all over fruit and date palm sap. And so that's actually how a lot of people get infected with Nipah is that they've eaten contaminated fruit. Markets in Kerala bustle like normal, but fruit sellers sit idle. An outbreak of nipah virus in Kerala this month has killed more than a dozen people. Its natural host is the fruit bat. It's enough to stop people from eating anything the bat may have touched. And that contaminated fruit case is an example of what you were talking about before, how a virus goes directly from a bat to a human. It could be contaminated fruit. It could be that there are bats living in the same areas as humans and that, you know, you get exposed to the urine or their guano.

Those are possible ways. As far as I know, for coronavirus, there's no direct evidence that that's true. But we do know that is how Nipah infections in Bangladesh have been reported, that some of the people who harvest the date palm, of how the WHO handled this, of humanity in general for overpopulating and deforesting and flying like it's going out of style. As someone who's sitting in the lab studying these things, who knows what the dangers are, does it make you want to pull your hair out? You know, I think it's easy to criticize, but we have to remember a couple of things.

One, for the Chinese group that is dealing with this and the public health infrastructure there, we're right in the middle of cold and flu season. And for the most part, this virus is not appreciably different in a lot of its symptoms than, you know, the classic flu strains, high fever, respiratory dysfunction, coughing, sneezing, all of that. And so it's really hard, in my opinion, to criticize them for not catching it sooner. Maybe they could have been more aggressive or more forthright about what they knew in terms of it being a coronavirus. But it's hard to criticize an outbreak response when you have no idea the level of the infection. And really, this could have easily been an influenza strain or an adenovirus strain. I think we're in uncharted territories.

I think when you're quarantining, you know, over 50 million people, I think you're definitely trying to do something. Now, whether that'll be effective or not, we'll see. But there aren't a lot of tools in the toolbox in terms of once it's gotten to this point. How to stop a coronavirus in a minute with Vineet on Today Explained. Support for Today Explained comes from Ramp. Thank you. pocket. Ramp says they give finance teams unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp. You can go to ramp.com slash explained, ramp.com slash explained, R-A-M-P.com slash explained. Cards issued by Sutton Bank, member FDIC, terms and conditions apply.

Bet MGM authorized gaming partner of the NBA has your back all season long from tip off to the final buzzer. You're always taken care of with a sports book born in Vegas. That's a feeling you can only get with bet MGM. And no matter your team, your favorite player or your style, there's something every NBA fan will love about bet MGM.com for terms and conditions. Must be 19 years of age or older to wager. Ontario only. Please play responsibly.

If you have any questions or concerns about your gambling or someone close to you, please contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Vinit, we've talked about how these viruses start. Let's talk about how all of this could end. How do viruses like this finally end up going away, if

they do at all? So there are three ways that this really ends. You have public health interventions like quarantining that stops it. The virus just kind of can burn out on its own in terms of it infects all the people and then it's kind of gone forever. And the third thing is that it becomes kind of a seasonal event that it has these waves and it changes a little bit each year. And maybe you don't get infected every year, but it could be that it's a more periodic outbreak. And the first thing you mentioned, the sort of public health intervention, is that what we're seeing in China right now where they're quarantining entire cities? Yeah. So during the SARS outbreak, quarantine was the main way that the outbreak was eventually brought under control.

They quarantined all of the cases and they waited for the incubation time and basically stopped the infection that way. Here, they're doing basically the same thing on a much larger scale in the different cities in China. Is it too late to do quarantine when so many people have already died and been infected and this thing has traveled outside the borders of one nation state?

You know, if the quarantine had gone in place a week earlier, I think it would have been very different. At the same time, it's hard to say it won't work until the end. The hope is, you know, for China and the number of cases that they're seeing, you would argue it's too late for China, but it may not be for the rest of the world, that we can control these people that have been to Wuhan or been exposed and that we can keep these outbreaks low in other places.

If they hadn't put these restrictions in place, I'm not sure we could have said there would only be 11 or 12 cases in the U.S. or a handful of cases in Europe. And what about this idea of it burning out on its own? How often does that happen? It's hard to say, obviously, with the scope and the size of this. It's hard to say that this will burn out. At the same time, until recent history, I'm not sure that we would have been able to detect a coronavirus like this. This may have already happened in our lifetimes, but we didn't have the capacity to detect the virus. And everybody has these years where there's that bad cold that everybody had. It may have been a coronavirus 20 years ago. We just didn't have a way to detect it.

And so is it possible to burn out? Yeah. If enough people are exposed and generate antibodies against it, you don't get spread. The same idea of like a vaccine with like measles. The reason measles doesn't spread is because once it gets to a vaccinated person, it stops. But you have to have a critical number of people that have immunity to stop these viruses. And the last scenario would be what? This would become another influenza that we just see every year? Yeah, it's unlikely to be just like influenza because influenza changes every year. Coronaviruses in general are not thought to have that kind of level of change year over year. Coronavirus is, in general, not thought to have that kind of level of change

year over year. And so it might not mean that it may be that next year you're dealing with a very similar virus. So if you got it this year, you're unlikely to get it next year. But it may be that every few years a coronavirus could emerge that's similar to this virus, whether it's from a human or an animal source. The other thing about coronaviruses that we know with common cold coronaviruses and with MERS that our immunity to them wanes over time. And so while you may be immune that first year, each year your immunity drops a little bit. It's kind of the idea that your immune system just doesn't see that kind of virus over and over again. And so it's not primed it. And so then three or four years, you might be able to get infected with a very similar virus so that it could become more seasonal and that kind of idea. You sound optimistic, are you? Yeah. I mean,

I think we, I don't think we're in a doomsday scenario. You will only be able to give out 50 doses today. That's our 4C-11. Hey, excuse me, there's a line here. Excuse me. You know, if you've seen the movie Contagion, I don't think we're at that, where we're going to have millions and millions dead. On day one, there were two people with it, and then there were four, and then it was 16, and you think you've got it in front of you. But next it's 256, and then it's 65,000, and it's behind you and above you and

all around you. This is likely a virus that will be very similar to flu. It will be really bad, potentially, in people who are older and have these health disparities, health issues. For people who are younger, it'll be a bad cold. The vast majority of the people won't have severe complications. The older populations are very susceptible. And so that's the worry. I worry less about my kids and I worry more about my parents. Do you worry that we're not taking these kinds of viruses and outbreaks seriously? That we're just calling up people like you when we're in a crisis instead of taking the actions that would prevent these kinds of diseases in the first place? Well, I just think it's, you know, part of it's just an evolving world.

Part of it is we've always had these kind of outbreaks. Whether we've ever been able to detect them is one question. The other thing is how connected we are. Air travel changes all of the dynamics of how these viruses move around the world. But it's not like this coronavirus is the first virus that we've seen, you know, whether it was Zika a couple of years ago, Ebola, influenza. I think the reality is that we have to be prepared for whatever is coming next, because I think there's going to be a next virus, whether it's a coronavirus or a flu or a Zika-like virus or Ebola. It's just the nature of the world we live in. We're more people, we're more densely packed in, and we can travel around the world quickly,

and we're interacting more with new areas and new animals we've never been exposed to. I don't know that we'll be able to predict which of these viruses come out. I do think we can set up efforts to be prepared. Vineet Menachery does God's work at the Galveston National Lab, which is run by the University of Texas Medical Branch. You can read plenty of updates from us here at Vox on coronavirus at vox.com. Thank you. yourselves and your families from the virus from a public health worker and a doctor who lived through the SARS outbreak in China. I'm Sean Ramos-Verm. This is Today Explained.