tv Book Discussion on Pandemics CSPAN March 23, 2016 10:56pm-11:41pm EDT
six years and it changes everything. i don't think anybody can answer your question. >> better great conversation. and down like to say one thing. [laughter] you missed your queue. [laughter] [applause] >> if you're not aware this is what they call a book fair apportion proceeds donates a portion of everything to benefit the two organizations that we respect the lot. ever since willowbrook was shut down two-step bid began with a pair of starting an organization for the
holocaust that there were no longer needed if we didn't get rid of them in a very pretty way. >> one thing that often interest people the impact of superstorm cindy back in 2012 that the loggerhead the elevators in new york electricity stopped you could not charge your cellphone. you could not podcast because it required electricity. so the power of electricity in the internal combustion
to track the can -- with the new book "pandemic" tracking contagions, from cholera to ebola and beyond" please silence your phones now. we encourage questions after the event is over please place against a bookshelf for the book signing. her books include crude. the bounty hunters. and the fever. with tonight's book she
and that is very are with the zika virus in three at of 9k back to the united states have had at frivolities with their babies. so maybe it isn't just in brazil but it is a good example of what has been building nine generally over the past decades and why i wrote the book and why we have the infectious pathogens to reemerge. but zika is the latest we had ebola where we have never seen that before. and that avian influenza with that and the virus
coming out of the middle east and not including all the pathogens. west nile virus and old lumber. so what i want to look at as a journalist is how does a microbe a tiny little thing with no locomotion how is it could become of pandemic pathogen? paula deen at the history of epidemics one in particular is cholera. has actually caused said did pandemic it could happen in a matter of hours in the
latest is building on right now just off the coast of florida in haiti. and then going to wear new pathogens were either merging. to look at how it could shed light on what would happen to the other new pathogens. the history of cholera is indicative of what is have -- happening globally cholera came out of the environment like a lot of the new pathogens today although many today are coming out of animals and wildlife. said the cholera is a marine bacteria found in estuaries especially in bangladesh
were the of major rivers drain and it is a huge wetland in the water is alkaline and freshly and salty and dylan is in conjunction with his 2.10 -- plankton in that environment. of a giant mangrove swamp garett is crocs the with the british decided then 90% tavis settled so now they have contact with cholera in their environment that
allows that to spill over and what it does in our bodies is different than the environment. so it started in 1817 then spread into russia. we are disrupting wildlife habitats and they're coming into contact into a net happens there microbes can jump into our bodies to become pathogenic. from that we have ebola in the number of other viruses. from monkeys will most likely got zika end malaria
and hiv. this is how they are either merging and then to amplify that started in the 19th century people were walking out of the farms to come in to the factory jobs there wasn't a lot of room to sprawl everyone had to live near work or the possibility of work. so they were touching each other more with their food and water and in new york
there was no rule you had to empty that out. but they would lead is said to decompose that would happen before the waste ran into the streets and into the wells to permeate the ground water. as soon as it enters an environment like that it will just explode so that process of where started is just a few years ago but the majority live in cities by 2030. there will be city is more like monrovia. pour infrastructure and chaotic.
the prediction of all those that live in the slums. so now with this massive urban expansion ebola is a good example of that. but it never had infected with the few hundred thousand inhabitants. so then it new getty -- new guinea it effected a population closer than 3 million so that is why it was huge. and arguably zika is taking advantage of urbanization. maybe since before the '40's mostly in that editorial forest and is carried by a
the forest mosquito. but now in the americas is carried by a mosquito that specializes in living in human habitations. with the drop of water in a bottle cap they can live. so this is the perfect environment to breed in the only bite humans as soon as zika virus minute well expand rapidly. and then we carry these around that also started in an 18th-century with the steam ships across the
atlantic all up and down the navigable rivers and then to be connected in all of those waterways. said the erie canal had opened coming in from canada it happened again and again. we're much better today not just a few capital cities but hundreds of airports and in fact, you can make a map of all cities in the world by a direct flight this looks like a pebble to
expand our word pro where and when the epidemic will strake between effective the end unaffected cities. and with the way they expand today. is to drive the pathogens into human populations it is what we do about it. them political defenses and medical the fences to fight back and to contain these pathogens. spending a lot of time to dissect and coming down into
canada from cholera to do reconnaissance will this threaten the city of new york? and that collected data shows a clear picture all alone the erie canal a very clear picture but they turned it if the eric city to the empire state it is a huge part which would have been the obvious thing to do. son of dr. beck said it is
senior moment. [laughter] oh my god. where was i? the doctors. yes. that is anywhere my mind to quit because this is my favorite part of the story. in fact, there were companies that were distributing water and making money doing that. there is a swamp and the love manhattan. and the worst parts of the cholera epidemic and that was built on but was once a pont.
over the course of centuries it was built on top of a garbage landfill. so it was not stable. the groundwater was easily contaminated. all of the outhouses all sinking into the groundwater. to deliver the drinking water the river at the time was fresh and clean they thought it would cost too much money so they made the decision like flint michigan they decided not to attack the good water instead we
would put the well into the middle of the swamp. distributes that water to one-third of the people this is the repeated cholera epidemic. the good part the person who maneuvered all of this was alexander hamilton's nemesis and a murderer. on top of that it was called the of manhattan company. because they want to start a bank. but that banks still exist to this day. jpmorgan chase. that is their early history. [laughter] and i tell that story because with those drivers of contagion is a turnaround
added to develop the specific chemical cures penicillin, led ddt it became extremely potent to kill disease effectively and we gave public health over to the biomedical establishment. so now when we have an outbreak we'll look for social and political roots then we hope we can throw sufficient drugs at it to make ago way. but it is insufficient to hear those almeida.
summer to talk about the exponential growth one example of this is the operator can florida. in to be centered in key west generally. and to attack the insect and attack the virus. but of course, those mosquitos have been present for a long time. and that's is into do. to attack that chemical onslaught.
>> it takes seven to ten dates to transmit the virus. it slows down if it is cool. it is quite possible that that is true, that there is less virus around. at the same time, we are living at a time of unstable weather patterns. so, all we would need is really a good rainstorm a a week and a half before people started to come for the olympics and some of that water remain standing. these eggs can last for months. you just need a little bit of water and they will come alive again. i think it is a risky endeavor.
at the same time, there's no stopping zika, it is going to come. it is probably here in far larger numbers that we know. 80% of people who get it do not have symptoms. so what we are counting is the tiniest above the iceberg. that is even counting a lot of people even have symptoms probably just thing gets rash or fever they don't notice in they get better. so what we are counting is this tiny fraction that is probably here more widespread way than we know. if we consider the fact that we have 15 or so suspected cases of sexual transmission of the united states. if there is 100 introductions, supposedly 100 introductions of zika virus in the united states, 15 of those have transmitted sexually, those don't match up. sexual transmission sexual transmission is probably a pretty rare form of transmission.
most likely there's many more cases of zika virus. olympics are not, it is coming, it is going to be here and is just a matter of time before we see it manifest itself in a more detectable way. >> it's hard not to talk about what our government is doing on these issues. for for 12 years i was one of the leaders in dealing with infectious disease, with your comment under clinton and bush there were large stats of the national security council focusing on bio security. , because they are 25 agencies and you have to have white house controller you have nothing. obama comes in, he wipes it out. it's gone. it is not one of the 11 top priorities for the administration in terms of security. it is not even mentioned. and then under bush we had amazing efforts, tens of billions of dollars to figure
out how to get development of vaccines, diagnostics and they were not very well designed, all of that has been dismantled by obama. and actually the explanation was that we heard why they quoted was they thought it was important and therefore we do not. that was why the quoted. what was your take on how it's possible given that these are existential threats where a billion people today will die of an avian flu epidemic if it is roughly the same lethality as the previous. you can have quarantines, you cannot panic, how is it possible that this administration has essentially been zero interest
in this? >> i think you have set it all. i'm not sure you really had a question so much as a comment which is fair enough, absolutely. but i do think we need to do even more than that really. what i'm tried tried to talk about in the book is not just that stockpile vaccines and have experts -- and we do need that as well, but to really get at the root causes of healthcare infrastructure and poor parts of the world and we have enough primary health services to people who are most vulnerable? what are we doing about agriculture and the health of our animals and livestock? how are are we regulating the way we use land? we are breaking up tracts of land all over the place. there are a lot of reasons not to do that. and this is yet another reason.
so i think we need in all of the above approach and we need the expertise you're talking about for sure. i would like it to be even more multifaceted defense strategy. >> so as you probably know, d.c. d.c. has the highest rate of hiv in the united states, so from a global perspective, what lesson do you think can be learned in approaching epidemics on a smaller scale? >> because d.c. has things like an epicenter of hiv? so how does that translate into -- or any correlation of what you can learn from the global disease as it relates to a smaller population? >> i think we see it in the history of lots of contagions that it's when you have -- and this is an interesting aspect of the 1832 epidemic of cholera is that we had swells in the middle
of the city and that was such a driver of the epidemic because there are these neglected communities right in the middle of new york city. that was something new at the time. in the past, the the poor people were put out on the periphery of communities. with urbanization they're starting up in the middle of the city, that became an app a center that would spark out to the rest of the city again and again. i think there are a lot of parallels right now, even ibo that is a great example. we didn't have anything on the ground, even soap and water could've helped the spread of virus like that. but we do do not have even the most rudimentary services for the remote communities and that puts everyone at risk. i think it's a big lesson on the history of contagion. >> my name is scott and i'm
wondering if the government needs to focus on more of the developing world. i think it is not ridiculously hard when you take a given country and you know what is killing people in that country saying kenya were hiv and malaria are big killers, it's not ridiculously hard to figure out what investment you can make that will make the greatest difference of saving lives and have the greatest impact. but that gets harder when you're looking at pandemics when you don't know what the diseases are one it will emerge or where it will come from. this question or priority setting is important because we're never going to have all the resources we want it so we really to set priorities and invest in strengthening, there's a ton of things that we could do to prevent pandemics, but i don't have a lot of ability to say which things are going to
have the biggest bang for our buck so i'd like to hear you talk about it. >> i don't have the answer to, think you're right we need all of it. to me, the most glaring lack is primary health care and services for poor people in remote places. i was in haiti during that cholera epidemic. we traveled may be 50 miles from the capital but it took about eight hours because this place was so cut off, the thing thing that was so ironic is they were not so caught off that they cannot get it cholera, but they were cut off enough that they cannot get any resources to help them. that just really struck me, in uneven development where they had one type of water coming down from the hills that the belgium's had built 20 years ago as an aid aids project. never
give them any support for maintaining it, no services, no resources, no resources no know-how on how to maintain it. when i came there this pipe, they brought the sole drinking water to this remote community, was supposed to be on a cliff and because they're so much erosion in haiti it has slowly fallen all the way down to sea level. they had about 32 holes in it and nothing to patch it up. they were literally were literally using cloth and wrapping it around, so the water was dripping out, they had this tiny trickle of fresh water coming into the town. that was all of the reason why they had cholera because everyone was getting buckets and leaping it out. when you only have a bucket of water you don't give up eating and cooking, you give up washing as much. to to me that was a really simple things like clean water and aid that is