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the will gain? Experience does Rogers, I wiser it's great to see. You again should always be a lot better. Seeing you now. I feel happy to see you too, especially with the boat ties we talked about before your signature touch as I was saying, I try to start wearing a regular type or while it was like when Dylan started, switching to electric instruments, the Newport Folk Festival in there cries of outrage, so I had to what kind of cries of our you getting about your boat, I specially in these- I am glad they liked about the fight. To avoid the point was I tried to switch to regular tie for a while, and they said that there is no way that can happen. That's what a man a screwdriver than a man like what kind whose get upset you were in a regular tie with those people need to get a life at the? U S, bed and in a good natured way. I'm sure So we don't do very many, these Skype ones, but because there are so

Let's, sir, I don't you ve done Many of these that sometimes people talk over each other. It's very strange yeah. I guess since the it's the epidemic right. Otherwise, I'd be on a plane and come to see you and Alain yeah we'll do that again, some time, let's, let's get going so taking from the top. Let's, let's discuss give us your take on how we got here, because this is it's been very strange, obviously the president completely miss count. We did what was going to happen in the way he was explaining to the news. He was kind of saying that I was just a few cases in they'll be gone, and now I've see New York City shot down, the entire country is separated from each other. Everybody is isolating and home, give its ear take on how we got here, You know that the truth is we knew this was coming or something like it. We had a heads up and an even a even a heads up before last year,

because this is our third major corrupt. Virus disaster of the twenty first century. We had It's called SAR severe acute respiratory syndrome in two thousand Three that started in China and cause a terrible, epidemic in Toronto. It actually took the the role stones to do a concert to bring the economy back to Toronto. Two thousand three and then, Was mayors corona virus infection in two thousand twelve, and this is the third one. So we actually knew realize Corona viruses were going to become a new thing and we embarked on a big run. A virus the programme a decade ago? Undone each time they have caused devastating hospital epidemics. They affected healthcare workers. So the point is this fortunately has become a normal for the globe, is terrible. Corona viruses, epidemics- and we saw this one coming up in the end of twenty nineteen in China.

And I knew were in for trouble because that's what kimono viruses do so you knew that we were going to be in trouble because there was no way to contain it and keep it in China, where the difference. What this one compared to the other two was this the other two sars and mares? Now we call this new ones Sars to so the researchers one than mares than Sars to so both Sars one and mares me age, you so sick and at such a high case, fatality Ray Anybody you got it was immediately hospitalized and simply out of the community, that the difference with this one I write likely is it? Is it's pretty lethal, it's about five to ten times more lethal than Regular gather, seasonal flu but also there's a big group of people who don't get very sick at all and so you have this sort of perfect mix swear it's not the most lethal faction. We ve ever seen its not them

transmissible infection we privacy, but its high enough in both categories that a combined. This very toxic waste which you have is you have a group of people, who are getting very sick or in the intensive care unit like older people. Those with diabetes and high attention even a group of young people who are getting it very soon. And then a larger group who we're getting mildly sick? You could still walk around the community and be out, in about and stores in restaurants and infecting everybody. And so this is what caused the problem. It's all its highly transmissible lobby group of people were looking around spreading? It Agnes ball or subset, but a big subset, we're getting very sick and even dying in intensive care unit. So that's was playing out and what city right now for his do? We know why so many people are asymptomatic, we don't we really down there's a rough correlation

age, so younger people seem to do better and actually kids seem to do really well with this infection that don't they don't get with it with one exception that I'll tell you about it and at most kids, don't get very sick at all, but their helping, the community's spread, and we know quite know why also it but Something is very important in one of the reasons why I really want that. Come on and talk to you about covered. Is we there's this buzz out there in the community that it only old people that are getting sick and dying you're going to ice use but in fact the sun for disease. Control came out with this very chilling document a few weeks ago, showing at about a third of the very sick people in the hospital under the age of forty or forty four so between twenty and forty four young adults are get very sick, and that word has not got. Out adequately, because when the four infect disinfection first appeared so China? It was all

older individuals over the age of seventy does babies, and are we didn't hear about the adults, but then for reasons that we don't understand. We saw this big group in ITALY and France on site. And of younger adults and we're seeing now play out in the? U S. I know in on the people who you know, listen to you and watch. You know it's a big group between the age of twenty and forty four and they really need to hear that there, ask for severe illness despite what they might have heard previously, while we have a friend, Michael YO, who is actually on a podcast with me the week before he went New York is there that we can actually and that's when he got it, so he got with nineteen in Manhattan and then flew back, got sick and here's what's really. But maybe you could help me with this.

He said he was feeling terrible and then took at will and it got exponentially worse. Is that, coincidentally, do you think I mean there's there's been talks of avoiding Ibuprofen Michael's, forty five years, all very healthy very robust guy, so when he was, I mean he was in the hospital for a week in his words I almost died mean he was really very concerned with what about what about an So there's been a lot of buzz on the internet about Ibuprofen, and then the World Health Organization came out with a specific statement saying those are rumours side that lot of evidence to say the you get worse with Ibuprofen. Probably he was just one those young adults, that's gonna, get very sick and that's what this virus does. It has the ability to get into the pulmonary system in your lungs binds to reset

there on the cells of your lives and causes a terrible pneumonia, and on top of it get a big inflammatory response. So really can severe pneumonia, even preventing ability to breathe and that's why so many people who are getting really sick of this fires have to go on respirators. That's exactly happened, Michael, he got pneumonia. So there's is that there's a rumour that you shouldn't take ivy provand, but is that unfounded? Are you advising people take up your profile do think they should just avoided Justin case, and where did this rumour start from and what? What is the concern? And then and then you ve got the problem. You know some people in our offices, don't take aspirin, because if this is a respiratory virus infection, It could be a severe reaction with with aspirin as well so for Now- and I said the other things- was anything we say today.

I might look like the biggest idiot in the world tomorrow or next week, and that's because this is a brand new virus and We ve never seen before rights over on a steep learning curve, so we're learning new things about this virus every day. So that's why I you know- many things I want to say today by sound like a awful anger, hedging, it's it's because I am wearing We are learning so much. That's knew about this virus, so it's really import. That everybody be very mindful and pay attention to real help. Information than that accurate sources, because things move things change as we learn more about the this is a virus that you didn't even know existed, four months ago, and we ve learned about an incredible period of time. The Chinese put up a lot of. Formation on these pre prints servers about what the virus is, what this he glanced the genetic code. What the receptor abides too, when we

the original. Sadly, we call this new one Sars to the cuban night, so the vote, the diseases call covert. Nineteen, the viruses called Sars to Sars cord of ours too. When we had the original Sars one, it took us all, for year to learn all that information. Now everything's been compressed in a few weeks, so it's real extraordinary, but there still so much so much were learning right now that I'm so glad he brought them up. That is really important for people to understand people that may be haven't looked into the complications that are involved in trying to recognise treatments and cures for a virus that it is it's. U everyone's learning. Yeah and also in out and everything we have noted far about the viruses. What happened in China and it turns out the Chinese, they have seen: genetic differences to Europeans and Americans in an This can change depending on this, not just the pathogen. It's also what we call the host the person to so the fact you know that the virus

did young adults in Europe in the? U S in a way that didn't necessarily occur in China, is Wharton, and so we will keep we end. Then, who knows what happens when this virus in the Latin America, India or Sub Saharan Africa it may and it's not because the viruses mutating necessarily it's just that there is also the host component as well, which is quite important. Well, that's one! the issues that people are having in terms of blood type. There's there's all this talk of certain blood times, maybe more susceptible to the virus, particularly blood a well. Actually. This is the well known in the infectious disease. Literature there I mean there's a whole. I put went up on twitter, I think a week or so ago, there's the dozens of different pathogens. But by including viruses and that behave differently depending on a person's blood type, so host genetics influences things quote quite a bit national doubt. Let's talk about you,

Germany because I found that really fascinating. When I was reading on Germany and their low mortality rate would would you tribute that too? Is that the russian worth health care they have their. What is well, let me give you first, opposite side of the coin, and then we'll talk about Jack has the opposite? Side of the coin was happily in ITALY and Spain. Ten percent mortality so A ten percent of the people who were being diagnosis the nineteen of died, which is higher than just about anywhere else. I think what's happened there, is when the health system gets so overwhelmed. That so many so that in other words of transmission goes on for a long time and you haven't picked it up and then listen, peoples are showing up in the. I see you, then it's too late

and you start having massive numbers of people come into the icy you. The hospital can take care of everybody. They can integrate everyone, they can give everyone the highest quality care possible snowfall. The doctors and nurses there are heroes, but the fact that completely overwhelmed with patients. That's what fatality starts to to. Really rise. So we saw this in part, We saw this in italy- and that was the big worry about new york- that the same thing will happen sooner, but I'll hold that thought for a second in Germany. So far, we think that the carbon of those been my younger people getting it and the fact that the hospital system was getting ready and they ve got that. Infrastructure in place. Understand surge, although their worry now too, that it may Start going up an overwhelming things, and then you look out. Ok, so That's true. What's the story, the mortality rate in the United States an inch strongly so far one of the highest has been Orleans and I think

happened there? Was they kept? The Marty grow open. They had lots of mixed and people like large numbers of people getting infected, number wandered overwhelm the house system, just like ITALY, so there sullen in New Orleans rather case, fatality rate is between four and five, but there's other factor go on a new Orleans lots of people living in extreme poverty and power Poverty is very linked to diabetes and hypertension, and we know diabetes and high pretensions, a big risk factor for death, so normal, as is getting hit twice one because the health systems getting overwhelmed. And, second, I think have a lot of african Americans living in poverty with underline diabetes, nigh pretension and that's causing that two diskiver so you know I was just on phone. Today, with the leadership of Houston and saying you know, you know, we have a similar demographic to New Orleans in many ways were sister cities after Katrina, Conall linked at the hip,

and and another her sister city. We love them, but we have to recognise that even if we can handle the surge of their taxes, medical center, we still had back demographic of african American the Spanish with underlined, diabetes and hypertension, really word we're gonna see. High mortality in Texas now is another factor. ITALY in their high mortality rate smoking because when I was in ITALY, I was stunned by how many people smoke young people all people. It seemed like a large percentage of the population smoked, yeah Brad really glad you brought it up. I should have I've should remember to say that so yeah so in short, laughed so, for instance, chinese older chinese men and really high mortality rates and hear something very interesting? Smoking actually up regulates the receptor in the lungs that the buyer earnest spines too. So it seems to make

more copies of the receptor for the virus to bind to so that may worse than the disease. I think you're right. I think smoking is a factor that one question that we don't know is what is being done Does vat is raping also doing that, and could that be like somehow toes the young and all the young adults that were seen in the United States who are getting hospitalized, then action of high mortality potential getting very sick and their lives are being saved because their being intubated put around the bend. But is there a vapor connection again now, question. We don't know with something: that's gonna have to be looked at more this there's gonna a lot unravel when all this is over and along the way people are dealing with a law of misinformation, which is one of the reasons. One of many reasons why I'm so thankful for you for coming on the pod gas in and try and educate us on this thing? What allowed That's the reason I'm going, I been going on between word. You know we, I call led a team with my.

Twenty your science partner documentary, Lena Potassae, were trying to weave we develop vaccines, including krona virus vaccines, we're trying to get those out the door and clinical trials in between going on Fox NEWS, MSNBC and CNN and that's not an easy need, needle the thread either going and Fox NEWS Embassy amidst MSNBC Cnn, that's been really interesting, but I love the opportunity and didn't doing it, because this that there's a little. Lot abortion out, there's a lot of misinformation trying to get accurate. Information and also explaining the science behind it, because sometimes you hear something that doesn't sound right. It sometimes takes a couple of minutes to it explain that in and those three but these networks have been great about giving me some time to to explain it thinking behind at which they are narrowly. Wouldn't. Do that's great now, let's talk about treatments that are being considered, we know that z, packs or one of em and clearer queen can explain.

And what went horribly wrong with the couple that took the wrong kind of clerk when and turned out to be coy pon, cleaner, Ok, so let me let me put Gimme the framework for that some sense. When you talk about all the interventions, you have things gonna be ready down the line. Things are going to be ready, a little closer and things ready now so now and then we can. Talk about what I a and then get. Let me give you the framework to answer your clerk on question, so the highest bar. There is in terms of financial, Investment required in time to show saved he's a vaccine. So that's what What were doing another we are doing next You're down, that's gonna, be in a year, eighteen months away, according to doktor found, she could be lost within that next, here down, are what we call small molecule drugs new drugs that and discovered before it still takes a while, maybe

that is higher bars vaccine in terms of time. The next year down is re. Purpose sing existing medicines that we already know our relatively safe. And then showing that those drugs also work against the corona and that's gonna, be the clerk we category and I'll get to your question and then the nearest ones, the one that we can do now is what's called this com. The lesson and a body therapy I've been pushing very hard on, because I think we actually have a growing that right now so less the let's do it the clerk when Hydroxyl clerk, when this is that's one of the repast ones, That's not the lowest hanging fruit at the next lower saying fruit. This is a medicine as used for malaria its Et I malarial drug spin around for a decade. In fact, the World Health Organization was gonna head nineteen Sixty proposed an elimination strategy for malaria to treat everyone

with Clark when until we have or resistance in that derail that, but it than in some parts of the world still works as an and high malarial drug is also used as an answer inflammatory drug for the treat children of low base and other autoimmune diseases it you can make a bucket of it. It's cheap We know the safety profile we know can cause arrhythmia sensation, some patient other toxicities, but is generally as a pretty good profile We know that the drunken block the replication of the virus in the test to so in habits the virus. The in what we call in vitro in the test tube. Second, we know this drug reduces inflammation and that's nice, because one of the things you get with Covid nineteen Pneumonia is not only get the virus infection in the lawn. You got a lot of inflammation, so checks a couple of boxes in terms of why it's attractive to look at it, and then the Chinese did a small study.

And then a colleague of mine is a fascinating guy. I really appreciate his work as a scientist, vizir, very serious scientists in more say in France, did he rolled and he's the published at least two or three dozen papers in the journal that I found a call back neglected tropical diseases. Serious scientists works on all sorts of interests, either bacteria that kind of thing take borne diseases, small study showing that it worked uncovered patience and what he did He combined hydroxide clerk when, with the Z pack, the term mice and drug and found found that there is in effect, promise was a very tiny study and so people put those three. Together and all of a sudden. So we ve got the miracle cure I'm not sure that's gonna turn out to be the case, and we really need to do large studies to show that it really works and the reason I'm here looking back is,

in a nothing to do with a doctor, professor, always in a really important scientists. But it's a small study. We were there about a day, care to go with influenza that this hydroxyl claw when also inhibited. The influenza virus in the test tube. But then it didn't pan out and come in larger clinical studies. So I think have to be really careful and don't be too quick to to say ok, this is this is gonna, be a when we're not even close. Today Apple will know in the next few because we're really working hard to scale up local trials. Looking at that medicine now and in terms of vaccine away, but there is there isn't. There is a new theirs The new, though that we can do right now broke out that the talking so. This is something called convalescent, antibody therapy and it was, and it was- has been known for over a hundred years ago.

Was really scaled up during the nineteen eighteen influenza pandemic, inner that terrible pandemic DEC. Hundred tens of millions of people, It was shown that if you took individuals had one who had recovered from the disease who got infected, they survived that animal It is in their blood you could remove their blood in some cases, give them back. The red cells and take the plasma component and used as a therapy to treat patients- And in fact, during the two thousand and three Sars epidemic, the first ourselves one. There has been enough A study showing that worked. It actually could treat patients for it especially if you gave an early out in the course of the infection. If you waited too long, then didn't have nearly the same benefits we gave. It are only on the course of infection, prevent more serious infection, affectionate and even death, because you are, giving back antibodies the animal

This will last for ever, but enough to help you survive the infection. So a good friend and colleague, go no further time, Arturo accosted devolves a brilliant prefer for Microbiology Biology, Johns Hopkins, you know I started talking to me about in a Peter. Maybe we should be doing this for a covert nineteen and- and as the numbers started going up. I said I called him. I said: look our term going on. Is CNN tomorrow. Think this is an opportunity to tell people about this. I need your help. FI, what he was doing, he had written a paper with it, the colleague from Johns Hopkins, at least temporarily profile. I was getting always mangle her name preposterous at Albert Einstein, I item about this and that really got things moving along. So I've been trying to use my voice on.

Being on CNN Fox NEWS, is that not just to hear myself tat, but actually Ray specific issues to get people to care about about certain things, and I am pleased that, for this moreover, syndicate. I think and help to mobilise some action in now return as colleagues are doing together with the FDA said, there's a branch of the Food and Drug Administration see by the centre for Biologics Evaluation research, which is, as you may know, you may hear a lot of bad things the FDA? I think their fears, amazing myself, but Seeber, something very special. All these broke and scientists who deal with action Biologic thereof borders. It I've been talking with Peter Marks Doctor the marxist ahead of Seeber, and he teamed up with, with our turn, to get this network together, going away when twenty academic health centres, so that there could fine patients who recovered taking our blood, giving them back there. It says, collecting the plasma so that, when peace we'll come in sick. They can give

treatment and know how some clinical trial results. I hope in the next few weeks by really optimistic about that one for for saving lives, the other, our tourist talk to me about. Is I could use a smaller doses to give the Anna body to healthcare workers enter first responders, apprehensive, I'm getting sick you're. Here I mean I don't know the percentage First Responders York and that's why they turned the empire. State linked a siren last night in in two John are all of the all of them, first responders got sick. We notice was gonna happen. Maybe this this could help them so that's gonna, be really important is well now. The french government, in article this morning that they ve sanction clerk when as an official treatment and that their there having some good results. With that, our people currently using that in the United States or doctors prescribing that would see. This is just a lot of was called off label use, meaning that is not an improved indication but they're going ahead and use it

and you know I just I think- to an end- it maybe it'll turn out to be a good treatment, but the air hence, is, is not strong. The there's a study in Shanghai that suggested it didn't work. So we really need well controls trial, We really need to pin down the dose, because maybe it's a dosing they, maybe if you give too high or too low a dose, is not going to work, how you pair it with the zithromax. So it's going to take a at a time to work out- and this is the frustration that people have you're using my god. We have this terrible a pandemic. Now we need to get these new thing Peace and vaccines are very quickly. It's the hardest thing to do is the hardest thing to do is to accelerate new technologies for a new virus pathogen that we ve never seen before, while the apple make is raging while the pandemic is raging its weak? if we don't have a lot of track record doing this, we did it once

with Ebola. If you remember in twenty fourteen there was a terribly ball epidemic in West Africa affected. Thirty, three thousand, people. Eleven thousand people died That was in guinea, liberian Sierra Leone, and there were some initial vaccine trial started by american company that look pretty missing their licence. The technology from the Canadians, description, Manitoba, a public health Canada and look promising. But as the browse, got under way what happened with the recent international response to put in the health system because it turns The ball is not very transmissible. You just have to have some healthcare info. Structure, make certain that you're not doing Golly handling the the corpse of someone who has recently died, I'm from Ebola virus infection and the we even send in the hundred and first airborne vision we said in the scream eagles, which made a big impact on health, two

set. You know save West Africa from this infections of the W H out came in, there was UNICEF, there was doctors, borders. Lots, I'm sorry! I'm these Raley Army came in israeli defense. Defence force came in a lotta groups, came in to help West Africa so the vaccine never really got fully tested, but then five years later, when there was a terrible Epidemic Democratic Republic of Congo. That's when vaccine really came into widespread use in its probably one of the most important public health stories, never told It was under conditions of terrible conflict and war and political strife and civil, a civil war actually, the two hundred thousand people with this vaccine and largely help eliminate Ebola from Democratic Republic of Congo in that in that, during those hostilities less last year in

essentially saved. I think it's helped to stabilize the whole african continent such an amazing story and against this multi lateral effort that involve also U S. Government dna agent border and all of these organizations extraordinary story, As a result. We really said stabilizer Sub Saharan Africa, but the look at the timeframe, twenty fourteen first epidemic, the twenty nineteen, that's fine five years. That's a more realistic timeframe for him. Exchanges just to give people a sense of perspective, Peter one of the things that I was reading about who on is there was an NPR article. Recently there was talking about people testing positive after they had tested negative, where they attested negative and then a time period. Had gone by, and then they tested positive again are, we learning

if we were learning about this is a new virus, but is it? Is it possible that this is something you can read catch in a short period of time within a few months? Or do you think that these People had false negatives we don't know? I think there's a high likelihood that getting re infected once they develop antibodies Bobby, but we don't know for sure the problem with respiratory virus stick is is this we have now and we are, and that turns out, even before those three big pandemic, on a virus I was talking about, we ve known, Our current viruses is for even longer than that, because kids get alot of upper respiratory infections, with these other I've of current viruses that rip rarely cause serious illness deepen the lungs and the testing of for those viruses is a mess because number one. You are often not actually call during the virus. You're doing it's called pcr to look for the genome of the virus, and you don't if the viruses really there just bits in fragments of decision.

I'd virus that are testing pause four pcr all these are results like kids, with no Symptoms at all, art are testing, positive and then kids with symptom, there has been positive and negative, and it turns out Ignoring respiratory virus pathogens is not easy to takes a lot of time to do the quality, control and really figure out all the testing in the game. Foundation has a a very significant respiratory virus pathogens programme, which been looking into this for a few years now, and not necessarily for corona virus, prefer other rare, The toy viruses is very and every other respiratory pathogens. It's not a straightforward to diagnose respiratory infection says it is as it is: save for things that are in the blood because lotteries, respiratory viruses never get actually blood borne, so you're sampling

you guess from the nose earth or the orphan eared washings from the mouth of the throw just Polly inconsistency in the sampling says it's really problematic and I think that may have been partly responsible for the delays. The city steep and work it out. I get a perfect and just a longer than May. Perhaps they expected Peter is the possible silver remind to this cloud, that this is a wake up, call for people to really take serious the funding vaccines. The funding for pandemic research to make sure that we never let something like this happen again well course. We always say that. But then again we said this after Sars and two thousand three. We said it after

each one end, one in two thousand and nine. We said it after mares in two thousand twelve, but nothing's ever shut it down the green and childlike funny fourteen right. But the point is after every pandemic in everyone's has now we're gonna put some infrastructure in place, and the truth is how things are better now than they were so after Sars, two thousand three: they implement this set of international health regulations HR two thousand five I've been a lot of that was led by a friend calling my David Heymann has now at the London School of hygiene. Ethical medicine and with Chatham House in London, and he I think he was assisting director general's w each other so that they put that in place and a global how security agenda. Now we have this thing called Sapien: this coalition for epidemic preparedness innovations. There is no question, things are a little better than a better solution, surely better than they were, but is still not enough. It's stormed. We don't have the inference structure in place. We need to rapidly

he accelerate vaccines because lot of the times and an involved this because I've been one my whole life to developing vaccines for diseases, nobody s home vaccines for because you're, no financial, returnable, been doing this for palestinian disease. Actions that we spoke about last time but also we ve had this corona virus vaccine programme and the problem is the big industry. Nerves the multinational. Sometimes they get involved in this. Sometimes they don't This leaves it to you know a smaller biotechs which are mainly August, I'm accelerating their unique technologies or this handful of nonprofits like ours. It Texas, children's and Baylor College of Medicine. We collar Texas Children's centre for vaccine development. At a college of medicine and and it's a fragmented infrastructure and were always scrambling for fun? Even now we ve got to vaccines, were ready to move on worse

still spending out how many hours a day on teleconferences you know with with potential donors trying to get the sounds of clinical trials are so it's it's. It's definitely problematic, but Peter. I think we both agree. This is a very different situation than Sars or Meares or any those other things and that the entire? U S, economy, is totally shut down me if anything, is gonna, be a wake up call for industry event. If he's gonna be a wake up call for people with money, this is going to be because this is devastating for everybody knew you would think soberly, I am hopeful that things will change but but will have to salmon. So far, we have some good response in terms of our vaccine. We ve gotten can't eggs from a few individual donors somewhere in those discussions, but still been really tough to to movement, even with a crisis. This going on like this. Have we stopped you from eating fast food because of this. Because I know you had terrible diet we're joking around it well

tell you know. I have an interesting. I have actually lost about six pounds. A year is started this epidemic and I think what one is I'm stop sleeping rikers, I'm waking up doing tell it conferences with Asia, Europe in going to bed with teleconferences with days, trying to figure out how we can do our vaccine and knocked and were making a unique vaccine us a low cost one there b, is not only in the U S but but globally, and then the cause and everything else in and the one good thing is is that our stop travelling, and I realise that the Travel was really knocking crap out of the iter in terms of my health, so here we are talking about that on the show, all the different comedians that tour with all the time we're all at home now for the past month and we're gonna feel great, It's amazing what an impact it has on your, how to travel time, negative impact

the travel, really not so it sooner we ve got. Is a group of scientists really dedicated, even though the observe largely closed down at and Texas children. We got special permission to their working on the covert vaccine, so they're coming in some amazing dedicated group of scientists and then I've been basically in along teleconferences all the time I, to my wife, and I said I feel like I have to press star six just to talk to you. It's just been so crazy and then and then doing the media had some. I was going to the studio for a web and brown you from ice I abstained asserted ellipse, weird subterranean existence. Right now I mean that the Good NEWS, in other think the people I feel so terrible for those who you know now we're not getting paychecks. Because of this. I citizen and so many people suffering economic hardships right now. You know other all the people who use them

make my breakfast sandwich in the morning now I dont see them their, presumably not getting a paycheck her or all those things are the dry cleaners and all that kind of stuff. I feel so bad for them cause, I'm sure they don't have much of a safety net at all. Now, with theirs ever been a time where it's no one's fall, but half the countries out of work, at least, yeah, you know it's not like anybody did anything wrong like you could have who showed up for work. Every day worked hard plan D had done All the things that you need to do to have a successful business and the carpet gets pulled out from under yeah. I know it's just so heartbreaking, Harry somebody, heartbreaking stories, I mean the good It is, as you know, the the White House and Congress is the one thing there seem to be. Collaborating on is getting that stimulus package out there, the people who need it- and I hope I hope, there's some some funds.

For those people, but yes sire. I hope so too. What's your take on Sweden and Sweden's the way their hand willingness which is essentially they're, giving people the freedom to go to rest in bars and their share. Some things down, but there are quite a bit more open than the rest, the world and subsequently there there are experiencing a spike in cases where I mean problem again, as without a vaccine or other technologies, we have to use, go back to the fourteenth century. That's when quarantine was invented. It was when ships would come in to the harbour on Croatia and from Asia. Minor and they were fearful, they're bringing plague and they kept. The ships were forty days afterward, where the word quarantine came from an that's while we ve got right now so We know social distancing

probably only hope and and there's a few piece of evidence. For the I mean real, serious social decency narco into restaurants and think so. My colleague mark lip searches, a brilliant epidemiologist at Harvard has been Harvard has doing a lot of analyses and modelling, and one of the things he has shown is that when he looks at the cities in China, for instance, where they did social distancing, another aggressive measures, and so in the report the aggressively couldn't even do and in the United States, but they should but that the longer you alive transmission to go on before you intervene with social, distancing and other things. The way the surge in the worst, the epidemic and therefore, as me, talked about in ITALY, the worse the mortality so, for instance, and move on where he estimates of the forget, the exact numbers of these about six weeks of transmission going out before you intervene, then it was lights out, it was a massive surgeon hospital systems. Getting

overwhelmed and a lot of healthcare workers getting second I want to come back to that pointed out after we finish this as opposed to insult and shine and other play in China where you intervened after a week, then you got, You know there was the difference between having two thousand, impatience in your eyes, use across the city versus twenty that's the dramatic a different. So that's a lesson We need to learn for the. U S is We think we have an to really push hard on the social distancing and I think it's especially important in the cities, because it looks to me like what we're seeing so far in the? U S is more of an urban slash suburb. Verses royal divide, our seas. The big surges and I patients more in cities and rural areas. Other doktor far cheerfully his last night at the other night said: don't ignore the rural areas either, because we don't know- what's gonna happen there, so social

this financing is absolutely paramount and unfortunately, what's happening because things got so fucked up with the testing there. We ve now we ve sent unfortunately often found out that transmission, is going out for several weeks. Only when a lot of I see your patience started hitting the door. So this is what happened in New Orleans. What happened is primarily the try them but Lana just said you know all of a sudden. We found all of these people sharp and in the eye and the I see you so that's a nether lesson learned. We really not only doing the the diagnostic tests but the social distancing is really important and I've been on cars with the leadership of Houston, because you know you're right, it's it's! It is hurting the economy and in so many ways, but enough want to prevent Houston from locating the New Orleans experience. I've been saying to the to the mayor and everyone else in Houston. This is

fortunately well we're gonna have to do in the models are showing now pathetic. Organ institute, add in Washing Seattle, Washington, copying, stupor, help metrics an evaluation, and it they have now been looking at this debate. They do all these amazing things to look at the not only epidemic diseases but also chronic non communicable diseases, diabetes, heart disease and mental health issues, but they ve been at all. Hence our deck discovered epidemic and they just put it out on their website its health data dot org and you go to the covered eighteen sign of what their showing is, that day, anticipate the of this epidemic in the. U S. Is gonna hit, the middle of April, sir- we're not even at the peak yet Ass, it were to another. Two weeks of this is going to continue to go up against

in places like in Texas is gonna. Be delayed, is probably gonna be around around me. Second- and I thank him- before any was much around. There is well so their number. Say it's gonna be the next two months that are gonna, be the crunch time when it's gonna start real, going up and then, as we move into later and may also to go down and may be really bought him out by by June. Of course, It's a models and new virus pathogen, but what I've been saying. As you know, the president yesterday the day. Before said. Ok, I understand I said Easter now we're gonna go to April thirtieth. In my point, as well April, Thirtieth things are still gonna be picking and parts of the country less use. Thirty years. It is a time to reassess and then the decision whether we go another month, let's go a month at a time for now until we know where this setting, how long can we go? I mean if you, if, if let's take economics out of it,

What would you think if there was no concern whatsoever about economic loss and the damage to the economy? What would you recommend in terms of just from clearly just purely from medical perspective? well the problems from a medical on public health perspective. We don't really know where this virus is heading it, sir. I figured your proud? She said the virus makes the decisions we make the decision so long. Early true, because we can make weaken an intervention so hopefully, by the summer. This is not going to be a huge problem, but we don't know, and then we also don't know if this things mean back. So what did the out years? Look like? Is this? Does the even goes down this summer. Does it does it come back, again in the fall does come back, I begin early got now. She presented mountains. What's up, why would that happened? Why would a comeback? Why would a weapon

go away and then come back in the fall. Well, there's a few things that are happening one all the social distancing potentially could interrupt the transmission be useless number color reproductive number, which describes the number of people are getting. If a single individual has it. So the number right now is between two and four, depending on whose numbers you look at the ideas you bring that below one by the social distancing. There is also the question of whether their seasonality today, this fire sand. Again, the sky mark lips, it, has done some studies to show that their there seem The virus infection doesn't seem to be a severe in areas that have your temperatures and greater humidity, it's a bit of a soft call, but maybe There's gonna be some seasonality to this as well? And then- and so using the example of another seasonal virus influenza now, which p of course in the winter then goes down

in the summer months, had never really disappear, spotted it. It goes down then in the southern hemisphere, is the opposite. So in the southern hemisphere, p flew season is our summer, their winter in places like Australia and then in the tropics, it's about the same all year round, so we don't really understand seasonality. Potentially the virus. Could show start showing pattern like that and then the question Does a comeback year after year after year, like flew, does or an has show some kind of seasonality. He's all scenarios that that were being looked at such conferences are our vaccine. If it's used, Ngos should be no ghost. Draw the clinical testing hurdles, probably not going to be used for this twenty twenty epidemic. If it's used at all, it's gonna be used in the out ears. If this far starts to come back. Regular basis. Is there any their way to handle this, in terms of course,

teaching or social distancing like is there? Would there would it be possible to quarantine the people that are most risk instead of the general population? Well, well again, the price one gets to the fact that you know again there's this site. This is open older americans and people over the age of seventy diabetes, hypertension. But now we as the centre for Disease Control has been reporting. We ve had this big flocks of young adults, getting very sick and in the ice you so what point you say, pretty much everybody she's that red than among the children, even there, the children generally are children. Adolescents seem to do pretty well with virus? Now we realise, from studies coming out of China, was published in the Journal pediatrics put up by the mayor.

An academy pediatric, though about ten percent of infants, are getting very sick with this virus of infants or risk, so you start adding up. Ok, older people, are those online diabetes, hypertension and younger adults and fourteen fifteen year olds as well and we're hearing all these stories on CNN and elsewhere about you know valued colleagues, you know in their 50s and that kind of thing getting really sick or even even dying and then infants after a while it's just you can't you can't slice it that finds it becomes impossible to do it. Is it one of the things it's come up about them is people are now aware? People like myself, four aware of the number of people who die every year in the United States from the flu, which is staggering. Its lot more than ever thought before. We know like

No, the numbers like what would the veneer so dense. Seasonal flu is really bad. It sir, various year to year two different, very allowance of the flu, so it usually goes between twelve and two thousand people die every year of influenza and a majority of those by the way are not vaccinated. So even in years where there is not a good match between the flu vaccine in the flu, it could still reduce your likelihood of hospitalization. And ass. It s important message to get out the numbers here unfortunate looking worse for second. How does that? How does that work? How even if it's not matched up to this, the correct seasonal flu? How does it prevent you from being hospitalized because it is partially protective. So if you imagine virus that has all of these different pieces to it, and the end and all the antibodies, each reacting to a different piece of the virus and a perfect

all of the antibodies target the virus anew in a less than fact match only some of the other bodies, get the virus in their efforts, partially productive you know, have ever partial effect and So I say also the day is different and now the numbers of them of Americans who are dying or all over the maps. F you if you believe the number saying that there are between four and ten times the nuts The Americans and ass forget about her, for Ten times covered Sars to virus Cove and nineteen is for ten times more lethal, then regular, flew. So that I'll. Give you the bracket so that the minimum twelve thousand from flew the minimum that and die from carbon but he around fifty thousand the high and times tat could be. Five hundred thousand, so there three or hearing those numbers,

from the White House press conferences, saying maybe a hundred to two hundred thousand Americans, could die. I think it's probably I like that, do for health, metrics numbers that came out. They say. Eighty four thousand Americans will die in there peak season going from April it may in June, and then We don't know what will happen again in the years to the point. As a lot of Americans, you're gonna die, I'm hoping it doesn't get his highest two hundred thousand and again the models are really looking at this led the way, those numbers that I gave you. That estimate is asserted simplest version, that there is much more so to get a, but again their models based on us She said the new virus pathogen it's hard to get, Are the assumptions right? But the point is a many more p will die of this virus than even in about Lucy, I think

people are concerned. This is kind of setting a precedent and that this is gonna, be something that we have to do in the future. Is there a way to prevent something like this a full shut down of the of the country to happen in the future where are the ways in which we know we ve got this incredible scientific infrastructure in America, read the best research universities and stood in the world, and and I work to them. Did Baylor Ecology, medicine in Texas, children's hospital in and now a few things for Texas to say an university in Bailey University is well and and rice, and so the The answer is this This is why we have and then I am sure, the budget to thirty six billion dollars annually. We need to have a pipeline of technologies getting ready for this purpose. We should have enough. We had

you know all the funding we needed for a corona virus vaccine programme. We would have had several corner my respect, scenes and clinic trials and potentially we could have combined them in a way to be ready to go now. So, having figuring out a way to support. Organizations that all our there are looking at vaccines. Another countermeasures mountain terms, a promise they can sell that are going to help the it up. The health security of the country. I think it is really important. So one of the books that I wrote is called blue marble, health and finds this anew visual, and we spoke a little bit about this last time. The unusual number of illnesses from emerging infections like this one and

poverty related, neglected diseases. Actually, in the G20 countries, the G20 economies, the twenty wealthiest economies, especially the poor living in those actually caught for most of these diseases, and the problem is the G20 economies- are not stepping up to support these techniques use, we still rely too much on the. U S in the UK in the European Union, we ve got it you better with China and Brazil in some of these countries to help fund these global have taken. Apologies to get that's all we have otherwise. We gotta get back to the forties ensuring terms of social isolation. It seems the critical aspects of getting through this is having a strong immune system, what what emphasis, if any you guys putting on developing techniques or ITALY's educating people, how to strengthen their immune system and how to keep the body healthy

sir, certainly keeping the body healthiest is key right. I mean who this one of the populations that this virus is devastating are those with. I pretension and underlying heart disease, and I should were learning this virus itself now. Many causes lung disease, but heart disease as well. So we could talk about that, but you know keeping here. You know keeping yourself healthy could make the difference between life. For death, but even at a healthy individual with a new virus pathogen and you ve never seen before it takes time. The train, the immune system and then is to make the virus has already done in court will damage to your long, so no about it. Don't smoke, don't vapor drinking and moderation and keeping keeping FED, avoiding waiting hypertension than diabetes? If you can so she type two diabetes is not over

but he can do and there's some genetic predisposition is disposition to it. But if you keep your body healthy, that will definitely stacked the deck. In your favour. I was reading some about saunter use, regular sauna use and viral infections and the diminished impact of viral infections on people who regularly used Sana sauna because he chalk proteins aside queens where of anything that goes London's avalanche Joe, and for me this is a new one for expressing I did now as far as yourself, like joked around about the the fast food stuff we joked around about that last time you hear, but how You altered your approach to food because of this, diet. I have broadly because I've been so upset and so anxious to eat. Then I arrived as it's just me: I've been on teleconferences in my wife will. Actually, I we set up a little study here, inner and in our bedroom, and it's not much

but my wife will just bring me a plate of food food and I'll just you know you didn't then whatever's, but I I it's not that I. Say that trying to trying to eat a healthier diet? Be more careful? My wife, mental out, I'm trying to take care of me, but right now I've just been so upset about when I'm seeing not only with peoples offering in the hospital the people economically put out of work on and aunt em, so worried about all these health providers who are getting sick that they now I just Don't you want to eat and sleep much either I wake up in a four in the morning. You know get the numbers from the night before Aware Cove. It is heading in that I'm on teleconferences all day trend figure out how we accelerate this vaccine and now it's interesting. I've even noticed that, become a lot more emotional in my meetings and

in unknown as a pretty even tempered person ever getting upset. I've got really upset a few times. A couple of months, surprising. My colleagues and I think, what's bothering me the most is what I see happening to the nurses and the dogs in the respiratory therapists they're, just getting so hammered out of him by former students. My medical students, and I remember you know we have in medicine. Yes, nickel, match day. You know where it Fourth, your medical student. You open this envelope and figure out in you, learn where you gonna do you're you're residency, whether certain internal medicine or surgery or you're. No. Drought or or no surgery, whatever in You know a lot of the medical students would come and see me doctor. Out as where should I go to residency in, in the light of the meadow signal its great spend some time in New York. I you know I did my MD my Phd in New York, where my wife in New York, the great city grade

article centres not sign I in Colombia and Corn Alan, and why you and Einstein it's fantastic. To live in the city and I'm really. What now that I send em into no they're with no but inadequate protective equipment. Scared as hell getting getting sick or worsen and being overwhelmed by patients, I think I said on Africa was seen anyone MSNBC whenever, as I felt like, I sent them to hell. He known feeling a lotta guilt for being so enthusiastic about having them go to the hospitals in New York course? You can never know what what was gonna happen, but that's been bothering me is as well as a sound This is a very emotional time for me. The lack of sleep also has a big impact on the the immune system set pyramids.

This is no doubt about it. Now with you. Is it simply just because of anxiety? Is it a lack of time to sleep properly and have you looked into any sort of meditative practices or anything that can com the mind and allow you too, perhaps get a little bit more sleep, which would significantly probably improve your immune system yeah, no question. Well, I've looked in twelve one of the region, is a practical matter, because I've been doing evening, tv interviews in and their great opportunities because they reach such large audiences. I mean I've been on everything Chris Haze, the Tucker across into Hannity. In now, how many we'll do that right now: a guide to the extremes on the political spectrum, but it's been a great opportunity, but I deliberately try to be an all those networks. The southern don't give a shit about the politics this I see, no saving people's lives, never really be avoid. So I'm gonna lose that opportunity, but then I'm getting up

early in the morning either for teleconferences arena do see in a new day our american newsroom, with Dino Sandra Smith and and at Henry in those guys are amazing, operate well I'll, never get it too knows ever get a chance to talk to them. Country like that, although I do a little bit with Ebola, then with was good so and then talk about our vaccine and this also really import for Americans do here. Scientists, because working scientists tend to be invisible in this country, and I have a paper that just put out in the past. The library, science and plus biology about how the fact scientists are invisible and enabling for anti science movements to rise, and I think our Bible in part of our scientific profession that were, quite so here I have the chance of trade the advantage of that. But then a metallic conference after teleconference all day You know what I'm trying to get this vaccine

moving, so he came and take a nap sometimes in, and so a catches catches up to you. So the I've got it I sought to figure that went out, but it's it's something you're gone, straining oh yeah, when one thinks he brought up that I wanted to discuss. Is the damage this virus does to the lungs and two to the heart is well what? Then? scarring on people's hearts lungs did to talk about that and what, if anything, can be done to try to heal those people post infection? Well, so what happened? is in the virus, gains entry into the. Passages of the lungs, the the all the airway spaces and then at hand. If you ever see a cartoon, a scam drawing up our corona virus. It looks like it. Little ball with spikes sticking out of it and those spikes are called the S protein and actually the vaccine that we're making interferes

with the binding of a part of that as protein called the receptor binding no made for binding into the receptor. So at you, since those spikes, the of the spikes again entry to bind the recent, girls and in the long, which is actually an enzyme called the pseudo colonists, recently gets into the lung cells. So the first thing that happens is a large amount of virus is getting into the lungs and a triggers. What's called the innate immune system, meaning your natural first line body of defence and its signals. Something called a toll like receptors, which cause a lot of inflammation and so your sing, a big inflammatory response to that to the virus of the two components louder virus causing direct damage and then the host, all the laboratory response, and that's one of the reasons why you know when I heard about Hydroxyl clerk and a handsome enthusiasm, because it can maybe suppress the inflammatory component, whether it clinically has

the ability to make a difference. I I think the jury is still out yet, but so you ve got those two things going on the other thing that's happening beside and that's causing severe lung disease and there's all that inflammation and causes a condition known as a r d: ass, acute respiratory. Stress syndrome, where there's so much formation and scarring that it becomes called the oxygenate belongs, and people go into shock because it say ideas, syndromes and asked why a lot of people are dying. The other thing that happens, though, and we don't really understand the mechanism, is but the latter reports, and by what you can anybody download this there's this fantastic pre, Prince server called Bio Archive and met Archive its foot by culture Harbour laboratories and I check it every morning is called be: io are ex ivy and men.

I've. His d are excise these, but of course, being our beloved. So scientists have been great about sharing information that putting all their stuff up on these preferences. Is there no peer reviewed yet, but just that we get information into the hands of the scientists, nay, but he could look at them, but one of the things were seeing what that is a lot of hard injury. Whether people are having heart attacks, because there, and debated in the ice you and under stress and encourage shocks. Are there not refusing the heart roar and we No, that the old Sars virus, Sars one had the ability to go into the heart tissue and cause. Let's go Meyer Cardenas actual infection of a heart, so it's really the heart and lungs said that are getting down. There is also some evidence that the virus can go into detestable track. Well so that could actually be a potential route of transmission.

Fecal oral transmissions, whilst this is why people are getting so hammered. Is this direct damage from the virus and the inflammatory component to the alone is there the understanding of what, if anything, can be done to try to heal these people post infection, particularly like damage to lungs, yeah I think you know there are this: a question of other steer rights actually help or hurt. Steroids are always a mixed bag because their rights, can suppress inflammation help the inflammatory component They also suppressed, you mean response to the virus, so you can have an Greece number of virus particles potentially be so people are definitely looking into steroids, other. I am time, inflammatory drugs, but you know those who survive this. Unfortunately, most do I find that the Napolitano, They ve been hacking coughing for

long time afterwards and a lot of that is- and we see this flu is well another. Viral pneumonia. Is it's not because they're still infected with the virus and saw that scarring is, is the body a long time to remodel all the scar tissue and before the coughing stop, so we can anticipate that happening as well. What do you think it's possible to fully recover from this for people to do experiences, long scarring issues I think so, especially for younger people for older people. You know they may have some permanent plummeted. Deficits, but we don't know it still too early in this. Sir, in this epidemic. To know, is that a big boy, what's going on, is that it's just really too early. For so many of these things, the treatments that did dealing with the immune system is funny. I, which bore genetically more predisposed to have just by time and typically

You can take years and years to figure all of the sun and were in everybody's working overtime, trying to fit trying to make it contribution, figure figure this out at the Great news is the Data sharing among scientists has just been been amazing, everyone's you're, putting us either Rico, putting all their stuff. Up on Bio Archive men Archive and and and the major journals are doing: credible things also expediting publication, hey pursuing other the flagship journalist like New England Journal, a medicine lancet JAMA there, all putting that stuff out, there's faster, there can be no as ensuring quality and in the level of peer review. Our plus family journals public libraries sign so soon enough. You, if you look at the good stories that are happening around this. Definitely the data sharing the the journals not conducting

business as usual, recognising that there the stuff that their public could be life saving in responding to a public. Health crisis. I think that that's a nice part of the story, I'm hoping so much of what comes out of this- is a wake up call. So much of the new found understanding and appreciation for the science behind dealing with these diseases, appreciation of health care workers and first responders mean, if there's any bright lining. This. That's what I'm really hoping for that people. Wake up and recognise the good work that people like you have been doing and also in other. This is where we live in strange times, and these things can happen again and we need to be prepared. We need to put a lot of emphasis and effort and thought to that as a whole. As a whole society right. That's right! Thank you know. Maybe this will help us reassess some of our values and and do, you know appreciate that some of the sum of the thing was that the health care provision

is especially are doing in you know you're, seeing people volunteer, he noted glare guy right right into the belly of the beast. Your people in our who might have sub specialty practices, do something I I'm gonna put on my and ninety five mask my p p and I've been in helping. That's really. Why has there been such a shortage of masks and safety equipment for healthcare workers, and, how did this ever happen? We just we didn't get for the surge in time. I think in our thinking I sort of holding try and throw stones at this this agency, or this person or this group, because I don't really know what happened. I think is going to be really important that Congress, after this and conducted vested Geisha now from the standpoint of prosecuting people or

calling them out, but just say hey what the hell is wrong here and How do we avoid this? Again? I mean the problems with the testing in not having all the protect of equipment now we're getting geared up in mobilizing industry. But what could we have done better, especially in that way, the period when things were collapsing in one and the other cities in central China? When we know this was going to be bad and we knew this could become. One of them a pandemic threats in a wide carbon we have better use those. Six weeks, where'd you get ready in and what did we do and and and now is not the time to do it? as the last thing you want to do a start, distracting people and worrying about you know congressional hearings and and and that sort of thing when all is said and done, it has to be done Have we done the right spirit? Not again, we have to figure out a way to stop

he's partisan lines to say- and I was as a country we ve Gotta- figure out you to worked guy? Another sounds pollyanna, but you know when I was in and out before I move detection. A decade ago I was chair, Microbiology George Washington, university for ten years, in which I worked with Congress allowed to get legislation passed around neglected trial a call diseases that are different Washington, then I mean I would go out SAM Brown backs prayer, Breakfast Sambre next, governor cans, before he centre from can't Kansas, very conservative, Publican Senator walk the hall and go talk to centre delay. He's people from reminders are shared browns people and young too far far to the left, and nobody thought a twice about that. You know we all knew the other girls as to how to work together? And it's just not happening any more and in its tearing apart our countries. I hope the other thing that we get

out of this is figuring out awaiting that republic and start in the Democrats again and Democrats talk to reply lichens again, and figure that out as well. Well Peter I sure you time and I know you're incredibly busy- is there anything else that you need to say you think should be said about this before we wrap this up, we title you know, I can't tell you how important it is to you your voice to amplify a straightforward discussion about about this epidemic? I think you know year and just doing that you're making a huge contribution, because you have incredible bandwidth and and strawberry audience, When I last, I can't tell you at last time I did did talked about Europe I was on your shouting at last year around this time. Actually you know response. I got about neglected diseases of poverty in the. U S and vaccines, and you have so much is

such a powerful, show and powerful guy in being able to use this time to talk curve. It is nineteen and in what Sars is and why and we deal a pandemic threats. It's it's actually huge. Some very grateful for the opportunity to mobilise were very, very grateful for your Peter and let's talk again in person doing better times absolutely thank Sir take care and be safe out there. All the rest of us are, but by thanks, folks for tuna into the show, and thank you to legal, zoom, gotta legal zoom, dot com right now to get started on the last will a living and more or find out how you can speak to an attorney for advice on the right estate plan, legal zoom, where life meets legal. Thank you also to square space, the host of

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