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This Podcast Will Kill You

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Apr 20, 2020 • 1h 10min

COVID-19 Chapter 9: Economics

Episode 9 of our Anatomy of a Pandemic is here, and this week we’re stepping outside our public health sphere to examine COVID-19 from an entirely different perspective, that of an economist. Pandemics don’t happen in a vacuum, and the ripples of their impact extend far beyond those of public health, as nearly every person can attest to today. We’ve seen headlines about a global recession and high rates of unemployment, but what do those things actually mean? Have we seen something like this before or is this uncharted territory? And most importantly, what can we expect? We were curious to know the answers to these questions but we lack the expertise to take them on ourselves, so we asked economist Martha Gimbel, Manager of Economic Research at Schmidt Futures to join us on this episode about the economic impacts of COVID-19 (interview recorded April 14, 2020). A caveat: this episode focuses mostly on the economic impact of the pandemic in the US. As per usual, we wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below: What are some of the indicators that we use to know how the economy is performing, and what were the trends we were seeing in the months before this pandemic hit? Could you take us through a timeline of the economic impact, starting with the first signs that the pandemic was having an impact on the global economy? What industries felt the pandemic first, and where do we stand now? Could you break down the impact that we’re seeing on the global economy, the US economy, large corporations, small businesses, and the average consumer? Was there a global recession after the 1918 influenza pandemic? If not, what makes these current circumstances unique? Which countries or industries are the most vulnerable and why? Are certain countries or industries proving to be more resilient in the face of this global recession? Can you talk about the gig economy here and how our reliance on low-paid workers with no protection from their employers has impacted our own economic resilience? Can you talk about the implications of the numbers of unemployment insurance filings that we’re seeing and just how staggering they are? Are the current benefits offered through the unemployment system going to be enough to keep people at home and not seeking work in situations that put them at higher risks of exposure? Are there any general trends or predictions in terms of how long this recession will continue and what it will take to recover? How will we know when we have “recovered”? Are you seeing any innovative solutions that people are proposing or starting to implement in terms of a social safety net? What positive changes do you hope this pandemic will bring about? Where is the money for the stimulus checks coming from? Is that $1200 check going to be enough to keep people going for the next few months? Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Apr 14, 2020 • 1h 28min

Ep 48 Botulism: Why are you the way you are?

You don’t look surprised to see this in your podcast feed - or is that just the botox? This week we’re taking a tour of the wonderful world of Clostridium botulinum and the toxin it produces, at once both poison and prescription. First, we delve into how botulinum toxin acts to paralyze your muscles and under what circumstances you might encounter it. Then we iron out the wrinkles of the why of botulinum toxin, an answer that involves migratory birds, maggots, and marshes. The story continues with blood sausages, an unfortunate funeral party, and a massive shift from toxin to treatment as the therapeutic potential of botulinum toxin is explored. And the best part of this episode? Georgia. Hardstark. You’ve heard the always amazing, ever hilarious, and one of our personal heroes Georgia Hardstark on My Favorite Murder, but now listen to her share her firsthand experience with getting botox facial injections. This episode ranks among our top favorites we've ever recorded, and we hope you love it as much as we do! Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Apr 9, 2020 • 59min

COVID-19 Chapter 8: Disparities

In the eighth episode in our Anatomy of a Pandemic series focusing on COVID-19, we discuss how this pandemic will likely lead to a disproportionate impact on the most vulnerable populations around the globe. “Wash your hands.” “Stay at home.” “Practice physical distancing.” These are the public health messages for how to slow this pandemic. But what happens when you can’t wash your hands because you lack clean water or soap? Or if you can’t stay at home because you’re fleeing a war zone? Dr. Jonathan Whittall, Director of Analysis at Medicines Sans Frontières (aka Doctors Without Borders) joins us to talk about the challenges faced by the most vulnerable populations during this crisis and how MSF is working to overcome those challenges while bracing for the pandemic’s impact (interview recorded April 3, 2020). We wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below: What kind of projects are you currently working on? Can you talk about what you're seeing in terms of the differences between this COVID-19 pandemic and other public health emergency situations, such as cholera outbreaks in refugee camps or Ebola epidemics? What are some lessons that you think hospitals in other regions can learn from physicians or logistical coordinators that have worked in these situations previously? You wrote a great opinion piece about some of the challenges faced by the most vulnerable populations in trying to prevent infection with the virus that causes COVID-19. Can you talk a bit about those challenges and what the most vulnerable populations are? What are some of the ways that MSF has been trying to overcome those challenges?  What have we seen so far in terms of the impact of COVID-19 on these vulnerable populations? MSF has recently expanded their efforts throughout Europe - can you talk about what that expansion looks like and how different groups or activities are prioritized? As a part of a group that works internationally, can you talk about some of the challenges in coordinating this work internationally and why it's so crucial to communicate across borders? There's been a lot of discussion about how this pandemic may change the way we handle public health at national and, especially, international scales. What are some of the changes you hope to see?  Follow Dr. Jonathan Whittall (@offyourrecord) or check out the MSF-Analysis website (http://msf-analysis.org/). And read his fantastic article here: https://gulfnews.com/opinion/op-eds/bracing-for-impact-of-the-coronavirus-1.70570512 Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Apr 6, 2020 • 1h 1min

COVID-19 Chapter 7: Spillover

Coming at ya with our seventh episode in our Anatomy of a Pandemic series on the ongoing COVID-19 situation. So far in the series, we’ve discussed aspects of the virus’s biology, clinical disease, epidemiology, and control efforts. We’ve briefly touched on aspects of the virus’s ecology, including its origins, but we wanted to take a step back and ask, “how do spillover events happen and how do we stop them?” To answer those questions (and many more), we brought on Dr. Jonna Mazet, Professor of Epidemiology and Disease Ecology at the UC Davis School of Veterinary Medicine and Executive Director of the UC Davis One Health Institute, who has spent much of her professional life on the hunt for emerging pathogens (interview recorded April 2, 2020). We pick Dr. Mazet’s brain on how we look for and identify pathogens of possible public health concern, what work disease ecologists are currently doing on SARS-CoV-2, and what we can expect to see in terms of future spillover events. We wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below: Can you take us through a step-by-step of how surveillance of novel pathogens is done? From the logistics of international coordination to the sampling to the reporting - what does that look like? What happens when you do identify a potential spillover event? Can you talk about how you decide what a hotspot is? What makes a hotspot a hotspot basically? We've talked a lot on this podcast about spillover events, and obviously they can happen in many different ways, but can you give us a general overview of how one occurs? What are some patterns we see with all spillover events? Over the past 100, 200 years, land use change has increased and the barrier between humans and wildlife has decreased - have we seen a corresponding increase in spillover events during that time? What do we know at this point about how SARS-CoV-2 spilled over into humans? I assume eventually we will get a clearer picture of how that spillover event occurred. How can we use that information in the future? Can you talk about what it means for a pathogen to "jump species"? Do viruses more easily "jump species" compared to bacteria, or is it just that we hear more about the viruses? I'd like to talk about what happens when prevention has to shift to control. What are the first steps taken for disease ecologists studying this outbreak? How is the One Health approach being used to study and slow down the current COVID-19 pandemic? What role do we see wildlife conservation playing in spillover events or preventing them? Can you talk about how there can be a conflict in wildlife conservation for the greater good when people are also just trying to feed their families? How do you determine whether something easily moves between species? Is that a genomic question or is it an experimental question?  What do you think are some of the biggest barriers or challenges in identifying these spillover events in the future? The One Health approach is such a great example of interdisciplinary collaboration. Can you talk about what some of the different fields are that work in One Health? What positive changes do you hope to see come out of this pandemic? Follow Dr. Jonna Mazet (@JonnaMazet), the PREDICT project (@PREDICTproject), and the Global Virome Project (@GlobalVirome). Or check out their websites: One Health Institute (https://ohi.vetmed.ucdavis.edu/), PREDICT (http://data.predict.global/), Global Virome Project (www.globalviromeproject.org).The firsthand account was taken from a piece by Craig Spencer, MD written for the Washington Post titled, “How long will we doctors last?” Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Mar 31, 2020 • 1h 30min

Ep 47 Schistosomiasis: A Snail's Pace

It’s back to your regularly scheduled programming this week with an episode on schistosomiasis (aka bilharzia), that scourge both ancient and modern. We kick off the episode by walking you through the amazingly complex life cycle of these blood flukes and the myriad of symptoms they and their eggs can cause, including a “check out the reproductive output on this one!” moment.  We then trace its early appearances in mummies (of course) and ancient writings, following that up with an overview of how imperialism drove the field of tropical medicine in its early days. To wrap up this wormy episode, we discuss the current, staggering numbers on schisto around the globe. Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Mar 23, 2020 • 47min

COVID-19 Chapter 6: Mental Health

Welcome to Chapter 6 of our Anatomy of a Pandemic series exploring the world of COVID-19. If you have made it this far in the series, you might be feeling a bit overwhelmed by all of the information we’re throwing your way. You’re not alone. We were feeling a bit too deep down the rabbit hole as well. So we reached out to Rosemary Walker and Peter Rosencrans, two psychology doctoral students at the University of Washington to talk to us about the mental health impacts this pandemic has had and walk us through some coping strategies (interview recorded March 20, 2020). Hang in there, everyone. To help you get a better idea of the topics covered in this episode, we have listed the questions below: You are both in Seattle, which has been impacted longer than much of the US, so, how are you? (05:55) This is a brand new situation for all of us that's affecting so much more than our physical health.So what are we seeing in terms of some of the mental health outcomes? (09:21) What are some of the challenges that you, as mental health professionals, have faced so far and that you expect to appear in the future related to COVID-19? (15:59) What are some coping strategies that we could use to deal with some of these issues? (19:15) What are some resources for people who normally see a therapist, but who cannot now because of COVID-19? (31:43) How can we as individuals be good neighbors, community members, in this stressful time while still protecting our mental health? (36:50) Do you have any specific resources that our listeners could seek out? (41:09) Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Mar 23, 2020 • 44min

COVID-19 Chapter 5: Vaccines

Chapter 5 of our Anatomy of a Pandemic series covering all things COVID-19 goes through some of the exciting developments in potential vaccines for this new virus. Starting us off is an anonymous account describing the challenges faced by someone in the US trying to get tested for COVID-19. Then we review some of the basics of vaccines - how they work, the different kinds, and some of the challenges in accelerating the vaccine development pipeline during a crisis such as this. We sought the expert knowledge of Dr. M. Elena Bottazzi (interview recorded March 17, 2020), who is part of a group that is currently working on developing a vaccine for SARS-CoV-2. She answers a number of your vaccine- and treatment-related questions and sheds some light on the prospects of vaccine development for this particular disease. We wrap up again by going through the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below: What makes this virus a good candidate for a vaccine? (11:05) Why is it more difficult these days to produce completely protective vaccines vs partially protective vaccines? (13:29) How is the vaccine that your group is working on made, what is its target and how does it work? (16:02) What is the timeline of vaccine development, testing, deployment, and how soon might we see an effective vaccine for SARS-CoV-2? (21:19) What steps of this development process can be shortened to get an 'early release' of a vaccine? (25:49) It seems we are better at developing vaccines than we are antivirals; why is this? (28:55) Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Mar 23, 2020 • 59min

COVID-19 Chapter 4: Epidemiology

The fourth installment of our Anatomy of a Pandemic series takes a look at some of the epidemiological characteristics of the COVID-19 pandemic. But first, we hear about the experience of Katie Burson, who was quarantined along with her family on the infamous Diamond Princess cruise ship in February 2020, when cases of COVID-19 were reported among guests. Then we review some of the disease ecology of the SARS-CoV-2 spillover event and walk through a timeline of the pandemic, which, we have to admit, is pretty chilling to hear. We are joined by Dr. Carlos del Rio (interview recorded March 20, 2020), who chats with us about updated estimates for the R0 of SARS-CoV-2, reasons for regional variation in case fatality rates, and what the deal is with the slow rollout of tests in the US. We wrap up again by going through the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below: Do we know what the R0 is for this virus? (27:44) Is there a risk for a second wave of infection in China or other places where the disease seems to be slowing down? (29:31) What are the stages of an epidemic curve and what does it mean to flatten that curve? (31:03) Are people who get infected able to be re-infected or are they immune? (32:45) What is the relative effect of social distancing vs herd immunity? (33:31) How can we convince people who can stay home to actually stay home? (34:40) What are the differences between populations that contribute to the differences in case fatality rate between China vs Italy vs South Korea, etc? (36:28) What might we see in terms of numbers of infections or how long the outbreak will last? What's the end game? (38:00) Should the measures that have been enacted in some parts of the US be happening even in places with fewer cases so far? (40:55) Is this virus likely to become well established and another 'seasonal' respiratory infection? (42:16) What's the deal with testing in the US? Why was rollout so slow at the beginning? (43:14) When should a person try to get tested if they suspect they're infected? (45:58) What has this outbreak taught us so far about our ability to respond to pandemics, and how can we do better moving forward? (46:36) Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Mar 23, 2020 • 54min

COVID-19 Chapter 3: Control

Welcome to the third chapter of our Anatomy of a Pandemic series, in which we cover the many aspects of the COVID-19 pandemic. In this chapter, we discuss how epidemic control can be managed from the individual, state, and national levels, as well as the importance of international collaboration to prevent the uncontrolled spread of disease. We start off with a firsthand account from Dr. Colleen Kraft, featured in COVID-19 Chapter 2, who shares the challenges she faces on a daily basis during this crisis while acting as Associate Chief Medical Officer at Emory University Hospital. Then we review some of the terms you’ve probably seen all over the news lately, such as “flattening the curve” or “social distancing”. Dr. Krutika Kuppalli (interview recorded March 18, 2020) shares with us her expertise from a global health and pandemic preparedness perspective, and she answers some of your questions relating to the steps you can take to protect yourself, your loved ones, and your community. We wrap up again by going through the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below: Now that community transmission is established in the US, what can we do to slow it down? (18:05) Do we need to enact these control measures (social distancing, etc.) everywhere, even in places currently have low case numbers? (19:51) Are travel bans effective in slowing disease spread? (21:20) How can we tell if our control measures are working? (22:52) How soon do we expect to see the effect of these control measures? (24:00) There have been a lot of comparisons with seasonal influenza. How does COVID-19 compare to seasonal influenza and why are we taking such extreme measures to reduce the spread of this disease when we don't do so for seasonal influenza? (25:22) How well prepared was the US for this epidemic? (28:25) What have we learned so far to help us stop the spread of this pandemic and prepare for future pandemics? (31:19) What are the risks as this pandemic spreads to less well-resourced areas? (33:39) Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.
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Mar 23, 2020 • 48min

COVID-19 Chapter 2: Disease

This marks the second installment in our Anatomy of a Pandemic series, in which we discuss the various aspects of the COVID-19 pandemic. In this second chapter, we explore what we currently know about the disease itself, from symptom progression to incubation period and the role that asymptomatic individuals play in the transmission of disease. Our firsthand account, told from the perspective of a respiratory therapist, illustrates the severity of this disease and the frightening, yet very real, prospect of running out of medical equipment, protective gear, and hospital beds. We then discuss what we currently know about COVID-19 from a clinical disease perspective. We are joined by Dr. Colleen Kraft (interview recorded March 19, 2020), whose voice you may recognize from our first episode on coronaviruses. She helps to break down some of the disease-related questions sent in by our listeners. We wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below: What does "respiratory droplet" transmission mean, and how is this different from something with "airborne" transmission? (15:08) What are the symptoms of COVID-19? (16:48) How long is the disease course, and how does this vary between mild vs severe symptoms? (18:45) What does "supportive care" mean in the context of caring for people who fall severely ill from COVID-19? (19:40) How much does viral load correlate with the severity of symptoms? (20:47) What is the incubation period of this disease, how long do people remain infectious, and are asymptomatic people contributing to the spread of disease? (22:22)  What are the groups that are particularly at risk for severe disease? (24:00) Why do children seem to be more resistant to this infection? What about children who are immunocompromised, are they at risk? (27:40) What is the case fatality rate, and how might we expect it to change throughout the course of this pandemic? (29:09) Are there long term complications associated with COVID-19? (31:58) Is it possible to get re-infected if you get this virus and then recover? (32:54) The full article our firsthand account came from can be found here: https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients Learn more about your ad choices. Visit megaphone.fm/adchoicesSee omnystudio.com/listener for privacy information.

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