Finally sampled fruit bats and found the viruses that killed the animals and they called it hendren a virus. It hasnt killed many people, doesnt pass from human to human but it is a knock on the door. A reminder to us of where these things come from, how they emerge, why they spillover some of the fact that they are not called independent cases that are part of a pattern in the pattern reflects things we humans are doing on the planet and they get into humans and in some cases because a local outbreak which is easily controlled or comes to a end on its own and in other cases they cause widespread suffering and death. Is the coronavirus continues to affect the country we are taking a look at author programs about pandemics we have had in our archives. Up next john barry discusses his book the great influenza which discusses the 1918 influenza outbreak. Heres a portion of his book from 2004. Now you have the enemy, the enemy of course is a virus. All influenza viruses are bird viruses. Every one of them. Periodically and through history it has happened 3 to 5 times in a century, periodically and influenza virus will jump species from birds to people and it can do this because it is one of the fastest mutating of any virus in existence. Biologist referred to it and a few other viruses as a mutant swarm because they dont theres no single even a viral some cycle, there is no single virus. Like a swarm of hornets, they are all moving around an average kind of virus and one in influenza virus infects a cell, in about 6 hours that single cell ends up a meeting, or it explodes in between 100,000 and 1 million new virus particles escape from that cell and every one of them is different. Most of them are so different that they are defective, they cant infects another cell. Only one of those viruses but that is still between 1000, and 10,000 viruses from one cell are able to infect a new cell but that mutation rate allows it to jump species. In 1918, was not by any stretch the only lethal pandemic in history of influenza but they are not all lethal. We went through pandemics in 1957 and in 1968, while they killed considerably more people, the normal death toll for influenza is 36,000 people a year die of influenza. 57, 68, double in 68, 57, three or four times the normal amount of people but compared to 1918, it was like a severe epidemic season. Now, the story really begins when the virus jumps from birds to people. Nobody knows exactly for certain where that happens. Most pandemics have begun in asia but there was some overlooked epidemiological evidence that i managed to trip over that strongly suggests that this virus actually jumped species in kansas and that it moved from rural kansas, Haskell County in the Southwest Corner of the state come moved from rural kansas to what is now fort riley and fort riley had been 56,000 troops very closely packed in barracks, they were being trained to kill and as it turned out would be far more effective at killing than anyone could imagine. As i said, this was a war waged by nature against man. Is hit with full force. It took about six months for the virus once it jumped species, it wasnt immediately efficient at infecting man. It had to adapt and that took a while before it really became at home in humans, really became efficient at invading humans but about 6 months after it jumped it became very lethal and all over the world simultaneously it exploded in this lethal form. One of the first places hit by this severe form, the second wave, was during the spring, and outbreak, in camp devens, it is close now, just outside boston and i will read a letter from a physician to another physician describing what was going on. These eventss start with what appears to be an oily ordinary attack of influenza. But it rapidly develops the most vicious type of pneumonia that has ever been seen. Two hours after admission they have mahogany spots over the cheekbones, two hours later you can begin to see the cyanosis, when you start turning blue because of lack of oxygen. You see the cyanosis extending from their ears and spreading over the face until it is hard to distinguish the colored men from the white. It is only a matter that is how dark they were turning, spread rumors of black death they worst turning so dark you couldnt distinguish black from white. It is only a matter of a few hours then until death comes. It is horrible. One could stand to see one, 2 or 20 men die but to see these devils dropping like flies, averaging 100 deaths a day, pneumonia means and about all cases death. We have lost an outrageous number of nurses and doctors, it takes special trains to carry away the dead. There were no coffins and the bodies piled up something fierce. Goodbye, old pal, god be with you until we meet again. As this virus spread across the world and throughout the United States, it put extreme pressures on the political system and in fact it is a very good case study that is quite relevant, too relevant to fears about bioterrorism not to mention the possibility of another influenza outbreak and it demonstrated the political system then was not prepared to handle it. Politicians have the wrong priorities. They were so focused on the war and the irony, the unfortunate irony is this hit when we were literally only for 5 weeks away from the end of the war. Virtually every enemy country we were fighting except germany was going to stop. Germany have already started to send out feelers for peace but wilson and the entire administration were so focused they would not do anything for Public Health that might in any way jeopardize the 100 persons war effort, what wilson called ruthless brutality he wanted to infuse the american spirit with and as a result not only the federal officials but Public Health officials and mayors and governors all over the United States essentially lied. First they told people that this was only ordinary influenza. Then they told people that fear kills more people than the disease. In philadelphia Planning Issues liberty loan rally, hundreds of thousands of people were about to be in the streets, this was early in the outbreaks of the general public wasnt aware that there was a problem. Privately, one doctor was warning the Public Health commissioner that this rally would create a readymade inflammable mask. He was trying to get newspapers to prince warnings, they all refuse, the Public Health commissioner refused to pay attention. There were many other physicians saying the same thing. They held this rally again, hundreds of thousands of people, 72 hours later in philadelphia influenza absolutely exploded. To the point that not only did they run out of coffins which happened in almost every city in the United States but they actually used steam shovel to dig mass graves where they simply rolled bodies wrapped in sheets in. A priest literally drove for strong carriages down the street calling upon people to bring out their dead. Very reminiscent of the black death. The same thing was happening all over the country. Very rapidly society began to disintegrate and the reason was people very soon were getting a great disconnect, they could see their spouse was dying in 24 hours sometimes and the bodies lying there, you cant get the body out, nobody will take the body out. Down the street somebody else is dying in a few hours and in a few days, there are emergency hospitals being formed all over the place and at the same time the Public Health authorities in the mayors, the only thing you read in the newspaper is fear kills more than the disease, dont worry, you can keep yourself safe so this ridiculous reassurance they were getting was so conflicted with what they were seeing about them it destroyed their trust in all authority and ultimately society is built on trust and without it as i said it began to disintegrate. Reporter our look at pandemics continues with investigative journalist sonia shah who in 2016 talked about the spread of Infectious Diseases in the past and argued for the need to look at the social and political root causes for them. The first pandemic of color started in 1817 and started to spread into russia into industrialized cities of europe and this is exactly what is happening today with our new pathogens. We are invading Wildlife Habitats or disrupting Wildlife Habitats. Either way we are allowing animals and people to come into novel intimate kinds of contact and when that happens their microbes can jump into our bodies and become pathogenic. From bats we got ebola and a number of other viruses, size as well, candles are probably giving Us Middle East respiratory syndrome. From monkeys we most likely got the cup. From other nonhuman primates we got malaria, hiv, from birds we got influenza. This is how they are emerging as we are allowing them to amplify in our cities and crowds. That started in the Nineteenth Century, people were flocking out of the farms to come for you factory jobs in the city and there wasnt a lot of room to sprawl back then. They didnt have metros to take you to outlying areas so everyone had to live near the possibility of work so places like new york city in the Nineteenth Century had 77,000 people, this meant they were breathing on each other more, touching each other more, their waste was contaminating, their food and water, there is no sewage system in 19thcentury industrialized cities. In new york they had outhouses, there is a rule you had to empty any of that stuff out. People did what they did in the countryside, just let it sit and try to decompose but with 77,000 people per square kilometer that wouldnt happen before the waste ran into the streets, overflowed peoples wealth, contaminated groundwater. Soon as a pathogen like cholera and his an environment like that word spread through contaminated waste it just explodes so that process started in the Nineteenth Century, only reaching it speak now. Just a few years ago humankind lived in cities, that the 7 a few years ago. The majority of us will live in cities by 2030 but they are not going to be cities Like Washington dc and san francisco. They will be more like freetown and monrovia and mumbai. Ad hoc, lots of slums, poor infrastructure, chaotic but 2 billion people will live in slums, that is the prediction and so new pathogens taking advantage of this right now, this massive urban expansion in poor parts of the world in particular. Ebola is a good example of that. We have had Ebola Outbreak since the 1970s but ebola never had infected a place of more than 100,000 inhabitants before 2013. Only in 2013 when it came up in guinea, it had infected three Capital Cities with a combined population of 3 million. That is really important reason it was a huge conflagration. Arguably is ecovirus is also taking advantage of urbanization. We had seek a virus since the 1940s and even before but mostly in equatorial forest in asia and africa and it was carried by a forest mosquito and that forest mosquito mostly bit animals. It didnt bite people that much so people didnt get a lot of zika virus but now zika virus is being carried by a mosquito that specializes in living in human habitations. It can actually breed in a drop of water in a bottle. All our plastic garbage we leave around in our urban areas are perfect environment for this mosquito to breed in and they only bite humans. As soon as zika virus got into that it started to explode. It has expanded rapidly as urban areas especially in the tropics of expanded. And then we carry these things around, we disseminate them. That started in the Nineteenth Century in earnest with the steam engine where we started taking steamships across the atlantic, in the rivers and connected all those waterways by using steam engines to build canals so 1825 the ear he canal had opened just in time for colorado to come from london and paris into canada into the waterways down to new york city and into the entire interior of north america and that happened again and again and again. We do much better today with our Flight Network. We have not just a few Capital Cities with airports but hundreds of airports, tens of thousands of connections between our airports and in fact, this is a map i have in the book, you can make a map of the cities of the world connected by direct flights. If you run a simulated flu pandemic on a map like that it looks like a wave, a pebble dropped into a sea expanding outwards. You can predict where and when an epidemic will strike simply by measuring the number of direct flights between infected and noninfected cities. That is how essential our Flight Network is on the way epidemic spread today. These are the ways i talk about in the book, how modern life increases the risk of these epidemic that is driving pathogens into human populations. The other part of the book is about what we do about it. We dont take these things lying down. We have differences, political defenses, medical defenses, all kinds of things we can do to fight back, to contain these pathogens. An interesting look at what happened in 1832 in new york, we are trying to dissect that outbreak in particular. In 1832 colorado came to canada, the governor sent one of his top doctors into upstate new york to do reconnaissance to see what was happening. Is cholera going to threaten new york . He collected the data that has been mapped and the map appears in the book. It shows a clear picture of clusters of cases all along the hudson river and the erie canal and even a time series, you can see it coming down, heading straight for new york city, very clear picture and nobody in new york wanted to quarantine the rivers or those canals. The canals turned new york city into a bathwater port, the premier port of the country, turns new york into the empire state, it is a huge part of the economy. Nobody wanted to close the waterway which would have been the obvious thing to do to protect the city so doctor back said it might look like cholera is coming down the waterways and looks contagions but it is caused by miasma which is, this is a 2000yearold medical theory that diseases like cholera and other contagions are spread too stinky air, bad smell and they decided to blame those bad smells on the poor and immigrants, especially irish in 1832. This wasnt just badmouth them in the press, there were massacres of irish workers during cholera epidemics in the Nineteenth Century. So i think i am having a senior moment. Of my god excuse me, im going to my notes. Where was i. Okay, yeah, yeah, yeah. The doctors, the doctors, yes, yes. This is actually, funny that that is where my mind went because this is my favorite part of the story. They didnt want to quarantine the waterways. In fact, there were companies at the time that were distributing cholera contaminated water and making money doing that. The slum in the middle of manhattan if anyone has seen gangs of new york, that is where the worst parts of the cholera epidemic affected that because it was crowded and filthy and that had been built on what was once a pond, the only source of fresh water on manhattan for a long time. The pond had been over the course of centuries filled with garbage and the slum had been built on top of that garbage filled landfill so the ground underneath the slum was really lowlying, unstable. Groundwater was easily contaminated under this slum. All their materials sinking into groundwater. The state of new york touted a company to deliver Drinking Water to the people of new york and that company, instead of having upstream sources of water, the river that was fresh and clean and they knew would taste her, they thought that would cost too much money so they had Something Like flint michigan, decided not to tap the good water, they decided instead to sink their well in the middle of that swamp and they distributed that water to one third of the people of new york and this is through repeated cholera epidemics. This is the good part, the person who maneuvered all this was aaron burr, Alexander Hamilton absent nemesis and murderer. On top of that the company that did this, the Manhattan Company, the reason they wanted to save this money was to start a bank which they did, the bank of the Manhattan Company and that bank still exists to this day. Do you know who it is . Jpmorgan chase, biggest bank in america. That is their early history. I tell that story in the book because i think we dont really look at the political and social drivers of contagions enough and i think it is an interesting turnaround from the past. We had a lot of malaria from the 1600s through the mid1900s and really got rid of it before we had solid Biomedical Solutions by changing our land use policy. We started building dams of course, we had engineers and scientists on the board of these dams to make sure we wouldnt extend the mosquito habitat. We changed housing practices, people started putting screens on windows and doors, we uplifted people out of poverty in rural areas to give them electricity, mechanization, we built it out. This is well before we had ddc or choroquine but then we started developing chemical course, penicillin, ddt and this created a whole new biomedical establishment that became very powerful and potent at curing disease very effectively. Gave over Public Health to the biomedical establishments. What happens now when we have outbreaks of contagious disease we dont look for the social and political roots. We wait for the epidemics to erupt, people get sick and we hope we can throw sufficient vaccine and drugs at it to make it go away. Im not too worried in some cases but what i say in this book is it is not sufficient for new diseases because when new pathogens come up we dont have the vaccines all made up can we dont have the drugs and yet these things can spread exponentially. Were talking about exponential growth of untreatable disease. One example of this, of not looking at the social and political roots is the dengue outbreak in florida in 2009. Dengue c