S1: Despite all efforts, the number of infections keeps rising, with nearly 3000 new cases reported in the past 24 hours. Over the weekend, a Boston student tested positive. He returned from Suhan just one day before Logan Airport started screening for the virus.
S2: This is how to. And I’m Charles Duhok. As you might be able to hear, I’m a little sick at the moment, which given the headlines right now, got me thinking about an episode we did last year called How to Survive a Pandemic.
S3: At the time that we recorded that, the threat of a pandemic was mostly hypothetical.
S1: But now across China tonight, empty streets and cities on alert.
S4: The deadly corona virus outbreak is spreading faster, raising new concerns all around the globe.
S5: Parents are now being told not to take their children to school.
S4: Sold out of masks by 10 o’clock this morning.
S3: People line standing guard to keep outsiders from coming in. The new coronavirus outbreak that began in central China is causing a lot of panic, and that’s in part because of how fast it’s spreading. The World Health Organization has declared it a global health emergency, and most experts say it looks increasingly like a pandemic.
S6: Of the almost 20000 people who are now infected, over 360 of them have died, which is pretty scary, though it’s also frightening is how panic can go viral online so easily. Hello? You hear me? Yes. This a few nights ago, I reached out to Jordan Schneider and Athina saule, some friends of friends who live in Beijing.
S7: You’re seeing these videos coming out of one of these nurses breaking down, crying, saying like the world is ending, like, we can’t do this anymore. You know, there are really scary photos of just like bodies lying in hallways and sort of medical services being completely overwhelmed.
S8: Yeah, I’d say like the virus itself does not seem to be so deadly. But the fact that the Chinese hospitals are are short on medical supplies and availabilities, that’s really scary.
S6: Jordan and Athena say Beijing is hardly recognizable right now.
S7: There is a viral video that went around, someone walking down on one of the main thoroughfares in Beijing and there were just no cars, which is pretty surreal for a national capital that has 20 million people in it. Most of the restaurants are closed. All the gyms are closed offices. People are either working from home or not going into the office or just work has been canceled.
S6: Jordan and Athena left Beijing and are actually in Malaysia at a hotel with a bunch of other Chinese citizens. But the fear and suspicion of those who might have the virus is still very present.
S7: For the past few days, we were staying at a hotel in Malaysia where every single guest was from China. Fifteen of them were from Rouhani.
S9: And the whole time, like the whole talk of the of the of the guests at this hotel was, you know, what’s up with those Walheim people?
S7: We can tell them by their accent we should stay away, not sit next to them. There was an open buffet and people were sort of worried about eating in the same places the as the one guest. So I think this is certainly something that is making people more suspicious of others.
S10: There’s a lot we still don’t know about the Corona virus, and there’s also a lot of misinformation out there. Maybe your mom keeps calling worried about you or you’ve heard that someone in your city has been infected and you’re wondering what should you do right now? What can you do to stay safe? Today, we’re going to debunk a few myths and give you some real tips to protect yourself and your family after this quick break. We’ll talk to a doctor who lived in China during the 2003 Saras outbreak and who can tell you what you need to know in order to stay safe. Don’t go anywhere.
S6: How does it start? Like, what’s the what are the early warning signs? Something’s going on.
S11: Well, in China, the early warning signs tend to be rumors, right? Because there’s not a vibrant independent press. So you hear that there’s a new disease circulating. You hear that people are dying and that’s what makes it scary. And then you have to kind of roll back and figure out, well, how is this spreading and how lethal is it really?
S6: This is Elizabeth Rosenthal, a doctor who covered the SARS outbreak in China over a decade ago for The New York Times. She’s written books about health care. And today is the editor of Kaiser Health News.
S11: You know it as a journalist. It’s it’s really wild because you’re trying to get around a country where quarantines are being imposed. And we wanted to go to the to the hospital where SA’s patients had been kept. And so you do these trips and you have to be careful.
S6: So let me ask as a as a mom. So. So as a journalist and as a doctor, you have one perspective. But you were there with your kids and your husband, right? How old were your kids when you were there?
S11: Well, at the time of SaaS, they would have been 8 and 10. OK. You know, my kids were at the international school in Beijing, and I would say probably half to two thirds of the kids families chose to to leap, though, or the whole families leave the country altogether. They left Beijing. Yeah, OK. You know, there there are various reasons why people make that choice. Right. One, you worry that what’s going to happen is what we’re seeing now, that you won’t be able to get out if you wait too long. So. Right. Better get out of Dodge while we still can. Yeah. You know, as a physician, I felt like they were in a pretty safe space that I could control. And and, you know, one of the high risk areas for transmitting disease is on airplanes. Right. Or in airports. They’re very crowded. There’s recirculated air. And we had, in fact, at our school had a mom get sick on a famous flight from Hong Kong to Beijing, where 17 people, I believe, got infected from one person who had SaaS. Oh, my God. So, you know, those enclosed spaces can be very high risk if you have a very sick person on board, which apparently was the case in that flight. But, you know, the more information comes out and the more you understand about the virus, the less scared you get. But also, I would say when there’s too much half baked information, then also fear and panic spreads. And one thing I have to say as I watch the reporting on the Corona virus, now that I’m not doing it, it bothers me a little bit. The people are called keep calling it the deadly corona virus, because by all indications, it’s not nearly as deadly as SaaS. And, you know, do we say the deadly influenza virus? Well, yes. You know, people can die from a whole lot of viruses, but we really have to keep things in perspective. And I can tell you a world where everyone walks around with masks and is paranoid about everyone else. As was the case. And when SaaS was kind of a full blown problem in Beijing is really not a fun world to live.
S6: Yeah, and remind remind me how how contagious and fatal was sors?
S11: Well, SARS killed about 10 percent of people who who were infected. OK. So pretty high mortality rate. Yeah. And it killed young people as well as old people. So that’s a little different than what we’re seeing with the coronavirus. Most of the people who’ve died in the Corona virus, I don’t think anyone’s died outside of China. Right. And most of them have been old or had other conditions, which means they’re kind of weakened anyway. We all see these photos from China of everyone wearing masks on the street. It’s really hard to get any infectious disease when you’re outdoors. It’s in these tight enclosed spaces that you have to worry.
S12: Well, it’s interesting. I mean, here in New York, I ride the subway system and I’ve noticed I’ve seen more people with masks on. Yeah, there’s almost. And I feel terrible about this. But there’s almost this suspicious response to think like, are they with your mask because they’re sick, right. Or are they suspicious of all the people around them and they’re worried that someone else is sick.
S11: So I was on a plane at really at the height of the SARS epidemic or outbreak, where it was mostly me and epidemiologists from the CDC. And we all started wearing our masks because we knew at that point, you know, planes were a high risk environment. And then the beverage cart came and we were like, OK, masks on. Now, I would say I probably would have kept it on if the guy next to me or the woman next to me was was coughing their brains out. Right.
S12: So let me ask you, what would you guys do every day, day to day that was different? What was the protections you guys put in place?
S11: You know, what was really important was what happened at the school for my kids. They said, you know, do not send your kid to school with any sickness at all. And then they would do this hand-washing thing, which they both probably. Still sing the hand-washing song so they would wash their hands many, many times a day at school. And that was really important as I was. What surprised me and I known about, you know, good sanitation, all that for years as a doctor. But during those months of SA’s no kid who stayed at that school got sick with anything, it was like a miracle. Yeah. No, no, no. Stomach bugs. No, no sniffles. I mean, because everyone was really conscious of sanitary stuff.
S12: So let me ask this for for folks who are listening, who aren’t in China, who are trying to put this risk, they’re reading in the paper every day of a coronavirus virus, trying to put the risk in perspective. And the the hallways of hospitals are jam packed and they have, you know, 45 cranes to try and build a hospital in 10 days to to take care of the sick. It’s hard to just say I’m going to trust that things are gonna be OK. How should listeners put this into context and what should they do?
S11: Can I do the. I’m a Dr. Yang, too. I’m a doctor. And you should wash your hands and not panic, because you have to understand that a lot of the reactions at the center of an outbreak have nothing to do with us here. You know, 3000 to 6000 miles away. And some of the interventions you see going on, in fact, probably many of them are just, you know, officials wanting to show that they’re doing something. You know, you you do what you can.
S13: And I think for those of us in the U.S. right now, just remember, you know, the flu is your problem, not the Corona virus in Bohun.
S2: So you don’t need to be panicked right now, particularly if you’re living here in the United States.
S14: But coming up, a scientists will tell us what to do and more importantly, what not to do if the Corona virus outbreak takes a turn for the worse.
S15: This is Dr. Tom Inglesby and I am the director of the Johns Hopkins Center for Health Security, and I work on trying to prevent respond to pandemics. What’s your favorite pandemic movie? I think the one that’s probably relatively close to what could happen is the movie Contagion.
S16: Don’t talk to anyone. Don’t touch anyone. Stay away from other people.
S5: As the Corona virus started to spread. People on social media began showing clips of the 2011 movie Contagion and streaming services began reporting a surge in the number of people watching the movie online. It’s faster than it’s mutate.
S15: It’s a great movie. I don’t agree with everything that happened, but I think that the thought through how a pandemic would appear in the world and I would move from animals to people and I would slowly appear in various places.
S6: I got the role of CDC pretty excuse me, pretty right. Or as lone. So it’s one thing for me to have a slight cough. But when you’re talking to a guy who travels the world fighting infectious diseases, coughing is not what you want to hear.
S17: We turn to Dr. Inglesby because he’s been interested in the subject for a long time.
S15: I think as a kid, I thought about epidemics and pandemics and about what kind of systems we had in place in our country. And so it’s always been a fascination mine.
S17: One of the reasons I was really interested in talking to you, it was because a couple of years ago, right before Hurricane Sandy, I remember being in the car with my wife and they were coming on the radio and they were saying, look, a hurricane’s coming in. And I turned to my wife and I was like, should we should we drive to New Jersey and just go check into a hotel? And both of us were like, no, that’s crazy, right? Like like we should clearly they would tell us if we needed to to flee New York. And it was kind of this moment I thought about a lot since then, because if something really bad does happen, like how how do I actually prepare for and survive a pandemic?
S18: Yeah, I think it’s it’s a it’s a great question. Fair question. I think some of the signs of seriousness are when health care workers get seriously ill or die from a disease. And that’s that’s something that health authorities in the United States and around the world take very seriously.
S19: It’s pretty theoretical to discuss these kinds of questions when the epicenter of a pandemic is halfway across the world. But one thing the Dr. Inglesby emphasizes that even if I hear about a pandemic spreading where I live, I shouldn’t head for the hills and I shouldn’t panic. Rather, I should shelter in place and be prepared and realize that these situations develop slowly. So there’s plenty of time to make good choices.
S18: It’s not going to be a moment where there’s no pandemic and then suddenly there’s a terrible pandemic and all is lost.
S15: I think even early on in big outbreaks, there are many moments of possible intervention and there’s gonna be a lot of isolating people and a lot of potential quarantine if they can identify individuals who were directly exposed with infectious diseases.
S20: Things mount slowly over time. It takes perhaps four days, seven days for someone to get symptoms from the person they were infected by.
S6: The next thing you can do in advance is to stock up on some basic necessities because you probably won’t need them. But it’s always smart to have supplies on hand in case of an emergency.
S15: Families should have a few days supply of water and food in their basements so that they can take care of themselves for a little while and have a plan in case you all are. Your family is. If you have older people in there moving around, have a plan and how you’re gonna communicate. The problem with pandemics again is the time course is different. You know, the pandemic that that that happened in 1918, which is long time ago with influenza that took, you know, a year and a half to move around the world.
S6: But what if the pandemic is raging in and you look out the window and you see this kid who looks sick? This happens all the time in the movies, right. You’re inside and your best friend is knocking on the door with his family. And they they want to get in. Should you barricade yourself inside and just refuse to help?
S15: I don’t think that’s a good idea. I don’t think society is going to completely break down around that and become kind of tribal to the point of families taking care of each other and, you know, fighting off others. I’m not saying that as somebody who’s very obviously very sick should be brought back into your home. What I would say is we should plan to do what we’d hope someone would do for our kids. If there were a kid out there who looked sick calling the ambulance, wearing the right kind of mask and gloves. If you can be a big mistake to not do anything, because then that person is going to go around and infect other people and then it grows and then the risk to your family is higher. So it’s in everyone’s interest to try and get sick. People cared for and not walking around infecting others. You just have to find a safe is the safest possible way to do that.
S20: And remember, the other thing is this disease sickens a third of us or half of us. And 1 percent of those people die, which would be a tragedy. Something along the line or 2 percent like 1918. The other people who recover their immune. If they’re ready, they can help people. At that point.
S10: So we should help people. And the truth is we’re gonna know how to do that because there’s gonna be lots of advice from government agencies and and public officials about what to do and who to call if someone looks sick. And society will continue. We’ll still need truck drivers to continue delivering food and cashiers to help bring things up inside grocery stores. Maybe you’ll wear a mask on your way to work. But if everything changes overnight, a pandemic is actually going to be just one in a long list of problems that we’re dealing with. But that brings up the final question. In the worst case scenario, how do we protect ourselves over time? Can we ever outrun something like the coronavirus?
S21: Pandemics are going to move around. They’re going to move around the country. They’re gonna move around the world. That’s the whole definition of a pandemic. Every year, a third of the world gets sick from influence. Unfortunately, it’s a relatively mild illness, but that goes to all the corners of the country.
S18: It doesn’t stay just in the city and then spare a rural location or a farm.
S6: What are the things that makes it hard is that when you hear about a disease like the Corona virus, there’s this impulse to do something, anything to feel like you’re actively responding and that impulse can actually be dangerous. In fact, long before this outbreak of the coronavirus, Dr. Inglesby helped organize a simulation of a global pandemic crisis for a bunch of current and former government officials to see how they would handle it. Even then, with experienced professional politicians, it did not go well.
S15: And so what that exercise did was over a series of mock National Security Council meetings. They were presented to a number of very difficult dilemmas and had to think through them together and make decisions about how they would respond.
S18: So, for example, the discovery of cases of this new virus for which we have no vaccine and which is killing people. We’ve discovered that virus in Germany and Venezuela in the story. And what is the proper response? Should the United States close travel and trade to those two countries to try and prevent the spread of disease into the country? And on the one hand, polling in past outbreaks, the United States shows that the American public strongly supports closing borders, try and prevent disease from getting in. On the other hand, we know from science and public health that closing borders never, ever has worked. And the consequence of closing a border is that you interrupt the movement of scientists and people who can try to help. And if you do take that action and then the United States gets a case, do you then risk the rest of the world saying we will now shut you out of moving your people and goods around the world? It’s a cascade. It’s like a domino effect.
S17: And what’s the right answer for the German even?
S18: I think the right answer is that we can do sensible screening at airports. We can isolate people early. We can crash on vaccine development. Although it’s still gonna take us probably years. But we shouldn’t take what we think is kind of the politically instinctively the right move without understanding the public health and science shows that’s never held before and could really hurt us.
S19: We’ve already seen this with the coronavirus in China and other countries. And so I asked Dr. Inglesby if so many of our first instincts are wrong.
S15: Then what should we be doing for people who are listening this show if they have a concern about a pandemic in the future? And what would they do and will they be able to get vaccine and medicine? I think a call to their legislators to say, hey, I’m tracking this issue. I I pay attention to this. I want you to support medicine in vaccine development and science around infectious disease to make sure we don’t deal with this. That’s a good thing. And I think, you know, people I think sometimes despair and say, what is my voice going to do in a world that’s so chaotic and your politics is so broken? I do think that relatively small numbers of people calling a legislator’s office makes a difference.
S6: Call your congressman.
S15: That’s that is one thing you can do. It’s not obviously not the only thing you should there, but it could be on your list.
S10: There’s still a lot we don’t know about the coronavirus, but I had one more question for Dr. Elisabeth Rosenthal.
S12: Like, let’s say we’re not talking about Corona virus, we’re talking about virus X and let’s say it starts in the U.S. and people are looking up this podcast. What should they do to prepare? Like what? What do you do at your home in Washington, D.C. right now?
S22: Nothing. You know, nothing. I’m I’m aware of what’s going on in the world. I read reliable news sources. And, you know, if there were an outbreak, epidemic, I would probably buy masks ahead of it. Not for this one for sure. But if it was more serious, I would have some mass on hand. I would avoid, you know, public places that were enclosed. But, you know, the world is mostly filled with health, not disease. So you can make yourself a little crazy seeing, you know, the next killer virus around the corner.
S5: So keep calm and carry on and remember to wash your hands. Thanks to Dr. Elizabeth Rosenthal and Dr. Tom Inglesby for all of their great advice. Here’s hoping that none of us will have to ever use any of it. And look for Dr. Rosenfeld’s book, An American Sickness How Health Care Became Big Business and How You Can Take It Back.
S6: Also, thank you to Jordan Schneider and Athena saule, who have a podcast named China EconTalk.
S5: And finally, if you would like to know what supplies you should have on hand in case of an emergency, go online to emergency dot CDC dot gov. Do you have a big question that you’re trying to find the answer to? If so, send us a note at how to add Slate.com and we might be able to help. How Choose executive producer is Derek John, Rachel Allen is our production assistant and Mayor Jacob is our engineer. Our theme music is by Hani’s Brown. June Thomas is the senior managing producer of Slate podcasts and Gabriel Roth is Slate’s editorial director for Audio. Special thanks to ushe soldier and Sung Park.
S23: I’m Charles Duhigg and I’m sick, but thanks for listening.