Pandemic: How to Prevent an Outbreak

To walk, I think we'll go on low setting.

We may end up surveying both, but...

Yeah.

This site is a forgotten place.

But it should be a warning to us all.

We'll identify the anomalies and mark those out.

So you're trying to narrow the focus of the radar pulse, is that it?

Yeah, we're looking for a change in the density of the soil.

There are some anomalies sort of popping up.

This is a pretty strong one here, there's one there.

At one meter in and then over at three.

Each stake represents a probable body.

This is essentially a mass grave.

A hundred years ago, a deadly influenza virus

infected hundreds of millions of people around the world.

It overwhelmed hospitals.

It overwhelmed mortuaries.

So towns all over the world needed a quick solution.

We could be standing in any number of towns

across the US, or Kenya, India, Vietnam.

This grave site is a reminder of the devastation

a flu pandemic can wreak.

This kind of carnage is not relegated to history.

When we talk about another flu pandemic happening,

it's not a matter of if, but when.

- Take the stethoscope, and... - Yes, ensure that the gown covers.

We have received reports of an outbreak of respiratory illness.

Make sure you have a good seal.

Give me a thumbs up once you know you have a good seal.

About eight other countries around the world

are also reporting similar outbreaks.

I can't breathe.

Unofficial case count is about over 220 with eight deaths.

We don't know what the case definition looks like

and we don't know the laboratory analysis of this particular outbreak.

We know that we are dealing with something novel,

we just don't know exactly what we're dealing with,

but some of the patients are not testing positive

for these normal seasonal flu viruses.

I don't feel okay.

Currently, the Emergency Department at Kings County Hospital

is operating at 104%

and so we have set up a mobile satellite emergency department.

What's going on?

- I'm not doing well. I can't breathe. - Okay. Okay.

I need intubation equipment. There's no intubation equipment.

Somebody get the ice. Ashley.

I wouldn't turn it off at this point, I don't think we have time.

Can you check the X-ray on bed one?

Yeah, that's it.

The simulation is ended.

Let's go back to the debriefing room.

- Thank you. - Thank you.

So all who participated, please come to make a circle.

I think one of the things that we tried to bake into the simulation

was just healthcare worker safety.

I think that was one of the biggest takeaways in the previous outbreaks.

If I have to take the time out to switch my gown

and someone needs to be intubated,

I'm gonna pick their life over switching out my garment.

We're talking about a severe respiratory disease.

Really big lesson learned, and we mentioned this over and over,

is that healthcare workers were disproportionally affected

in MERS and SARS,

and it shows us where we need to improve on.

So if you're not protected, if you can't protect yourself,

then how are you gonna help others?

My job is to contain the virus here in New York City.

What worries me is that it just takes one person to start an outbreak.

We're basically human incubators,

we can host a number of different diseases.

It's just a matter of time where the next pandemic is going to start,

we just don't know where or how, but we know it will.

I remember, at a very young age, watching a movie called Outbreak,

and in this movie you had a novel virus

that started in California that quickly spread.

Healthcare workers get suited up, and I was like, "Oh, my God,

working in that high-risk environment, this is amazing."

That was a formative moment for me, and I have been pursuing a career

in infectious disease preparedness ever since.

In even a small outbreak, you have what we call "hoarding."

We saw this in the H1N1 outbreak

where vaccines were not made available in the United States

in a timely fashion because countries were hoarding it...

You know, these infectious disease outbreaks

are scarier and more deadly than conventional warfare.

So this is something that people should pay attention to,

but they forget in their day-to-day lives.

My job is to remind them.

Hello.

Okay. Knocked out, okay.

Okay, I'll be there in a second. Okay.

Yeah, I can hear it, too.

I wake up in this building. I eat in this building.

I put my pajamas on in this building and I sleep in this building.

How did I know you'd be the one to make my night?

I'm telling you.

Juanita.

When I came out of medical school...

in the back of my mind I still had that vision

of what it was to be a small-town doctor.

Very old-school, the one doctor in town.

I want you to hold your breath.

Big deep breath in and hold it.

They saw patients in the clinic,

they were the ones that were rotating through the ER.

They were the ones seeing the patients in the hospital

and delivering babies.

I wanted to be that guy.

I wanted to be that one

who took care of the patient when they were well

and took care of the patient when they were sick.

- Stick it out and say, "Ah." - Ah.

And took care of the patient when they were hurt

and ran into the patient in different social situations

outside of the hospital or clinic.

You okay?

- I need to see what's under there. - Yeah.

I had other physicians that talked to me

and I'd say, "What advice do you have for me?"

And they'd say, "Reconsider."

But nobody could dissuade me. I was gonna do it regardless.

Hi, there.

- So were you diagnosed with the flu? - Yeah.

They swabbed you?

- It was positive? - Yes.

- Do you remember if it was the A or the B? - I think it was the A.

- A, okay. - They did both of our noses.

- That was Wednesday. - You should be at the end of it,

but you're not feeling better...

Yesterday, my symptoms started getting worse.

Okay. Have you been feeling sweats, chills?

Chills. He wakes up in a sweat.

She said that you have not been feeling well at all.

That you really haven't been getting over the flu like you ought to.

Big deep breath in. Well done. Good. Do that again.

I don't have every resource that a large hospital has.

I honestly have no idea what I would do in a situation like a pandemic.

We're gonna be lower on the totem pole

in terms of getting replenishment of our resources.

Places that have higher populations

are gonna be the places that get that lifesaving medication first.

I think that we would be overwhelmed.

We wouldn't be able to manage

should a flu pandemic occur in our little county.

We have to follow the virus. Where is the virus located?

Very good.

And the virus is located in birds.

My job takes me all over the world.

My main responsibility is trying to prevent, trying to detect,

and respond, and control emerging viral threats.

There is no single, more dangerous influenza virus

circulating in this planet today than the avian flu in China right now.

60% of the people who are infected die.

Chinese and global health authorities

are watching a new strain of bird flu. It's called H7N9.

This is definitely one of the most lethal influenza viruses

that we have seen so far.

Authorities in China

are at pains to say they're on top of this potential outbreak.

At least 108 cases, 22 of those people infected died.

The recent H7N9 virus has a very high mortality rate.

That said, it remains an inefficient virus for infecting people.

So far, this virus has not yet spread beyond China,

but it could happen at any time.

- When were these birds last vaccinated? - Seven days ago.

So they had a problem with neighboring farms having outbreaks?

Yes, they did.

Some people bought sick chickens at the market.

There are almost endless variations of the influenza virus.

They're denoted by different combinations of H's and N's, such as H5N1.

The H's and N's ultimately define

the physical characteristics an influenza virus will have

and just how deadly that infection might be.

The pandemic flus and the seasonal flus are profoundly different.

A pandemic influenza will likely come from an animal

and it will be a new and novel, never-seen-before virus.

When a novel virus emerges from animals, we will not have natural immunity.

Our systems will have no means to fight the infection off,

which means it has the potential for being very deadly.

That's why there are researchers around the world

committed to developing a universal vaccine

that will be effective against any and all influenza viruses.

I don't really get stage fright anymore.

I used to do this thing where if I knew I was about to go on the stage,

my heart would start beating and I'd feel like I was gonna pass out,

but I knew for the work that I wanted to do,

I had to be an effective communicator.

If I wasn't able to communicate my science,

then it was almost like the science didn't exist.

Can you get the slides up?

That's a different slide there.

All right, good afternoon, New York.

So, yeah, I'm the co-founder, Chief Science Officer,

and the Chairman of Distributed Bio,

and this afternoon I'm gonna share with you

the story of a slow-burning revolution in biologic therapeutic discovery.

I never memorize a specific speech.

I think about the arc of the story I'm gonna tell,

and really good storytelling, those rules apply to science.