CDC Communication Lag and Future Concerns

Saw Bones is a show about medical history And nothing the hosts say should be taken as medical advice or opinion It's for fun Can't you just have fun for an hour and not try to diagnose your mystery bil We think you've earned it Just sit back, relax and enjoy a moment of distraction from Weird growth Y're worth Ss back. Hello everybody and welcome to Swbones a marital tour of Misguided medicine. I'm your co host Justin McRrooy. And I'm Syidney McRrooy. Oh, you got it right under the wire say to push that little Sydney has had this timer on our table, like every subence we've recorded for, I mean, thirteen. a long time. Yeah, it's a physical physical timer to try to keep us on track. Well, if I could see their little recording thing But I can't see it. Okay, I don't need another member of my family to go my case about my tabs. All right. There's so much stuff on the screen all the time. I do. I have it's notably kind of a nightmare. It's hard to record in here, like when you're not in here and I'm recording because things start making noise and I never know what things are making noise and I don't know what things I can close A lot of them are my experiments too. They have nothing to do with podcasting. A lot of it has to do with my life extension experiments. some of my Nanoarticle stuff, you know, I'm doing a lot of really exciting work here It's mainly through D printing. Justin, we have an update. Yes. We wanted to talk about Hantaavirus. It was such a swiftly evolving situation that Like our last episode was outdated almost as soon as we recorded it. So this one we are recording just to like timestamp it here at twelve PM This is Monday may eighteenth. Roughly twenty four hours before your we have released this episode. It's about as close as we can cut it. Yes, and still get it out there. So if there are things that we didn't mention in the last episode, there's a really good reason for that. att the time of recording, they had not happened yet. Yes. So there is the next one Now if I had mentioned them Whoa. Wha. Can you imagine? Yeah, wow. that would be limitless pill era territory. likeike you could definitely be selling that. Honestly, let's get out of the podcasting businessiz if you can pull that kind of stuff off. Justin, we're going to talk more about antiavirus because this is an evolving situation. and I think that while, as we said in the last episode It is not It is not COVID two. There is no expectation at this point that it would lead to any sort of global outbreak or that we would have uncontrolled spread of cases That doesn't mean there might not be some more cases to come, but the idea that it would reach COVID levels, there is no one expecting that or it wouldn't make sense, right? It's not logical. So that's all good news. However, as we talked about in the last episode This is kind of a trial run for the U. S in a sense, now that we have decided to disengage from The World Health Organization and kind of the global community as a whole Yeah. And since viruses don't do that, You know They don't see borders They don't don't. Th then this is a good, this is a teachable moment. Y teachable.. hopefully. I mean, it's sad that it has to come at the expense of lives, but Absolutely. At this exact moment that we're recording, there are no new fatalities. so that's great. Yeah. That's good news. The number of cases that we know about has climbed to eleven. Currently at this exact moment, that's the number we've got Everybody when we left off, the ship was about to in Tenerif and everybody was going to go home. Yes. Yes. The plan at that point in the sense that they would go to their home countriry. Yes and then their home countries would then decide what to do what to do with them. So everyone was going to be repatriated. Yes. Yes And then at that point except for some randos that just decided to kick it in some other country, right? Wasn't there some people that were just like, I don't' not going to go back to America. I'm going to go Well, I'm actually gonna go I forgget where the other area was. So as far as I know, all Americans did end up in America. There are some people, I think who are still at some of the remote. like there is still somebody at a remote island the ship stop. I paid for this vac. I paid for this cruise and I'm going to see it through the garden. Look there's no one around. There's no line for the buffet This is fantastic. Let' it. That would be my dad. It would be. Yeah I pay for it. We're not leaving. We're gonna S this through Do we get a refund we do? Well we're still gonna it's even better. We do feel strongly now that the begin I mean, well, pretty conclusively, the beginning of this outbreak was contact with rodent materials dropping saliva, whatever while the original patients, the Dutch couple were bird watching in a landfill which I didn't know was a place that you washed birds. And I think some bird watchers have sort of spoken out that this is not something that they're normally deeply into. Really I don't know. I don't I mean, like birds are everywhere, I guess. They are. Yeahah. So they're there too. I mean, I guess if you looked at all the other ones, you know. then that's where you look. And that's where you look. I don't know Well I think what would be interesting to know from from a bird birdder is that are there specific birds you expect to see I mean, I think we can maybe dig into that, but I don't think there's going to be an answer Heo I don't think there's a bird so cool I would be like Yeah, we'll go ahead and hit off human communicable Hantav virus for us. Well, that no one knew they were doing. I mean, obviously. I'm just saying we can definitely I would love to see a picture of the birds on offer there and I'm sure they've got some beautiful plumage or what have you, but I just don't think it's going to be a tit for tat where I'm going to feel great about it. It's a good it's a good lesson sort of in like risk management in general in life. Be in medicine, it kind of plays into, you know, we'd answer the weird medical question like about full body scans. like, why don't we just all get full body scans? And there's always this sort of like, well, but what would you find? and like is it necessarily and what would you do about it? And there' a reason there's always like this risk benefit. thingsings are population level I think this is an example of that in life. Like you would never have expected this Yeah. there's no way to that's true prepare or predict There are just, I mean, you do the best you can in life. You wear your seatbt and a helmet when you're riding a bike and you get your vaccines and then sometimes Ativirus happens. I mean, I feel you know what I mean? Like there's just there are some things in life we cannot control. Okay, That's fine. Yeah, for sure. one hundred percent. I'm just saying As a layman Some of us may have forgotten that we are with all of our modern conveniences, we are indeed still more And maybe we should just try to play it safe, huh? Maybe make Mbe we should try to make good choices. So there were five patients among the various people from the ship who were then repatriated. F of them were from France. They were taken to strict isolation when they arrived in France And one of them, the reason I'm telling you about the French passengers is that one of them did test positive And as of the last check I had, she was still still quite ill. We talked about the idea on the previous episode that a patient could be put on EMO ECMO is what I'm saying there. I realize I should have spelled that out extracporeal membrane oxygenation. So ECMO. and it's like an artificial, you'll see it listed as either an artificial heart machine or artificial lung machine or an artificial heart lung machine. It is an speial body machine. Yes. it's a very advanced form of life support that we usually reserve for pretty critical situations and we know specifically for Htav virus it can improve outcomes. It improves your chance of survival. So last I checked This particular patient was still in ECMO. and I mean, it's clearly critical. So you know, hopefully, hopefully She got to care soon enough. I will say Um that this patient initially reported some symptoms. according this is all, I mean, allegedly, this is all based on the news articles I've read that this patient specifically reported some symptoms to the health officials I don't know if it was still I think still on the ship and then when she docked in Tenerif, and they chalked all of her symptoms up to anxiety So Good reminder specifically female presenting patients are often Our symptoms are often under under investigated under Uh, evvaluated It's a good reminder also Man You know? Yes But hopefully hopefully she got to care soon enough. We know the faster we can get, that's what really with some of these severe diseases, your chance of survival kind of depends on where you are when you get sick because the closer you are to the most advanced life support, you know and advanance care then the the better ods of survival. So hopefully since she was in France, by the time her symptoms got really bad, thingsings will be okay. Yeah There was also a Spanish passenger quarantined in Madrid who tested positive on Tuesday at the at the last check that I read This was from the Spanish Health Ministry who posts on X Does everybody post on X now? Not everybody. I'm not on there I'm not even I'm not looking at X, but I am looking at news articles where they're citing X. It so How do I do with the hat? I mean, you know, I don't know. You got to have a I don't have to maintain a brand on X because I don't have I'm not What is it? All of Spain? Is that whose acc account is it No, it was a health ministry. It's a health ministry. They have their own excuse. I mean, probably all the American government organizations do too, but Anyway. As far as I know at this moment, that that passenger is actually doing well. It's not as in severe condition as the French passenger U off the Americans So What we know is that eighteen people arrived in the US after the ship docked in Tenorif. Now. You got to remember as we're trying to trace this, there are two different groups of people Broadly speaking They are the ones that in Ten There's the group that by then, we knew there was an outbreak. We know exactly who these individuals are, and we knew exactly where they were headed. And their whereabouts have been followed consistently. So these are sort of our known risk. And in theory, the only people they've been around and could potentially have exposed the virus exposed to the virus are each other. Because trace we we've traced the whole acing. Yeah So this group is less I mean, I'm concerned about their health and safety because they have been exposed to a potentially fatal virus. But I'm not concerned about them from a public health standpoint because we know where they are, we know who they are, and we know what we're doing about it. At least, I know what we're doing in the US. Every other country has got to do their own thing. you know, that's the way things work. g I think still if there are people who have any anxiety about this, I think the group of individuals that they're fearing, not fearing the people, but fearing what could have happened are the people who left the ship earlier. As we noted, there were people who left the boat back in April flew to Johannesburg or flew to other places and then some of whom arrived back in the U. S at home. They did not know initially that they had been exposed to anything, So why would they have been taking any precautions? So they went back to their lives And if they have people they live with, we can assume they may have exposed them. Cruise ships supportort us. I mean, like they we've been on several cruises with the Joke folks and like People get on at different times. They get off at different times, they have different entry points, different exits, you know people get stuck, you know, they'll miss a u u Dparting a departation. Disembarkation? Disembarkation Disembarkation. Disembarkment. disisembarkment I don't know But it happens. it's not it it's a porous, you know, things. it would not be hard for somebody to No. So I and that is that is again, the question is One, we think I mean, we know where all those individuals are in the U.S. I am assuming that all other countries where these individuals who had potentially been exposed arrived are also tracing them. And that is as far as the World Health Organization is saying, yes We are following all the individuals who have been exposed They are each being monitored by the protocol that their're home country or state in our case has decided on There are also the individuals who are on that flight, that eighty eight passenger flight to Johannesburg What is their threat And then the people who were on that plane who then got on other planes what are there. So I mean, this is sort of like the u the unknowable question mark right now. Yeah. And part of the reason I think it's really important to know why we can't answer all of these questions is that Hanta virus is a fairly rare. Disease the disease that is caused by Htivavirus. It's pretty common in rodents, but not in humans. And so the outbreaks we've had in the past that we've been able to trace are few and far between. And so our knowledge of how the virus spreads is still pretty fresh And And as I mentioned, there's only been one other sort of large outbreak of this And' strain of the virus in the past. It happened at a birthday party. then Some of the individuals who were at the birthday party exposed later attended a funeral and then it further spread from there. So there were sort of like two group events where individuals were in close contact for prolonged periods of time, one on top of another that allowed the virus because the virus spread over through the end of twenty eighteen and the beginning of twenty nineteen So as a prolonged, and as we know, it's got a prolonged potentially incubation period. so you know, you might not present with symptoms until up to six weeks after you've been exposed. Wow that's why it allows for that. Now from that outbreak, as I said, what we learned is that Most of the time it spreads through super close contact, prolonged super close contact. The big question mark from it, as researchers have noted is that there was one case that as far as we know, from that birthday party back in twenty eighteen, where an individual who had Hanta virus infected another individual through what we would consider casual contact briefly and walked away. Okay And this is this is why there's still this question marking. So Let's focus on the eighteen Americans who arrived in the US And we're taken to Omaha, Nebraska. Now, when I first heard that, my question was, why are we taking all the Americans to Omaha, Nebraska? That's not a port. No Landlocked, right Not on an ocean. So it doesn't seem the closest place in the US. And my first thought was Atlanta, where the CDC is Yeah. So What is in Nebraska? What are the Americans doing there? and where are they so far? I'm gonna tell you after we go to the b buildilling department, Let's go. 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So currently, while they are being kept in a biocontainment unit, which is different than a quarantine Biocontainment, we believe that the person has it or we know they have it quarantine, we know they've been exposed. Does that make sense? That distinction? OkayK. So there are two individuals who and I think they chose maybe it's closer to where they live. I don't know. For whatever reason, these two individuals chose to stay in Atlanta in a biocontaining unit And there is one individual who's in a biocontainment unit in Omaha. that is because this is the doctor. that we mentioned previously from Bend, Oregon who was I think he is a retired oncologist. So that's Dr. Stephen Kornfeld, who who as I mentioned, is he just happened to be there in the right place, the right time, right time, I guess From my perspective, I would consider it the right time because I'd be helpful. the wrong time if you're being exposed to hand to fireres. Let's not make a judgment. He was there at the time. He was there and he stepped up to the plate. Yeah, rightight. So that's a baseball thing So he u tested This was interesting because I saw the news report that he tested weekly positive And that's not a thing, right? L like possibly positive, like sort of positive. And a lot of people are like, what it's like a pregnancy test. you're either positive or negative. Right. And that was the reason it was reported that way is that a sample was sent from multiple people on the ship to an offshore lab to two different labs and one of his tested positive and one tested negative. But it was from the same sample. Yeah. Do you know what I mean? So there's no way, I mean, it was one or the other.l Schrodinger's antivirus situation. But because it was that before they sent it in. if you think about it, they actually learned nothing That's true. It was that before So we don't know for sure. But because of that, he is being kept in a biocontainment unit where he was initially.anest Well they did. And he has since tested negative and is asymptomatic. So there's two possibilities and he's kind of floated both. It's really interesting. I think U I mean, I don't want anybody to get infected with anything But we can we make a quick blanket statement, okay? Let's Blanket statement, this is all bad We hear at Swbones wish that no one had gotten sick and no one had gotten anti virus. We hear at Swbones If we say things like cool or good, you have to understand it is with a huge asterisk that this is quite bad. Yeah, we wish no one had gotten sick And I just want to say that up front That is the under cururrent. Yes. everything we're saying here because I think having to remind everybody that we think this is a bad situation is getting a little exhausting. So across the board Anti Hntiv virus. That's where we're at So Dr. Kornfeld has since tested negative and I think the advantage of having somebody with a healthcare background who then is inside this situation and can explain it. he has theorized that either one, he was never positive and the test was probably incorrect or two, he may have had it earlier and had milder symptoms. I guess he had had a few mild symptoms early in the journey prior to the outbreak being known. so and it's possible that you get a really mild form of the virus. And so maybe that's why he had this weak positive is because he was on the tail end of it or the more likely he just never had it to begin with. Yeah. So since he has since tested negative and he continues to be asymptomatic I believe he has also been moved to a quarantine room as opposed to a biocontainment room. R It's a little bit better. So quarantine is if have been exposed and a bioc containment is if we think you have it. Or we know you have it. O we know So Why Nebraska The only national quarantine facility in the US exists in Nebraska Our federal government Us our tax dollars built the Nebraska quarantine Center back in twenty nineteen, which pretty. retty lucky timing. thinkink about it. Yeah. Yeah U because we do not have any other facility for this specifically nationally. I feel like I was right 'causeuse it was just there. It was far away. You know what I mean? It's just like like what's the farthest away place you can think of America right now Nebraska iss kind of in the middle Yeah, exactly. far far No, it's not I mean, it's really close to the state far around It's the farthest away we can all get from it. You know what I'm saying? Like Everybody's just like, I don't even know how to Nebrka. You are talking like we live on a coast. Yeah. We do not. We live in West Virginia.'s from Nebraska J Ja I didn't know that Well Do you think Jojo lobbied to get the National Qarantine Center A one point in Nebraska. At one point in our lives many years ago, I did a Google search to see if there's some sort of like Mecca in Omaha, Nebraska to Joosua that would necessitate us like visiting and paying some sort of like feilalty to the The JoJo Siwa Memorial or not memorial, the museum or what have you. And as far as I know, there is no birthsite like museum for JoJo Siwa in Omaha Nebraska currently. And the girls have grown out of that that interest No, that this is just where just like Jo just see Murd herself They've grown out of the Jo Jo Siwa that our kids is true. This is true So anyway, so because Nebraska has this quarantine center, which is perfect for situations like this, we have a large number and I mean, large, I'm saying like There are fifteen people now sixteen who are being kept there. So not not I mean, large enough that we need a big place. to monitor them. We don't necessarily need them in a biocontainment unit because as far as we know, they they don't have the virus And so to keep them in, I mean, if you've got a more You got to think about what is in the room and what do they have access to? An individual who is not sick at all, as far as we know, doesn't need to be in a room with like a bunch of medical equipment R. If you are sick, we need you in like a hospital ish room. essentially. But a quarantine room can be a little different. And if you've seen their TikTok from people inside who are like sharing what their experiences, if you look at what's happening there, it looks more like a nice hotel room. you know? I mean, it's hospitally. It definitely has a hospital vibe to it But it's got like a workout bike and a little desk and it's like a larger room and you have your own bathroom, of course.' nice It's really nice. They bring you all your meals. I believe you get to order your meals there. so they like give you some choices. Obviously you have all the modern conveniences. You can be on your computer and your phone and tablet and call your loved ones and Faceetime and all that makeake TikToks Do I start the podcast You probably I mean, you could podcast from a cor say if you have to work, it's like not You could. I mean I don't think they come outfoted with studios and microphones. I mean always canceling would be Like I'd have to get that figured out pretty quickly. But I feel like they would want to be. they would they would just from a there would be a moral imperative to not stop the signal. You know what I mean to keep America laughing. I mean that well the internet is flowing, the bandwidth is present because again, TikToks are TikToks of plenty. So so that is why we have that's why everybody's in Nebraska right now. And we could use this for this is obviously wasn't just for anta virus. It was for anything, a disease of consequence is the thought. So either considerable and that's, I think, two different ways to think about it COVID Obviously, there was, especially depending on what variant, what generation of COVID we were talking about. In the early days, the mortality was extremely high. And so the consequences of catching COVID, you know, the risk was very high.. It was also very contagious. So it was both of those things um, Handavirus is different. The risk of catching it is much, much lower, right? So the risk of it becoming a global pandemic is incredibly low, possibly zero, but we don't like to say. We don't like to speak in absolutes Uh, but the consequences of catching it are very severe because we know it does have a high fatality. So it is worth treating as if it was just as bad as COVID. becausecause if anybody gets it, it sucks. Right, R. Yes. So that is and I think it's important to kind of, if you're seen the way we're treating and, especially if you look at I mean, all of the images from when the ship landed and individuals were being taken to their planes and taken into the quarine facility in Nebraska, you see all of like it looks like you're watching contagion or something. You know, It looks like a movie, like a scary movie because everybody's wearing those suits. It can give you COVID flashbacks But that's just because the consequences of catching this could be so severe. So it's kind of like you're going to take every precaution you possibly can. I'm overgeralizing here, but like There there is a severity of we we don't want everybody to get it and that's very severe. Yes. And then there's this severity of like I don't want to get it But that's also very severe in this case because the consequences of that are serious enough that it's worth taking all this precaution It' And I think it's interesting on a smaller scale, on a microros scale, on microscale microca It's interesting because I've been watching some of these conversations play out in various groups that I'm in that also contain physicians and watching the conversation between healthcare professionals who understand the science and who know that the risk of catching this is very low. And they're talking about things like should I fly on a plane next week? We had a cruise booked this summer, Should we still go? And I guarantee you, these conversations that these mostly healthcare providers are having a lot of people are having in their homes Yeah. And the answer, the science answer is you probably don't need to change any of your travel plans more than likely. I mean, depending on who you are and where you are, you don't That being said I understand why this would, you know Yeah spooky a little bit. So anyway, the question at this point, everybody's asymptomatic, who's being kept in quarantine The question is Can they leave And are you saying can they leave yet or can they leave when they're do they need to stay for the entire forty five day quarantine? because it could be that long before symptoms present. So until then they're potentially In facted Isy in a way that makes me you think the decision's up to me, but that can't be right Certainly, not I'm not going be consultant. From all the interviews I've watched when they ask the officials at the Nebraska quarantine Center, can they leave The answer is we are strongly encouraging them to stay Okay We have highly trained bears on the perimeter. I can escape our bears. I think this is an interesting question and I don't know that we've faced this exact situation, especially in a world where COVID now exists Um If they are asymptomatic and they coordinate with their local health department to a self isolation situation wherever they're going. Should that should that be should that be enough Do we trust people Oh wait, do we? I don't know. I'mstand this one legally can we force them to stay Can we make that I mean, if someone says, you know what, I hear your strong encouragement, but I called the health department back home. We set up like a thing where I'm going to check my temperature and they have somebody assigned, like a DIS, a disease investigatative specialist who's going to check in with me every day and I'll report this and this if it happens to this health official and I have this whole plan and it's all been signed off on and Justin notarized it Can I go home Can they tell them no I mean Who's the they in this case Who's the agency? Well, certainly the healthcare providers can't. I mean, if I have a competent patient who wants to leave the hospital, I can't stop them. Sure, C can't do that. But can the government Mm. I mean, and who? the CDC, the NIH Health and human serervices. Hey, Listen, I will do my part president. I will do my part for public health at any point I'm not trusting myself into the hands of the US government for all the money in the world currently. So I don't know about. you may have to catch me in this exact scenario that we are talking about. I believe I would flee the premises and put myself in the capable hands of doctor Siddney Mcgroll. It's serve out my quarantine and comfort. It's a tricky question. I can't see, I don't know. You know what I'm not gonna predict