Political Influence on Public Health

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Use our link so they know we sent you. groundneews d. com slash next When I heard there was a new and rapidly spreading Ebola outbreak There was basically one person I wanted to talk to Craig Spencer. People ask me this, do you Do you feel PTSD? Do you have flashbacks? Like what does it make you think is a doctor pandemic expert Also, he had a bowl He got sick right in the middle of New York City a little more than a decade ago It makes me realize that I have a very short window where I can be useful And I'm like, oh, for the next week, people who otherwise wouldn't listen to me are going to have to listen to me Craig was infected in twenty fourteen hadd been treating Ebola patients in West Africa. thenen he got home. And he spiked a fever I interviewed him back then Despite its common perception as a disease that makes you bleed Ebola is maybe best described as the flew from hell It can go from headache to vomiting to organ failure Fast And it is very contagious if you come in contact with a patient's body fluids Craig doesn't really like talking about what that meant for him physically. No, I mean, I had the best case scenario of the worst case scenario, right? I was treated in a high quality facility. I had thirty to forty providers taking care of me at any point and I was taking care of thirty to forty folks. in Guinea. And so even though my nineteen days were no cake walk and I wouldn't recommend them to anybody, they were nothing in comparison to, you know the dozens or really hundreds of patients that I saw You've written about how youd treat whole families. and they'd be caring for each other and how effffecting it was Yeah, I remember there was one family that came in late at night on two motorcycles. I think there was like seven folks in the family That was like the first family that was, you know, quote unquote, mine that I was going to take care of after I', you know, trained And I got really close to them. And It was such a humbling experience. One because I learned a lot about Ebola, two, because I learned how horrible Ebola can be, particularly for kids. you know, for young people it felt universally fatal and this is before I had children of my own Do they survive None of them U, I think one of the kids survived Craig got uncommonly close with his family. Eespecially the mom who is watching her kids die onene by one He even gave her his cell phone number, which is kind of verbotent weeks later, he was in the hospital fighting off Ebola himself His cell phone started blowing up He was sending everyone to voicemail But I saw I't know if it was a two, five seven whatever the guuinea area code was come up And those go, that's weir And so I answered and it was this woman. Um And she was calling Yeah, she had heard I was sex, she saw my picture on TV and was calling and it was like a twelve second phone call But it was like, Hey, I'm thinking of you and I saw you were second you know, like a blessing and then, you know, that was that was kind of it Eventually after you got better, you returned to treat people in Africa and outbreak that you were part of was brought under control. And I imagine that must have felt in some ways powerful for someone like you to have treated people in the outbreak, gotten sick, yourself recovered, treated more people And then to be part of a public health response that brought this disease to heal Do you think the global public health system is doing that Now So you see The Africa CDC, you see Congo, you see Uganda here really taking a leading role, which is great. We're going need resources, financial, logistical, human resources from outside Do you think the United States is interested in providing those resources People working on this response as part of the CDC and state and like kind of the normal mechanisms that we would normally have as part of this that are awesome. They are great. They're incredible. they're competent. I know them. I know them very well. good people But there's not enough of them. They don't have the resources they need And quite frankly, the people that are trying to coordinate above them are not fit for purpose. Today on the show Craig Spencer knows Ebola inside and out. And he's ringing the alarm about the latest outbreak I'm Mary Harris You're listening to what next? Stick around Hi, I'm PJ Vote. My podcast search engine has a new two part series for you. Of all the new technologies coming out of AI, the most transformative one might be driverless cars. They're already on the road in ten American cities, and they're quickly coming to more We tell the story of how we got here. The secret team at Google spent fifteen years building what might be the safest vehicle on the road, and we cover the fights brewing in blue cities, where unions and politicians are working to keep those cars off the streets Listen to seearch Engine wherever you get your podcasts You've worked in and around Africa for fifteen years at this point, is that right And that's right here Can you do a little one on one on this current outbreak and where it stands? Like justust paint me a picture of how we learned about the outbreak where it's taking place, what it looks like there So this outbreak was declared about three weeks ago kind of came out of the blue When it was first declared, there were over two hundred and something cases, which might not sound like a lot for people that got used to COVID case numbers of like hundreds of thousands a day twow hundred and something embola cases all at once is massive That would make it already one of the biggest Ebola outbreaks ever. That means that this outbreak and the day, the moment it was first declared was bigger than the overwhelming majority of outbreaks are when they end. Well That means that we didn't pick it up when it was first starting to circulate and had likely been going on probablyroably for months beforehand. Yeah, do you want to talk about why it might not have been picked up? Yeah, so this The way that I explain this to my kids who have been asking like Dad, why are you the news while you're making breakfast talking about Ebola, what is this saying There are justust like ice cream, there are different flavors. Ebola is the ice cream here, but there are different flavors of Ebola. There's your vanilla, your talkol your strawberry. One of them is the Zyir species. O is the Sudan species and one is the Bundabugyo spepecies The Zyer species is the one that I was infected with, that I've treated For all intents and purposes, more common, much more cal and more responsible for most outbreaks Sudan is next and was responsible for an outbreak just a year ago And Bunde Bugyo has only been seen two other times before this Bll They all look from the outside the exact same the clinical manifestations, how sick they make you. they all mortality rate? It seems to be just as high From the outside, they all look like ice cream, but once you dig a little underneath the hood, they are all quite different And so that means if you are doing testing because you're on the ground taking care of patients and you're like, these people got Ebola And you do the Ebola testing for Zyir where you do the Eblla testing for Sudan They're going to come back in negative because if you're looking for vanilla and chocolate, you're not going to see strawberry The problem here was that this was a different flavor that we normally don't test for because we never see it. We've only seen it two other times. Do you think we might have seen it earlier if the public health infrastructure had been essentially untouched Yeah. so let me say also that Kongo is really good at this. They've had morebola outbreaks than anyone. they have great lab capacity. They have alerts like this all the time Do I think that if USAID in particularly there was a greater CDC and US. presence still in Congo Over the past year that this would have been detected earlier, I think that that's undoubtedly true Would it have been a day, a week, a month earlier? It's hard to say, but Knowing the folks that would have been there would have been part of these discussions It wouldn't have stopped at, Hey, we did testing for Zaiir, we did testing for Sudan. I think we're done. This is something else. It would have been a whoa, who whoa, what about this, this, this and this And I don't think that is By any means a lack of competence on The the part of the conongoles, I think that just points to the importance of collaboration in this space particularly what the U.S. is able to bring to bear with our expertise or resources So I do think that there is a delay here. You know, Rubio tried pinning this on the WHO. for the delay, which I think is Marco Rubia searyate. Yeah, exactly I find fascinating because you know over the past year, the US has withdrawn from the World Health Organization, an organization that had helped create, you know, sixty, eighty years ago Um But it was accusing the WHO of delaying on something that it's not even responsible for N to say looking at what I can see from very far away, right? It seems like this outbreak has a lot of bad facts going on. There is the lack of funding from Washington that has been ongoing for like a year Like I looked at the data, the Washingon Post published data about like how much money had gone to the Congo in terms of assistance and aid It had been something like one point four billion in twenty twenty four. And in twenty twenty six, it's twenty one million. It's just a massive drop, right? So that's one thing The other thing is This is taking place in very rural areas, very close to a lot of conflict. So it's not just a public health problem. There's like a public safety Pble So all of these things are happening at once, and then there's also evidence of spread. Like we're seeing cases as far away as Kampala, the biggest city in Uganda, which there is a lot of people there. Do you you sound like an optimist to me when you're talking and I think that that's um I think that's good I wonder if you see the facts the same way I do Yeah. So on day one, I saw not only a big number of cases, which was concerning, I saw that they were geographically diverse across a really tough region, so you point to the conflict This is a place where sentially from one village to another, you can have different militias responsible for your safety It's a place where I've worked a bunch in the past. It is not an easy place to work because of that It's not an easy place to work because Just getting from A to B, you know, maybe it's twenty miles, but that can take you a whole day depending on the quality of the roads. So to see so many cases across such a big area partarticularly on day one, and you noted that there were cases as well in the first day in Kampala, so talking you know, hundreds and hundreds of kilometers away That means that this had been going on for some time and had had spread. re pretty far in a place where moving is not particularly easy There's also the funding cuts issue. There's also the fact that Um This is a place where There's a whole host of reasons why people wouldn't trust, particularly outsiders Historically, you know, the colonial experience was not particularly great for the Congo but also over the past year People know that the clinics that maybe they were going to beforehand that may have been supported by USAID or organizations, humanitarian groups that were supported by USAID have closed And they're tuned in enough to know why. And I have a good friend that's worked in Congo over thirty years, and he told me that in the past year, he's been doing a survey looking at the impact of USAID cuts. And he said that in the last year after these cuts, the combination of violence, blasts, the loss of USAID has resulted in an increase in deaths of three hundred thousand people over the baseline, which is already not great And he said that the amount of anti American sentiment tied to that has been remarkably high. So it's not like you can just go surge in people to like fix it because there's a huge trust problem you've created. Yeah And I mean, even the good news here doesn't seem like good news. like in the last week There was reporting that the WHO and the CDC were actually scaling down their estimates of how many Ebola cases there were from like a thousand to something more like three hundred But You know, I saw some public health officials basically saying that may look like good news, but what it actually indicates is just on the ground. Like we can't even count the cases right. I was like, oh, yeah, that's not great. Yeah. You know, initially there was these big case numbers that balloon to over one thousand and then they've pulled them back to around four hundred today. And part of that is Ebola looks like malaria, Ebola looks like a lot of other things at the outset. And if you don't have good systems to record these types of things The U. S. helped build and maintain these systems up until they were torn apart last year then you can't follow these things. And I think a lot of that is kind of the fog of the early days. You include a lot of potential cases in that count and then you get testing that allows you to change that number. I I think you, four hundred is certainly better than one thousand, but four hundred cases This still makes us like the third largest Ebola outbreak ever To your point, we're getting staff and stuff on the ground We're getting the cavalry there, but we don't have all the horses in place. And by that I mean You can have the people in the PPE, but if you don't know how to use them and if they're not well coordinated, then they may not be all that effective yet. I'm optimistic then in the coming weeks We're going to have a better idea of what exactly this looks like and we'll be doing a better job of standing up treatment centers and the places they need to be working with communities so they trust us better As things stand right now, I'm a little more optimistic than I was a week ago. that doesn't make me particularly optimistic about the near term. Your baseline, optimism was low. Yeah. And look every single bull outbreak is humbling. Everyone, there was, you know, in the Liberia, outbreaks of just over a decade ago, like Liberia went through two incubation periods, forty two days after the last case to be like, we're done. know they could celebrate and say, we have no morebola that evening, the same evening anotherother case was reported. Oh my gos. it's just like such a humbling disease. And so That is particularly to your initial question, ofike. Who do I want to yell at You know, the U. S. approach has been so focused on this idea of fortress America that if all we do is build a wall tall enough, thick enough, deep enough We can prevent Ebola from coming into the U.S. And I'm here to tell you that like The only way, like if you're concerned about the threat to Americans, which if we're going to be fully selfish about this here That's fine. I still wouldn't recommend that we go about this this way becausecause the only way to get rid of the threat to Americans is by getting rid of the threat at all and allowing this to balloon and get out of control in Eastern Congo allows it to spread into the region, allows it to spread even more broadly We'll be back after a quick break. Curious about the future of healthcare Tomorrow's Cure, the chart topping and Ambie Award finalist podcast from Mayo Clinic brings it to you today I'm Kathy Worser, and in this new season, I sit down with researchers, doctors, and industry experts who are leading the way in medical innovation cutting edge technology to breakthrough treatments, will'll explore how new solutions are improving and even saving lives In the season four Premiere, I'm joined by dermatologist Dr. Saranna Wiles, along with biomedical engineer Dr. Adam Feinberg to talk about how three D bioprinting is revolutionizing medical research and accelerating breakthroughs in healthcare. It's a compelling look at the tools shaping tomorrow's treatments So go ahead, follow tomorrow's cure on Apple Podcasts, Spotify or your favorite podcast app. Well, U. S officials would say we're not allowing it to spread in balloon and they would defend this approach they're taking. L right now the US has banned non citizens from the Democratic Republic of Congo, Uganda, or South Sudan from entering the U. S.. It's not allowing Americans who've been part of the treatment response and are infected to come to the U. S. They're quarantining elsewhere. And they've actually even established they're establishing a quarantine center in Kenya which was apparently part of a larger plan that had been out there for a while Um, And this has been controversial. peopleeople in Kenya are angry about it now. Um But I wonder if you want to talk about this Kenya quarantine center, the idea of keeping people, especially aid workers who may have been exposed away from the U. S. and what you think is so problematic about it. I think some people would look at it and say Well, we're keeping the disease out isn't that good Yeah. I think it's a great question. It is unfortunately a false sense of security We can't keep diseases out. I think, you know, look what happened with Hontavirus, you know, what feels like forever ago. When people were saying like sink the boat with Hntavirus. Do you know what I mean? I think there is this vibe of just like stop and I guess I can understand that. One, let me just say that I don't think that's the plurality of people I wrote a piece just about a year ago for the New York Times about empathy and what role it should have in our global health response. And let me tell you, that is the best response to anything that I've ever written because We don't make the moral argument enough and we assume that it is an empty argument anymore, particularly in the aftermath of the cuts of the last year It turns out I got emails from Conseratives. I got emails from Buddhists, monks, I got emails from pastors from people all around the world that said Thank you for making the moral argument for why we need to do this global health work So I think there are loud voices that may say synth the boat But when it comes down to it, not only isbola is Ebola a disease of compassion, But I think at the end of the day, most of us may be afraid But we want to continue being compassionate Even folks that don't want a bully here in the U.S want to make sure that we manage it abroad, not just because it's in our selfish interest, but because It's a horrible thing, and I think people can see that. And so When I see something like a Kenya this Kenya treatment facility I can understand why on face value, it might make sense manage the outbreak there, brring Americans there My problem is that it's hard for me to see this all unfolding particularly with the knowledge I have of you know, then citizen Trump's tweets in twenty fourteen saying Anyone that goes to Africa to help shouldn't be allowed to come back here. Oh my gosh, I'd forgotten that. Him saying that anyone who allows Ebola into this country, yes, is an incompetent leader And I can tell you that as the conversations were happening around whether to repatriate an American being treated with Ebola to the US. from Congo was happening, I can tell you from multiple credible sources that the reason they were brought back to the U. S. was because of the White House. And so what does it mean when we abdicate our global health leadership role as we've done over the past year. It means things like Ebola only get worse and that there's going to be more of them But what does it mean when we as a country abdicate the responsibility we owe our own And I think that is a whole incredible next level place that I don't think we want to go and is so inconsistent with what we normally do to help those that we send abroad to either fight conflict or disease, thinkink about a few months ago when one of those pilots went down in Iran behind enemy lines the amount of resources that the U. S put into making sure that that single person madeade it back to the US. the money, the time, the risk that we put into that. And then contrast that with the fact that We are essentially hearing this administration is willing to go out on every single limb. to prevent any American from coming back into this country with Ebola just because we want to satisfy a White House you know directive of keeping this virus out at all costs. Now, That should piss us off morally But as taxpayers, even if you don't care about the moral argument Over the last decade, the only good thing that came out of illnesses like mine and my treatment in the US is that we said,f, we should probably have facilities like these on the ready at all points And let me tell you over the past decade, we have built and sustained to the price tag of like hundreds of millions of dollars incredible facilities around the U. S that can take care of high consequence pathogens, Ebola, Honta virus, etcetera. I mean, I always hear about people going to where inbbrasa. So Nebrka has a quarantine unit, but it also has a biocontainment facility. So does Bellevue, so does Emy, so does thirirteen hospitals around the country that we have exactly for this. Let me tell you, I was with them two months ago at this It's called NeeTak NTAac National Special Pathogens system. We have a couple of different things that are related and I was with him two months ago These people were straight up nerding out Before any outbreaks, they were like, how do we share this aliquat between you and I? How do we make sure that the monoclonals can do like this and we can get them these people spend every day of their life with a passion. preparing for pathogens. sounds like a tremendous untapped resource right now. A tremendously untapped resource that not only is really good But if like your thing is doge and money and the, you, the resources that we have that we need to focus on, like we've put a lot into this over the past decade. We've sustained this incredible system We need to use it, standing up some UrSAatT's temporary facility on an airbase in Kenya, I think is not only