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0:00:00
Ben Radford: Welcome to Squaring the Strange, the podcast that examines all manner of the mysterious and the mundane through a critical lens. So let’s square the strange.

(MUSIC)

0:00:10
BR: Welcome back to Squaring the Strange. This is episode 112-C. I am your co-host Ben Radford, and with me is…

Celestia Ward: Celestia Ward. And don’t say 112-C. People are going to be wondering what happened to 112-A and B.

BR: Well, the C is nomenclature for coronavirus.

0:00:54
CW: Oh, OK. That makes a little more sense. So we’re talking about the coronavirus. Is this an emergency breaking news mini episode?

0:01:01
BR: It kind of is, because, you know, why not?

0:01:05
CW: Well, much like new viruses, episodes can evolve. And if this one gets too long, it’ll just end up episode 113. Now, Ben, you deal in a lot of panics and hysterias and diseases from overseas can cause that. So you’ve been dealing with a whole new crop of stuff you can research, right?

BR: I have, yeah, as listeners know, one of my interests has always been in in myths and legends and things including disease legends. On previous shows we’ve talked about rumors and the damage that rumors can do in any number of circumstances, including, of course, witchcraft beliefs and social rumors and media panics and moral panics and weird things like that. And unfortunately, the recent news about the coronavirus has led to more of that. So rather than wait another few weeks to get it out there, we thought we’d go ahead and put out a quick episode on it.

CW: Yes. All right. Well, by all means.

BR: Yeah. So just very briefly, as if you’ve unless you’ve been living under a rock for the past month and a half, you’re probably aware of the coronavirus epidemic panic that’s going around. And let me just sort of begin with a little preface and sort of set the stage. So the coronavirus is actually it’s a category of viruses. So it isn’t the coronavirus, it’s a coronavirus.

0:02:28
CW: It’s a coronavirus noval, I think they call it noval with an A.

0:02:32
BR: Yeah, the official name is 2019-nCoV, and for noval, CoV for coronavirus. And there are many coronaviruses, and I’m not going to get too much into depth because I’m not a medical doctor. We have medical doctors, I’m not one of them, but this much I know.

0:02:53
CW: Stay tuned because we will be phoning into a medical doctor by the end of this mini episode.

0:02:59
BR: Yes. So two of the best known and most deadly coronaviruses are SARS and MERS. Probably SARS is probably the best known. And as with many of these, the symptoms are fairly standard. cough, maybe a fever, shortness of breath. There are some early reports of nausea, vomiting and diarrhea. So again, fairly sort of standard bad cold influenza type symptoms, nothing like Ebola bleeding from your orifices, things like that. So it’s still scary and certainly deadly, but that’s what we’re talking about.

0:03:34
CW: And with any flu-like illness, the problem with symptoms like that is every half-cocked fella out there who gets a cold now thinks they have the coronavirus.

BR: Right, so that’s you know it’s the old you know what do I have let me ask Google and suddenly you’ve got everything from leukemia to lupus to God knows what. But there are a couple things to keep in mind. Number one, 80% of patients recover within about a week or two. It’s sort of like a bad cold in that regard. It can be worse, but most, the vast majority of people do recover pretty much normally as you might if you got the flu. 20% result in severe infections and pneumonia, and in some cases, death. And of course, that’s especially true with immunocompromised people, such as children and the elderly.

CW: Yeah, there’s a lot of diseases that end up kind of killing you via pneumonia.

BR: Yes, not a pleasant way. It is spreading faster than either MERS or SARS, but it’s less deadly than either one of those. I need to clarify what less deadly means. I actually saw in the news, I think it was yesterday, there was an unfortunate and sort of misleading headline that said that it’s now deadlier than SARS. Well, what they meant was, and I know what they meant, because I read what they were saying, then I sort of winced when I saw that, because what they mean was the death toll is now higher than SARS.

0:04:52
CW: So it’s the difference of having a really, really, really venomous snake in your backyard but there’s only like two of them or you could have a hundred lesser deadly venomous snakes that won’t kill you as fast but there’s more snakes.

0:05:08
BR: Right, so it’s technically true in one sense that it’s deadlier than SARS. In another sense, that’s not a useful way to think about it. The death rate for the recent coronavirus is about 2% compared to 10% for SARS and 35% for MERS, the Middle Eastern respiratory syndrome. So-

0:05:29
CW: Oh, I didn’t realize MERS was that deadly. That’s really kind of scary retroactively there.

0:05:34
BR: Exactly. So is it killing people? Absolutely. Is it a concern? Absolutely. Are more people per infection dying than SARS and MERS? Absolutely not. It’s a fraction of that. There’s no vaccine for it, and because it’s not caused by bacteria, antibiotics won’t help. So don’t ask your doctor.

CW: But handwashing will help.

0:05:52
BR: The handwashing will help, absolutely. The first case came about on December 31st, or 30th, 31st, in Wuhan, China. About a month later, it was declared a national health emergency here in the States. Numbers change by the day, so whatever number I put out now will almost certainly be out of date by the time you hear this, but as of now, about 900 people have died, and there’s been about 40,000 worldwide cases, primarily in China. Now, 40,000 sounds like a lot of people, and it is a lot of people, but keep in mind that China has 1.4 billion people.

0:06:29
CW: Yeah.

0:06:30
So, keep that in mind. The average person has very low risk of catching it, certainly the average American. So, as of now, I think there’s three cruise ships that are under quarantine, several airplanes have been quarantined. One of the problems, of course, is that in the early stages, people are asymptomatic. It’s got an incubation period of between, I think, two and 14 days. So in theory, there are, well, not just in theory, there are people walking around today who feel healthy, but are carrying it right now and may not start feeling symptoms and will be asymptomatic for several days, during which, of course, they may be infecting other people.

0:07:11
CW: So there’s the facts as you know them. Tell us about the fiction.

0:07:15
BR: Yes, the fiction. So one of the interesting things about diseases, and I don’t mean to make light of it, but it’s an interesting topic, is of course there are different angles to it. There’s sociological angles, there’s economic consequences, there’s these sorts of things can be approached in a lot of different ways. My main interest is in information, particularly myths, misinformation, lack of information, things like that. So in the case of the noval coronavirus, there’s basically three different types of information. We have lack of information, we have misinformation, which is sort of wrong, sincere beliefs, and we have disinformation. So these are jokes, conspiracy theories, people sharing information that they pretty much know isn’t true, but they’re sharing it around anyway. In the case of a lack of information, of course, this is always a problem in the early stages of any outbreak because scientists are still trying to get their mind around what’s going on. You’ve got epidemiologists who are trying to track these cases, doing research trying to contain where people come from, who they’ve been exposed to, identifying patient zeros. There’s lots and lots of working parts to it. As is always the case, scientists don’t know everything. If they knew everything, then this could have been contained, you know, from day one. But as is life, information is sometimes slow to get around. Sometimes there is misinformation. And unfortunately, in this particular case, the efforts to stop and stem the spread of it were thwarted by the Chinese government.

0:08:52
CW: Yeah, that’s been a common refrain from a lot of the stuff I’ve read. And that leads to headlines from the Daily Mail saying that, you know, China is preparing to cremate, you know, 40,000 bodies and they have to be, you know, they’re running the crematoriums day and night and they’re just, you know, quiet about it.

0:09:11
BR: Yeah. Yeah. And so, you know, as with a lot of these cases, there’s a grain of truth to it. Right. I mean, it is is absolutely undeniably true that the the Chinese government was initially reluctant and may still be reluctant to share information about it. Apparently, they they have silenced one of the first doctors who raised the alarm about it. And he’s since died. This but again, this is keep in mind, this isn’t unique to this coronavirus. This is what they do.

0:09:40
CW: It’s not unique. It’s not unique to China either. I mean, right. It’s a good thing in America. You know, our government doesn’t clamp down on information and and threaten whistleblowers. Oh, wait. No, we had a whole exercise in that recently. So, yeah, pretty much every government has been careful about what gets out about anything.

0:09:58
BR: Yeah. And as I mentioned, because these outbreaks are multifaceted, it has consequences for tourism, it has consequences for trade, economics. So there are legitimate, if sketchy, reasons why a government may be slow to acknowledge what’s going on. And again, this happens in lots of circumstances. Keep in mind the downing of the Ukrainian aircraft a month ago by Iran, right? There was clear evidence that they did this. There was video evidence and everything else, and yet they denied it for what, two, three, four days until they finally had to admit it. You know, Iran didn’t want to admit that they accidentally shot this passenger plane out of the sky for understandable reasons. So it’s not some nefarious conspiracy theory. It’s just that governments don’t all governments are less than transparent when it comes to potentially embarrassing things.

0:10:56
CW: Yeah, well, embarrassing and harmful. And, you know, I mean, this this information has not been good for Chinese business or tourism or or or even I mean, there’s all sorts of incidents of racism being reported now for Chinese people who live here or who are traveling here.

0:11:16
BR: Absolutely. So that’s so moving from lack of information to misinformation. Let’s talk about that for a minute. Right. So, you know, when these sorts of these sorts of disease legends and lore go around and by legends, I mean that in a folklore sense, I don’t mean something that’s necessarily not true. It’s just a story that’s circulating, whether true or not. So in this particular case, one of the most common ones is, of course, people want to know where did it come from? Obviously, there’s this huge thing. It’s on the news. People are freaking out. OK, so where the hell did this thing come from?

0:11:49
CW: That also that also belies a lack of understanding about how viruses or even organisms of any kind can mutate and evolve. And so, oh, it had to come from somewhere. It was a space rock or it was a scientist or it was a weapon or.

0:12:06
BR: Right. Yeah. And and and typically, of course, where people think it came from is from them, the capital T, them over there, the other people, the dirty, unclean, nasty, creepy third world people. And so a lot of times there’s this element of sort of racism and xenophobia inherent in a lot of these legends and stories, but where this particular thing came from. And again, this is pretty common. We’ve talked about this on the show before. For example, there’s a lot of urban legends that have this sort of underlying xenophobic theme to them. You see this theme coming up over and over again. And you also saw this, of course, in 2018 when you had Fox News contributors talking about the, remember the caravans, the Central American migrants?

0:12:55
CW: Oh yes, they were bringing drugs and gang members and criminals and disease.

0:13:01
BR: Oh right, yeah, not just the gang members, it was tuberculosis, HIV, leprosy, smallpox.

0:13:07
CW: Leprosy, God.

0:13:09
BR: That was, yeah, that was one of the things that was claimed. And again, it’s all part of the fact that none of this was true. You know, the migrants are coming up through, I think, is mostly Honduras, Nicaragua, Guatemala. These were not disease riddled people. They couldn’t have marched. They couldn’t have gone. They couldn’t have physically gone so far as they did come up the border. If they were as disease riddled as they thought. In fact, there’s an irony here, because in many of the countries where these people came from, they actually have higher vaccination rates than Americans do.

0:13:43
CW: Oh, burn, burn, America.

0:13:45
BR: So yeah, so you’re worried about these those unvaccinated people across the border. No, no. Vaccinate your own damn kids before you start bitching about that.

0:13:54
CW: And then another historical irony is the only time foreigners have ever set foot on a foreign land and brought tons of diseases, I’m thinking about the Western Europeans coming to the Americas and bringing with them all sorts of deadly things for the natives, including later blankets filled with smallpox in a weaponized sort of way.

0:14:13
BR: Right. And that’s one of the conspiracy theories about it, right? And so, so, you know, turning back to the novel coronavirus. So one of the early rumors that that circulated was that it came from sort of weird Chinese eating habits. So far, and again, epidemiologists still don’t know exactly where it came from, but the most likely explanation is it probably came from a meat market in Wuhan, China. And meat markets all over the world are sometimes not the cleanest places. There’s dead animals, and that’s sort of what it is. Yeah, you get flies and insects attracted to that. And you get that anywhere. You get that in Brooklyn. It’s a thing. That’s the nature of the business. So there’s nothing inherently disgusting or contaminated about a Wuhan meat market because of course they’ve had meat markets there for centuries. So if just having a meat market in Wuhan was inherently problematic, then this would have emerged decades ago.

0:15:17
CW: But the extra to that is, ooh, they’re eating bats, that’s gross.

0:15:24
BR: Right, so that was one of the legends was that it was bats, and there was a video that circulated, allegedly of a Chinese woman eating bat soup. And of course, to Americans, they’re like, number one, well, bats are actually cute and very helpful. But some people are afraid of bats and are like, oh, this is disgusting. Whatever else. Well, as it happens, that particular video wasn’t filmed in China. As I recall, it was in Micronesia. Are there people in China that eat bats? Probably. It’s not a main. It’s not a it’s not traditional cuisine. If you go into a Chinese restaurant, good luck getting bat soup. So the point here is that that particular strain of the urban lead, that particular strain turned out not to be true. But it sort of reinforced people’s minds, the idea that these unsanitary things by these foreigners are bringing this disease to our doors. And again, this is very common, these disease legends. I think back to the AIDS legend. One of the stories about AIDS was that somebody, presumably an African man, had sex with monkeys 1,500 years ago and this is what brought AIDS from simians to humans. HIV later became AIDS.

CW: I mean, I can’t even count the different AIDS origin stories I have heard in terms of, you know, everything from eating monkey brains, which is, you know, not entirely off the mark. It was from bushmeat, probably. Right?

BR: Right.

0:17:02
CW: Yeah. But yeah, it was constructed in a lab. It was, you know, set, set, of course, set by God. Yeah.

0:17:10
BR: Right. Yeah. There’s all sorts of different stuff. And so the best guess as of now as to how AIDS actually emerged was that chimpanzees ate infected monkeys and then humans ate the infected chimpanzees probably in Cameroon, which sounds kind of gross, but it’s game meat out there. That’s what they do. It’s not unusual. It’s a known thing, just as hunter-gatherers and other people around the world eat what they eat, what they eat. They eat what’s there.

CW: I’m pretty sure people living in Africa would find mad cow’s disease pretty gross. And we get that from the way that, you know, cows have been processed sometimes.

0:17:51
BR: Right. So, you know, there’s that and there’s also the the conspiracy theory, right? And we sort of touched on this earlier, this idea that that the the novel coronavirus is sort of a bioweapon that either was developed intentionally by the government, it’s not clear which government, but a government, if you will, or that somehow escaped from a top secret government lab. And again, this is this is classic conspiracy theory.

CW: If I can quote one of our elected representatives, Senator Tom Cotton of Arkansas, he was on Face the Nation just this past week. And he openly said on a national news show that he he suggested that the virus might have come from the biological warfare program of China. In a stunning summmersault of the burden of proof, he said, and I’ll quote him here, fact, Super Lab is just a few miles from that market. Where did it start? We don’t know, but burden of proof is on you and fellow communists. So, that’s not how burden of proof works, Senator.

BR: There’s so much to unpack there. We could do a whole show on that, but we won’t. So, yeah, so there’s and again, keep in mind that this goes back to there’s a long tradition of this. This is not new. In 1500s Europe, for example, there were people that were accused of intentionally spreading the bubonic plague, typically foreigners, non-Catholics. That was that was who was blamed.

0:19:32
CW: Probably by the senators of that day. The rulers are equivalent of senators.

BR: And you had you had similar sorts of urban legends Being shared in the african-american community for example that AIDS was a government project to kill black people or that some of the popular drinks and foods that were that were common in black neighborhoods such as Tropical fantasy soda or churches fried chicken even cigarettes menthol. Kool and Marlboro had had secret sterilizing agents that was all part of this huge conspiracy program to to essentially eliminate the black community. So, again, this is all this is all part and parcel of these these these legends. And we’re going to see a lot of stuff like that with the coronavirus as it’s breaking in the news right now. And you don’t have to be some foolish layperson to fall for it.

CW: I was just reading in The Washington Post. They mentioned Megan May, who’s a university professor that researches emerges emerging diseases, Russian misinformation that had crossed her path, claiming that the Chinese government was lying about how many people had died from it. And a lot of this stuff looks fairly believable, the way it’s presented. I mean, there’s troll farms, there’s all sorts of ways that various interests get misinformation out there, and it might come to you from a trusted source like a friend or a relative off of their Facebook feed. And I think BuzzFeed kept a running list of the wildly inaccurate stuff that was coming out about the coronavirus for the first month there. One of the things that this Washington Post article said was that there is sometimes the goal of perhaps, you know, the Russian disinformation campaigns have many goals and one of them is sometimes to just cloud the environment with so much misinformation that you can’t really tell what’s completely accurate. It’s not easy to pick it out.

BR: Right. And that’s of course, that’s especially true for for disease stories. I mean, it’s it’s it’s ready made for that, unfortunately, because, you know, people are in some cases justifiably concerned about it. The average American is in far greater danger of catching the flu than this coronavirus. But I mean, again, it’s just that’s the nature of these things is that people, they want to take control over their destiny and their health. And so they see this information online. And of course, a lot of times there’s this a lot of the time the information is sort of limbed or sort of married with anti-government information, you know, anti-government sentiments. You have, you know, questioning Big Pharma.

0:22:31
CW: They’re lying to you. You’re being lied to left and right. Don’t trust anybody.

0:22:36
BR: Right, exactly. JoeBob1990 on Twitter, he knows what the deal is, but don’t trust those CDC people. They’re trying to kill you.

0:22:45
CW: Yeah, yeah.

0:22:46
BR: But, yeah, so there’s all sorts of information going around. And so, again, the first one we talked about is where did it come from? So the other thing that people want to know in these sorts of stories and legends is how do you get it? How do you prevent it? And how do you cure it? So this is where we get into more misinformation.

0:23:02
CW: Oh, is this going to involve onions in your socks?

0:23:04
BR: No, not this time. But feel free. So there’s all sorts of all sorts of bad information out there. I’ll just touch on a couple of things. Online people have been circulating information that if you avoid spicy foods, then you won’t get the virus. This is of course not true.

0:23:26
CW: I am so getting the virus.

0:23:28
BR: Other people claim that eating garlic can prevent it. Also not true. Some people say, no, no, it’s vitamin C because of course, you know.

CW: Also the cure for cancer and the common cold, vitamin C can do everything.

0:23:40
BR: There you go, cannabis, things like that. Now, one of the most, a lot of these are sort of self-evidently silly. If you want to take vitamin C and eat garlic, I mean, go for it. There’s no harm done. There are some preventatives and cures that can do harm. For example, there’s something called MMS, miracle mineral solution.

0:24:01
CW: Yeah, that’s been for years that’s been making the rounds in the skeptical news as something that’s been a new form of child abuse pretty much.

0:24:10
BR: Yeah, it’s basically it’s 28% sodium chloride in distilled water. Do you want to take a guess at how much you would pay for a gallon?

0:24:22
CW: A gallon, well I know that people are dosing their kids with it to try and get rid of autism and hyperactivity and all sorts of other things. If you’re buying it on Goop, it’s going to probably run you about $1,200.

BR: $900 a gallon.

CW: Holy crap!

BR: To be fair, most people only plunk down about $30 for 4 ounces.

0:24:48
CW: It’s bleach. You’re buying bleach.

0:24:51
BR: Yeah. So sometimes the instructions say to add lemon juice to activate it, whatever that means. And as I mentioned before, in some cases, you know, part of the reason that these stories and these myths are believable is there’s a grain of truth to them. There is a grain of truth to the idea that China has tried to and maybe is still trying to downplay and not be transparent about the spread of the virus. In this case, there’s a grain of truth insofar as it’s true that chlorine dioxide or bleach can kill the coronavirus. That’s true.

CW: Well, that’s why you clean up a hospital room with it, but you don’t drink it!

0:25:32
BR: Yes, therein lies the rub, as they say. You put it full strength on surfaces and it kills things. You don’t drink it. You certainly don’t dilute it and drink it.

0:25:42
CW: It’s because it can also kill you.

0:25:44
BR: Right, yeah. So it’s not only not useful for fighting the virus, it can of course do harm for you. Then, so we’re turning from the things that absolutely don’t work to the things that kind of don’t work, we have the very common face masks.

CW: Being in a tourist town, I see a lot of face masks.

0:26:05
BR: Yeah. And, you know, there in fact, it’s been a problem recently because the there’s been a run on face masks and there are people hoarding them and selling them at a marked up price and there’s actually a shortage of people who actually need them in hospitals.

0:26:18
CW: Yeah, I actually I actually saw a conspiracy thing on talk radio the other day that they were supposing that China had engineered the virus in an effort to sell out of face masks because China is the main producer of face masks. So it was all an economic ploy to sell a bunch of face masks. Plausible, right?

0:26:44
BR: If that makes sense to you, sure, why not, right? I once already heard was that this whole thing was a stunt in order to sell vaccines. If you think back about 15 minutes to the beginning of the show, I mentioned that there is no vaccine. So that doesn’t, it’s, you’re, no one’s making money off vaccines because there is no vaccine to make money off of. You idiot. Anyway, so back to face masks. So face masks don’t actually help that much. They’re most useful for putting them on people who are already infected to help keep them from coughing on other people. They’re marginally effective for the average person who’s not sick, but that’s if you use them correctly, which most people don’t do.

0:27:31
CW: Okay, yeah, and there’s so many different kinds. People are buying like the ones that are sold for when you’re using a paint gun, like the little hard round ones. And then there’s the soft ones and there’s the pinchy ones with the wire for where your nose bridge is.

0:27:45
BR: Yeah. I mean, it’s, it’s not, it’s, you know, it’s not going to hurt anything unless of course there’s actually a doctor in some nearby hospital that could use the damn thing because you’re just wearing it for, you know, for, for no particular reason and they’re dealing with people who are actually are sick. That is an environment in which these are absolutely known to exist and to be spread around. So let me move on to a couple other types of misinformation that aren’t about where it came from or how to prevent it. A lot of times there are social media warnings, right? So we see this all the time with fake warnings about child abductions or fake warnings about this or that. And of course, once again, social media is being used to spread all sorts of misinformation. Occasionally good information, but unfortunately, it’s much easier for the myths and misinformation and rumors to spread. So there’s been a handful of false reports about the coronavirus emerging in U.S. hospitals. There was a Facebook post and some social media posts about a high school in Santa Clarita, California. Another one, I think, at USC in Los Angeles, where somebody had said on social media that there’s some coronavirus-infected patient, and of course, turned out not to be true. Same thing happened in Dallas County, North Texas. But part of the problem, of course, is that people see these online, and if they have any reason at all to doubt the government story, right, if you if you’re already predisposed to think the government is hiding from something from you, you know, you’ve got somebody, maybe a friend of yours who’s who’s sharing this information, this rumor on social media. You’re like, well, hold on, the local news isn’t saying anything. Why aren’t they? Why aren’t I hearing about it? Well, the answer is because it’s not real. But for some percentage of the people, they’re going to see this disparity, say, well, hold on, you know, I got –

CW: Yeah, the absence of information proves the conspiracy theory.

0:29:42
BR: Right. So so this is one of the problems. And then you have people like this guy, James Potok. Have you heard of him?

0:29:50
CW: I have not.

0:29:51
BR: So this this guy, James, he’s kind of a like a wannabe rapper, social media influencer. And yeah, yeah. And you’ve done some stuff on that type, haven’t you?

0:30:05
CW: Yeah, Joey Salads comes to mind.

0:30:08
BR: So this guy, on February 3rd, he’s a Canadian guy. He took a flight from Toronto to Jamaica. There’s an interview with him. I’ll just briefly quote what he told the interviewer that he did. So I stood up on the airplane about two, three hours into our flight, almost close to landing, and I said, can I have the attention of everyone on the plane? I just returned from Wuhan province and I kind of laughed and said, I don’t feel too well. And then laughed down and sat down again.

0:30:34
CW: OK, so…

BR: That’s a riot, huh?

0:30:39
CW: Yeah. So did they treat that similarly to how they treat jokes about bombs?

BR: They did. They did.

0:30:45
CW: Oh, good. Imagine that.

BR: He was, he was restrained. He was taken to the back of the plane by flight attendants, put a mask on. Oh. The entire flight turned around, returned to Toronto. All 240 some people on the plane had to get off in Toronto where they just come from.

0:31:05
CW: Oh, geez. And they were going from Toronto to Jamaica. Do you know how many Canadian vacations that guy ruined?

0:31:13
BR: Several dozen, if not a hundred.

0:31:15
CW: Oh wow.

0:31:16
BR: Yeah, so he was then checked by medical authorities for that, and he’s like, oh, I was just joking, and no one was laughing. He later tried to defend himself by saying, well, I didn’t technically say I had the coronavirus. I just announced to the entire plane that I’d come from Wuhan and I wasn’t feeling well, so don’t blame me.

CW: Oh, for crying out loud.

0:31:39
BR: So you have these sorts of people and again, you’ve talked about some of these sort of stunts on the show I the thing I forgot to mention, of course, is that he videotaped the whole thing. He wanted to share that on YouTube and Instagram because he thought would be a fun little prank.

CW: Because that’s what they do. That’s the YouTube pranksters way.

0:31:59
BR: Yeah, it’s adorable Just to wrap up. So, you know one of the One of the reasons why these sorts of rumors spread number one as we mentioned when you have something that’s that’s frightening people justifiably or otherwise they cling to any any information they have and They often times as we mentioned sort of adopt this populist anti CDC anti-government Tone right they figure well, you know, what what aren’t they telling us? see anti-government tone, right? They figure, well, what aren’t they telling us? When you look at it from a psychological point of view, the things that scare us most are these sorts of diseases, right, because it’s something that’s literally invisible. You can’t tell by looking at somebody whether they have the coronavirus or not. That can only be tested and verified through lab results. And you don’t know who among you is sick or not sick or maybe sick but asymptomatic or maybe sick but just have a cold. It leads to this uncertainty and in that context of uncertainty, rumors and misinformation flourish.

CW: Yeah, that makes sense.

BR: And the other thing to keep in mind is that a lot of times these sort of folk beliefs and these legends and these rumors, they offer a false certainty, right? Because with epidemiology and science and medicine, they don’t know everything, right? They can’t tell you exactly who the next person is going to die from. They can’t tell you exactly what’s going to happen.

0:33:26
CW: And what they do know is complicated.

0:33:28
BR: Yeah, it’s complicated, it’s nuanced, there’s a lot of factors, a lot of moving parts. That’s how science works. But people, they like simplicity, they like binary answers. They want to know, well hold on, don’t give me all this complicated stuff. If I drink this bleach solution, will this keep me from getting this? If I do this, if I do that. And unfortunately, the world doesn’t work that way.

0:33:52
CW: Yes, don’t give me modern medicine. I want the certainty of onions in my socks.

0:33:56
BR: Exactly.

0:33:57
CW: And I know I’m protected, because a meme told me so.

0:34:00
BR: The underlying thing here, of course, is that oftentimes people are very bad at assessing risk. They don’t distinguish well between absolute risk and relative risk. They freak out over flying for two hours in a plane because they saw a helicopter plane crash in the news last week. But they don’t pay attention to the fact that they’re on. They’re far more likely to die in the traffic accident on the way to the airport than anything else.

0:34:24
CW: Yeah. Or like you said, the flu versus coronavirus. Coronavirus is a new threat. It is a newsworthy threat. It is what we’re seeing in the social media and the news blogosphere. But I honestly did witness two women the other day in the supermarket grab one of those hand sanitizing towelettes that they offer you by the shopping carts and they just cleaned out the whole cart thing and said the coronavirus man it’s going to be it’s here you’re going to get it so just you know got to clean the whole thing and they were talking to each other like this is a real threat that was on their shopping cart and I mean the chances of…

BR: Did they have cigarettes in their mouths by any chance?

CW: No, but I’m just sitting there thinking the you know if there’s anything on that shopping cart, it’s probably a common cold or a flu. It’s not coronavirus. But by all means, use the towelette if it makes you feel better.

0:35:20
BR: Knock yourself out. Yeah, and that sort of goes back to why some of these folk remedies are so popular is that the things that actually work are simple. There are things that you’re supposed to do no matter what the hell you have. It doesn’t matter, if someone is coughing near you, you wash your hands, you stay away from them, you have them cough into their hands. Normal everyday things. So the advice that doctors and epidemiologists offer, it’s mundane, it’s boring, it’s stuff everybody knows that they should do. Yet because of the virus seems to be new and deadly and scary and extreme and and extraordinary, people sort of look for these extraordinary measures to combat it, when in fact it’s just the mundane things you’re supposed to do anyway.

CW: On that note, let’s reach out to somebody who works in the trenches of infectious disease. I’m going to give a call to Dr. Dan Ketterer, who works as an infectious disease doctor and has a few things to say about coronavirus that we should all take a listen to.

(MUSIC)

0:36:42
Dan is a wonderful fellow who I met at Dragon Con years ago. He is an infectious disease doctor who also bicycles all over the country and outside the country to raise money for HIV vaccine and research and to help those affected. Dan, tell us in a nutshell your credentials and why we should listen to you when it comes to infectious diseases.

0:37:06
Dan Ketterer: So I am a MD. I have been practicing infectious disease now for the past six years. I’m double-boarded in internal medicine and infectious diseases by the American Board of Internal Medicine. And why you should listen to me? I mean I’m funnier than every other person that’s been on all of these podcasts talking about coronavirus.

CW: Okay, well there’s that. You’re out of Atlanta, correct?

DK: Yes, but, I always have to like predicate like not CDC. I’m in private practice. I primarily in my private practice do a lot of sexually transmitted diseases, HIV, and really focus my practice on LGBT health care and health care for those in the poly, kink, BDSM community and communities that have had medical disparities in the past and have in a lot of ways lost trust in the medical system and I got into medicine and infectious disease to help rebuild those relationships.

0:38:15
CW: That is a worthy vocation there. Thank you for all you’ve done. And so we’ve discussed, Ben and I were just discussing a lot of the myths that have surrounded coronavirus and tend to pop up when you have any disease, especially the diseases that have been coming out of China and Asia in the recent decades. What can you tell us about the actual level of panic we as an American society should be having over coronavirus and what don’t we know?

0:38:44
DK: So the amount of panic that anyone should have is always zero. One of the things that, despite there being more podcasts about coronaviruses than cases of coronavirus that is not really coming out, is we should not confuse a strong response by health organizations like the WHO and Many people will sort of look at quarantines and what we call examining trace contacts. So people who infected people have been in close contact with. They will look at that and they will see places like China restricting travel and say, oh, this is because it’s an epidemic. But actually they’re doing the correct things in reducing cases and trying to limit the spread of it outside borders. The worst thing anyone can do in a situation like this is panic and get on the nearest plane to get out of a country when they may be actually incubating the virus and potentially can then expose many, many people that way and spread the disease a lot faster than if it’s contained in a single area.

0:40:04
CW: Okay, so the containment efforts should not make everybody even more nervous. It should be, I mean, because in the press all we’re hearing about is entire cities are on lockdown in China and there’s stranded cruise ships filled with thousands of people and yeah.

0:40:23
DK: That’s the only reason I really came on here to do this because like I said you can pick on pretty much any podcast you can pick a f***ing knitting podcast and they’ll talk about coronavirus right now and you’re gonna hear someone with you know some government credentials talking about the current statistics of it which are going to be basically stale within three days because there are still continuing to be new cases of it. Actually, one cool, hot exclusive you’re gonna get is they finally actually named the virus today.

CW: They being the WHO.

DK: Yes, yes. So, I don’t know, you may have heard multiple terms being thrown around for it. It was Wuhan coronavirus is the one that first got picked up in the press because that is the area of the world where it came from. 2019-NCOV is the term that we have been using.

CW: Novel coronavirus is what I heard yesterday.

DK: Yeah, novel coronavirus or nCoV, yeah. But that’s not really pronounceable.

0:41:26
CW:You can’t really. It doesn’t roll off the tongue, yeah. Well, don’t keep us in suspense. What’s this name?

0:41:32
DK: Yeah, it’s COVID-19. COVID? I know, it just rolls right off the tongue. COVID-19. How do you spell that? C-O-V-I-D, like C-O, coronavirus, V-I, virus, disease, 19, 2019 being when it was first isolated.

0:41:50
CW: Gotcha. Okay. Well, you sound like somebody who’s dealt with a lot of numbers and acronyms and disease names over your…

DK: That is medical school. That is medical school. And yeah, it’s all about learning acronyms and eponyms and all of those other things. Although there’s a big push in the medical field to eliminate eponyms because they’re not descriptive of diseases. So an eponym for those at home is when you name a disease after a person. It just tells you who was either behind the discovery or the first person to name it. Or it gives you some bit of medical history but it doesn’t actually help you in describing the disease.

CW: Yeah actually most of the diseases I can immediately think of involve a person’s name Huntington’s, Parkinson’s, Alzheimer’s.

DK: There’s a big big big push now in the medical community to eliminate all of those.

CW: Okay.

DK: And the other the other thing is often you’ll have folks who have made multiple discoveries that have multiple things named after them. Things like that. So it gets confusing.

0:42:54
CW: Yeah, that would get confusing. Now what about naming it after animals? Because I know prior to this we had the swine flu and the bird flu and…

0:43:01
DK: No one ever calls it swine flu. No one in the medical community ever calls it avian influenza or they never call it those things. I mean avian influenza may be sort of the loose term, but typically when epidemiologists, infectious disease doctors, if we’re going to talk about a virus like influenza, for example, we’re not going to talk about it under those very broad terms. We’re going to talk about it under a more specific term. So, with influenza, it gets broken down into three major types, A, B, and C. The two types we worry about the most are A and B. And more specifically, if we’re going to be talking about influenza, we often will talk about it with a sort of prefix to it, which is the H number and the N number. And what the H and the N stand for, those are proteins on the outside of influenza. And the different sort of strains of influenza will present different proteins on the outside, and that’s what your immune system reacts to. That’s how it recognizes these different types of influenza viruses. So, yeah, so like the swine flu, H1N1, is what we would actually call it. But to call it swine flu or to call it avian influenza is often a misnomer because these viruses can infect, will typically infect multiple, multiple different animal species, especially influenza A, where the reservoir is in birds, it’s in pigs, it can be in several different things. It’s not species specific necessarily. So that’s why you’ll have, and the reasons that avian influenza causes a real high mortality to it is you’ll have these influenza viruses reach, so you can have multiple viruses infect a single cell, and when multiple viruses infect a cell, they exchange genetic material. There’s what we call anagenic drift and anagenic shift with influenza. Drift is mutations in influenza that usually come from the fact that influenza isn’t very good at proofreading its genetic material when it copies itself and over time, over a period of time, will have slow sort of changes in the virus and especially in those proteins that are on the outside of the virus that you’re the original virus that maybe someone’s immune system would have recognized or would have been part of the vaccine now your antibodies won’t recognize that virus. Those are like slow changes, but the big changes the drifts. Which is what you see in influenza a where they will have multiple types of influenza infecting single cells, exchanging material, and then getting these big changes. What that results in is typically a relatively new strain which does, there hasn’t been a lot of, there isn’t a lot of sort of immunity in the population to. And so where viruses, and this is where influenza and coronavirus actually really overlap.

CW: I was curious about that because I want to –

DK: I’m getting there. I’m like an old person telling war stories. Okay, I’m gonna get there. I’m gonna get there.

CW: Tell me about the coronavirus, Uncle Dan.

DK: Oh, geez. All right, so where diseases tend to get out of control is when people have not, they have no immunological memory of them. So what I mean by immunological memory is our immune system, kind of more specifically our B cells and T cells have memories. So we can produce, if we’re exposed to a similar or same infection again, we’ll rapidly kick our immune system into high gear and produce antibodies that are specific to bacteria or a virus. And what those antibodies do is it allows other parts of our immune system, like our lymphocytes, T-cells, natural killer cells, to say, hey, this is foreign and it’s bad. We need to go over to these virus or bacteria which are coded with these antibodies and do our magic to basically eat them or secrete some sort of chemical that will help break it down and help your immune system remove that pathogen. The problem with things like novel coronavirus is, so without getting too technical, but through that sequencing, we can see that, okay, all of these people that are infected, the genetic code of the virus, it’s an RNA virus, is very similar between all of them. And what that tells us is there hasn’t been enough time for there to be that antigenic drift, that sort of slow changes in the mutation, which means a lot of people are saying, hey, why is it called 2019 virus? You know, could there have been cases before this? Sure, but but what it looks like is that these are all very close copies in the ICE list that were obtaining from people, meaning that it was likely obtained from a single source and all around the exact same time.

0:48:39
CW: So it’s like a copy of a copy of a copy. You can kind of tell when you look at the copies, these are still pretty like the original, so it hasn’t been out that long. So, okay.

0:48:50
DK: Exactly. So, influenza is just continuously changing, which is why people are like, well, I got a flu shot last year. Why the hell do I have to get one this year? With influenza, the reason people have to get vaccinations every year is because of that genetic drift or shifts. And for right now, how the vaccine is being prepared, we have to prepare it months in advance and try to predict what viruses will be the main viruses in any given population, because there’s multiple circulating flu viruses at any one time. But the flu vaccine is what we call quadrivalent, so meaning we can basically stuff what we think is gonna be like the four main types of flu in the flu vaccine, but it’s never going to cover all of them. So, to debunk a few influenza vaccine myths, one, you can’t get the flu from the flu vaccine. It is 100% not possible if you’re getting the intramuscular flu vaccine doesn’t cover all circulating types of influenza. But, certain years we do a very good job of predicting what the circulating types are going to be, and this year is actually one of them. So, we tend to cover influenza B better in the vaccines because influenza B has a smaller animal reservoir, seals and humans, and it also tends not to mutate as fast as influenza A. So influenza A, so your swine flu and avian influenza are influenza A’s, and those A strains are the ones that have always been responsible for the pandemics.

0:50:46
CW: And so the A flus are the more deadly ones in terms of…

DK: No.

0:50:52
CW: No?

DK: Oh God, I’m so happy to bust all these things. No, A and B are both equally deadly. And B actually can be technically worse in children. They are both equally deadly. It’s just that B tends to… They’re both able to do these genetic recombinations. B tends to do it slower. So, hence why A is usually seen in these epidemic cases where it’s something novel, it’s something brand new, and there isn’t a lot of widespread immunity in the community, which is why it’s so important to have these vaccinations because what you’re doing is you’re basically creating a preemptive immunity and you’re also protecting folks who don’t get vaccinated that may or can’t get vaccinated, which is a very, very small subset of people that can’t get vaccinated for influenza. The amount of people that can’t is very small.

CW: Okay, now how does coronavirus stack up to the flu? Is there any relation between the two and our immune responses to them? I mean, what can you tell us about that?

0:51:56
DK: Yeah, so this coronavirus, there is not going to be sort of inherent immunity, which is why researchers and scientists are very cautious about this right now. You’re not going to hear people in the medical community say, hey, relax, this is just going to burn out like SARS did. There is something that is mainly seen more in epidemiological research, but it’s been in a lot of these news and podcasts where they talk about the are not of a virus and then that is the in our with a little subscript zero by the way It’s not it’s not a single word like like Jason and the are nots or something like that But what the are not is it’s sort of an average of how many people are you going to infect with your disease, assuming the people you’re in contact with haven’t been vaccinated or don’t have some sort of protective immunity.

0:53:02
CW: I remember I remember reading something about that and that we get that below one.

0:53:07
DK: This is this is the one good thing I think that has been in the sort of coronavirus coverage and it’s sort of been like sort of at least subtly tucked in there is yeah, yeah, it’s sort of a moving target. It can change as a disease progresses over time. So if you look at something like measles, where measles is airborne, meaning you don’t have to be in close contact with someone, you can just be in the same room or you can come into that room a few hours later and still get the disease because that person is continuously exhaling that disease.

0:53:44
CW: So like super contagious, nightmarishly super contagious.

0:53:48
DK: Yeah. So the R0 is dependent on a few factors. How long is that person going to have the disease? How long is the disease infective in a person? Those are sort of the two big factors. Oh, and the third factor is how is it transmitted? All right, so take HIV, for example. HIV is gonna be transmitted through, primarily through sexual contact, exchange of bodily fluids like blood when you’re sharing needles, or before they screen, blood products, transfusions, right? So HIV has an R0 value of about 3. It’s not that it’s you can cough on someone and give them HIV, but once someone has HIV until they get the virus under control and undetectable, there is a risk of them transmitting HIV for their entire life. So, it’s a long duration. It’s a long period of time that they can transmit it. With coronavirus, the amount of time that they can transmit it is still not entirely known. So there’s a lot of questions still about coronavirus. And unfortunately, China has been very restrictive about letting researchers from other countries come in. And that’s one of the big problems is we’re dealing with sort of a black box and getting a lot of our stats from Chinese sources. We don’t have an R0 for coronavirus right now at all. It’s a moving target and I think part of the reason that there was a big original panic of it was that number was going as high as four when the news came out. So people were estimating it somewhere between three and four, meaning one person would potentially pass into four people before the disease sort of resolves in that person and they’re no longer infectious. That number has moved down.

0:55:42
CW: Okay, so it’s going in the right direction.

0:55:45
DK: Yeah, it’s gone down. So it’s probably closer to be between the high ones to threes and then can continue to go down.

0:55:56
CW: And since we’re not talking about a disease that you’re infected with your entire life, more like a couple of weeks.

DK: What we think, yeah, it’s gonna be about two weeks.

0:56:01
CW: So that would indicate, as you said, it sparked off a lot of concern because that would indicate geometric progression of this, if you’re quadrupling the number of people who have it every couple weeks.

DK: The concern, yeah, so the concern, and there was there was sort of an early tweet from a actually a fairly reputable epidemiologist that used a lot of panic-inducing language and shouldn’t have and he eventually had to walk it back, but the damage was done. There’s a good podcast called On the Media that talked about this, podcast shout out. But a lot of the concern, and again, not panic, concern is what you don’t have people there studying it from non-governmental organizations.

0:56:55
CW: So until that happens, it’s going to be, as you said, like a black box.

0:56:58
DK: We have to trust their number of cases, that they’re reporting them correctly. We have to trust their fatality rate.

0:57:09
CW: So one thing we’ve heard is that face masks are, number one, they’re running in low supply, and number two, they aren’t really effective. Can you explain why or how?

0:57:19
DK: Yes, absolutely. So I can’t explain why they are running out of short supply, I guess, supply and demand economics. All right, so the reason why face masks are not the godsend in prevention is if we think this is spread via close contacts and droplets, someone doesn’t have to come up to you and cough into your mouth for you to get this disease. What will happen, which is much more likely, is people will rub their eyes or they’ll touch their face, and they do this subconsciously. You don’t realize how many times a day that you do this. And when you do, it doesn’t matter if you’re wearing a mask, you are running the risk of potentially infecting yourself. The other thing people do when they wear masks is they will take them off and scratch their face. They will eat food. They will do different things without the mask on. So while a mask actually can be helpful, and certainly if you are a healthcare practitioner and working around people who you think may have been in contact with COVID-19, you absolutely should wear a mask, but at the same time, you also have to be extremely cognitive about touching other parts of your face or mucous membranes, and also absolutely 100% positively religious about hand hygiene, which in this case and in almost all other infectious diseases, strict hand hygiene is one of the best ways that you can help prevent spread.

0:58:50
CW: Wash your hands, especially at the airport.

0:58:53
DK: Yes, and also, if you are sick, not just with coronavirus, but with influenza, a cold, or anything like that, learn the proper Dr. Dan way to cough or sneeze. Do not cough or sneeze into your hand. Also, do not cough or sneeze, if possible, into a Kleenex. Because people will then leave their Kleenexes on a airplane tray table, they’ll put them on a surface that people eat off of, and then you can get what’s called fomite transmission. What you wanna do, the cool doctor way to cough or sneeze, is to feel the sneeze coming, lift your shirt up over your nose entirely, like I’m doing right now and probably messing with the audio and then sneeze into your shirt or into your elbow.

CW: Okay, shirt or elbow. Got it.

DK: I mean the only time you wouldn’t sneeze into your elbow is if you were a WWE wrestler and planning on clotheslining someone because then you can potentially infect them. Other than that, sneeze into your shirt. shirt and then wash your f***ing hands with soap and water.

1:00:05
CW: Gotcha, gotcha. That’s good information, Dr. Dan. We will pass that along.

1:00:10
DK: Yeah, and also early on it was not and still is not entirely known how it spread. The way things are leaning right now and of course all science can be falsified at a later date when new information comes around, which is the great thing about science and not religion.

CW: Yeah.

DK: Oh, and the best thing coronavirus has done, as a fun aside, is it has actually canceled the Dalai Lama’s touring ability.  So at least one good thing has come out of the coronavirus outbreak or COVID-19. COVID-19. At least we’ve stopped the Dalai Lama in his tracks. Finally, finally, finally.

1:00:55
CW: I didn’t realize that was a concern. Now, you were saying?

DK: How is it transmitted? So we think it’s close contacts.

CW: Okay.

DK: So meaning when you look at cases, and what I talked about earlier, where you’re doing this contact trace sourcing, you basically look at folks who are infected or folks who are symptomatic and then you say, okay, who has this person been in close contact with over a period of time? And then what you want to do is take those individuals and quarantine them.

1:01:28
CW: Yeah, and that’s… Which is what’s been going on.

1:01:30
DK: Which is what’s been going on. Now, I have a question as somebody who, you know, you do rounds in hospitals, you deal with people in Atlanta who have come down with something. How does the everyday doctor in a major metropolitan city in America test for coronavirus?

CW: Is there a reliable test right now? How do you guys know if you have COVID on your hands?

DK: Yeah. Test, yes. Reliable, maybe. There was actually some stories that came out today talking about there may have been some batches of the testing equipment that was faulty, but the way the testing is done right now is not testing that’s going to be available at pretty much any hospital. You’re going to have to send your specimens in. CDC is doing the processing, and what you do is you take, in this case, respiratory you can get someone to basically hack up a big loogie, or you can take specimens kind of deeper from the lungs, and then you send that specimen out, and then they’re able to do a type of testing called PCR, polymerase chain reaction, where they are able to take what they know about the genetic of 2019 COVID, so they take your specimen, they isolate the DNA from it, they’re able to basically mass produce that DNA from the specimen, and then they are then able to see, okay, does it match with the DNA of COVID?

1:03:04
CW: Okay, so the CDC knows the genetic profile of COVID-19, and it’s not like you could just, it’s not like a swab of your cheek and they can tell you in an hour if you have strep. This is more where people doctors across the country are looking at their patients who have bad pneumonia and they are sending samples I guess through the mail to CDC or what?

1:03:33
DK: Man, I’m so glad I’m talking to you. Is this what people think?

CW: I have all these misconceptions. Help me clear them up.

DK: So many misconceptions. Okay, so the the best most reliable symptom of COVID-19 is fever and then pneumonia, but it’s not, but at the same time 49 out of the 50 states are currently in basically the worst part of influenza season.

CW: Yes.

KD: And the symptoms overlap. So you are not going to send every specimen to CDC. It is only under a very, very strict conditions that you would. And those strict conditions, and this is the reason why it’s very important for people not to panic and then travel and leave a country if a disease is endemic in an area, it’s better for them to just stay home and do sort of isolation in an area where it’s endemic is they’re only supposed to send the specimens if you have recently traveled from Wuhan or an area where it is currently endemic or you have had close contact with someone, i.e. a family member of someone that’s infected or has traveled from Wuhan.

1:04:47
CW: Okay, so those are the…

DK: And you have symptoms and you have fever and respiratory symptoms.

1:04:52
CW: The patient history being all important there. Okay.

1:04:56
DK: The history is essential. Otherwise, the few resources that we have will be completely saturated with testing and you also run the risk of developing a potential, although unlikely, false positive, causing massive panic.

1:05:17
CW: That’s, yeah, okay, that makes sense.

1:05:20
DK: Especially since treatment at this time is still being kind of worked out, but there is the possibility that we can use some drugs that we already use against RNA viruses may also be active against coronavirus.

1:05:35
CW: Gotcha. Now, I got one last question. Donald Trump, who, as you as you imagine, is well known for his scientific and medical knowledge, has claimed that we won’t have to really worry about the coronavirus after it warms up, after the weather turns nice. Can you tell us what, if any, gobbets of truth are in that statement?

1:05:54
DK: I’m trying to think if there is any truth to it at all.

1:06:06
CW: Okay.

1:06:07
DK: Yeah, there is no reality to that.

1:06:11
CW: Okay, so it’s the-

1:06:13
DK: I mean, part of the reason that we see a higher number of cases of influenza being in close contact with people because influenza is transmitted through droplets, much like what we think coronavirus is as well. But like I said earlier, we’re still not entirely sure how this virus is being transmitted.

1:06:35
CW: Gotcha.

1:06:36
DK: We suspect it’s gonna be droplet or close contact, but there’s still a lot that’s known, or I’m sorry, a lot that’s unknown at this situation.

1:06:45
CW: Okay, so.

1:06:46
DK: And at this time. So no, I mean, everything about that is completely and utterly wrong.

1:06:50
CW: Okay, so even though you’ll have fewer people huddling together for warmth in close quarters and passing along every sort of virus, but it’s not like it’s gonna get burned off by the heat of the sun and sterilized or anything like that.

1:07:04
DK: No, what’s gonna give us the best chance of stopping coronavirus in its tracks is two things, really. Strong, nuanced public health response without panic. People following- It’s the quarantines.

1:07:21
CW: You’re talking about quarantines.

1:07:23
DK: Yeah, you know, potentially isolating, quarantining, and doing source tracing to find people who have been exposed and making sure that they’re closely monitored and also quarantined. That’s a huge, huge, huge, huge, the biggest portion of all this. Is limiting the number of cases. And then the, and making sure people adhere to that, that they don’t panic and go and take a plane somewhere and potentially spread it to a whole lot of people who have no immunity and are going to get this illness. So what you see with coronavirus, there’s so much stuff I can talk about that you don’t hear about in these other podcasts, which is, so part of the problem with coronavirus is, so a lot of the people that have coronavirus are health care workers.

1:08:07
CW: Oh yeah, yeah.

1:08:08
DK: So that’s a huge segment of people who are currently infected with coronavirus, and they were transmitting the virus to people who are the most immunocompromised. So the death rate of coronavirus, of the, sorry, COVID-19, it looks like the fatality rate is about 2%, which is considerably less than SARS and MERS, Middle Eastern Respiratory Syndrome virus. So it’s substantially less, and it may even be less than 2% because they may not be counting the people who had only a mild infection and did not seek medical treatment, but a big part of the problem is the health care workers who are in contact with sick patients in general, patients who may have compromised immune systems, small children and the elderly that may be coming into hospitals for different reasons, they were spreading them to them. So the mortality rate may be sort of falsely elevated for those two reasons.

1:09:17
CW: That makes total sense. I guess time will tell.

1:09:19
DK: That’s one thing you don’t hear about. The second thing you don’t hear about, and if anything makes me nervous, so the way coronavirus actually kills people, or one of the big ways that coronavirus actually kills people, which you never hear about, you just hear people die from coronavirus, they’re developing a small percentage of people with coronavirus will develop not just pneumonia, but something called acute respiratory distress syndrome or ARDS. And the problem with this acute respiratory distress syndrome is does not matter how many breaths you take, you’re not getting oxygen into your bloodstream because you have so much inflammation. So if you have a deficiency of getting oxygen out of your lungs and into your bloodstream, which is what you see in ARDS, you have to be either on a ventilator and really pushing a large amount of basically 100% oxygen on these folks at very high volumes to basically kind of force oxygen into people’s bloodstreams. Or you do another procedure called extra-corporeal membrane oxygenation or ECMO, which is essentially putting oxygen into someone’s bloodstream as it’s circulating out of their body like a dialysis unit.

1:10:46
CW: Wow, both of those sound equally awful.

1:10:49
DK: Right. So the big problem, and you also can see this in particularly bad influenza years, this is the one thing I’m worried about and you don’t hear about is you can absolutely positively saturate every single ventilator and ECMO machine.

1:11:05
CW: Oh. You can have a…

1:11:07
DK: So if there’s enough cases of severe disease, all ventilators and all ECMO machines can be tied up.

1:11:15
CW: So it’s…

1:11:16
DK: And this has happened, meaning the next person that comes in with a severe pneumonia and develops ARDS, there’s not much you can do. You’re not doing the recommended therapy and those people are very likely to die. So that’s why it’s so incredibly important to find, one, a treatment so that you can, so the way antivirals work, completely different than the way antibacterials work. Which is why you can’t take an antibacterial for a virus. Viruses are, a long debate, they’re not really alive. So you can’t really target it in the same way you target a bacteria. And viruses hijack your own cell’s ability, like nucleus and cellular machinery, to make more copies of itself. So drugs that we have to use against influenza or against viruses in general have to basically target just a couple different things of viruses. They have to target sort of viral reproduction or it has to target proteins that the virus makes with its genetic code. And then the way antivirals work is, like the antivirals that they’re looking at for COVID-19 will, if you think of DNA or RNA as made up of those bases, the base pairs, and thiamine, cytosine, and guanine, or uracil in the case of RNA. What these medications, a lot of the medications do and the ones they’re looking at for COVID, they mimic some of the base pairs, but once they’re incorporated into the, like, either the RNA or the DNA that the virus is making when it’s copying itself, it basically acts like a bookend. And once that medication that looks like the base pair incorporates in, it can’t actually finish copying and it just stops. And so what you have to do is, and then help eliminate the virus.

1:13:42
CW: That sounds like a very complicated, microscopic decoy.

1:13:45
DK: Yes.

1:13:46
CW: Like, use this, use this instead of that.

DK: Yeah, basically. And so, you know, in my field, what I deal with on a day-in, day-out basis, HIV, we use medications that target multiple different areas of the virus so that if one fails or if that virus mutates and becomes resistant to a particular target of the virus that we have multiple, we have other drugs that are also acting against it that will sort of take up the slack. It’s sort of going to be seen if coronavirus will require multiple medications or multiple targets for drug therapy for it to be effective. So that’s still being worked out. And the best way we’re going to be able to do drug research and rapidly deploy medications or a preventative vaccine against this is if we can get global researchers into China with both control of the virus through isolations, quarantine and contact tracing, and then also doing on the ground research to test different agents and medications and vaccine candidates.

1:15:04
CW: Gotcha, okay. Well, Dan, Dr. Dan, you have been a font of information and I’m sure our listeners will appreciate all the nuances you have brought. I learned some medical stuff about viruses I did not know. And it sounds like there is still a lot we don’t know about coronavirus, but I’m sorry, COVID-19.

1:15:22
DK: That’s right.

CW: But we shouldn’t panic.

1:15:24
DK: Yeah. To your listener in Atlanta, if you’re looking for a infectious disease physician that is LGBTQ kink BDSM friendly, look me up. www.idcga.com.

1:15:41
CW: Dr. Dan Ketterer, thank you very much for being on the show.

DK: Cool.

(MUSIC)

1:15:45
CW: Well, Ben, you’re back with us now. That was nice of Dan, Dr. Dan Ketterer, to give us a few moments or quite a few moments of his time and go into some in-depth analysis of the coronavirus from the point of view of an infectious disease doctor.

1:15:59
BR: Yeah, it was cool to hear from him and I’m glad that we could get this information out in a timely manner. Obviously, you know, with something like the spread of the disease, it’s in the news, people are talking about it, and the sooner you get the information out, the better.

CW: Yes. And as Dr. Dan mentioned, we have a brand new name for the disease as of today. Or when you listen to this, it’ll be yesterday. If you listen right when it drops, the new official name is COVID-19. We also learned the most effective way to sneeze. So we can sneeze and cough the Dr. Dan way from now on into your shirt or your elbow.

BR: All the better or at least not someone else’s shirt or elbow because that would be weird.

CW: That could be taken as assault. Yes, don’t do that. Next up we are going to be talking next week, it’ll be one week from now, we’ll be talking about the Minnesota Iceman with Ron Pine.

BR: Yes, a fantastic, fantastic topic. I’m looking forward to it. It’s one of the stranger angles into an already strange topic.

1:17:18
CW: Okay, listeners, I hope you guys enjoyed this bonus episode. Every once in a while we’ll throw out an extra episode so that it kind of goes back to the weekly schedule, but otherwise we’ll be once every two weeks. We’re glad you tune in either way, whether it’s bi-weekly or once a week or whenever we can get it out, but generally it’s every other Thursday we will drop you a lovely episode.

BR: Boom!

CW: All right Ben, well I’ll talk to you soon about the Minnesota Iceman.

BR: Bye-bye.

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1:18:12
friends. If you’re short on cash but want to provide moral support, remember to recommend us to a friend. If you’re short on friends, hey, remember that each five-star review helps us get higher on the podcast charts. Squaring the Strange is a production of Two Heads Studio, LLC. Copyright 2018. Theme music by Shriekback. Additional music by Memory, Keytard and Feathered, and Pasquale Romero. Additional support provided by Ashley Romero, Robert Sundin, and of course our listeners and patrons. The views and opinions expressed in this podcast are those of Squaring the

1:18:47
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Transcribed with Cockatoo