Hi, I'm Wendy Zuckerman and you're listening to science. Best is from Gimlet Way are on a break. We were on a break working on new episodes around next season. That was until we started hearing about this new virus infecting people in China, with the number of cases going up and up. There are nearly 300 confirmed cases, 830 confirmed cases now heading towards 3000. More than 4500 have been infected. China has gone into full blown crisis mode, building new hospitals, closing schools and shutting down transport between cities, effectively putting millions of people under lock down. The country has quarantined multiple cities. The streets are deserted, shops are shut. It is cut off from the rest of the world,

but still their cases showing up around the world. Cases confirmed in Japan, South Korea and Thailand in Europe, Australia to the United States right now, though the vast majority of infected people in China as of January 30th that's today. Chinese officials have reported almost 10,000 confirmed cases, and more than 200 people have died. The head of the World Health Organization has just raised the alert level I'm declaring a public ALS emergency of international concern today on the show. We're going to ground zero to talk to a doctor in China who's treating patients. Now. We'll also talk to researchers who were tracing this virus back to its source and trying to figure out how bad this whole thing might get. A few months ago, we didn't episode about a fictionalized pandemic where things got pretty bad. Will this be anything like that? And finally, we'll hear from the man who is advising the president about this outbreak.

We have only five minutes, 20

five minutes. Was that the president in the room?

Well, I can tell you it was

to stop. Let's head to Ground zero Wuhan, the city in China where this virus broke out. Doctor is a doctor in John Non Hospital at Wuhan University, and he's seen the outbreak grow from its earliest days. Normally, Doctor Wait works in the allergy department, but early in January, he got a call from his boss saying, You're needed elsewhere. Ah e. On January 3rd, I got a phone call from the director of our department. He said the medical service team had told us to send help to stop the virus spreading. At the time, I had no idea what I was going to get involved with that night. I was actually pretty nervous,

mainly because I had no idea what I was getting myself into, what I could do to help or where I'll be sent to help you shoot. The next day he went to the hospital, and because the people there was so worried about how dangerous this disease could be, Dr Way had to bundle himself into what he calls Ah, full body anti virus suit. It basically looks like a spacesuit hooded with this hat, and then I'll be covered from head to toe in an anti virus suit. And there's a zipper, which also has a hoody and top, finally finishing up with an aural mask and face mask to cover up my whole face. His first shift at the hospital was pretty calm. But then in mid January, things took a turn. It's winter over there, and Dr Quay remembers that it was really cold outside and infected people were lining up at the hospital.

Some were really sick and they didn't have enough beds of the hospital. What time does that? Most of the patients were seeded are waiting outside of the hallway standing. I felt overwhelmed and stressed, since I couldn't take care of many patients immediately. Three disease that's infecting people is a kind of virus called a Corona virus. It's a family of related viruses and not all of them a deadly. In fact, according to the Sadie say, most people have been infected with a Corona virus. At some point in their lives, they typically give you just like a running nose or a cough. Mild symptoms. But this virus, it's new science didn't know about it before. For now,

scientists are calling it 2019 n. C o ve the novel Corona virus. And yet some of the patients infected. They are also experiencing pretty mild symptoms. But the patients that doctor way is saying they have high fevers. Some have chest and muscle pain. Some have difficulty breathing. Dr. Quay remembers a patient that he sold one nice e. Remember, a more severe case when I made a huge impression on me was one case from before Chinese New Year around January 15th or 16th. I was working the day shift. This patient was very fragile, and she came in, carried by her family to the hospital. She had so little spirit left in her that she couldn't even lift her head up.

She just seemed very fragile. She was sent to emergency care, and he thinks she survived. But he's not sure way. We're totally unaware of the seriousness of the time and how many people would be infected. Currently, the fatality rate of the virus is estimated to be between two to full percent. That means some two in every 100 people who get infected and get treatment a dying. That doesn't mean that 2% of those who are infected will die because that number doesn't include people who get sick, have a bit of a cough, maybe feel lousy, but don't seek treatment. This is all unfolding in real time, though, and there's still a lot we don't know. So leaving the hospital next question.

Where did this virus come from? There's a lot of reports, meaning it toe a wet market in Wuhan, a place where they sell seafood alongside poki, pines and foxes and snakes and other animals. But then it became clear that some of the earliest patients had never been to that market, leaving the question, Where did this virus come from? And just how long has it been infecting people for, well, really? Early in this outbreak, Chinese researchers worked out the genetic code of this Corona virus, and they uploaded it into an international database. They keep adding samples from other patients. So now scientists in China and all over the world using these sequences toe unravel where this virus came from and when it first emerged and one of the first things they did was to compare this virus is genetic code with other nasty viruses,

ones that we already know about, and Bam! They found something. This'll virus was really similar toe a virus found in bats. So we think that's bets. That's Christian Andersen, the director of infectious disease genomics at Scripps Research Institute. He's one of the scientists who's been researching the origins of this virus. You know, bats probably don't get sick from this virus, right? So the virus gets to infect bets and just sort of hang out there. So this virus is hanging out in bats, maybe for a while. How did it jump to humans. Well,

it might not have been a direct job like with SARS, which was another Corona virus that emerged in 2002 and killed around 900 people. Well, that disease started in bats as well, but it had what's called an intermediate host a middle animal, that it infected first Christian talk to produce a Merrill Horne about it. We know from Sauce, for example, that there was an intermediate host, as it's called over Sivits. What's it? What's us of it? I think it's like a cat, like I'm googling it now. Oh, it is.

Yeah. It's kind of like a cat. Very long spotted cat. It's pretty cute, actually. Okay. Vehicle? Yeah. Yeah. So we think something similar probably happened with this Corona virus to write for this virus. If there was an intermediate host, we don't know what it waas. An early paper suggested it might have been snakes, but Christian doesn't think that's right. We also don't know how this virus got from one of those animals in tow. Us this state,

you really don't know it's possible the animals were simply just there and, you know, droppings or whatever around the animals. People could get into contact with that. They could be traded in the market. They could be consumed for food. But Christian told us that it's not surprising that this happened when you have animals, including humans, all living next to each other. A virus has a lot of chances of leaping from one creature to another. It happened with a bowl of bird flu, even the bubonic plague. Okay, the next question. When did this virus make the jump? There's this idea out there that the virus has been around for a while,

simmering away, infecting people before the word got out. Is that true? Well, he's how scientists like Christian of finding out. First they take all those samples of the virus is from different patients. You know, the ones that have been uploaded to the database and they compare them to each other. And what you're going to see because virus has changed slightly over time, is that you're going to see that the virus is air. Going to be slightly different between different patients is a virus is mutating all the time. It's not necessarily dangerous mutations sometimes that just changing. So the idea is that if a virus has been around for a while, it will have accumulated lots of different tweaks to its genetic code. There'd be lots of versions of it out there, but if the virus is really knew,

it would look pretty much the same in every patient who has it. And that's what Christian found here. He looked at the genetic code of the virus found in 27 patients, and they were all really similar. Other researchers found the same thing, So this means that this virus, it probably emerged really recently, and what we can show is that it happens somewhere around mid November, too early December. Based on this early research, it looks like this virus was first born, maybe in November, China told the World Health Organization about it on December 31st. So this idea that the disease was simmering away for ages before we knew about it, Christian says No. Based on the genetic data that we can show that that's not what was going on.

It really was picked up very, very rapidly after the break. How contagious is this new virus? And if someone new is infected, what should you do. Welcome back today. We're looking into what we know about this new Corona virus that showed up in China late last year and has since been found in at least 18 other countries in the U. S. Five people who recently visited China were diagnosed with this virus. On January 30th we heard that the husband of one of those people is now also infected. It's the first case of human to human transmission in the U. S. And while this is very much a moving target since the outbreak, scientists have been scrambling to understand this virus. So our next big question is, how is this spreading?

And how contagious is it for that? We went to Dr Katherine Pulis. She's an infectious disease expert. Katherine used to work at the National Institutes of Health, and she's now at Penn State Health in Pennsylvania. If we started to have cases here at the hospital, I would be on the front lines of this and what's happening in your hospital right now. Right now, we're preparing for, I think, a very real possibility that we may see one of these cases, or even more than that here. One of the initial fee is about this virus was that it would survive floating around in the air. That is, it would be airborne. If true,

it would mean that you could get infected from someone just breathing knee you. Some other viruses act like this. So for measles, for example, if you walk into a room where someone with measles has been even within two hours, you could potentially get infected. Oh, wow. But Katherine says that other similar Corona viruses that we know about they mostly don't spread for the air. She thinks this disease is spreading a different way. So most Corona viruses are spread through droplets. Somebody coughs or sneezes. They form a respiratory droplets and that comes in contact with someone. Their eyes, they breathe it in. They touch their mouth.

Something like that. With droplet transmission, the droplets fall pretty quickly. They're not hanging out in the air for you to breathe them in. So that is how we are assuming that this is spread. But we don't have the full information yet, So can you give me a little more data was given. This is unfolding. Why do scientists think that currently this is just spread through droplets like, What are the clues that you're using to get that information that most of the cases so far have been very close contacts if they've been spread outside of China? So, for example, there have been a couple reported instances of human to human transmission in other countries besides China, so places like Germany and Vietnam. So a traveler had gone there and they came back and they spread it to somebody. But those cases were in very close contact with the person that was sick.

They were staying in the same hotel room, touching the same things. If something is airborne, you would have 10 20 people potentially infected. That wouldn't be close contacts, and that's not what we're seeing. So can someone spread this before they start getting symptoms? That's a question that everyone would like to know the answer to. So there's been some reports coming out about that, that they're potentially people that have spread this before. They're experiencing symptoms, but we're still learning a lot more about these cases to see what might be going on. Most respiratory viruses are the most contagious. When people are having symptoms, you know even if one person spreads it when they're asymptomatic, the majority of people are not going to.

So every person who is sick on average, how many people will they spread it to? So that gets into a concept called a basic reproduction number or are not value? And that value sort of tells us how many people someone could potentially spread the virus to. So, for example, if you hadn't are not value that was less than one. An outbreak would die out because each person is not able to spread toe one additional person. Once you get above one, an outbreak can sustain itself. The virus will continue to exist. It won't die off on its own. So what they've reported on this is a range between 1.5 and three, but with a lot of uncertainty about those numbers. So if you look at it in isolation, one person could potentially have the ability to spread to one and 1/2 to 3 other people.

As a comparison. When scientists look at this number for the flu, it's about 1.3, and for measles, the R value is roughly 15. Yet measles is bonkers, contagious So this new Corona virus scientists are currently thinking it's between 1.5 and three. So now just moving on to what people should be doing about this. If you live in China, you know, should you be wearing a mosque witnessing a lot of Babel with mosques? Do they actually work? We don't know how well they work, but I expect that they provide some protection. So at the very least, they probably keep people from touching their mouth after they've,

you know, maybe touch something that somebody's coughed on or something along those lines. The Katherine says where we go wrong is that we slip out grubby fingers under the mosque when we ate. When we scratch our face and the virus can sneak in that way, yeah, it's totally defeating the purpose of the mask. It probably provides some protection, but it shouldn't be relied on by people that that's gonna protect them definitively. And don't use the mask. Thio substitute for other ways to prevent infection like good hand washing and not being in contact with people that are sick, have there been studies that literally show when you wash your hands, it reduces the risk of infection? Absolutely, absolutely. I think washing your hands is the number one most important thing you can do to prevent infection. Who would have thought that your best weapon in the battle against an outbreak is a humble bar of soap?

When do you think this one? I think that the next two weeks will give us a lot more information about whether this will be contained primarily in China or whether this will become a global epidemic. And Catherine told us that for now this doesn't same as scary as some of us might be thinking. So I actually went into infectious disease because I saw the movie outbreak when I was like 11 year old. So I don't think this is going to be outbreak. But I do watch thes respiratory viruses very closely because they certainly have the potential to spread and make a lot of people very sick. Right. And speaking of outbreak and worst case scenarios, just a couple of months ago, we created our own West Case Scenario pandemic episode and you've listened to it and and I was just wondering, you know, how are things panning out differently in this case, Yeah, that was terrifying. I listened to that, and that was a very terrifying outbreak that you created.

I think the good things that we know already One of the first things you said in that podcast was that every person was infecting 10 more. I certainly don't think that's happening with this virus. And another thing you had mentioned was the mortality rate, which I believe was 40%. Ah, certainly don't think we're anywhere near those numbers. So, you know, I think those things are reassuring. And we just need to watch and see how the next couple of weeks shape up and how well this virus is able to be controlled. Moving forward. There was one last person that we really wanted to hear from about this outbreak because it's his job to advise the president of the United States about what's going on.

Yeah, thanks. Hello?

Hey, Anthony Fauci,

Hold on one second. Just hang on.

Okay,

I'll be finished in five minutes. We have only five

minutes. 20 five minutes. He was that the president in the room?

Uh, well, I can tell you, it was, but what's up?

Anthony is the head of the National Institute of Allergy and Infectious Diseases. We had him on the show a few months ago to talk about our pandemic episode. And I know you've been talking to the president as you do about these issues. What did you tell him about this virus?

Uh, Wendy, I can't tell you anything. I tell the president of the United States. I'm sorry. We had a very long meeting.

How worried are you right

now When you say worry. I mean, I don't worry. I either get prepared or I do something about it. I think from the standpoint of the American public, should they be frightened? No. Is this a serious situation? Yes. Certainly. In China it is. But right now, the risk in the United States is low. That could change. You know, we need to be prepared for the worst.

The worst would be if we started to see this virus passing on to lots of people who haven't been in China because that would open up the possibility of this virus really taking off internationally Now. So far, there's been just a few reports of this, including one in the US that we just heard about today. On January 30th a woman was in Boo Han when she returned to her home near Chicago, and she passed the virus on to her husband. We asked Anthony if this new case was concerning,

we would have liked to have not seen that. But it's not surprising that we have seen that The thing you need to do when that happens is what the CDC is doing and the state and local health authorities are doing. They've identified the person, they're isolating them, and they will now do contact tracing on that person's contact

Contact. Tracing is when research is getting touch with the people that someone who is infected has been around to see if they've spread the disease. And do we know if the husband has infected anyone else?

We don't know that right now, And that's the reason why the CDC is doing contact tracing.

Meanwhile, China has taken some pretty extreme steps to try to stop Maur and more cases of the disease coming out. Some cities that have been hit the hottest, basically in lock down, with citizens unable to late.

Well, you know, I think it's it's unprecedented. A cz a matter of fact, Will it work? Um, people asked me, Do I think it's gonna work? And my answer? Honestly, I really don't know. I mean, I've seen people do restrictions on social interactions and travel, but never to this magnitude where they've essentially locked down 45 million people. So that could work. I don't know. I mean, there's no president, no benchmark for this to compare it to this degree of shutting down of transportation and citizens in the country.

Do you think that if there was an outbreak insane New York, you know Wu Han's a little bit bigger than New York? Would would there ever be a lock down in the same way?

I doubt it very, very much. I cannot imagine that New York or Los Angeles or San Francisco could be locked down like that. I would be. I would be stunned and very surprised if that were the case

with making a vaccine for a Corona virus. How long might it take?

Well, we've already started. We could probably have a vaccine that we could start using anywhere you know, from a year to year and 1/2 it's gonna take at least a year

to have that. And by then, do you think the pick of this outbreak will be our bone?

No, I'd have to say, I don't know when. I think it is too early in the outbreak to make any conclusion about where this is going. Absolutely. It's too early. We can't say that this is mild or that didn't see no under control. We don't know. It's still evolving. It's still evolving. There were over 7000 cases now, you know, up from 6000 yesterday, up from 4000 the day before.

Given what we know about, I guess the pattern of what happened with saws. And

when you I love you, you're wonderful. But I'm telling you six different ways. We cannot predict. We can't. This is an evolving situation. It could go either way. It could take her out like SARS. Or it could take off in a very, very widespread way. And that's the truth. Wendy, I gotta go.

Thank you so much. Thank you so much. Okay, So we don't know how bad this will get on. The research is still very much in flux, but here's some things that we think we do know about this virus right now. It's killing roughly 2 to 4% of people who are infected and go to get traded. We think it's mainly spreading through coughing and touching. So if the virus makes it to your area, one of the best things you can do to protect yourself is to wash your hands, which I guess we should all be doing anyway. So far, the virus has been pretty contained in China, with relatively few cases outside. This is all evolving. Science is doing its best to keep up. That's science passes,

so we'll be back with a brand new season in March in March. But in the meantime, we have some special treats for you. We made a playlist of all about favorite episodes. So if you want to tell your friends about science fesses and where to start, you can send them to this playlist. Or if you just want to see what is some of our favorite episodes, head to www dot science messes Science V s dot show slash playlist, and we also started making mini versions of our episodes for when you know, you just want to swing one back search for shots of science versus shots of science verses and you can listen for free on Spotify. This'll episode was produced by me, Wendy Zuckerman, Merrill Horne, Rose Rummler and Michelle Dang Where. Edited by Blythe Terrell and Caitlin Kenney. Fact Checking by Lexie Crop Mix and sound Design by Sam Bear Music written by Peter Leonard,

Emma Manga and Bobby Lord. A big thanks to Dr Paul Della Matta. Dr Victoria Cole is, um and Shanley, recording assistance from Margo Wall and Randy Scott Carroll. Translation by She, U N John Deng and Ci Young Swang A special thanks to Bobby Lord Zuckerman family and Joseph Lovell Wilson. I'm Wendy's look, um, in fact, you next time.