China, FLU, Obesity discussed on The Joe Rogan Experience
Oster home. The Joe Rogan experience. Podcast by all right here. We go so what you said. When you sat down was absolutely perfect the timing could not have been better. We'll tell everybody what you do. Michael Well thank you. I'm a black of a better term medical detective. I've spent my whole career tracking infectious diseases down trying to stop him. Try to understand where they come from so we can make sure they don't happen in the first place but most of all trying to respond to situations just like this just like this and just off the bat. How serious is this? Is this something that we need to be terrified of or is this overblown or howdy. Stand on this well first of all you have to understand the timing of it in the sense that is just beginning and so in terms of what hurt pain. Suffering death is a cow happened so far is really just beginning This is going to unfold for months to come yet. And that's I think what people don't quite understand What we saw in China I'm convinced as are many colleagues. As soon as they release all of these social distances he's mandated stay in homes haven't left her home in weeks and weeks kind of thing when they go back to work there. On planes trains subways buses crowded spaces manufacturing plants. Even China is going to come back again and so this really is acting like an influenza virus. Something that transmits very easily through the air. We now have data to show that you're infectious before you even get sick in some cases quite highly infectious. Just breathing is all you need to do. So from this perspective I can understand why people say well wait a minute. Flu Kills a lot more itself every year than this does and remind people beginning probably the best. Guess what we have Right now. On what limited data. We have say this could be at least ten to fifteen times worse worse seasonal flu year. We see ten to fifteen times whereas in terms of fatalities. Yeah Yeah and just illness and in fact I just I brought some numbers. We conservatively estimate that this could require forty eight million hospitalizations ninety six million cases actually occurring over four hundred eighty thousand deaths that can occur over the next three to seven months with this situation. So this is not one that take lightly and I think that's what I can understand if you say there's only been ten deaths twenty or fifty deaths just remember two weeks ago. We were talking about almost no cases in the United States. And now we're testing for it and watching the spread as it's unfolding. Those numbers going up astronomically three weeks ago. Italy was just living life. Just fine now. They're literally in a virtual shutdown in the northern parts of Italy and that's the challenge with infectious disease like this. It can spread very quickly and it also can affect people. I think maybe to put this into modern terms because this is something we think of often. When we think of pre antibiotic days you know the old time medicine We have an employee at our center for Infections Research and policy at the University of Minnesota. And she has a dear friend. Who Lives in Milan Italy and she works at a hospital there and she texted us to this employee of ours last night and this was an email that came out yesterday from one of their physicians in Milan at the largest hospital. He said I just got a very strong message. From a cardiologist at one of the Milan's largest hospitals they're deciding who they have to let die the aren't screening the staff anymore because they need all hands on deck and they have very small areas of the hospital. Dedicated denied Cova patient where they still screen doctors. Everybody else's dedicated to Cova patient. So even if they're positive meaning that they're sick they don't and they don't have a severe cough or fever than they have to work He says that that they're seeing an alarming number of cases in the fortysomething age rage and is these cases so we need to stop thinking that this is an old person's disease but this is what's going to unfold not just move on that's unfolding Milan. It's unfolding here in Seattle and this is what's going to continue to rolling Lee unfold throughout the world. Yeah where did this rumor? Come from that. It's an old person's disease is it. Just because the majority of the people that have died from it so far older yes in fact that's the primary risk factor for Diana's being old and then having certain underlying health problems for example in China Those men over the age of seventy who also smoked were eight to ten percent of them died. Sixty five percent of older Chinese men. Smoke the Case fatality rate or the percentage of people who die women in that same age where it was only about two percent in that case. Very few women smoke now. The challenge we have is. That's the Chinese data but there are a series of factors that we worry about that if the overlay on this disease are going to cause bad outcomes and we happen to be right at Ground Zero for one of the major ones here in this country and that's obesity We know that obesity is just like smoking in terms of its ability to really cause severe life threatening disease and forty five percent of our population today over the age of forty five in. This country are obese or obese men and women so one of the concerns we have is. We're going to see more of these What I would call very serious and life threatening cases occur in our country because different set of risk factors and we saw in China now. You mentioned that there's some sort of inconvenient period before people become sick. They're still contagious. What is incubation period? And how do we know about it when we call something incubation per? We're talking about from the time you and I got exposed meaning. I was in a room breathing. The air that somebody else who is infected with the virus was expelling out. I breathe it in. How long from that time period till the time period that you get sick? And what is that? That's called the incubation period. So that's win. Case numbers can double or triple every so many days in this case is about four days so and we actually have data there from people who are exposed one time one time only and we know when they were exposed. Were exposed to how sooner they get sick afterwards so the chauffeur in the car where an individual was sick showing symptoms than the chauffeur gets it four days later there one time and one time on the chauffeur does not show any symptoms. He's still contagious. Also be contagious too or he and that's one of the things that's challenging here as you and I might expose to somebody who is totally matic. No symptoms that virus would appear well. That's not a very strong virus. But in fact when it infects US could kill us. So we've seen cases of fatal disease that were exposed to people that had minor symptoms themselves. Wow this is what's unfolding here and this is what I think is such an important. I said why the timing is so important because Joey really gotta get information out to the public through so much information right now and we're GonNa do this for a while. This is not going to happen overnight. I worry I keep telling people were handling this like. It's a corona blizzard two or three days Mac normal. This is a corona virus winter. And we're going to have the next three months or more six months or more that are going to be like this. And so far this thing has been unfolding exactly as we predicted. We and our center put out a piece January twentieth and said this is going to spread worldwide. At the time people said add China we put out a piece the first week February and said this is GonNa pop probably the last week February first week of March. Because what happens is has what's called an are not redoubling time of these every four days so to increase doubling every four days so if you go to four eight sixteen it takes a while to build up when you start going from five hundred to one thousand two thousand four thousand. That's what we're seeing happening. Places like Italy. We're beginning to see it in some ways up in Seattle. It's what happened in China and You know when people are confronted with that suddenly this low risk phenomenon that talks about isn't so low anymore and that's why you need to prepare people for now. What can be done like? What can the average person do? I see people walking around with masks on wearing gloves. Is that nonsense largely first of all We'll step back. The primary mechanism for transmission is just the respiratory route. It's just breathing in studies in Germany. Which just have been published literally in the last twenty four hours. They actually followed a group of people who had been exposed to somebody. Automobile Manufacturing Plant and then they had nine people that with this exposure. He said if you have any symptoms all contact us we WANNA follow up. They agreed well. They got infected and so in the very first hours just feeling bad sore throat. They went in and sampled the throats their their saliva their nose for virus. They did blood. They did stool. They did urine and they found that at that very moment when they first got sick they had incredibly high levels of virus sometimes ten thousand times out and we saw with SARS in their throat meaning they were infectious at that point already. They hadn't even had symptoms yet. Have Really Nature Lamer coffee yet and and that's where we're concerned because that's the kind of transmission try you know. I always have said in trying to stop influence. Irish transmission like trying to stop the wind. It Oh we do. We've never had anything successfully do that other than vaccine. We don't have a vaccine here so what's happening is people in public. Spaces are getting infected. And the way you need to address that is unfortunately if you're older over fifty five slender line health problems which unfortunately a lot of Americans do. We have Obesity then right now. You don't WanNa be in large public spaces and trying to potentially get infected so you can take care of that part as far as can public health. Do we talk about this? We're not gonNA have a vaccine anytime soon. That's happy talk What we you know. We can close schools one of the big challenges. We have right now if we close schools. What did we accomplish in influenza virus when we close schools outbreaks because it turns out? Kids are get infected in school. And they're like little virus reactors you know they come home and they transmit it to mom and dad and brothers and sisters and So we close school sometimes. Christmas breaks are always great for kind of putting the dampening effect on flew in this case. Kids are not getting sick very often. Which is one of the really good news features of this disease into China. Only two point one percent of the cases hundred nineteen years of age in is that you know we don't completely know and I'm GonNa come to that in a second because they're getting infected it turns out one study showed that they still get infected with the virus but they don't get sick and we have that happen there's a disease called. Infectious Hepatitis Hepatitis. Say where we have outbreaks in daycares and the way we know have. An outbreak is transmitted through the stool. Fecal ORAL IS MOM AND DAD and the daycare providers get sick and the kids does symptoms will go in and test. The kids are all positive so some diseases.