SPEAKER_1: Welcome to StarTalk, your place in the universe where science and pop culture collide.
SPEAKER_1: StarTalk begins right now.
SPEAKER_1: Welcome to StarTalk.
SPEAKER_1: I'm Neil deGrasse Tyson, your personal astrophysicist, and of course, your host.
SPEAKER_1: We are returning to our sort of medical professional in chief, Dr.
SPEAKER_1: Irwin Redlener.
SPEAKER_1: You may remember him from a previous episode.
SPEAKER_1: He's the director of Columbia University's National Center for Disaster Preparedness.
SPEAKER_1: He's also a professor at Columbia University's medical school.
SPEAKER_1: This is being recorded on April 23rd.
SPEAKER_1: Of course, you need to date everything that involves a discussion about the coronavirus because things change daily.
SPEAKER_1: So we just want to get an update on that last conversation we've had with him, which was, in fact, back on March 3rd, which seems like forever ago.
SPEAKER_1: Was it after then or before then it was officially declared a pandemic?
SPEAKER_2: I think it was just before it was officially declared a pandemic by the World Health Organization.
SPEAKER_1: Are they the ones with the power to do that?
SPEAKER_1: I mean, could you have declared it a pandemic without...
SPEAKER_2: Well, actually, I did, but nobody cared.
SPEAKER_2: But yes, I did.
SPEAKER_2: But no, but people were already thinking that it should have been declared a pandemic before WHO stated so.
SPEAKER_2: And there was a lot of reluctance, by the way, because, you know, once you say we have a global pandemic and a global emergency, you've elevated the conversation quite a bit.
SPEAKER_2: And the criteria for a pandemic is a deadly outbreak in a particular place that all of a sudden begins to disappear.
SPEAKER_2: It starts to cross international borders, so that's the pan in the demic there.
SPEAKER_2: And that is starting to happen way before the World Health Organization declared it to be so.
SPEAKER_1: And if I remember correctly, social distancing was not yet a thing to be invoked.
SPEAKER_2: Correct.
SPEAKER_2: Certainly not in the way that it's invoked now.
SPEAKER_2: We're sort of talking about it vaguely.
SPEAKER_2: And by the way, this really terrific expert named Mike Osterholm in Minnesota has suggested we don't even use the term social distancing, that we use physical distancing.
SPEAKER_2: And he makes the point that we don't actually want to be socially distant.
SPEAKER_2: We want to try to use whatever is available like Zoom and FaceTime and whatever phone calls to try to sustain and amplify our social connections.
SPEAKER_2: So, I just recently started having read him be interviewed on this subject, started referring to this process as physical distancing.
SPEAKER_2: I think it's a good idea.
SPEAKER_1: I will be happy to do that going forward, especially since, of course, we are not socially distant at this point.
SPEAKER_1: We are right next to each other.
SPEAKER_2: Yes, we are.
SPEAKER_1: Electronically, neighbors.
SPEAKER_1: I just remember it was only two weeks after we had our last recording with you, where I had started recording with StarTalk out of my home.
SPEAKER_1: So, things were happening fast, and millions worldwide have been affected.
SPEAKER_1: Tens of millions have filed for unemployment.
SPEAKER_1: New York City has become a global epicenter.
SPEAKER_1: And so, could you update me on the hospitalization rates and some of the statistics related to testing versus who's hospitalized and what the state of respirators are?
SPEAKER_2: Sure.
SPEAKER_2: So, let me get a little bit of background here is probably worthwhile.
SPEAKER_2: So, right now, it is anticipated that at least 50% of the world, including the US it may be as high as 60 or 65%, will contract the virus that's responsible for COVID-19.
SPEAKER_2: And it's formally called SARS-CoV-2, the name of the virus.
SPEAKER_2: But in any case, we expect, let's say, half the US population, that's about 160 million people, will actually get infected.
SPEAKER_2: And somewhere between 10 and 15% will have to go to the hospital.
SPEAKER_2: And so, the vast majority of people will get either zero to very moderate symptoms that could be cured for at home.
SPEAKER_2: But we'll have about, let's say, it's 15% go to the hospital.
SPEAKER_2: And about 5% will end up actually in the ICU requiring a mechanical ventilator, which means a breathing machine.
SPEAKER_2: So, a tube is put down in your throat.
SPEAKER_2: It's connected to basically a pressure machine that is forcing air and oxygen into your lungs.
SPEAKER_2: There's been a very interesting problem, Neil, that I think you'd probably be interested in.
SPEAKER_2: So, there's a group of professionals called modelers.
SPEAKER_2: And modelers take certain assumptions, like what is the infection rate or what is it likely, what are we likely to see in terms of percentage needs to go to the hospital.
SPEAKER_2: And they create projections of what the future has in store for us when it comes to, let's say, something like a pandemic.
SPEAKER_2: Those modelers are currently all over the map to the point where there's so many different assumptions you could put in and there's so much unknown about this particular virus that when they're whispering into the ears of people in government who have to make statements, order mechanical ventilators, order personal protection equipment, and so on.
SPEAKER_2: And some modelers are saying, you know what, we're going to need another 100,000 mechanical ventilators in New York.
SPEAKER_2: And another modeler says, no, well, our calculation says we'll need 20,000.
SPEAKER_2: That kind of disparity has become very prevalent to the point where nobody's really trusting the modelers.
SPEAKER_2: And I hope no modelers are listening to this because they're really very nice people.
SPEAKER_2: But the fact is, you know, these models are totally dependent on the information put in.
SPEAKER_2: And since we have so much uncertainty, a lot of different assumptions could be put in.
SPEAKER_2: Anyway, long story short, because there was seemingly such a tremendous demand and a tremendous need to build more hospital beds, especially ICU beds, we had the Army Corps of Engineers who are a wonderful, very talented group of people that are connected with the Department of Defense.
SPEAKER_2: They came, for example, to New York to a huge convention center called the Javits Center and built a 2,500-bed hospital.
SPEAKER_2: And then the Army or the military also sent up a hospital ship called the Comfort to be docked in the New York Harbor to give you more beds.
SPEAKER_2: Turns out we're not going to need many of those beds.
SPEAKER_2: And the theory, though, was that it'd be better to overplan than underplan, except the problem with this, Neil, has been that every single city in the country, anticipating their own surge, maybe not as steep as New York's, but pretty steep, were all demanding things at the same time.
SPEAKER_2: And since the federal government was so extraordinarily and profoundly disorganized, and I have to use the word incompetent in creating national plans and settling national priorities, we ended up having some places with more than they need, other places who don't really have much need right now, but probably will in the near future.
SPEAKER_2: It's not a thought through plan with the amount of federal oversight and direction that we might have hoped for.
SPEAKER_1: So, Irwin, let me get back to the modeling comment just for a moment.
SPEAKER_1: So we do a lot of modeling in astrophysics, and we would pass judgment on a model based on whether there were too many loose ends that were sort of, if not arbitrarily tied together were at least, even if you had a good reason for assigning a value in one place or another, if there are 10 or 20 different values, you start getting noise after a while.
SPEAKER_1: You start getting something you can't trust.
SPEAKER_1: So let me just ask you, what are some of the input parameters to these models?
SPEAKER_1: I know one of them would be, if you have the disease, what's the average number of people that would contract it from you?
SPEAKER_1: That's a very important number, correct?
SPEAKER_2: Exactly.
SPEAKER_2: And originally it was 2.3.
SPEAKER_2: So a little more than two people would likely be infected by you.
SPEAKER_2: But there's now this recent data to suggest it may be somewhere between five and six people.
SPEAKER_2: And the multiplier effect from that, just that difference of infectivity has a tremendous outcome or output that is befuddling and it makes the control of this much more difficult.
SPEAKER_2: One of the things that we have to do in controlling the spread of a virus like this is to do something called contact tracing.
SPEAKER_2: So if you turn out to have a positive test, somebody presumably from the health department will call you up and say, let's go over your last two weeks of who you've been in touch with, where have you been, and let's try to figure out who we need to call to make sure they get tested.
SPEAKER_2: So if you're only, let's say, infecting on average two other people, that's one thing.
SPEAKER_2: If you're infecting on average five and a half people, that makes that job of contact tracing horrendously more complicated, difficult, and expensive.
SPEAKER_2: Right now, by the way, we have about 2200 people who are designated contact tracers in the United States, and some people are now estimating we need over 100,000.
SPEAKER_2: Some people are saying it's as high as 300,000 people who could do contact tracing if we're going to get control of this.
SPEAKER_2: Part of that is based on the fact that we think the disease is more infectious than it was.
SPEAKER_1: So this notion that you'd be infecting two other people or six other people, that's, of course, greatly mitigated by physical distancing, right?
SPEAKER_1: So if you say the rate is this, and then, so please engage in physical distancing and when everyone does, that number drops and that changes the model.
SPEAKER_2: Right.
SPEAKER_2: And the other thing, I mean, we can just go on and on about this, but the fact is, if we're not doing testing, we're doing some, but nowhere near as much as we need to, we don't really know who's positive.
SPEAKER_2: If we could test the entire population right now, we could say, well, these public health interventions like physical distancing, wearing masks when you do go outside and so on, could potentially have such and such effect.
SPEAKER_2: But if we don't even know the baseline of how many people are infected and who's infected, that obviously throws a monkey wrench at this entire challenge that we have.
SPEAKER_1: So part of, as I understand it correctly, part of what makes this virus particularly insidious is the incubation period before you even have a symptom that would indicate that you might have it.
SPEAKER_1: And are you contagious over that time?
SPEAKER_2: Yes.
SPEAKER_2: So this has also been a point of controversy.
SPEAKER_2: So most people, it is thought between the time of contact or contracting the infection and the time of getting symptoms, if you're going to be in the category of people that get symptoms, is about five days.
SPEAKER_2: But the incubation period is somewhere between two or three days on the one end and 14 days on the other end.
SPEAKER_2: So if you've had a contact with someone who's positive and you don't get tested and you don't have symptoms within a two-week period of time, you're not likely to be positive.
SPEAKER_2: So there's that.
SPEAKER_2: But then if you're talking about a population of 328 million people, even small percentage changes can have huge differences in the output and the outcome of your modeling analysis.
SPEAKER_2: So it becomes very complicated.
SPEAKER_2: Dr.
SPEAKER_2: Oz famously said the other day about the things we should open schools again all over the country, in which case he says we'd only get another 2% or 3% fatality rate, which is millions and millions of people if you think about the entire population of the US.
SPEAKER_2: So we have to be careful even about small numbers when we're talking about what's going to these modeling inputs.
SPEAKER_1: So what you're saying is a small percentage on a huge number is a lot of people and a lot of newspaper headlines.
SPEAKER_1: Correct.
SPEAKER_1: So that brings me to a question about a possible second wave.
SPEAKER_1: This coronavirus got me reading about the 1918 flu pandemic and there were multiple waves and it went away and it came back.
SPEAKER_1: So we started, you started by saying we might ultimately have half the population of the United States having been infected with the coronavirus.
SPEAKER_1: Presumably that spread over some period of time.
SPEAKER_1: That would presume multiple waves so that we do flatten the curve.
SPEAKER_1: We don't overrun the beds, but still it runs its course.
SPEAKER_1: Again, this presumes it's before we have a vaccine.
SPEAKER_1: So tell me about second waves and how do we mitigate that?
SPEAKER_2: Well, essentially my feeling now is that a second wave is inevitable and possibly a third wave after that.
SPEAKER_2: And this is the reality of it, which of course brings us to the question, well, now what?
SPEAKER_2: That's going to be the case.
SPEAKER_2: Then I think we're going to have to be prepared for a lot of interventions that are the physical separation and sheltering in place type before we have an effective vaccine, which is still a year to a year and a half away, even with some very, very much accelerated research to get a vaccine development out to market.
SPEAKER_2: So we're in for a long haul, Neil.
SPEAKER_2: This is one of the things I've been trying to grapple with for myself personally as well as for all the rest of us, because what does this mean?
SPEAKER_2: I'm now not in my, where I usually live in Manhattan and life is very, very different.
SPEAKER_2: I'm not sitting next to you as was the case when we last had this kind of conversation.
SPEAKER_2: And what if it goes on for months and months and months?
SPEAKER_2: What if it goes on for a year?
SPEAKER_2: And by the way, we're not even sure that this particular virus will be amenable to an effective vaccine, and it may not be.
SPEAKER_2: So there's some who have speculated that we might be seeing annual recurrences of this particular virus and annual reinstitution of the physical separation and having meetings digitally via the internet for the foreseeable future.
SPEAKER_2: I think eventually we'll get this tackled, but if you're planning your wedding for next fall, I would be thinking about making sure you don't have a non-refundable deposit on the place because I think I need to be sober.
SPEAKER_1: So before we go to our commercial break, give me something hopeful just to get us through the commercial, okay?
SPEAKER_2: Something hopeful is that we're actually learning a lot in two ways, Neil.
SPEAKER_2: One is we're learning a lot about our ability to adapt and to our ability to become more resilient as people, which is really great.
SPEAKER_2: There's a second thing, let's say for after the commercial, but it's really important.
SPEAKER_1: Oh, okay.
SPEAKER_1: We'll come back to the other half of a positive comment.
SPEAKER_2: Good news.
SPEAKER_1: From Dr.
SPEAKER_1: Irwin Redlener when StarTalk returns.
SPEAKER_1: Thank Welcome back to StarTalk.
SPEAKER_1: I'm here with Dr.
SPEAKER_1: Irwin Redlener, Director of Columbia University's National Center for Disease Preparedness.
SPEAKER_1: Oh, excuse me, Disaster Preparedness, which it's got to be the coolest business card anyone has ever carried.
SPEAKER_2: I'll be happy to trade with you.
SPEAKER_1: Let's pick up some of where we left off.
SPEAKER_1: We were trying to understand what could be a recurrence, multiple recurrences, which would happen if, according to your early comment, half the population would ultimately get the disease.
SPEAKER_1: Would you say that all of our social distancing or physical distancing has done the job?
SPEAKER_2: Well, it's the only tool we have, let's put it that way.
SPEAKER_2: We don't have a specific medication that we'll treat.
SPEAKER_2: COVID-19, we certainly don't have a vaccine.
SPEAKER_2: So whatever has worked is what we've been doing, which in other words, if we're actually seeing a slowdown in, let's say, New York City, the thing that we imposed was pretty strict sheltering in place and closing down of schools, restaurants, mass events and everything, but really by grocery stores and pharmacies.
SPEAKER_2: So I do think that has been working.
SPEAKER_2: And it's good.
SPEAKER_2: The question now, of course, is we're being pushed like crazy now to restart businesses and some governors who are ready to get back to business, like on Monday.
SPEAKER_2: And it's a very unfortunate rush at a time where we don't really have enough tools to actually control it.
SPEAKER_2: And we'll just accelerate the extent and the duration of a resurgence of this virus.
SPEAKER_2: So to that point, by the way, our center at Columbia is putting out a report that is going into the very specifics about how and when can you open a barbershop or another retail business or your local restaurant.
SPEAKER_1: There's a lot of hot air about all that now.
SPEAKER_1: I mean, like you were saying, people are protesting and banners and placards.
SPEAKER_2: Yeah, yeah, yeah.
SPEAKER_1: And you can feel for them if they're out of a job, right?
SPEAKER_2: I mean, I totally feel for them.
SPEAKER_2: Totally feel for them.
SPEAKER_2: So the governors have to be very careful that in their desire to respond to legitimate, very, very legitimate concerns that people have about their income and paying the rent.
SPEAKER_2: This is serious business for people.
SPEAKER_2: It's not just a matter of inconvenience and changing their norms.
SPEAKER_2: It's, you know, can I pay the rent next week?
SPEAKER_2: So I get all that.
SPEAKER_2: But the question that we have to balance is, if we reopen too quickly before we have the ability to control spread and even just the basics of getting testing done, that's a potential disaster that nobody wants and nobody wants to be responsible for.
SPEAKER_2: So we have a lot of thinking to do, and that's the basis of the report that we're just going to be coming out with.
SPEAKER_1: Could you remind us, some of us who took biology a long time ago, what are the specifics of an antibody test?
SPEAKER_1: What is actually going on in that test?
SPEAKER_2: So there's two kinds of tests that we're talking about.
SPEAKER_2: One, which is referred to as a PCR test, which doesn't mean anything.
SPEAKER_2: What that is, though, it measures the presence of the virus by looking for particles of the virus's RNA or DNA, but RNA particularly.
SPEAKER_2: And it says, they do the test, this is with the nasal swab, where they put a long swab down your nose.
SPEAKER_2: They get a sample of the mucus in the back of the nose.
SPEAKER_2: They send it to the lab, but in the lab they mix it with reagents and they come up and they say, okay, this person tested positive for the presence of the virus.
SPEAKER_2: The other category of tests are the serology tests or the antibody tests.
SPEAKER_2: And in those tests, we're looking to see if you have evidence that your body has built up a resistance via something called antibodies.
SPEAKER_2: So you may not be testing positive right now for the actual presence of the virus with a PCR test.
SPEAKER_2: But if you have high antibodies, that may mean that you had it in the past and you've now built up resistance to it because you now have antibodies.
SPEAKER_2: So one measure is for the virus and the other measure is your body's reaction to it.
SPEAKER_1: So you're saying the antibody that I might have created in my own physiology to fight a coronavirus that I might have had, is it that unique for you to say you made that antibody for this virus?
SPEAKER_1: You can do that?
SPEAKER_2: Well, there's different kinds of antibodies.
SPEAKER_2: So there's something called IgM, which happens as soon as you get an infection.
SPEAKER_2: So as soon as you have a new virus or bacteria that your body doesn't like, it produces some generalized antibodies called IgM.
SPEAKER_2: A few weeks later, it produces a much more specific antibody to the thing that we might be talking about, like coronavirus, and that's an IgG antibody.
SPEAKER_2: So as we get better and better at that, we're going to get more and more specific about, oh, this antibody, this IgG, is specific for coronavirus, so you had coronavirus, even if you didn't have symptoms or you had very mild symptoms, we'll know that.
SPEAKER_1: Can you imagine a near future where we do have the antibody test or the other test, and you say, okay, those, you folks are immune or more immune than others, you can start going back to work?
SPEAKER_1: Is this realistic?
SPEAKER_2: Yes, it could be realistic.
SPEAKER_2: Yeah, the problem here, Neil, is that we don't know how long those antibodies will last and how protective they'll actually be.
SPEAKER_2: And some people think that the antibodies that you build up to coronavirus may not be as protective as we like them to be.
SPEAKER_2: And second of all, even if they are protective, we don't know if they'll be protected for a month, six months, a year, or whatever.
SPEAKER_2: So this is in the category of the great unknowns that are really making people work on this uncomfortable about predicting when and how this whole episode is going to end.
SPEAKER_1: I don't mean to complicate things further, but is COVID-19 more or less susceptible to mutations compared to other viruses, the common cold or anything else?
SPEAKER_2: Yeah, the coronavirus is capable, this particular one, of a lot of mutations to the point where, and this is one of the reasons why it may be complicated to find a vaccine that works, because there have been significant mutations of the virus to the point where the vaccine that you made up was very specific to the version six months ago, and no longer specific is obviously a major problem for us.
SPEAKER_2: And on the other hand, they could also be creating a new vaccine every season.
SPEAKER_2: You know, like we get our annual flu shots, which hopefully everybody, or certainly your sophisticated listeners will be getting an annual flu shot.
SPEAKER_2: But it may be that we'll be able to add a coronavirus component to the annual flu shot, and that would be a great thing if we could make that work.
SPEAKER_1: Tell me about the death undercounts that have been recalculated.
SPEAKER_1: What was going on there?
SPEAKER_2: Relatively recently, that was what went into this fact that we have, I believe, very significant undercounting of the deaths associated with COVID-19.
SPEAKER_2: And there's a couple of reasons for that.
SPEAKER_2: Number one is we didn't start doing testing effectively, certainly in this country and most other countries, until well after the situation started.
SPEAKER_2: There was just a report in the last few days about somebody who died in early February who was thought to have coronavirus.
SPEAKER_2: And there's a lot of anecdotes, anecdotal stories about people who had a relative, a friend who died in late January, early February, who had symptoms very consistent with coronavirus, but we weren't doing testing.
SPEAKER_2: So that's a problem.
SPEAKER_2: A second problem in the undercounting is that a lot of people are dying because of the COVID-19 pandemic who don't actually have the virus.
SPEAKER_2: And let me explain.
SPEAKER_2: So if you have severe chest pain, you're having a heart attack, and you go to an emergency room in New York City a week and a half ago when the emergency rooms were like chaos beyond what you can imagine, you might get appropriate evaluation and treatment for your symptoms in a timely manner because the ERs were way over overcrowded.
SPEAKER_2: The staff was completely consumed with taking care of COVID patients.
SPEAKER_2: So your care might be delayed, and you might not be getting everything you need in a timely fashion.
SPEAKER_2: So if you died under those circumstances, the autopsy might not show evidence of COVID-19, the coronavirus, but you will have died as a consequence of the presence of this huge outbreak in various cities.
SPEAKER_2: So there's going to be a lot of assessment, ultimately, of the fatalities associated with this.
SPEAKER_2: If we saw a third more fatalities than we currently know about, I would not be surprised.
SPEAKER_1: By the way, that shouldn't be an unusual way to account for things.
SPEAKER_1: I remembered, I was young when I first heard, they talk about the lethality of a snowstorm, for example.
SPEAKER_1: Someone might get left out in the cold and freeze, sure, but you also, the heart attacks from people shoveling snow.
SPEAKER_2: Exactly right.
SPEAKER_1: The whole trickle down of ways and means that people are touched and affected, and in some cases, lethally.
SPEAKER_1: But before we get our second and last break, let me just ask, the United States looked real bad in the numbers when it finally arrived on our shores.
SPEAKER_1: Is there something we should have done that we didn't do, and what countries got it right?
SPEAKER_2: Countries like South Korea, like Singapore initially, Hong Kong and so on did much more aggressive testing than we were doing.
SPEAKER_2: And there were three types of failures that happened in the United States that are important.
SPEAKER_2: The first is that we completely screwed up the testing.
SPEAKER_2: We just didn't get it right, we made many mistakes, and we were extremely far behind other countries that were doing a more appropriate amount of testing.
SPEAKER_2: And that lack of testing left us totally in the dark with respect to who had the disease and who did not.
SPEAKER_2: That was a big problem.
SPEAKER_2: The second problem was that the messaging that came from the White House was a freaking disorganized mess, basically.
SPEAKER_2: And that disorganization of messaging left the governors and mayors have to improvise and make it up on their own.
SPEAKER_2: And we ended up with disparate policies all over the country.
SPEAKER_2: And that was a mess.
SPEAKER_2: And the third thing is that we horrendously underprepared for what was happening to the hospitals.
SPEAKER_2: So all the problems of personal protective equipment like gowns and masks and all of that, lack of sufficient mechanical ventilators, all of this was part of the third huge mistake that the country made.
SPEAKER_2: So inadequate testing, bad messaging, and inadequate preparing for the onslaught that a lot of hospitals got in this process is really among the things that we messed up pretty badly.
SPEAKER_1: Here's something I wonder, all things considered, the United States is a pretty healthy country, all things considered.
SPEAKER_1: And so an interesting statistic I saw, which I hadn't thought to think about before, was country by country, how many hospital beds per capita do they have?
SPEAKER_1: Hospital beds per 100,000 in the population, let's say.
SPEAKER_1: And the United States hospital bed number was relatively low.
SPEAKER_1: And so what could possibly take us by storm is anything that ends up sending that need above the average baseline rate.
SPEAKER_1: And then you can't blame the health system for that at that point.
SPEAKER_2: This blame issue is very complicated.
SPEAKER_2: Because first of all, for business reasons, a lot of hospitals make decisions about how many beds they want.
SPEAKER_2: You know, beds are also a big breadwinner.
SPEAKER_2: But on the other hand, hospitals that are underutilized, like a lot of rural hospitals, just get shut down.
SPEAKER_2: That's one thing.
SPEAKER_2: The second thing is that hospital systems operate much like many businesses now in what's called just-in-time ordering.
SPEAKER_2: So, a lot of companies that may years ago have had these huge warehouses with everything stocked, that maintaining of big supplies was costly.
SPEAKER_2: So, they maybe only have a few days of whatever their commodity is and then reorder, so they don't have to have massive warehouses.
SPEAKER_2: And hospitals are doing the same thing in terms of their backup equipment, mechanical ventilators and other kinds of, let's say, whatever it is, their stockpile of regular needs.
SPEAKER_2: So, that also leaves us very vulnerable.
SPEAKER_2: So, if you need a lot in a short period of time and you don't have it and the federal government stockpiles are also depleted, we end up with what we saw in New York City and other places.
SPEAKER_2: So, it's a complicated business, but a lot of the decisions by hospitals are not made on the basis, oh, we might get a 100-year storm or a 100-year pandemic pop up and we need to be ready for that.
SPEAKER_2: That is a stress on the budget, so a lot of that never disappears.
SPEAKER_1: Just before we take our last break, a quick question.
SPEAKER_1: There's occasional talk you hear about whether you can believe the numbers that have come out of other countries, especially China.
SPEAKER_1: Do health professionals have any reason to doubt the numbers that come from one country versus another in this?
SPEAKER_2: I think so.
SPEAKER_2: You know, especially China has not been exactly transparent historically, and I think we probably were late to be informed about what was happening in China.
SPEAKER_2: We needed to get more of our professionals, say, from the CDC and other places to get in there and really help them figure out what was going on.
SPEAKER_2: That could have happened earlier.
SPEAKER_2: We don't have a real number in terms of fatalities in China for a variety of reasons.
SPEAKER_2: So China is like an extreme example of why we're skeptical about information from other countries.
SPEAKER_2: But Iran also, and I don't know, it's all kinds of political implications and geopolitical implications of having low number versus a high number and so on.
SPEAKER_2: So there's a lot of variability, but there's also a lot of variability in the populations.
SPEAKER_2: We tend to have a much younger population than China and some other countries.
SPEAKER_2: You know, we have different rates of chronic illness that we have, so let's say compared to South Korea or Japan and so on.
SPEAKER_2: So a lot of differences make the numbers not necessarily perfectly compatible or comparable.
SPEAKER_1: So we're going to take a quick break.
SPEAKER_1: We're going to come right back to my interview with Dr.
SPEAKER_1: Irwin Redlener on the coronavirus.
SPEAKER_1: Stay tuned.
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SPEAKER_1: We're back, StarTalk.
SPEAKER_1: Dr.
SPEAKER_1: Irwin Redlener, Director of Columbia University's National Center for Disaster Preparedness.
SPEAKER_1: Let's pick up where we left off.
SPEAKER_1: We're talking about reporting of numbers around the world.
SPEAKER_1: I hate to even bring this up, but it's out there.
SPEAKER_1: Conspiracy theorists, let me not give them more credence than they deserve, but let me just ask.
SPEAKER_1: We all know in the town where this virus first arose, isn't there a CDC kind of operation going on there?
SPEAKER_1: A disease lab?
SPEAKER_2: Yeah, yeah, yeah.
SPEAKER_2: There is, and one of the way out there, conspiracy theories is that this virus was developed and released in a lab in China, or maybe it was developed and then accidentally released.
SPEAKER_2: But a lot of people have looked into this and the vast majority of, I think, as far as I'm concerned, all legitimate scientists have debunked the notion that China deliberately created this virus.
SPEAKER_2: And there's ways of testing for that, which are pretty sophisticated, and I can't begin to explain it to you, but I will say that I don't have any, what I would consider to be legitimate colleagues who think that that actually happened in China.
SPEAKER_1: So one thought was that it was a weaponized virus that was intentionally created.
SPEAKER_1: That's not even where I'm going.
SPEAKER_1: Just if you do have a viral outbreak in a place where you have viral research going on in labs, that is almost a coincidence too strong to ignore, correct?
SPEAKER_2: Well, I would say that's contradicted by the fact that almost every single major outbreak and pandemic that we've had in the last 100 plus years has emanated from China.
SPEAKER_2: And that's because, or some place in Africa where these wet markets are prevalent, where people are eating, they eat bats and other kinds of animals that are considered exotic.
SPEAKER_2: And a lot of those viruses, other than the ones that are the avian flu type viruses, that a lot of these viruses like MERS and SARS have come from people consuming animals that tend to harbor these kinds of viruses that can mutate in a way and then become transmissible among people.
SPEAKER_2: But yeah, I wouldn't put much stock in the fact that it was even being developed in a lab intentionally at all.
SPEAKER_2: But, you know, strange things have happened in our world.
SPEAKER_2: And so I guess we can't 100% rule it out.
SPEAKER_2: But the prevailing thought amongst actual scientists that that did not happen.
SPEAKER_1: It's encouraging to learn.
SPEAKER_1: Also, we're kind of stuck where the public is looking for expertise and because of the evolution of the virus, advice related to combating the virus has evolved.
SPEAKER_1: Dare I use that word in that way?
SPEAKER_1: So we do remember the clarion call to not wear masks.
SPEAKER_1: It's not necessary.
SPEAKER_1: You're not going to likely to catch it that way.
SPEAKER_1: Now we're hearing everybody's got to wear a mask.
SPEAKER_1: So what is the public supposed to do?
SPEAKER_1: How are they supposed to react when they see this flip-flopping of messaging?
SPEAKER_2: Well, it wasn't that many weeks ago too, by the way, Neil, where the mayor of Seattle said no gatherings of more than 500 people are allowed.
SPEAKER_2: And then de Blasio days later, the mayor of New York, Bill de Blasio, said no gatherings of 500 people or more.
SPEAKER_2: And then other mayors were saying 100 people or more.
SPEAKER_2: And characteristic of a situation like this where there are so many unknowns, people are saying things, and especially in the absence of central guidance from the CDC, where they say at point X, we don't want gatherings more than 10 people.
SPEAKER_2: That means that the mayor of Seattle and the mayor of New York don't have to sort of make it up based on whatever is their information, their inputting.
SPEAKER_2: The issue of masks, which has become sort of the national norm, except nobody at the White House press briefings ever wears a mask or does anything other than crowd together in front of the microphone, but that aside...
SPEAKER_1: Rubbing the noses and eyes, right?
SPEAKER_2: Yeah, rubbing somebody else's nose.
SPEAKER_2: I mean, it's like the whole thing.
SPEAKER_2: But other than that, actually, I think people end up then concluding that, yes, it's better to wear masks so that you are not inadvertently breathing in viruses that may be in the environment from other people and that if you are to be infected, you're not breathing out viruses that can affect somebody else.
SPEAKER_2: And those kinds of changes or evolution in policy is not uncommon, and that's one of the uncomfortable things we do have to get used to, that there's so many unknowns that as we learn more, policies will change and will continue to change.
SPEAKER_1: Two last questions.
SPEAKER_1: One, is this the new normal?
SPEAKER_1: How much of this are we going to have to get used to as a permanent alteration in our daily routines?
SPEAKER_2: So, I think this is going to be around for a lot longer than we may have hoped for, and it may be recurrent.
SPEAKER_2: So, one of the ways I've looked at this question is if you're 80 years old, you are likely to spend the rest of your life, or 75 or whatever it is, the rest of your life living in this kind of very unusual, abnormal world, and yes, you got to get used to it.
SPEAKER_2: If you're 25 or 45, you're still going to have to get used to what may be a very long process, but you will be around when the light at the end of the tunnel, so to speak, actually appears, and we'll get back to a much more normal way of life.
SPEAKER_2: So, it depends on who you are and what you're dealing with, but the fact is that we're going to have to get used to this going on for quite some time.
SPEAKER_1: And as the old joke goes, you hope that the light at the end of the tunnel is not the light of an oncoming train, of the dark tunnel.
SPEAKER_2: Yeah, and I've been saying, there's a light at the end of the tunnel, but it's a really, really long tunnel.
SPEAKER_1: My last question, and you promised, leave us with something hopeful because you bummed us out for this whole show.
SPEAKER_1: Give us something to think about.
SPEAKER_2: So, here's what I really, and I actually think this is possible, maybe it's wishful thinking, I'm calling it possible.
SPEAKER_2: It may be that we come out of this entire experience with a whole new idea of the necessity for international cooperation.
SPEAKER_2: There are certain problems that are not going to be solved by any individual or any individual country, any specific country, that dealing with the prevention of pandemics, which are global phenomenon, requires a whole lot more international cooperation, information sharing and research cooperation than we've been used to.
SPEAKER_2: But there may be spillover.
SPEAKER_2: So if we want to talk about how we need international cooperation for dealing with pandemics, we also really need it for the climate crisis.
SPEAKER_2: And we really need it to make sure that we are preserving biodiversity.
SPEAKER_2: And I think if we're really lucky and we work at it, we could change the dynamics of how countries interact with each other and end up collectively, as our old late friend Carl Sagan, what I'm sure said, and you said many times yourself, Neil, that we're living on this tiny speck of nothing in this vast universe.
SPEAKER_2: And the fact that we have these global planetary problems that need to be solved, we need to get our acts together and do it collectively if we want to really survive.
SPEAKER_1: Well, Irwin, that's the most hopeful thing I've yet to hear about the coronavirus, that it might prep us for future challenges that require international global cooperation.
SPEAKER_1: So, why don't we end on that note?
SPEAKER_1: Irwin, I'm delighted and honored to even call you a friend.
SPEAKER_1: We've known each other for a few decades now, through Carl Sagan, actually, I think was, through that collaboration it was.
SPEAKER_1: And so, thanks for, I know you were in high demand, writing op-eds and showing up on the news.
SPEAKER_1: I'm delighted you gave a little bit of your day for us here at StarTalk.
SPEAKER_1: Thanks for joining us.
SPEAKER_2: My pleasure, Neil, as always.
SPEAKER_2: See you again.
SPEAKER_1: This has been StarTalk.
SPEAKER_1: I'm Neil deGrasse Tyson, your personal astrophysicist, as always, and perhaps now more than ever.