00:00Doctor, first of all, I want to ask a dumb question, and that is, is it hantavirus or hantavirus?
00:05We've been wrestling with this all morning.
00:07Because we have differing opinions on this.
00:09And then I also, I grew up with this out west.
00:12I know, David, you spent some time there as a kid.
00:14I didn't think it spread like this.
00:16So how do we say it, and how does it spread, and how dangerous is it?
00:20All right, three great questions.
00:21Good morning, and thanks for having me here.
00:23I've always called it hantavirus.
00:24That's what I was taught when I was in medical school.
00:26So let's go with hanta.
00:29Okay, most strains of hantavirus are spread from rodents to humans, and they don't spread from human to human.
00:35There is one strain that is an exception to that, and that's the Andes strain.
00:39And unfortunately, that's what we have on the cruise ship so far.
00:43It's a pretty dangerous virus.
00:45And so if you grew up in the American southwest, New Mexico, Arizona, you've probably heard of hantavirus.
00:50You usually get it from rodent droppings, getting aerosolized, and you breathe it in.
00:54And 30%, 40% mortality rate, maybe even higher, so it's a pretty dangerous virus.
00:59Thankfully, we have not seen large outbreaks in the past, but this one is different, partly because it's the wrong
01:04strain or it's a bad strain, the one that spreads.
01:06And it's ended up being on a cruise ship, which is a pretty good petri dish for a lot of
01:11viruses spreading.
01:12My turn now for a two-part question.
01:14The first is Nebraska.
01:16Why Nebraska?
01:17I remember this being a facility that was used during the Ebola outbreak, I think maybe during the early days
01:20of COVID as well.
01:22So that's my first part.
01:23The second is what will happen to these patients when they get there?
01:26What does this quarantine look like in practice?
01:28Yeah.
01:29Two good questions.
01:30So Nebraska, we have these special pathogen units across the U.S.
01:34University of Nebraska Medical Center has got one of the best ones in the country, I'd argue, one of the
01:38best in the world.
01:39The most dangerous pathogens, people who might be infected with them can go there.
01:44They've got fantastic safety protocols, some of the best clinicians in the world on these topics.
01:49So that's why Nebraska, that's why our Ebola patients went there, and that's why it's a good place for these
01:54folks to go.
01:56Look, I don't think, do I think they need that?
01:58I don't.
01:59I think they're doing it out of an abundance of caution.
02:01I think that's totally reasonable.
02:02What's going to happen is they're going to be monitored very closely.
02:05What we know about hantavirus in the one strain that spreads from people, that people usually only spreads when people
02:11have symptoms.
02:12So you could make the case that if they're feeling great, they don't have to be in a place like
02:17this.
02:18But again, I think out of caution, they're going to watch them very closely.
02:21Obviously, if any of them develop symptoms, they're going to need to get tested and treated.
02:24But that's going to be the plan.
02:25I'm surprised how quickly this has gotten into people's minds, possibly because, you know, we're all still a little scarred
02:32from COVID.
02:33Actually, the New York Times writes about COVID PTSD and how this is a lingering legacy.
02:37I was walking down the street in New York, and some woman on the phone, young woman, said,
02:41you know, I really just want to go meet my friends before the hantavirus takes us all.
02:45This was yesterday here.
02:46But it is serious.
02:49It sounds like it's unlikely to cause a huge outbreak, at least immediately.
02:53But if you are getting symptoms, what do those look like, and how quickly do they progress?
02:58What should you be on the lookout for?
02:59Yeah, and I want to just reiterate, I think the chances that this is somehow going to become a big
03:04global outbreak is exceedingly low.
03:06It's just I don't think it's going to happen.
03:08Now, let's talk about symptoms.
03:09The problem with this virus, like most viruses, they all start off about the same way.
03:15A fever, a headache, you know, just feeling lousy.
03:18By the way, that's like, you know, we all have symptoms like that when we get viral syndromes.
03:23It then progresses pretty rapidly.
03:25There are two forms.
03:26There's a pulmonary form where you get very severely short of breath.
03:30It really infects your lungs, and you can get very sick that way.
03:32There's another form where you get much more in the abdominal pain, infects your vessels, and you can get very
03:38sick and die in that other way.
03:40So it starts off pretty much like most viral syndromes, and then it can progress pretty quickly after that.
03:45Let's ask about the vaccine for this.
03:47So Bloomberg reporting Moderna has done some early stage work on the vaccine for hunter viruses in the U.S.
03:53It's working with Vaccine Information Center at Korea University College of Medicine on a potential immunization.
03:58What's the status of the development of immunization for this?
04:01Is that something we should be looking for in your estimation here in short order?
04:05Yeah, so look, the mRNA platform is awesome, and obviously we used it during COVID to get vaccines out to
04:11the American people very, very rapidly.
04:13As you probably know, Secretary Kennedy is not a fan, and therefore he's really blocked the development of mRNA vaccines
04:20here in the United States.
04:21I think, by the way, completely irrationally.
04:23There's no logic for that.
04:25So now companies like Moderna and European countries are working with other countries.
04:30In terms of the hunter virus vaccine, it's still pretty early stage.
04:34Eventually, we need to go through, you know, kind of large clinical trials.
04:37There aren't that many people getting infected with this, so you're not going to see those trials.
04:40So it's not anywhere near prime time.
04:42But the good news is I don't think we need it right now.
04:45I mean, we should develop it.
04:46Obviously, if it becomes a bigger outbreak, we should study it much more closely.
04:49But for most people, this is not going to be an issue.
04:52We're not going to be getting hunter virus vaccines anytime.
04:55Since we have you, I do want to ask you, there's some reporting from the Wall Street Journal that President
04:59Trump has signed off on a plan to fire the FDA commissioner after policy fights about vaping, the abortion pills,
05:05and others.
05:06He was actually asked about it last night.
05:07We've got some sound for you.
05:08What's going on with Martin McCarrick?
05:11Nothing much.
05:12Are you going to fire him?
05:16I've been reading about it, but I know nothing about it.
05:20So Trump's saying, asked what he knows.
05:22He says he doesn't, you know, is he going to do it?
05:23But he says he knows nothing about it.
05:25What is your take on this and the state of play at the FDA right now, how well it's functioning
05:30and morale inside that agency?
05:33Yeah, that's a great question.
05:34Obviously, I don't know exactly what's happening in terms of Dr.
05:37McRae's status.
05:39There's all this confusion.
05:40I've been reading the same stuff that everybody else has.
05:42In terms of the FDA, I mean, I think what I would say is I actually was a pretty big
05:46fan of Marty.
05:47I have been for a long time of him getting nominated.
05:50I think he has tried to do a good job.
05:53I think he's made some missteps.
05:55And it's been complicated because there's a lot of political pressure from his boss, the secretary of HHS, to do
06:02certain things that I think a typical FDA commissioner would not face from a typical secretary of HHS.
06:06So I think Marty's had a hard job and, you know, and as I said, I think he's been he's
06:13very qualified to do this.
06:14How this plays out, I don't know.
06:16But the FDA is struggling because they've lost a ton of staff.
06:19They've been doged.
06:20And that has meant some of their best scientists have left.
06:23Marty's been managing a pretty, pretty difficult agency that's under a lot of stress because of some of those moves.
06:30We'll see you next time.
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