00:00Let's pick up from what we just heard there, what we expect to happen here over these next few hours.
00:04It sounds like many countries are marshalling aircraft to the Canary Islands to bring their citizens back to their respective
00:11countries.
00:12Perhaps we can just take the U.S. as an example here.
00:14What's going to happen here over the next 24 to 36 hours?
00:18Well, thank you for having me.
00:20The first thing is that, you know, fortunately what we hear is that the passengers that are being disembarked are
00:24all asymptomatic.
00:25In other words, they don't have any symptoms of Hentavirus, which means maybe they're not infected yet.
00:29We don't know.
00:30They could still have been infected and they're going to develop symptoms later.
00:33So the first thing that's going to happen is all passengers will undergo a health screening.
00:37They're going to be, you know, questioned.
00:39They're going to have physical exams.
00:40They may draw some blood.
00:41And then after they decide whether they're truly asymptomatic or not, they'll put them on a plane.
00:46And the American citizens are going to come over to the serious communicable disease unit at the University of Nebraska,
00:52which is fairly large.
00:53And they're going to be then processed again over there.
00:56And if they happen to be symptomatic, if there's anything that is suggestions of infection, they'll be kept in isolation.
01:03Otherwise, if they still continue to be asymptomatic, they'll be sent home and encouraged to quarantine and to watch themselves
01:09for the next six to eight weeks.
01:11Doctor, I want to ask you how this spreads, because I know that it is usually something that you get
01:18by coming into contact with animal droppings that have this virus.
01:22It is not usually spread from person to person, or that it can be.
01:24Prevailing wisdom is that if you get it from person to person, you have to be in very close contact.
01:29But some of the reports we're seeing from the ship is that not all of these individuals who have tested
01:34positive for this virus were in close enough contact that virologists would usually assume they were susceptible to contracting the
01:40virus.
01:40I know this is a different strain than we have here in the U.S., and that is more possible.
01:44But is that concerning, that this seems to be a method of transmission that this virus doesn't usually take?
01:50No, it actually does.
01:51This antivirus is the only one that's pressed person to person.
01:55And there was an outbreak in Argentina in 2018, 2019, where some of the things that you're mentioning actually happened.
02:01Some person just got infected because they were in the same room with another person that was infected, or they
02:06were in the same bathroom.
02:06It is very clear that if you have very close, intimate contact, for example, in this case, the index case,
02:13then his wife got infected, they were in the same cabin, they could have been, you know, intimate sexually.
02:18There's a lot of reasons why the wife got infected so quickly and then developed symptoms.
02:23But that doesn't mean, you know, it's an all-or-none phenomenon.
02:26Clearly, there's a lot of things about the transmission we don't fully understand.
02:31And I think this outbreak is going to help us try to understand that.
02:34It is very clear that the closer you are, the more intimate contact, the more likely you are to get
02:39infected.
02:40But that doesn't mean that we have not seen sort of what appears to be fairly casual mechanisms of infection.
02:47I'm curious about the global public health apparatus that's being marshaled to bear here in Tenerife.
02:52So the United States has pulled out of the World Health Organization.
02:55That's something that's changed since the COVID-19 pandemic.
02:57And I wonder what the consequences are to that as you see them, as we watch this effort unfold.
03:04And what we can learn from this experience.
03:06Yes, this may not lead to the kind of global pandemic that we saw with COVID-19.
03:09But what can we learn from the way that governments respond to this crisis that's breaking out on this ship?
03:15Well, you know, first of all, I want to say that the World Health Organization has really done a remarkable
03:20job.
03:20Starting with their director general, Dr. Tedros, and then the rest of the WHO team, Maria van Gerhoeven and her
03:26team.
03:27They've done a tremendous job.
03:28And, you know, Dr. Tedros is there and side in Tenerife helping and providing leadership and talking to the Spanish
03:34government and ensuring that the boat was able to dock over there and the passengers can be safely and securely
03:39disembarked.
03:40I think we have seen a much diminished CDC.
03:44If you think about a prior outbreak, let's think the outbreak of Ebola.
03:49CDC very quickly was involved.
03:50CDC very quickly sent a team over there.
03:53CDC was providing something very important, which is technical assistance.
03:57We're not seeing a lot of technical assistance happening from CDC right now.
04:00In fact, it almost seems like the CDC response occurred after many, many days.
04:04It was almost, you know, too late, too little, too late.
04:08And that's unfortunate because, you know, we need a strong CDC.
04:11As American citizens, we want a strong CDC.
04:14We want a CDC that's a leader in global health, not only nationally but globally.
04:19And to see such a diminished CDC, to me as an infectious disease physician and as a public health expert,
04:25is actually quite painful.
04:26And that seems to compound the concern.
04:29People really are stressed about this.
04:30We were talking yesterday about how we've literally heard people on the street in Manhattan talking about it.
04:34And then the WHO director, Dr. Tedros, was talking about the concern of a wider spread of this virus.
04:42I want you to listen to what he said.
04:43The concern is legitimate because we have all experience because of COVID, especially in 2020.
04:54And that trauma is still in our minds.
04:58So people will have questions.
05:00People will have concerns.
05:02And that's what I try to address in my message to the people of Tenerife.
05:06We hear you.
05:07We understand.
05:09But the situation is much better now.
05:13How worried should people be that this is not an isolated outbreak?
05:17I think about this one, I would not be worried.
05:20I agree with Dr. Tedros.
05:22I think there's still a lot of trauma left from COVID.
05:24But I would say don't be worried.
05:26But this is not the first outbreak.
05:28This is not the last outbreak.
05:29What are we worried about is that we will continue to see this kind of outbreaks.
05:32We are continuing to have outbreaks like this one.
05:35Believe me, a hint of ours in a cruise ship was not in my bingo card of things that was
05:38going to happen in a cruise ship.
05:39And yet it happened.
05:40So we're going to see more things like this one.
05:42And what people in the U.S. need to be worried about is our public health infrastructure.
05:47They need to be worried about how we can see the CDC has been significantly diminished in relevance.
05:53And a lot of people have left.
05:54A lot of expertise have left CDC.
05:56So I would say that what we need to ask for and what we need to be worried about is
06:00the state of our public health and global health expertise in our country rather than this specific outbreak.
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