Dr. Ashish Jha, Part One: How Did the Pandemic Start?

Transcript

ERIC: From the Museum of Science in Boston, this is Pulsar: a podcast where we ask for answers to the most frequent questions we receive from our visitors. I'm your host, Eric, and for all of 2020 and 2021, the most common questions we have received about the pandemic have been: How did it start? And, when will it end? We'll answer both in a special two part episode with public health expert Dr. Ashish Jha. Next week, I'll talk with Dr. Jha in person and this week, we'll turn to our virtual exhibit: COVID Conversations with Dr. Jha. We partnered with Storyfile to record Dr. Jha's answers to over 500 questions. You can try it out on our websites virtual exhibit page on MOSatHome by asking Dr. Jha any question about the pandemic, public health, vaccines, and much more. Today's episode features this virtual exhibit to explore where the pandemic started and Dr. Jha's background and approach to public health. Dr. Jha, please go ahead and introduce yourself.

ASHISH: Hi, I'm Ashish Jha, Im a physician, a practicing internist, and I have been studying public health for a long time. And I've been really interested in pandemics and disease outbreaks and how we understand them, how we prevent them, how we respond to them. And I have been studying and working on a response to the coronavirus pandemic that's affecting our entire planet.

ERIC: And what is your current position?

ASHISH: I work at the Brown University School of Public Health. I work at a public health school that's working to try and improve the health and wellbeing of people all around the world.

ERIC: What made you decide to specialize in public health?

ASHISH: As a doctor, it was very clear to me that while what I did in the clinic or what I did in the hospital made an important difference, that so many other things affected people's lives and health and wellbeing. and public health lets me study those things and work on improving those things.

ERIC: So our main question for today is how did the pandemic start? Where did this Coronavirus come from?

ASHISH: The coronavirus came almost surely from bats. And it started when a bat probably infected a human sometime in late 2019 in or around Wuhan, China.

ERIC: Do we know what kind of bat?

ASHISH: The coronavirus came most likely from a chrysanthemum bat. The species is rhinolophus ferrumequinum.

ERIC: And how did the virus spread from bats to humans?

ASHISH: Bats and rodents are often infected with viruses that can also infect humans or are very similar to viruses that can infect humans. But many of the times bats can live with these viruses without getting very sick. And then sometimes because of a genetic mutation, that bat that is carrying a bat virus can spread that virus to a human that then can be infected with that virus.

ERIC: There are an extraordinary number of different viruses on the planet Earth. How does this one that is responsible for the pandemic compared to other viruses?

ASHISH: So there are viruses like the measles virus, which is very contagious and the average person who gets infected with the measles virus can spread it to many, many, many people. And there are other viruses like the ebola virus, which even though it makes people very sick is not as contagious and you really have to be very close to somebody when they're very ill in order to pick it up. The coronavirus is somewhere in between. It is not as contagious as a measles virus, but it is much more contagious than an ebola virus. And what makes the coronavirus particularly difficult is that it is more contagious than some viruses but more deadly than others. And it is in that combination that makes the coronavirus so easy to spread around the world and cause so much illness.

ERIC: And what is the most effective way to fight the pandemic?

ASHISH: With any disease outbreak, the key is to get the outbreak under control. To know who's infected and who is not. To keep people who are infected separated from people who are not so we can protect society and take care of those who are sick. That is the key to controlling pandemics, or really any disease outbreak anywhere.

ERIC: We'll talk more about vaccines next week. But for today, can you give an overview of the history of vaccines. When were the first ones used?

ASHISH: The history of vaccines is actually quite a long one. For over 1000 years in China there have been practices of taking people who had recovered or were recovering from smallpox, scraping their smallpox lesions and having other people inhale those lesions, inhale the scrapings. It was a way of creating essentially a vaccine, where you gave small amounts of the virus to people. And then they built up immunity and were less likely to get sick from smallpox when they next encountered it. In more recent times in 1796, in a very famous experiment by Dr. Edward Jenner, he took cowpox and scrapings of cowpox, cows got cowpox. He presumed that cowpox was similar to smallpox. And he inoculated a young man with that, and then exposed that person, that young person, to smallpox itself, and found that having been inoculated with cowpox protected the young person from the smallpox virus. Since then, there has been more and more work developing and creating an understanding of how vaccines can really make a very big difference in protecting people from infections. Over the much of the 20th century, we have built out an entire group of vaccines, often starting with the virus itself, creating a weakened form of the virus so that when we give it to people, they don't get sick, but that they're able to mount an immune response. So that when the normal version of the virus shows up and people are exposed, their immune system can respond effectively.

ERIC: Can you give an overview of the mechanism behind vaccines? Another very popular question is exactly how they work.

ASHISH: Vaccines work by stimulating the immune system of the body, so that when the immune system encounters the virus, or the bacteria that the vaccine was developed against, the immune system goes into full action and makes sure that the person does not end up getting infected. There are many ways of stimulating the immune system. Sometimes you can take what's called an inactivated virus, a live inactivated virus, where the virus still has many of its original properties, but has become weakened, so it's not going to infect the person, but you can still generate an immune response. Other times, we use things called a killed virus where the virus has been deactivated, so it no longer is infectious. But it still has enough of its particles, that that can stimulate an immune response. More recently, we have been trying new approaches, including just using the genetic material of the virus, or just using certain proteins found in the virus, to inoculate people with the idea that we will develop an immune response against that genetic material or against that protein. And that might be able to protect us, when we actually get infected with the original virus itself.

ERIC: Do you think the world will be different moving forward because of the pandemic?

ASHISH: What we know from every other pandemic is that the world after a pandemic comes to an end is different. I suspect the way we work will be different, there will be more remote working. The way we interact with each other: people may give fewer handshakes and hugs than they used to before the pandemic. I also think how we socialize, how we connect with others. All of that is likely to change after the pandemic. And last but certainly not least, I'm hoping that coming out of the pandemic, people realize we live on one planet, that we are interconnected. We're interdependent, and that what happens in one place affects all of us. And that means we should have policies that promote and support health and wellbeing for people around the world, because it's good for us too.

ERIC: And where can we hear the latest from you, Dr. Jha?

ASHISH: I speak to journalists. So you may read about some of my comments. I appear on television to talk about the coronavirus outbreak. And then I give talks in public that are open to people so they can come and listen to my ideas and thoughts about what's happening with the pandemic. I also have a social media presence. I am on Twitter. And I tweet about things that have to do with this pandemic. I write blogs and other pieces about the pandemic. I try to communicate what is happening to as broad of an audience as possible.

ERIC: To wrap up this week's conversation what advice do you have for listeners who might want to pursue a career in medicine?

ASHISH: Medicine is a great field to study. So if you're considering becoming a doctor or a nurse, or any kind of a health professional, I would say go for it. It's a great way to learn about the human body. It's a great way to help people. It's a very fulfilling way to have a career and to spend your life.

ERIC: Dr. Jha, thanks so much for talking with me today.

ASHISH: You're welcome. It's been a pleasure talking to you. Goodbye.

ERIC: You can ask Dr. Jha your own questions about coronavirus, public health and more on the virtual exhibits page at mos.org. Next week we'll speak with Dr. Jha in person and ask: when will the pandemic end? Until next time, keep asking questions.

Theme song by Destin Heilman