Pandemic: How to Prevent an Outbreak (2020) s01e02 Episode Script
Pandemic Is Now
[child.]
Hurry up! [children talking indistinctly.]
[girl giggling.]
[indistinct chatter.]
[child giggling.]
[Caylan.]
Nice job.
Nice flick of the wrist.
[Caylan.]
The focus of my life is to allow my kids to be who they are.
Our lifestyle and the way that I raise my kids is just to continually be evolving, and awakening, and consciousness, and awareness and mindfulness.
[ball thuds.]
[Caylan.]
I believe a healthy child has the ability to build up immunity naturally.
[indistinct chatter.]
So, Pearl, do you know what the word consent means? - No.
- Me, either.
I don't.
It means you give someone permission.
Remember whenever we talk about body parts and I'm like, we all we don't touch other people's body unless we get permission, and then there's even certain places that we don't even touch - Don't say it.
- [chuckles softly.]
Don't say it.
[Caylan.]
You know, there can be people that you think you should be able to trust.
- [girl.]
Yeah.
- Whether it's a doctor, or it's a pastor, or it's an owner of a business, even the president.
And no matter who it is that we're in contact with, we have the right to be able to feel within our bodies, does this feel safe and do I do I want to move forward? We should all be given the freedom to do that.
And so we have to really think through how, if this bill passes, what the effects of that will be for all of us.
[crowd chanting.]
[newscaster.]
Dozens of people are rallying in Salem against a bill that would eliminate non-medical vaccine exemptions.
Now, if it passes, most unvaccinated kids would not be allowed to attend school and daycare programs in Oregon.
Supporters say the effort to limit exemptions is about safe schools and protecting children and adults.
Those against limiting exemptions question vaccine safety standard.
A doctor today described the measles vaccine as, "incredibly safe.
" [Caylan.]
Where's Khalil? Wait, you're right there.
One, two, three, four, five.
I still have to do the count.
This bill would require that whether you go to private school, or you're in public school, or in a charter school, you would have to get every single vaccine that they say that you should have at the timing that you should have it.
What does freedom mean, you guys? - [child 1.]
Free! - [child 2.]
Like, like You're just out there.
You don't have to do what people say or I don't know, I have to think about it.
I've never thought about it.
[Caylan.]
For me, it's not about whether you vaccinate or you don't, it's us having the freedom of choice to choose what we think as a parent is the best thing for our child.
Rumi, to calm us down, roll this over your heart.
- [Caylan.]
Okay? - [mumbles.]
[Caylan.]
I am confident that no one else can teach, direct and guide my kids' hearts, minds and souls better than me.
[Caylan.]
Everything with this whole vaccine bill is someone who believes that they know what's better for you than I do and what you do.
So, it's removing our choice.
[children cooing.]
[Caylan.]
On my family, this bill will have a very large impact, 'cause my oldest is passionate about basketball.
She will no longer be able to play on specific teams.
You won't be able to play soccer and you won't be able to play basketball if you don't get vaccines.
I don't feel comfortable getting vaccines, and if were to even muscle test them, I don't know if your body - would feel comfortable with it.
- You're making me cry.
- [Caylan.]
I'm making you cry? - I don't want that.
[Caylan.]
It's kind of a lot to take in, huh? I am raising you guys to be the 10% of the world, which means you're not gonna fit in with the 90% and that's okay.
[child giggling.]
[Caylan.]
We're advocating to our children "my body, my rules," and here, that is being stripped away.
As a protector of our children, to not have that, it's like, "What are we stepping into next?" [man speaking in native language.]
[man grunts.]
[woman speaking in native language.]
[woman exclaims.]
[newscaster 1.]
The commissioner of US Customs and Border Protection is ordering new steps to protect children in US custody after the death of an eight-year-old Guatemalan boy.
[newscaster 2.]
Four days after eight-year-old Felipe Gómez died, new autopsy results show that the boy tested positive for the flu.
Felipe now the second migrant child to die this month in US custody.
[speaking in native language.]
[woman in Spanish.]
My brother's health was good before he left It was so hard for us to understand why his death was so sudden.
Very sudden.
He was a mischievous little boy, but he always did well in school.
"I'm going to the United States with Dad," he said, excitedly.
[sniffles.]
"But I'll come back for Mom.
" That's what he said when he left.
[woman 2 in Mayan.]
I do regret that he left but we just did it because of how poor we are.
[rooster crowing.]
[woman 2.]
I'm very scared of the flu and of its lethal outcomes.
If another of my children dies, I'd lose all will to live.
[newscaster 3.]
US Border Patrol agents apprehended a group of more than 1,000 migrants, who illegally crossed the southern border near El Paso, Texas.
[newscaster 4.]
A decade ago, 90% of immigrants caught crossing illegally were single adult men from Mexico.
Today, nearly 90% are families and unaccompanied children from Central America.
[Susan.]
When I heard that Felipe died I mean, I was angry because it's all such bullshit.
We have horrible things that happen with the different hurricanes, with the tornadoes.
We don't need any man-made catastrophes.
And that's exactly what this one is.
[child.]
Mama.
Mama.
- [door closes.]
- [child whining.]
[child cooing.]
[indistinct chatter.]
[Susan.]
I volunteered 9/11 and went down the day after.
And then I went down to Katrina.
And I worked down there for almost two months.
If you're able to help, you have to go.
[indistinct chatter.]
[man in Spanish.]
Good afternoon.
[man speaking indistinctly.]
[Susan in English.]
In Tucson, people have rallied.
[man in Spanish.]
I want to make sure the children get to eat first and then the grown-ups.
[woman.]
Tangerine, perfect! [Susan in English.]
They make sure they're fed.
We give them two sets of clothing and then they have the to-go bags where they have food for their bus rides.
It's a little group here, doing this.
It's amazing.
[Susan.]
I'm so happy to be able to give the flu shots because I really, really believe in them.
And I think it's up to 36 cases this year of children that have died from the flu.
This is preventable.
It's ridiculous not to get 'em a flu shot.
- [man.]
Okay.
- It's okay.
[man in Spanish.]
Look, look.
Like this, look.
[Susan in English.]
I kept my license after I retired, because I knew I was gonna still be doing volunteer work.
But I hadn't given any shots since Katrina.
It's pretty hard to do.
Yeah, I was up all night.
I just couldn't sleep.
I kept thinking, "I'm gonna hurt these kids tomorrow.
" [chuckles.]
That's quite a large needle.
So, they're not gonna like me today.
[scoffs.]
- [Susan.]
Hi.
- [man in Spanish.]
Hi.
[man in English.]
That's it.
Okay, okay.
[Susan.]
I don't want to open all of them yet.
[man.]
Yeah, let's focus.
[child sniffles.]
- [Susan.]
Oh, silly.
You're a silly, silly.
- [laughing.]
[Susan.]
You silly! Okay, honey, I'm gonna pinch.
- [gasps.]
So good! - [man.]
That's all.
Okay? You want your Band-Aid? [man speaking in Spanish.]
[Susan in English.]
I would hate to have a baby or a child die just because I didn't think about doing a flu shot, I didn't want to go through the hassle.
Why take that chance? [typing.]
[Jake clears throat.]
There's a risk that somehow having a bunch of complementary DNA and their synthesis process might cause weird issues.
Okay.
Yeah, right on.
Done.
Cool.
Bye.
My vision for Distributed Bio is that I wanted to build fundamentally new things.
I wanted to create a space where innovation and a willingness to not be trapped by the past would allow people the bravery or the foolishness to try something new that hadn't been tested before.
So, when we have young scientists that come here, we give them really hard problems and then see what happens.
- How's it going, folks? I'm Jake.
- [woman.]
This is Jack.
[Jake.]
Nice to meet you.
Cool, thanks for coming out.
Come and step into my parlor, - I'll give you an update.
- [man.]
Sounds great.
[Jake.]
As you probably already know, if you receive a vaccine for flu on any given year, you get some protection and it lasts a little while, but the virus keeps mutating and making your vaccine obsolete, so you need a new one, and this sucks.
So our strategy was instead of make one vaccine you'd have to keep changing all the time, take all the different versions of the virus and load them in a shot, all at once.
That would teach your immune system to respond to parts of the virus that have never changed over 100 years and you provide a longer protection.
But the way engineering works, you can't do these things all at once, right? If someone's trying to go for the Apollo Program, you're trying to go take a rocket, put a bunch of people in it, send it up to the moon, that thing's not gonna make it.
So, the way you succeed in science is through iteration.
Kind of like our Apollo 1, Apollo 2, Apollo 3 The early tests, we just wanna ask, "Is the theory correct?" If we could take 100 years of flu, give a little bit of it all at once, would that teach the immune system to provide protection? Let's just keep boosting it over and over again.
I'm gonna stop drawing syringes, but you get the idea.
You end up giving them seven shots.
After giving the same vaccine seven times, then we've got these gorgeous responses that were great, but that's a ridiculous vaccine because nobody wants to get seven shots.
But we wanted to prove that the principle was sound, and we could create neutralization against future viruses.
So the next one is, "Can we make it more practical?" Less shots, higher, tighter, more broad response.
And that's the next experiments.
They're gonna be live challenges.
That's the ultimate test and that's why we're pumped.
I was asking them earlier, from an evolutionary perspective, why don't our bodies attack this naturally? - Isn't that strange? - [Jake.]
Yeah.
That is That is the single most fascinating and annoying thing about flu viruses, and that's what got me into it.
The virus hides its Achilles heel in an ocean of things it can flexibly change.
We're teaching the body to help focus on the Achilles heel and ignore that ocean of nonsense.
In the end of it, it's elegant and simple.
That could apply to any rapidly mutating pathogen.
We can go after flu, but we can also go after HIV, dengue, Zika, SARS, MERS and a whole bunch of others, so It's a big platform we're contemplating here, right? You build one thing at a time, but it's a good idea to have a big vision of where this could go.
If this just kept growing, could we have a big dent in making a pathogen-free humanity? Which I think should be not just us, but collectively a consequence of the biotechnology revolution.
I know that sounds like a big dream, but it's good to have big dreams.
Big dreams got us to the moon.
[birds chirping.]
[Syra.]
I live and breathe being a Muslim.
It shapes my daily life.
I don't drink.
I don't eat meat that's not halal.
And, of course, one of the Pillars of Islam is making sure that we pray.
Prayer is not for God.
It's for me, making sure I remember God day-to-day.
And also, in my way of life, making sure that I do no harm and help others.
So, I pray every morning before I leave for work or start my day.
[both.]
Syrup.
[both.]
Syrup.
[both.]
Syrup.
Syrup.
Yeah! [giggles.]
[Syra.]
I think it's very hard for me to distance myself from my work.
I struggle with that at times.
[child 1.]
Mommy, mine is dripping.
[Syra.]
For my kids, I actually don't tell them exactly what I do.
I think it's a little bit hard to explain.
They know Mommy works in a hospital environment.
My five-year-old is more concerned about, "How come other mommies don't work and you work?" [child babbling.]
[child.]
Can you [Syra.]
Your brother's with you.
My name is Dr.
Syra Madad, I am the senior director of New York City Health and Hospitals' system-wide Special Pathogens Program.
I deal with preparedness and response to these types of high-consequence infectious diseases across the entire enterprise of New York City Health and Hospitals.
Like, Ebola, SARS, MERS Seasonal flu is a big one that we see every year.
Anyone know what the definition is of a special pathogen? There is actually no definition, right? There is no defined definition of a special pathogen.
However, there are characteristics.
So, think about Ebola.
What are some characteristics of Ebola that make it a special pathogen? - [woman 1.]
High mortality? - High mortality.
High morbidity, high mortality, right? So it is deadly.
- What's another one? - [woman 2.]
It causes panic.
Causes panic, exactly.
It is something that can cause public panic.
It's something that creates a lot of fear.
There's two more.
[man.]
Hard to treat.
[Syra.]
Hard to treat, that is a third one, that you have no prophylactic treatment, or vaccine, or therapeutic intervention, so that's a third.
- The fourth? - [woman 3.]
Very contagious.
[Syra.]
Very contagious, there is a high likelihood of person-to-person transmission, so you have a lot of secondary cases.
Influenza is extremely hard to predict.
It just takes one person, one host, and then you can start a whole outbreak that can lead to a pandemic.
Over 3,000 commercial flights pass through New York City airports every single day.
If a passenger arrives in New York City with a novel disease like H7N9 flu, it can very well begin to spread undetected.
This is an airborne virus, so things like coughing and sneezing, mere fact of just breathing, is a way of spreading this disease.
Because there is no prior immunity the outbreak would proceed very aggressively.
There's 8.
6 million people here in New York City.
Every day, hospitals operate at over 100% capacity.
In a matter of weeks, a novel virulent influenza strain will incapacitate our city.
The demand for burials will become overwhelming and morgues will begin to overflow, just like we saw in 1918.
Within one month, the virus can spread throughout the country, and within a month after that, could be widespread throughout the world.
And all it would take is just one person.
[machine beeps.]
[beeping.]
[indistinct chatter.]
[newscaster.]
Eastern parts of the Democratic Republic of Congo are struggling to contain the second-worst outbreak of the deadly Ebola virus in history.
More than 1,100 people have died from the deadly virus in two provinces along the borders of three countries.
Experts fear the outbreak is increasing and that the virus could soon spread.
[Michel.]
In Ebola, you miss one case, it can trigger six more and then multiply.
For us, it's the worst scenario.
[man.]
There's the ETC visit.
Um There's also hopefully time to stop by an ITC training.
Mmm-hmm.
They want to know for the UN, what we are doing and what are the key challenges and how we address them.
[Michel.]
Goma is a very dense city.
Because of population movement, the risk of Ebola moving towards Goma is very high.
The outbreak started in a place called Mangina, with a family, and from there it moved to Beni city, and from Beni people moved to Butembo, where the situation has exploded now.
We are hoping that it doesn't reach Goma.
We have two million people.
With a high-density population, actually, Ebola can become incontrollable.
And the risk that it can actually spread to other countries is very high.
[in French.]
Hello, everyone, hello.
[people speaking indistinctly in French.]
People with a high temperature.
A high temperature, we will direct them to here.
All right.
Let's continue.
[Michel in English.]
To survive from this virus, the objective in Ebola is to move faster.
- Detect the first case, - [beeps.]
isolate the case and then stop the chain of transmission.
One patient moving from these Ebola-affected places to Goma and it can easily be a disaster.
[Dennis.]
Ebola virus is one of those viruses that is largely spread by direct physical contact between one person and another.
When there is an outbreak, it's largely contained within a defined geographic area.
Influenza and respiratory viruses are the ones that you're most concerned about, in terms of being able to spread rapidly from one human to another and spread around the world very quickly.
By way of example, the Ebola virus that spread in West Africa from 2014 to 2016, the worst Ebola outbreak in history, largely stayed within the three countries in West Africa.
One traveler went to Nigeria, one traveler went to Dallas, but they never spread.
And 30,000 to 50,000 people were infected, as opposed to H1N1 pandemic influenza virus, sometimes referred to as swine flu, that emerged in the spring of 2009.
Within 12 months, it had spread around the world and infected two billion people.
The 50,000 versus two billion tells us the challenges of dealing with an influenza-like virus, simply by virtue of how easily and rapidly it can spread.
It was just a matter of luck that the swine flu variant of 2009 wasn't more lethal.
Had it been, hundreds of millions of men, women, and children would have died.
[children giggling.]
[child in Spanish.]
We were traveling along with the Honduran caravan, and we crossed over a fence that was in the way and we ran into an officer further up the road.
He caught us.
We were taken to it was like a prison.
We were kept there for two days and transferred to a different one, until we finally got here.
[Susan in English.]
It's hard for me to listen to them tell about how they walked, and walked, and how some of the Mexicans took advantage of them and stole their money, and how the women were badly treated.
I can't get in my head what they've been through.
All I can do is make them feel better now.
[Susan.]
Hey, little one.
[gasps.]
Boom! Boom, boom, boom Here, you've gotta watch where you're going.
How's that? Better? Well, see ya.
[chuckles.]
[woman.]
You've got a little one.
[indistinct chatter.]
[man in Spanish.]
Good afternoon, how are you? Please come with me this way.
Hi! Say hi to me, how are you? Come stand here with me, come.
These papers that you have here are the most important thing you have now.
This is your legal status in the US, okay? With this, you can take your kids to school.
You can take them to the doctor if you need help.
I want to make it clear, you are no longer detained.
You are free.
- We are free, right? I think we are - [people laughing.]
[sniffling.]
[baby crying.]
Now, you're okay here [muffled crying.]
[woman.]
You're good, okay? [man.]
Please, try to relax, I know you're still very tense.
But not anymore, okay? [woman 1.]
You're all from Honduras? [woman 2.]
Yes, all of us.
[woman 1.]
How much time did you spend at the ICE center? - [woman 2.]
Two weeks.
- Two weeks.
How many days were you traveling? - Twenty-two days.
- [woman 1.]
Twenty-two days? [Eve in English.]
Does she want any ibuprofen? [in Spanish.]
Do you want something for the pain? Yes, because it itches Yes.
[in English.]
When people have been experiencing adverse circumstances such as inadequate food and water, dehydration and particularly stress, all those factors would increase risk in terms of getting flu and other illnesses as well.
[woman.]
She didn't fall, didn't hurt herself.
Is it getting better? Is she able to eat right now? [Eve.]
We knew that these refugees had been kept all together in some kind of facility for a few days under less-than-ideal conditions, then brought to us, and then they would be scattered across the country.
And I thought, "This is a public health issue disaster waiting to happen.
" - [woman.]
Cough drops, anything else? - [Eve.]
The tongue blades.
And they don't have to be sterile ones.
[Eve.]
I said, "We gotta do something about this.
We just need to get some flu vaccine for these people.
" - [Susan.]
It's Juan and Juan.
- [woman.]
Juan and Juan.
Juan and Juan.
Come on in, you're next on The Price is Right.
[Susan.]
The flu vaccine is about 50% effective.
But it also, even if it doesn't prevent it, generally modulates it so that it'll be much milder, so your risk of having a serious consequence is much less.
- [laughing.]
- [Eve.]
He laughs.
[Eve.]
I had a professor in pediatrics who said, "Why take care of people at the end of their lives when you can take care of them at the beginning of their lives and have an impact for the rest of their lives.
" [in Spanish.]
Take a deep breath.
[inhaling deeply.]
[breathes deeply.]
- Cough.
- [coughs.]
[Eve in English.]
Okay.
There are tens of thousands of deaths every year from the flu.
I'm not sure why that doesn't impress people.
People got freaked out about the Ebola virus when there was one case in the United States, but the flu virus, which can kill thousands of people, for which we have a prevention, people don't get it.
So, for us in the medical field, sometimes it becomes very frustrating.
[chanting.]
Kill the bill.
Kill the bill.
Kill the bill.
[all chanting and cheering.]
[Jaclyn over microphone.]
My eight children are healthy, happy and vaccine-free.
[crowd cheering.]
We're a responsible family that takes care of our immune system by living a healthy lifestyle.
[crowd cheering.]
[Jaclyn.]
We are in charge of our children, not the government.
- [both.]
We do not consent.
- [all.]
We do not consent.
[crowd chanting.]
[Caylan.]
The rally today at the courthouse There's something really powerful about a physical body showing up to say enough is enough and I want my freedom of choice.
Our specific beliefs, whether it be religion, personal views, health We are standing together, fighting for our rights in Oregon.
- Are you informed? - [all.]
Yeah! - Do you consent? - [all.]
No! [man.]
Thank you for turning up.
[Elizabeth.]
I don't want you guys harassed by these people.
I don't think they're gonna cause physical damage to our office.
I just don't want them getting in your faces.
So, it is World Immunization Day, actually.
- The radio told me today.
- [Elizabeth.]
Are you serious? No, it is not! - It's World Immunization Day? - It is.
I had no idea.
We could not have planned this better.
All right.
- We're gonna take that as a good sign.
- Yeah.
You know, there are certain things that push people's buttons.
Um, guns, gun bills Turns out immunizations is one of them.
There were already 42 voicemails when they came in this morning.
[Elizabeth.]
We've had a large number of protests.
People are pretty grumpy.
A lot of hate mail that eventually descended into death threats against me and my children.
I think the stairs are safer than the elevators.
[woman.]
Mmm-hmm.
- [Elizabeth.]
Good morning.
- [man 1.]
Good morning.
[man 2.]
Morning, Senator.
[protesters chanting.]
Stop 3063! Stop 3063! [protester over microphone.]
It's your job to storm this building and tell them to stop this over-reach.
[protesters cheering.]
[protester.]
Freedom now! Health now! Freedom now! [protesters chanting.]
Health now! Freedom now! [Elizabeth.]
I didn't come here to do easy stuff.
That isn't why I came to legislation.
I came here to protect Oregon's children.
[newscaster 1.]
The US is now dealing with the worst outbreak of measles since 2000.
There have been nearly 700 cases confirmed in 22 states this year.
[newscaster 2.]
Measles is clearly one of the most contagious viruses known to man.
[newscaster 3.]
The measles virus causes high fever and rash and can lead to serious complications.
[newscaster 4.]
Health officials are blaming the outbreak on misinformation about vaccines.
The vast majority of cases have occurred in children who have not received the vaccine.
[newscaster 5.]
The problem's so widespread, the World Health Organization is calling the refusal to vaccinate one of the biggest threats of 2019, right behind Ebola.
[Elizabeth.]
Vaccine hesitancy is one of the largest threats to human health there is.
The complications of a serious viral illness like measles can be very profound, up to and including death.
House Bill 3063, at its heart, does one thing.
If you have a child and you want that child to attend a licensed school or childcare provider in this state, that child either has to have a medical exemption or they have to get all the required immunizations.
If I don't want to immunize my child, I'm putting my child at risk.
You could make an argument that as a parent, I have that choice, and that right, but do I have a right to put your child at risk? Any baby under the age of one and people whose immune systems are suppressed, are really being placed at risk by people not immunizing their children.
The vast majority of people who choose not to immunize their children, do choose to obey traffic laws.
For example, immunizing your children is like stopping at a red light.
It's a pretty good idea so you don't run into somebody who's going the other direction with a green light, right? We all have to make a series of choices when we choose to live in society.
I mean, this is a public health emergency.
At some point, we have to take some tough votes.
[Sarah.]
There are times where I do feel like people look at me that either I'm too young or I'm a woman and out of place or both.
It motivates me to work even harder to be successful.
For those of you who have joined us recently, this is a good opportunity to see what we've been working on for the vaccine program.
Vaccines have been hugely successful in nearly eradicating many pathogens that have once plagued humanity.
However, they have failed in rapidly mutating pathogens such as influenza and HIV and others.
Many groups have tried to find a universal influenza vaccine.
All of these previous attempts have failed at producing a broadly-neutralizing, universally-protective flu vaccine.
More complex but also brilliant solutions have been attempted and failed for various reasons that maybe no one really knows.
So we just had to completely turn it around and say, "What kind of barriers exist and how can we do it differently?" Our approach is new, and then we tried it out in pigs.
The immune systems between pigs and humans are actually remarkably similar, so if it works in pigs, we can be reasonably sure it will work in humans.
What Jake did is he figured, "Okay, well, it's gonna be too expensive for me to run a pig study in the US, but I really wanna see this through and see if my idea is gonna work.
" So I wanted to do pigs and Guatemala became a way that I could do that.
Guatemala has a pretty big pig industry and I grew up down there.
My father still has a hotel and restaurant, so we had property nearby that I could use to set up a facility.
It turns out it's only about $40 or $50 US to buy a pig in Guatemala.
[Jake.]
And suddenly, this whole thing lined up where I realized there was an opportunity to go run these animal studies in Guatemala and then having nice labs in the States to analyze the results.
[Sarah.]
We paid a fraction, a tenth of the cost it would have been to run this study in the US.
And these are some pictures of us in Guatemala with our baby pigs.
We had a group of all-female pigs so we tried to give them all pig-related names.
Oh, it's Squeeyonce and Jennifer Hamiston and Kim Kardashioink, Spamela Anderson, Hamon Biles, Katy Porky, Squeeanna, - and then the list goes on.
- [all laugh.]
And right there was the moment when we realized that it was working.
[Sarah.]
I've flown down to Guatemala 16 times in about three years.
Right now, we're prepping to go back to Guatemala for one final test.
We're really confident in our data and we know that the vaccine works.
However, the vaccine requires seven shots to get the response that we like to see.
Nobody likes to go to the doctor to get shots, especially shot after shot after shot.
So we had to figure out how to get the same protection that we had before, but with fewer shots.
Ideally, one shot.
So that's our next big milestone.
We also need to move on to human clinical trials.
There is a lot of pressure leading up to this trip, because this is our final animal study in Guatemala.
What we want is for Centivax to be the last flu vaccine you'll ever need.
[woman in French over microphone.]
Thank you for giving me time to speak.
We have 1,023 cases, of which 958 are confirmed cases.
638 deaths, 321 healed.
[Michel in English.]
Ebola is a very contagious virus.
It's going to kill the whole family.
The whole village.
The whole city.
[in French.]
The first confirmed case is a 23-year-old woman.
The second case was a three-year-old child.
[Michel in English.]
It's a very painful disease, like a severe flu.
You have muscular pain.
You have fever.
[woman in French.]
For the fourth case, it's a 33-year-old man.
The fifth case is a five-year-old female child.
[Michel in English.]
And when it reaches organ failure, then you start bleeding.
I can see the patient suffering and dying with a lot of pain.
I have to solve this issue.
I have to stop the outbreak, and stop the suffering of all these people.
[woman in French.]
The sixth case is a 16-year-old girl.
The seventh case, is a 56-year-old man.
[Michel in English.]
This is the main motivation.
[Sam.]
When do you wanna schedule that for? [Michel.]
It takes a lot of heart, really, to do this kind of job.
[indistinct chatter.]
[imperceptible.]
Michel is able to engage people and build trust in people, in a way that cuts through any kind of hierarchy.
And really cuts through a lot of the different communities, cultures, nationalities that we have coming here.
[Michel in French.]
His Excellency.
His Excellency is handsome.
[Sam in English.]
Michel has a great respect, both for other people, but also other people for him, and I always was struck by his immediate ability to make people calm in a very stressful environment, and that's a real skill.
But we have not yet been able to overcome a lot of the lack of trust and the deficit of trust that communities have in us.
People are terrified, and they're terrified for a number of reasons, but this is a scary disease.
[interviewer in French.]
Okay, can we start? Doctor, how do you respond to views that vaccines against the Ebola virus are a means used by the West, Americans, to infect the population with the virus, to perpetuate the epidemic? [Michel.]
This vaccine doesn't have the Ebola virus.
It's a vaccine that stimulates immunity.
I've taken exactly the same vaccine.
There are rumors, notably in Goma, which are spreading, that a person has died from the vaccine inoculation.
That's not the case.
[Michel over radio.]
To date, I can guarantee we don't have any major incidents directly linked to the vaccine.
[Michel in English.]
In influenza, during the crisis, you may have to change vaccine, because the flu virus can mutate easily.
At least, the good thing for Ebola is that we have actually one vaccine.
It's an experimental vaccine that the manufacturer cannot produce in huge numbers.
At the beginning of the outbreak, we had 300,000 doses, and this is for worldwide.
We cannot afford to do a mass campaign.
We don't have enough vaccine.
So, in this case, the appropriate strategy is to vaccinate frontline workers.
[Michel in French.]
Okay, this doesn't scare you? Are you still okay with this? Okay, Doctor.
We will vaccinate the young lady.
[Michel in English.]
This vaccine will protect the health workers from the disease.
But, unfortunately, Ebola is not the only danger they face.
[wailing.]
[newscaster.]
A new spike in deadly violence has gripped the Democratic Republic of Congo.
Armed rebel groups are targeting Ebola health care teams in the country's eastern region.
Two aid workers were killed in one attack over the weekend.
[Michel.]
Two days ago, we had one of the vaccination team members being beaten and even thrown into the river.
We are experiencing attacks from different armed groups.
We became the target.
This is quite hard.
It's like fighting two armies.
The outbreak itself and the groups that fight Ebola teams.
[woman in Spanish.]
Good morning! [child.]
Do you have a pill for my ear pain? Are you in a lot of pain? Does your throat hurt, too? [child.]
Yes.
- Thank you! - [child chuckling.]
[gagging.]
[woman.]
Now, you can eat the lozenge.
[continues gagging.]
- Does it taste funny? - Yes.
[woman in Spanish.]
We're coming from Poptun, Ixobel, Guatemala.
[imperceptible.]
I didn't want to leave my country and my mother behind, but I had to.
I might lose a family member or even my girls, the most important people in my life.
I decided I'd rather leave.
- [woman 2.]
Mmm-hmm.
- [woman sniffles.]
But I know I'll be back with them someday.
Here's the one where they threaten my husband.
[child.]
Said they'd turn her into ground pork and kidnap us.
Until they get rid of every single person in the family.
That's what the message says.
- Were you scared when you saw it? - Yeah.
[woman.]
But, yeah, we're already here.
Things will be different once we are with our family, God willing.
Uh-huh.
[sniffles.]
[Eve in English.]
People don't like to leave their countries.
They have relationships there.
They have a feeling about the land.
I'm sure if it was a safe environment and they could make a living, they would be happy staying there.
You really feel you wanna do everything you can to make up for the horrible circumstances under which they've come here.
And I think everyone at the facility feels that way.
[Susan.]
I got two of them.
Both from Alia.
My one daughter, she's in North Carolina.
She's helping me out.
She sent the boxes for the kids.
I can't believe she got ten coats in here, but Oh, one of the little girls will love that.
That's so nice.
I hate giving out second-hand stuff that's all yucky.
[groans.]
[Susan.]
For everything these families have been through, and some have been through so much that we don't even know about, and then they come up to this country, and to die from anything, much less the flu, something preventable, it's inexcusable.
We're gonna do whatever we can to make sure that doesn't happen.
[Susan.]
Is it okay? Oh, oh [wailing.]
[Susan.]
Oh Oh Oh, baby.
[Susan.]
Oh Oh Hey, baby.
[Eve.]
The acceptance of the vaccine among the refugee families was very shocking, because I felt, after their experience, why would they trust us? But they did.
And when we said we are offering the flu vaccine, they basically all came to get it, and it was such a nice change from having to struggle with people, to fight with them about getting a vaccine.
That was very rewarding.
The challenges we're facing is maintaining a steady supply of the vaccine.
Somebody has to pay for it, and there is no money in any budget, really, to provide that.
I personally don't think a county should be responsible for this.
This should be a federal government response.
We are getting somewhere between 50 and 80 people a day.
There have been a couple of days where they had up to 100.
When it was clear that the vaccine was running low over the last few days, we've really been prioritizing just children and pregnant women.
We haven't been able to give it to adults.
And I feel bad turning people away, 'cause they come wanting it.
They say, "But I'm leaving tomorrow.
Can't you give it to me?" And we say, "This is what we have.
We have ten doses left.
" - [woman.]
Okay.
- [woman 2.]
You know this guy? [woman 3.]
Okay.
[Eve.]
Okay.
[Eve.]
So I think we only have, um five or six doses left of the vaccine, and obviously we won't get any tomorrow, it's Sunday.
Who knows about next week? - Yeah.
- So we're probably gonna be out.
They do understand that this flu season is now, and it's kind of - Yes.
- This is the time.
That's crazy, okay.
[Eve.]
Unless we get something on Monday, we won't be able to give people the vaccine.
[Jake.]
My family owns a bed and breakfast in Guatemala, and because we had a little piece of extra property away from the bungalows, we were able to use that to build an animal facility to test the vaccine.
[Jake in Spanish.]
What an old hotel! [laughing.]
- [Jake in English.]
How's it going? - How you doing? - It's good to see you, man.
- Hey, a long ride, huh? They're paving both sides of the road at once.
That's smart.
We had to retreat an hour and a half It took a special engineer to figure that one out.
- Hola.
- [Jake.]
Hey, hey, what's up? [Jake in Spanish.]
How are you? [man.]
I'm fine, thank you.
- [Jake.]
What's up? - [man.]
Hey, man, how are you? - All good, all good.
- Good? [Jake in English.]
I love coming back to Guatemala.
It will always feel like home to me.
But it also feels, every time I come back, like I'm one step closer to achieving our vaccine goals.
- [Sarah.]
Ooh, fresh paint.
- [Jake.]
Nice.
- Looks really good.
- Yeah.
[Sarah.]
They are so freaking cute.
[pigs oinking.]
[Sarah.]
They look really good.
- They look healthy.
- [Jake.]
Yeah.
Hi.
Hi, piggy.
- [pig farts.]
- Oh Did a poop.
[Jake.]
I remember when I did the first vaccine study.
I was scared the whole time.
Imagine cooking a cake, where you're gonna spend six months on it and bring all your friends in, and you don't know if the whole thing's gonna be a mess at the end.
This is really one of our most important experiments yet, because if we're successful, it'll be a huge step towards human trials.
[clicks.]
[Jake cooing.]
Who's gonna help us solve influenza? Who's gonna help us solve influenza? You are.
Hurry up! [children talking indistinctly.]
[girl giggling.]
[indistinct chatter.]
[child giggling.]
[Caylan.]
Nice job.
Nice flick of the wrist.
[Caylan.]
The focus of my life is to allow my kids to be who they are.
Our lifestyle and the way that I raise my kids is just to continually be evolving, and awakening, and consciousness, and awareness and mindfulness.
[ball thuds.]
[Caylan.]
I believe a healthy child has the ability to build up immunity naturally.
[indistinct chatter.]
So, Pearl, do you know what the word consent means? - No.
- Me, either.
I don't.
It means you give someone permission.
Remember whenever we talk about body parts and I'm like, we all we don't touch other people's body unless we get permission, and then there's even certain places that we don't even touch - Don't say it.
- [chuckles softly.]
Don't say it.
[Caylan.]
You know, there can be people that you think you should be able to trust.
- [girl.]
Yeah.
- Whether it's a doctor, or it's a pastor, or it's an owner of a business, even the president.
And no matter who it is that we're in contact with, we have the right to be able to feel within our bodies, does this feel safe and do I do I want to move forward? We should all be given the freedom to do that.
And so we have to really think through how, if this bill passes, what the effects of that will be for all of us.
[crowd chanting.]
[newscaster.]
Dozens of people are rallying in Salem against a bill that would eliminate non-medical vaccine exemptions.
Now, if it passes, most unvaccinated kids would not be allowed to attend school and daycare programs in Oregon.
Supporters say the effort to limit exemptions is about safe schools and protecting children and adults.
Those against limiting exemptions question vaccine safety standard.
A doctor today described the measles vaccine as, "incredibly safe.
" [Caylan.]
Where's Khalil? Wait, you're right there.
One, two, three, four, five.
I still have to do the count.
This bill would require that whether you go to private school, or you're in public school, or in a charter school, you would have to get every single vaccine that they say that you should have at the timing that you should have it.
What does freedom mean, you guys? - [child 1.]
Free! - [child 2.]
Like, like You're just out there.
You don't have to do what people say or I don't know, I have to think about it.
I've never thought about it.
[Caylan.]
For me, it's not about whether you vaccinate or you don't, it's us having the freedom of choice to choose what we think as a parent is the best thing for our child.
Rumi, to calm us down, roll this over your heart.
- [Caylan.]
Okay? - [mumbles.]
[Caylan.]
I am confident that no one else can teach, direct and guide my kids' hearts, minds and souls better than me.
[Caylan.]
Everything with this whole vaccine bill is someone who believes that they know what's better for you than I do and what you do.
So, it's removing our choice.
[children cooing.]
[Caylan.]
On my family, this bill will have a very large impact, 'cause my oldest is passionate about basketball.
She will no longer be able to play on specific teams.
You won't be able to play soccer and you won't be able to play basketball if you don't get vaccines.
I don't feel comfortable getting vaccines, and if were to even muscle test them, I don't know if your body - would feel comfortable with it.
- You're making me cry.
- [Caylan.]
I'm making you cry? - I don't want that.
[Caylan.]
It's kind of a lot to take in, huh? I am raising you guys to be the 10% of the world, which means you're not gonna fit in with the 90% and that's okay.
[child giggling.]
[Caylan.]
We're advocating to our children "my body, my rules," and here, that is being stripped away.
As a protector of our children, to not have that, it's like, "What are we stepping into next?" [man speaking in native language.]
[man grunts.]
[woman speaking in native language.]
[woman exclaims.]
[newscaster 1.]
The commissioner of US Customs and Border Protection is ordering new steps to protect children in US custody after the death of an eight-year-old Guatemalan boy.
[newscaster 2.]
Four days after eight-year-old Felipe Gómez died, new autopsy results show that the boy tested positive for the flu.
Felipe now the second migrant child to die this month in US custody.
[speaking in native language.]
[woman in Spanish.]
My brother's health was good before he left It was so hard for us to understand why his death was so sudden.
Very sudden.
He was a mischievous little boy, but he always did well in school.
"I'm going to the United States with Dad," he said, excitedly.
[sniffles.]
"But I'll come back for Mom.
" That's what he said when he left.
[woman 2 in Mayan.]
I do regret that he left but we just did it because of how poor we are.
[rooster crowing.]
[woman 2.]
I'm very scared of the flu and of its lethal outcomes.
If another of my children dies, I'd lose all will to live.
[newscaster 3.]
US Border Patrol agents apprehended a group of more than 1,000 migrants, who illegally crossed the southern border near El Paso, Texas.
[newscaster 4.]
A decade ago, 90% of immigrants caught crossing illegally were single adult men from Mexico.
Today, nearly 90% are families and unaccompanied children from Central America.
[Susan.]
When I heard that Felipe died I mean, I was angry because it's all such bullshit.
We have horrible things that happen with the different hurricanes, with the tornadoes.
We don't need any man-made catastrophes.
And that's exactly what this one is.
[child.]
Mama.
Mama.
- [door closes.]
- [child whining.]
[child cooing.]
[indistinct chatter.]
[Susan.]
I volunteered 9/11 and went down the day after.
And then I went down to Katrina.
And I worked down there for almost two months.
If you're able to help, you have to go.
[indistinct chatter.]
[man in Spanish.]
Good afternoon.
[man speaking indistinctly.]
[Susan in English.]
In Tucson, people have rallied.
[man in Spanish.]
I want to make sure the children get to eat first and then the grown-ups.
[woman.]
Tangerine, perfect! [Susan in English.]
They make sure they're fed.
We give them two sets of clothing and then they have the to-go bags where they have food for their bus rides.
It's a little group here, doing this.
It's amazing.
[Susan.]
I'm so happy to be able to give the flu shots because I really, really believe in them.
And I think it's up to 36 cases this year of children that have died from the flu.
This is preventable.
It's ridiculous not to get 'em a flu shot.
- [man.]
Okay.
- It's okay.
[man in Spanish.]
Look, look.
Like this, look.
[Susan in English.]
I kept my license after I retired, because I knew I was gonna still be doing volunteer work.
But I hadn't given any shots since Katrina.
It's pretty hard to do.
Yeah, I was up all night.
I just couldn't sleep.
I kept thinking, "I'm gonna hurt these kids tomorrow.
" [chuckles.]
That's quite a large needle.
So, they're not gonna like me today.
[scoffs.]
- [Susan.]
Hi.
- [man in Spanish.]
Hi.
[man in English.]
That's it.
Okay, okay.
[Susan.]
I don't want to open all of them yet.
[man.]
Yeah, let's focus.
[child sniffles.]
- [Susan.]
Oh, silly.
You're a silly, silly.
- [laughing.]
[Susan.]
You silly! Okay, honey, I'm gonna pinch.
- [gasps.]
So good! - [man.]
That's all.
Okay? You want your Band-Aid? [man speaking in Spanish.]
[Susan in English.]
I would hate to have a baby or a child die just because I didn't think about doing a flu shot, I didn't want to go through the hassle.
Why take that chance? [typing.]
[Jake clears throat.]
There's a risk that somehow having a bunch of complementary DNA and their synthesis process might cause weird issues.
Okay.
Yeah, right on.
Done.
Cool.
Bye.
My vision for Distributed Bio is that I wanted to build fundamentally new things.
I wanted to create a space where innovation and a willingness to not be trapped by the past would allow people the bravery or the foolishness to try something new that hadn't been tested before.
So, when we have young scientists that come here, we give them really hard problems and then see what happens.
- How's it going, folks? I'm Jake.
- [woman.]
This is Jack.
[Jake.]
Nice to meet you.
Cool, thanks for coming out.
Come and step into my parlor, - I'll give you an update.
- [man.]
Sounds great.
[Jake.]
As you probably already know, if you receive a vaccine for flu on any given year, you get some protection and it lasts a little while, but the virus keeps mutating and making your vaccine obsolete, so you need a new one, and this sucks.
So our strategy was instead of make one vaccine you'd have to keep changing all the time, take all the different versions of the virus and load them in a shot, all at once.
That would teach your immune system to respond to parts of the virus that have never changed over 100 years and you provide a longer protection.
But the way engineering works, you can't do these things all at once, right? If someone's trying to go for the Apollo Program, you're trying to go take a rocket, put a bunch of people in it, send it up to the moon, that thing's not gonna make it.
So, the way you succeed in science is through iteration.
Kind of like our Apollo 1, Apollo 2, Apollo 3 The early tests, we just wanna ask, "Is the theory correct?" If we could take 100 years of flu, give a little bit of it all at once, would that teach the immune system to provide protection? Let's just keep boosting it over and over again.
I'm gonna stop drawing syringes, but you get the idea.
You end up giving them seven shots.
After giving the same vaccine seven times, then we've got these gorgeous responses that were great, but that's a ridiculous vaccine because nobody wants to get seven shots.
But we wanted to prove that the principle was sound, and we could create neutralization against future viruses.
So the next one is, "Can we make it more practical?" Less shots, higher, tighter, more broad response.
And that's the next experiments.
They're gonna be live challenges.
That's the ultimate test and that's why we're pumped.
I was asking them earlier, from an evolutionary perspective, why don't our bodies attack this naturally? - Isn't that strange? - [Jake.]
Yeah.
That is That is the single most fascinating and annoying thing about flu viruses, and that's what got me into it.
The virus hides its Achilles heel in an ocean of things it can flexibly change.
We're teaching the body to help focus on the Achilles heel and ignore that ocean of nonsense.
In the end of it, it's elegant and simple.
That could apply to any rapidly mutating pathogen.
We can go after flu, but we can also go after HIV, dengue, Zika, SARS, MERS and a whole bunch of others, so It's a big platform we're contemplating here, right? You build one thing at a time, but it's a good idea to have a big vision of where this could go.
If this just kept growing, could we have a big dent in making a pathogen-free humanity? Which I think should be not just us, but collectively a consequence of the biotechnology revolution.
I know that sounds like a big dream, but it's good to have big dreams.
Big dreams got us to the moon.
[birds chirping.]
[Syra.]
I live and breathe being a Muslim.
It shapes my daily life.
I don't drink.
I don't eat meat that's not halal.
And, of course, one of the Pillars of Islam is making sure that we pray.
Prayer is not for God.
It's for me, making sure I remember God day-to-day.
And also, in my way of life, making sure that I do no harm and help others.
So, I pray every morning before I leave for work or start my day.
[both.]
Syrup.
[both.]
Syrup.
[both.]
Syrup.
Syrup.
Yeah! [giggles.]
[Syra.]
I think it's very hard for me to distance myself from my work.
I struggle with that at times.
[child 1.]
Mommy, mine is dripping.
[Syra.]
For my kids, I actually don't tell them exactly what I do.
I think it's a little bit hard to explain.
They know Mommy works in a hospital environment.
My five-year-old is more concerned about, "How come other mommies don't work and you work?" [child babbling.]
[child.]
Can you [Syra.]
Your brother's with you.
My name is Dr.
Syra Madad, I am the senior director of New York City Health and Hospitals' system-wide Special Pathogens Program.
I deal with preparedness and response to these types of high-consequence infectious diseases across the entire enterprise of New York City Health and Hospitals.
Like, Ebola, SARS, MERS Seasonal flu is a big one that we see every year.
Anyone know what the definition is of a special pathogen? There is actually no definition, right? There is no defined definition of a special pathogen.
However, there are characteristics.
So, think about Ebola.
What are some characteristics of Ebola that make it a special pathogen? - [woman 1.]
High mortality? - High mortality.
High morbidity, high mortality, right? So it is deadly.
- What's another one? - [woman 2.]
It causes panic.
Causes panic, exactly.
It is something that can cause public panic.
It's something that creates a lot of fear.
There's two more.
[man.]
Hard to treat.
[Syra.]
Hard to treat, that is a third one, that you have no prophylactic treatment, or vaccine, or therapeutic intervention, so that's a third.
- The fourth? - [woman 3.]
Very contagious.
[Syra.]
Very contagious, there is a high likelihood of person-to-person transmission, so you have a lot of secondary cases.
Influenza is extremely hard to predict.
It just takes one person, one host, and then you can start a whole outbreak that can lead to a pandemic.
Over 3,000 commercial flights pass through New York City airports every single day.
If a passenger arrives in New York City with a novel disease like H7N9 flu, it can very well begin to spread undetected.
This is an airborne virus, so things like coughing and sneezing, mere fact of just breathing, is a way of spreading this disease.
Because there is no prior immunity the outbreak would proceed very aggressively.
There's 8.
6 million people here in New York City.
Every day, hospitals operate at over 100% capacity.
In a matter of weeks, a novel virulent influenza strain will incapacitate our city.
The demand for burials will become overwhelming and morgues will begin to overflow, just like we saw in 1918.
Within one month, the virus can spread throughout the country, and within a month after that, could be widespread throughout the world.
And all it would take is just one person.
[machine beeps.]
[beeping.]
[indistinct chatter.]
[newscaster.]
Eastern parts of the Democratic Republic of Congo are struggling to contain the second-worst outbreak of the deadly Ebola virus in history.
More than 1,100 people have died from the deadly virus in two provinces along the borders of three countries.
Experts fear the outbreak is increasing and that the virus could soon spread.
[Michel.]
In Ebola, you miss one case, it can trigger six more and then multiply.
For us, it's the worst scenario.
[man.]
There's the ETC visit.
Um There's also hopefully time to stop by an ITC training.
Mmm-hmm.
They want to know for the UN, what we are doing and what are the key challenges and how we address them.
[Michel.]
Goma is a very dense city.
Because of population movement, the risk of Ebola moving towards Goma is very high.
The outbreak started in a place called Mangina, with a family, and from there it moved to Beni city, and from Beni people moved to Butembo, where the situation has exploded now.
We are hoping that it doesn't reach Goma.
We have two million people.
With a high-density population, actually, Ebola can become incontrollable.
And the risk that it can actually spread to other countries is very high.
[in French.]
Hello, everyone, hello.
[people speaking indistinctly in French.]
People with a high temperature.
A high temperature, we will direct them to here.
All right.
Let's continue.
[Michel in English.]
To survive from this virus, the objective in Ebola is to move faster.
- Detect the first case, - [beeps.]
isolate the case and then stop the chain of transmission.
One patient moving from these Ebola-affected places to Goma and it can easily be a disaster.
[Dennis.]
Ebola virus is one of those viruses that is largely spread by direct physical contact between one person and another.
When there is an outbreak, it's largely contained within a defined geographic area.
Influenza and respiratory viruses are the ones that you're most concerned about, in terms of being able to spread rapidly from one human to another and spread around the world very quickly.
By way of example, the Ebola virus that spread in West Africa from 2014 to 2016, the worst Ebola outbreak in history, largely stayed within the three countries in West Africa.
One traveler went to Nigeria, one traveler went to Dallas, but they never spread.
And 30,000 to 50,000 people were infected, as opposed to H1N1 pandemic influenza virus, sometimes referred to as swine flu, that emerged in the spring of 2009.
Within 12 months, it had spread around the world and infected two billion people.
The 50,000 versus two billion tells us the challenges of dealing with an influenza-like virus, simply by virtue of how easily and rapidly it can spread.
It was just a matter of luck that the swine flu variant of 2009 wasn't more lethal.
Had it been, hundreds of millions of men, women, and children would have died.
[children giggling.]
[child in Spanish.]
We were traveling along with the Honduran caravan, and we crossed over a fence that was in the way and we ran into an officer further up the road.
He caught us.
We were taken to it was like a prison.
We were kept there for two days and transferred to a different one, until we finally got here.
[Susan in English.]
It's hard for me to listen to them tell about how they walked, and walked, and how some of the Mexicans took advantage of them and stole their money, and how the women were badly treated.
I can't get in my head what they've been through.
All I can do is make them feel better now.
[Susan.]
Hey, little one.
[gasps.]
Boom! Boom, boom, boom Here, you've gotta watch where you're going.
How's that? Better? Well, see ya.
[chuckles.]
[woman.]
You've got a little one.
[indistinct chatter.]
[man in Spanish.]
Good afternoon, how are you? Please come with me this way.
Hi! Say hi to me, how are you? Come stand here with me, come.
These papers that you have here are the most important thing you have now.
This is your legal status in the US, okay? With this, you can take your kids to school.
You can take them to the doctor if you need help.
I want to make it clear, you are no longer detained.
You are free.
- We are free, right? I think we are - [people laughing.]
[sniffling.]
[baby crying.]
Now, you're okay here [muffled crying.]
[woman.]
You're good, okay? [man.]
Please, try to relax, I know you're still very tense.
But not anymore, okay? [woman 1.]
You're all from Honduras? [woman 2.]
Yes, all of us.
[woman 1.]
How much time did you spend at the ICE center? - [woman 2.]
Two weeks.
- Two weeks.
How many days were you traveling? - Twenty-two days.
- [woman 1.]
Twenty-two days? [Eve in English.]
Does she want any ibuprofen? [in Spanish.]
Do you want something for the pain? Yes, because it itches Yes.
[in English.]
When people have been experiencing adverse circumstances such as inadequate food and water, dehydration and particularly stress, all those factors would increase risk in terms of getting flu and other illnesses as well.
[woman.]
She didn't fall, didn't hurt herself.
Is it getting better? Is she able to eat right now? [Eve.]
We knew that these refugees had been kept all together in some kind of facility for a few days under less-than-ideal conditions, then brought to us, and then they would be scattered across the country.
And I thought, "This is a public health issue disaster waiting to happen.
" - [woman.]
Cough drops, anything else? - [Eve.]
The tongue blades.
And they don't have to be sterile ones.
[Eve.]
I said, "We gotta do something about this.
We just need to get some flu vaccine for these people.
" - [Susan.]
It's Juan and Juan.
- [woman.]
Juan and Juan.
Juan and Juan.
Come on in, you're next on The Price is Right.
[Susan.]
The flu vaccine is about 50% effective.
But it also, even if it doesn't prevent it, generally modulates it so that it'll be much milder, so your risk of having a serious consequence is much less.
- [laughing.]
- [Eve.]
He laughs.
[Eve.]
I had a professor in pediatrics who said, "Why take care of people at the end of their lives when you can take care of them at the beginning of their lives and have an impact for the rest of their lives.
" [in Spanish.]
Take a deep breath.
[inhaling deeply.]
[breathes deeply.]
- Cough.
- [coughs.]
[Eve in English.]
Okay.
There are tens of thousands of deaths every year from the flu.
I'm not sure why that doesn't impress people.
People got freaked out about the Ebola virus when there was one case in the United States, but the flu virus, which can kill thousands of people, for which we have a prevention, people don't get it.
So, for us in the medical field, sometimes it becomes very frustrating.
[chanting.]
Kill the bill.
Kill the bill.
Kill the bill.
[all chanting and cheering.]
[Jaclyn over microphone.]
My eight children are healthy, happy and vaccine-free.
[crowd cheering.]
We're a responsible family that takes care of our immune system by living a healthy lifestyle.
[crowd cheering.]
[Jaclyn.]
We are in charge of our children, not the government.
- [both.]
We do not consent.
- [all.]
We do not consent.
[crowd chanting.]
[Caylan.]
The rally today at the courthouse There's something really powerful about a physical body showing up to say enough is enough and I want my freedom of choice.
Our specific beliefs, whether it be religion, personal views, health We are standing together, fighting for our rights in Oregon.
- Are you informed? - [all.]
Yeah! - Do you consent? - [all.]
No! [man.]
Thank you for turning up.
[Elizabeth.]
I don't want you guys harassed by these people.
I don't think they're gonna cause physical damage to our office.
I just don't want them getting in your faces.
So, it is World Immunization Day, actually.
- The radio told me today.
- [Elizabeth.]
Are you serious? No, it is not! - It's World Immunization Day? - It is.
I had no idea.
We could not have planned this better.
All right.
- We're gonna take that as a good sign.
- Yeah.
You know, there are certain things that push people's buttons.
Um, guns, gun bills Turns out immunizations is one of them.
There were already 42 voicemails when they came in this morning.
[Elizabeth.]
We've had a large number of protests.
People are pretty grumpy.
A lot of hate mail that eventually descended into death threats against me and my children.
I think the stairs are safer than the elevators.
[woman.]
Mmm-hmm.
- [Elizabeth.]
Good morning.
- [man 1.]
Good morning.
[man 2.]
Morning, Senator.
[protesters chanting.]
Stop 3063! Stop 3063! [protester over microphone.]
It's your job to storm this building and tell them to stop this over-reach.
[protesters cheering.]
[protester.]
Freedom now! Health now! Freedom now! [protesters chanting.]
Health now! Freedom now! [Elizabeth.]
I didn't come here to do easy stuff.
That isn't why I came to legislation.
I came here to protect Oregon's children.
[newscaster 1.]
The US is now dealing with the worst outbreak of measles since 2000.
There have been nearly 700 cases confirmed in 22 states this year.
[newscaster 2.]
Measles is clearly one of the most contagious viruses known to man.
[newscaster 3.]
The measles virus causes high fever and rash and can lead to serious complications.
[newscaster 4.]
Health officials are blaming the outbreak on misinformation about vaccines.
The vast majority of cases have occurred in children who have not received the vaccine.
[newscaster 5.]
The problem's so widespread, the World Health Organization is calling the refusal to vaccinate one of the biggest threats of 2019, right behind Ebola.
[Elizabeth.]
Vaccine hesitancy is one of the largest threats to human health there is.
The complications of a serious viral illness like measles can be very profound, up to and including death.
House Bill 3063, at its heart, does one thing.
If you have a child and you want that child to attend a licensed school or childcare provider in this state, that child either has to have a medical exemption or they have to get all the required immunizations.
If I don't want to immunize my child, I'm putting my child at risk.
You could make an argument that as a parent, I have that choice, and that right, but do I have a right to put your child at risk? Any baby under the age of one and people whose immune systems are suppressed, are really being placed at risk by people not immunizing their children.
The vast majority of people who choose not to immunize their children, do choose to obey traffic laws.
For example, immunizing your children is like stopping at a red light.
It's a pretty good idea so you don't run into somebody who's going the other direction with a green light, right? We all have to make a series of choices when we choose to live in society.
I mean, this is a public health emergency.
At some point, we have to take some tough votes.
[Sarah.]
There are times where I do feel like people look at me that either I'm too young or I'm a woman and out of place or both.
It motivates me to work even harder to be successful.
For those of you who have joined us recently, this is a good opportunity to see what we've been working on for the vaccine program.
Vaccines have been hugely successful in nearly eradicating many pathogens that have once plagued humanity.
However, they have failed in rapidly mutating pathogens such as influenza and HIV and others.
Many groups have tried to find a universal influenza vaccine.
All of these previous attempts have failed at producing a broadly-neutralizing, universally-protective flu vaccine.
More complex but also brilliant solutions have been attempted and failed for various reasons that maybe no one really knows.
So we just had to completely turn it around and say, "What kind of barriers exist and how can we do it differently?" Our approach is new, and then we tried it out in pigs.
The immune systems between pigs and humans are actually remarkably similar, so if it works in pigs, we can be reasonably sure it will work in humans.
What Jake did is he figured, "Okay, well, it's gonna be too expensive for me to run a pig study in the US, but I really wanna see this through and see if my idea is gonna work.
" So I wanted to do pigs and Guatemala became a way that I could do that.
Guatemala has a pretty big pig industry and I grew up down there.
My father still has a hotel and restaurant, so we had property nearby that I could use to set up a facility.
It turns out it's only about $40 or $50 US to buy a pig in Guatemala.
[Jake.]
And suddenly, this whole thing lined up where I realized there was an opportunity to go run these animal studies in Guatemala and then having nice labs in the States to analyze the results.
[Sarah.]
We paid a fraction, a tenth of the cost it would have been to run this study in the US.
And these are some pictures of us in Guatemala with our baby pigs.
We had a group of all-female pigs so we tried to give them all pig-related names.
Oh, it's Squeeyonce and Jennifer Hamiston and Kim Kardashioink, Spamela Anderson, Hamon Biles, Katy Porky, Squeeanna, - and then the list goes on.
- [all laugh.]
And right there was the moment when we realized that it was working.
[Sarah.]
I've flown down to Guatemala 16 times in about three years.
Right now, we're prepping to go back to Guatemala for one final test.
We're really confident in our data and we know that the vaccine works.
However, the vaccine requires seven shots to get the response that we like to see.
Nobody likes to go to the doctor to get shots, especially shot after shot after shot.
So we had to figure out how to get the same protection that we had before, but with fewer shots.
Ideally, one shot.
So that's our next big milestone.
We also need to move on to human clinical trials.
There is a lot of pressure leading up to this trip, because this is our final animal study in Guatemala.
What we want is for Centivax to be the last flu vaccine you'll ever need.
[woman in French over microphone.]
Thank you for giving me time to speak.
We have 1,023 cases, of which 958 are confirmed cases.
638 deaths, 321 healed.
[Michel in English.]
Ebola is a very contagious virus.
It's going to kill the whole family.
The whole village.
The whole city.
[in French.]
The first confirmed case is a 23-year-old woman.
The second case was a three-year-old child.
[Michel in English.]
It's a very painful disease, like a severe flu.
You have muscular pain.
You have fever.
[woman in French.]
For the fourth case, it's a 33-year-old man.
The fifth case is a five-year-old female child.
[Michel in English.]
And when it reaches organ failure, then you start bleeding.
I can see the patient suffering and dying with a lot of pain.
I have to solve this issue.
I have to stop the outbreak, and stop the suffering of all these people.
[woman in French.]
The sixth case is a 16-year-old girl.
The seventh case, is a 56-year-old man.
[Michel in English.]
This is the main motivation.
[Sam.]
When do you wanna schedule that for? [Michel.]
It takes a lot of heart, really, to do this kind of job.
[indistinct chatter.]
[imperceptible.]
Michel is able to engage people and build trust in people, in a way that cuts through any kind of hierarchy.
And really cuts through a lot of the different communities, cultures, nationalities that we have coming here.
[Michel in French.]
His Excellency.
His Excellency is handsome.
[Sam in English.]
Michel has a great respect, both for other people, but also other people for him, and I always was struck by his immediate ability to make people calm in a very stressful environment, and that's a real skill.
But we have not yet been able to overcome a lot of the lack of trust and the deficit of trust that communities have in us.
People are terrified, and they're terrified for a number of reasons, but this is a scary disease.
[interviewer in French.]
Okay, can we start? Doctor, how do you respond to views that vaccines against the Ebola virus are a means used by the West, Americans, to infect the population with the virus, to perpetuate the epidemic? [Michel.]
This vaccine doesn't have the Ebola virus.
It's a vaccine that stimulates immunity.
I've taken exactly the same vaccine.
There are rumors, notably in Goma, which are spreading, that a person has died from the vaccine inoculation.
That's not the case.
[Michel over radio.]
To date, I can guarantee we don't have any major incidents directly linked to the vaccine.
[Michel in English.]
In influenza, during the crisis, you may have to change vaccine, because the flu virus can mutate easily.
At least, the good thing for Ebola is that we have actually one vaccine.
It's an experimental vaccine that the manufacturer cannot produce in huge numbers.
At the beginning of the outbreak, we had 300,000 doses, and this is for worldwide.
We cannot afford to do a mass campaign.
We don't have enough vaccine.
So, in this case, the appropriate strategy is to vaccinate frontline workers.
[Michel in French.]
Okay, this doesn't scare you? Are you still okay with this? Okay, Doctor.
We will vaccinate the young lady.
[Michel in English.]
This vaccine will protect the health workers from the disease.
But, unfortunately, Ebola is not the only danger they face.
[wailing.]
[newscaster.]
A new spike in deadly violence has gripped the Democratic Republic of Congo.
Armed rebel groups are targeting Ebola health care teams in the country's eastern region.
Two aid workers were killed in one attack over the weekend.
[Michel.]
Two days ago, we had one of the vaccination team members being beaten and even thrown into the river.
We are experiencing attacks from different armed groups.
We became the target.
This is quite hard.
It's like fighting two armies.
The outbreak itself and the groups that fight Ebola teams.
[woman in Spanish.]
Good morning! [child.]
Do you have a pill for my ear pain? Are you in a lot of pain? Does your throat hurt, too? [child.]
Yes.
- Thank you! - [child chuckling.]
[gagging.]
[woman.]
Now, you can eat the lozenge.
[continues gagging.]
- Does it taste funny? - Yes.
[woman in Spanish.]
We're coming from Poptun, Ixobel, Guatemala.
[imperceptible.]
I didn't want to leave my country and my mother behind, but I had to.
I might lose a family member or even my girls, the most important people in my life.
I decided I'd rather leave.
- [woman 2.]
Mmm-hmm.
- [woman sniffles.]
But I know I'll be back with them someday.
Here's the one where they threaten my husband.
[child.]
Said they'd turn her into ground pork and kidnap us.
Until they get rid of every single person in the family.
That's what the message says.
- Were you scared when you saw it? - Yeah.
[woman.]
But, yeah, we're already here.
Things will be different once we are with our family, God willing.
Uh-huh.
[sniffles.]
[Eve in English.]
People don't like to leave their countries.
They have relationships there.
They have a feeling about the land.
I'm sure if it was a safe environment and they could make a living, they would be happy staying there.
You really feel you wanna do everything you can to make up for the horrible circumstances under which they've come here.
And I think everyone at the facility feels that way.
[Susan.]
I got two of them.
Both from Alia.
My one daughter, she's in North Carolina.
She's helping me out.
She sent the boxes for the kids.
I can't believe she got ten coats in here, but Oh, one of the little girls will love that.
That's so nice.
I hate giving out second-hand stuff that's all yucky.
[groans.]
[Susan.]
For everything these families have been through, and some have been through so much that we don't even know about, and then they come up to this country, and to die from anything, much less the flu, something preventable, it's inexcusable.
We're gonna do whatever we can to make sure that doesn't happen.
[Susan.]
Is it okay? Oh, oh [wailing.]
[Susan.]
Oh Oh Oh, baby.
[Susan.]
Oh Oh Hey, baby.
[Eve.]
The acceptance of the vaccine among the refugee families was very shocking, because I felt, after their experience, why would they trust us? But they did.
And when we said we are offering the flu vaccine, they basically all came to get it, and it was such a nice change from having to struggle with people, to fight with them about getting a vaccine.
That was very rewarding.
The challenges we're facing is maintaining a steady supply of the vaccine.
Somebody has to pay for it, and there is no money in any budget, really, to provide that.
I personally don't think a county should be responsible for this.
This should be a federal government response.
We are getting somewhere between 50 and 80 people a day.
There have been a couple of days where they had up to 100.
When it was clear that the vaccine was running low over the last few days, we've really been prioritizing just children and pregnant women.
We haven't been able to give it to adults.
And I feel bad turning people away, 'cause they come wanting it.
They say, "But I'm leaving tomorrow.
Can't you give it to me?" And we say, "This is what we have.
We have ten doses left.
" - [woman.]
Okay.
- [woman 2.]
You know this guy? [woman 3.]
Okay.
[Eve.]
Okay.
[Eve.]
So I think we only have, um five or six doses left of the vaccine, and obviously we won't get any tomorrow, it's Sunday.
Who knows about next week? - Yeah.
- So we're probably gonna be out.
They do understand that this flu season is now, and it's kind of - Yes.
- This is the time.
That's crazy, okay.
[Eve.]
Unless we get something on Monday, we won't be able to give people the vaccine.
[Jake.]
My family owns a bed and breakfast in Guatemala, and because we had a little piece of extra property away from the bungalows, we were able to use that to build an animal facility to test the vaccine.
[Jake in Spanish.]
What an old hotel! [laughing.]
- [Jake in English.]
How's it going? - How you doing? - It's good to see you, man.
- Hey, a long ride, huh? They're paving both sides of the road at once.
That's smart.
We had to retreat an hour and a half It took a special engineer to figure that one out.
- Hola.
- [Jake.]
Hey, hey, what's up? [Jake in Spanish.]
How are you? [man.]
I'm fine, thank you.
- [Jake.]
What's up? - [man.]
Hey, man, how are you? - All good, all good.
- Good? [Jake in English.]
I love coming back to Guatemala.
It will always feel like home to me.
But it also feels, every time I come back, like I'm one step closer to achieving our vaccine goals.
- [Sarah.]
Ooh, fresh paint.
- [Jake.]
Nice.
- Looks really good.
- Yeah.
[Sarah.]
They are so freaking cute.
[pigs oinking.]
[Sarah.]
They look really good.
- They look healthy.
- [Jake.]
Yeah.
Hi.
Hi, piggy.
- [pig farts.]
- Oh Did a poop.
[Jake.]
I remember when I did the first vaccine study.
I was scared the whole time.
Imagine cooking a cake, where you're gonna spend six months on it and bring all your friends in, and you don't know if the whole thing's gonna be a mess at the end.
This is really one of our most important experiments yet, because if we're successful, it'll be a huge step towards human trials.
[clicks.]
[Jake cooing.]
Who's gonna help us solve influenza? Who's gonna help us solve influenza? You are.