Unseen Enemy (2017) Movie Script
1
[ overlapping news anchors ]
Hello, good morning.
This is "Breakfast..."
Thanks for joining us,
everyone.
I'm Zoraida Sambolin.
It is 5:00 AM here
in the east...
Good morning, everyone.
Welcome to "Early Start"...
[ overlapping voices
in various languages ]
[ overlapping news anchors ]
The Centers for Disease Control
today issued a health warning
following a worldwide outbreak
of a mysterious form
of pneumonia.
The highly contagious
virus SARS killed nearly
300 people...
8,500 people around the world
have come down with SARS.
[ in Chinese ]
I feel very worried.
I feel anxious
for the health of the masses.
[ overlapping news anchors ]
The World Health Organization
has declared
a swine flu pandemic.
...spread
of the H1N1 swine flu.
The outbreak has spread widely and cannot be contained.
Woman:
I don't think we can contain
the spread of this virus...
Influenza pandemics
must be taken seriously.
[ overlapping news anchors ]
A big outbreak
of a deadly Ebola virus
has killed more than...
The Ebola outbreak
that started
in the West African country
of Guinea has now spread.
Our people know nothing.
There is no cure.
Man: They don't
have the resources
to actually contain...
Male anchor:
Governments around the world
are considering new measures...
Woman: I'm calling
from the New York City
Health Department...
...your temperature reading
from last night.
[ overlapping news anchors ]
The U.S. Department
of Agriculture
confirmed another case
of bird flu.
One and a half million
state turkeys
have been killed
to prevent the spread of...
Woman:
It is really critical
that they control this...
Man:
We have to respond
to the challenge.
Female anchor:
Three latest victims
of the new respiratory virus
called MERS
have come from
Middle Eastern countries.
They believe it originated
in bats or camels.
Man:
It causes pneumonia
and rapid kidney failure.
[ overlapping news anchors ]
As the Zika virus continues
to infect people
across the globe...
The outbreak
started in Brazil,
a suspected link
to severe birth defects.
Zika typically is transmitted
through mosquitoes.
Man:
When the weather
starts to warm up,
more of those mosquitoes
could start coming north...
Barack Obama:
Because I believe there is
such a thing as being too late.
[ overlapping news chatter ]
[ voices stop ]
- Jeffrey Wright: Our home.
- [ whispered voices ]
You can almost hear
the biological chatter.
[ overlapping chatter ]
Wright: Just when technology
and science were supposed
to make us safer,
we suddenly seem
more vulnerable to outbreaks.
[ siren wailing ]
[ crowd clamoring ]
Dr. Peter Piot:
Whether we like it or not,
our world
is globalizing evermore.
And that's not only true
for markets and for production,
but it's also true
for behaviors, for diseases.
So we're more vulnerable
because of our mobility.
Secondly, we are
far more people,
and we are also
living more and more
in very crowded cities.
That's fantastic
from the perspective
of a virus,
because in no time,
it can infect
hundreds of thousands
of people.
Dr. Larry Brilliant:
Over the last three decades,
there have been
about 30
newly emerging diseases
that have the potential
to be pandemics.
If we do nothing--
it's not a matter of "if"
there will be a global pandemic.
It's just a matter of when
and which virus
and how bad.
Wright:
The world changes around us
at increasing speed.
We cause
a lot of that change
migrating to cities,
stripping the Earth
of its resources,
and altering
primeval jungle.
Laurie Garrett:
We are seeing whole,
entire ecologies
that which you can see
with your eye
and that which
you can only see
with a microscope,
one system after another,
completely reshaped.
Is there a sense...
In every case,
this affords opportunities
for viruses and bacteria
to seek out new homes,
cause new havoc,
including disease
for human beings.
Wright:
When contagion happens,
life alters in an instant.
We don't feel safe.
We lose trust.
- [ baby crying ]
- [ siren wailing ]
Peter Sands:
Fear spreads very quickly
when you have
an infectious disease
outbreak.
Communication
is so much more pervasive.
People know what's happening
in another part of the world
so much more quickly,
so much more vividly
than ever before.
So the contagion of fear
moves faster
than the contagion
of the pathogen,
the disease itself,
and the fabric of society
starts to deteriorate.
Brilliant: There's something that destroys the soul of a community...
that happens when an epidemic
is out of control.
It's not just the large number of casualties and the deaths,
which are itself
unthinkable,
but it's what it does to a--
the social fabric
of a community or a nation.
[ distant horn honks ]
[ panting ]
Dr. Soka Moses:
[ panting ]
Ah?
Hmm?
[ man speaking
over P.A. ]
Man:
Ebola is transmitted
through bodily fluids--
saliva, blood,
urine, feces.
This is an invisible foe.
Wright:
Ebola first surfaced
in West Africa
in a remote
rural community.
But in our increasingly
connected world,
this Ebola outbreak
didn't stay in the countryside.
The virus quickly found its way to the region's largest cities
and health systems that were
completely unprepared.
Moses:
[ groaning ]
[ woman leading prayer
in native language ]
Moses:
[ chatter ]
Piot:
I think we all
underestimated,
absolutely everybody.
I know that one case of Ebola
is an emergency.
Every new case can give rise
to more cases.
So it's really act now
or pay later.
Christiane Amanpour:
Right now, the World Health
Organization and other doctors
are saying it is out of control
in this area of West Africa.
It's the worst outbreak
ever that they've recorded
in this part of the world.
It's unprecedented
for several reasons.
One, first time in West Africa
that we have such an outbreak.
Secondly, this is the first time
that three countries
are involved.
And thirdly,
it's the first time
that we have outbreaks
in capitals,
in capital cities.
This could explode
into a really mega-crisis.
I think so,
and it is already
a mega-crisis...
I really thought,
how can this epidemic
be controlled the usual way
when there are
so many outbreaks
in different places?
[ siren wailing ]
Piot:
The three countries
in West Africa
that are affected
by the Ebola outbreak
have some of the worst
health indicators in the world.
There are
not enough doctors.
There are not enough nurses.
It is a system
that is understaffed,
underfunded,
and where the infrastructure
is very, very old.
Let's go back to 1976
when you were a younger man,
and you actually
codiscovered this virus.
- It was in Zaire.
- Piot: Yes.
Amanpour:
Now the Democratic Republic
of the Congo...
Piot:
And they said that there was
a mysterious epidemic.
This was very lethal,
high mortality.
There were nuns
who had died.
A small group
would go to the mission
where the epidemic
had started, apparently.
They asked for volunteers,
and I think I was
about the first one
to raise my hand...
although I had
absolutely zero experience
in doing this.
[ speaking French ]
Our mission was to--
one, to put in place
some basic measures
to contain it
and using quarantine.
That's what we thought.
And two, to find out
how is this transmitted?
Because that's the key
to stop epidemics--
to know exactly
what the risk is.
How is it transmitted?
It's really
a detective work.
So we tested
whole villages,
talked to the population,
and then have
a very primitive
questionnaire.
How old,
where have they been,
have they traveled?
And what we found was that
there were very few survivors.
Very few,
and that indeed
the what we call
"case fatality rate"
was over 90%.
[ man speaking French ]
Nearly all new viruses
come from animals.
I mean, we are also
an animal.
We are, you know,
human primates.
So, during the outbreak,
we started collecting samples
from all kinds of animals.
I even took blood
from pigs
because a number of pigs
had died
at the beginning
of the epidemic,
so we said,
"You never know."
But we didn't find
any trace of Ebola.
My boss at the time,
Stefaan Pattyn,
had always told me,
"Watch out for the bats."
And it became
a bit of a joke.
But the old man
was right
because
the only reservoir
that we think
where Ebola is hiding
are some kind
of fruit-eating bats.
Dr. George Gao:
[ screeching ]
Garrett:
If we look around the world,
we can see that
bat populations
are being severely stressed
by climate change.
Some of them
because they live
in the upper tiers
of rainforests
and feed on wild fruit.
But the upper tiers
of the rainforests
are getting the most impact
of this heat increase
and increased
UV radiation.
Add to that
that humans are encroaching
into the rainforest,
into bat habitats,
precious caves.
They're very shy creatures.
They do not seek you out,
no matter what vampire movies
you ever saw.
[ thunder rumbles ]
As humans encroach,
we see more and more
bat populations starving
and coming into
human habitation areas
to feed on our
agricultural production.
And in the process,
they're passing their virus on
to other animals
and to humans.
We are imposing changes
in the microbial world
willy-nilly,
thoughtlessly,
and we do so at our peril.
Wright: We have dramatically increased our contact with animals
in a variety of ways:
through deforestation,
industrialization
of agriculture,
and vastly increased
consumption of animals.
HIV spread out of Africa
from a few monkeys
and chimpanzees
to infect millions of people
on every continent.
SARS jumped from a bat
to a civet cat
to a villager in China
to more than 30 countries
in a matter of weeks.
Animal and human health
are completely linked.
In the 21st century,
75% of all new
infectious diseases
have come from animals.
Sometimes directly,
in other cases,
through intermediaries
like mosquitoes.
If anyone had sat down
and done, you know,
a fantasy hit parade
of emerging diseases
that might
come to the Americas
from Africa
or from Asia,
Zika would never have
even been on the list.
Zika virus originated
in Africa
and had never been
off the African continent
until it started
making its way
across Asia
and South Pacific,
ending up
in French Polynesia
and Yap.
Yap is a small place
that most people
have never heard of,
but when Zika hit it,
70% of the population
got infected.
That was really
quite startling,
if anybody had been
paying attention.
Wright:
But they weren't.
Zika jumped
from the South Pacific
to Brazil in 2013,
two years before it was
identified there.
[ indistinct announcement
over P.A. ]
Wright:
The timeline corresponds
to an increase in travel
between the South Pacific
and Brazil,
including visitors
who attended a pre-World Cup
soccer tournament,
the Confederation Cup.
Male announcer:
Go-o-o-o-al!
Someone was carrying
the Zika virus,
and some mosquitoes
bit that individual,
absorbed the virus,
and that's the beginning
of this saga.
[ thunder rumbles ]
And then undoubtedly,
the El Nino weather event
provided the necessary
ingredients--
rainfall and drought--
that fundamentally changed
the conditions on the ground
and allowed for the spread
of this virus.
[ Veronica Maria dos Santos
speaking Portuguese ]
[ crying ]
Wright:
In 2015, the Zika virus
suddenly spread across Brazil,
primarily through the bite
of one type of mosquito.
The medical establishment
only began to comprehend
Zika's danger
as the number of babies born
with the birth defect
microcephaly
started to dramatically
increase.
[ Dr. Vanessa Van der Linden
speaking Portuguese ]
Garrett:
Since the alarm went sounding
around the world from Brazil,
we have seen
almost every day
another revelation
about this virus.
What we now know is that
this is a very dangerous virus.
We grossly
underestimated it.
It is malaria in that
it is transmitted
by mosquitoes
and can cause
enormous outbreaks.
It is HIV in that
it is sexually transmitted.
And it's worse
than all of the above
as we've come
to understand
what this virus
actually lives on.
Where does the virus go
in a pregnant woman?
It goes into this tiny
forming creature, the fetus,
and it feeds on it
and re-infects
back into the mother's
bloodstream over
and over again.
And what is it feeding on
in that fetus?
Baby brain cells.
And so, every single part
of the brain
of that developing child
is damaged.
Wright:
The Zika virus
affects its victims
in a completely different way
from the Ebola virus.
What they share in common
is how fast they can move,
randomly attacking some
while sparing others.
Some epidemics grab
our attention,
while others, in spite
of the larger number
of victims,
remain more hidden.
- [ signal bell clanging ]
- [ train horn blowing ]
[ music playing
on radio ]
Female DJ:
...oldies all the time
on your hometown station,
and of course adding in
some holiday music.
Oh, it's so close.
On a local note,
I'm gonna pass along to you
that those
in need of a flu shot
may still get them.
Walk-ins are welcome
at the Steele County
Public Health,
weekdays between
8:00 and 4:00.
Owatonna, Minnesota--
it's a beautiful town.
To me, it's like
"Mayberry R.F.D.,"
Opie Taylor's town.
Gwen Zwanziger:
The name Owatonna
comes from
an Indian princess
that was sick,
and the chief brought her here
because of the healing waters.
[ quacking ]
Terry:
When we moved here,
it just felt like home.
I think we got lucky.
The good Lord just gave us
two good kids.
- Woman: Three, two...
- Gwen: Do something.
Terry:
Sarah was always
the princess
and Shannon
was the opposite.
She was a tomboy.
She loved skateboarding
and she loved
video games.
- Gwen: Shannon, she was
a complete surprise.
- [ baby crying ]
Sarah was almost 16,
and I was 40.
She was a joy.
Right from the get-go,
she was a joy for everybody.
Whoa!
Terry: We were
a tight, tight family.
Gwen:
Her first time out
by herself.
Oh, my gosh.
Terry:
I remember
when she got her permit,
she was just so tickled.
Gwen:
There she goes, by herself.
Terry:
So, I was so proud of her.
Gwen:
Oh, my gosh!
Oh, my gosh!
Somebody's driving.
- Gwen: Catching snowflakes.
- [ dog barks ]
Gwen:
Hi, girl. Oop.
- [ dog whines ]
- [ laughs ] Oh, hi.
Gwen:
Shannon was in her
senior year of high school.
Terry:
She came home
Wednesday night,
said, "I think I got
the flu at school."
That was Wednesday,
and Thursday,
she just seemed to be,
you know, baseline
for being sick,
but she wasn't
getting better.
And that's when
Terry and I agreed
that we've got to take her.
Terry:
When I took her that Sunday
to go to the hospital,
we waited two hours.
It was that packed.
That's when I knew
there was a big epidemic
of flu going on.
And she's sitting next to me,
and she's got her head on me,
and I took a selfie,
sent it to her mom,
saying,
"We're still waiting."
The doctor said
it was just the flu,
that it had to run its course.
They gave her
some cough medicine
just for comfort,
and Terry went and got it
while I got her back up
in her bed.
[ clicking, chiming ]
[ wind whistling ]
Gwen:
It's about 5:00
in the morning.
I was sitting
in the living room
and I heard her
moving around upstairs.
I thought, "Wow," you know,
"she's getting out of bed."
[ sniffles ]
I got up, and I went
to the coffee maker,
and I saw in my peripheral
that she got up
and she went
into the bathroom.
She tapped
on the shower curtain,
and I said, "You want
to take a shower?"
And she nodded yes,
and I said, "Okay."
I was filling the water up.
I only got it about so full.
She laid back,
but her knees kept buckling.
You know, she kept pushing
on the end of the tub
to keep herself
from sliding under, and...
and then I saw her eyes.
And...
[ sighs ]
I pounded on the wall
and woke Terry up.
Said, "She's not breathing,"
and I come running down, and...
[ clears throat ]
I still remember her
on the floor,
her mom giving her CPR.
I never had to do that
before.
And it's nothing like
they teach you in class.
All I could do
was dial 911.
[ touch tones beeping,
line rings ]
Operator:
911, what's going on there?
Terry:
My daughter,
she's 17 years old.
- Gwen: She's not breathing!
- Terry: She's not breathing!
- Dispatcher:
She's not breathing?
- Terry: She's not breathing.
Dispatcher: Okay,
I'm sending the paramedic
to help you now.
Just stay on the line
with me, okay?
- Gwen: Come on,
breathe for Mama!
- Terry: Breathe, Shannon.
- [ sirens wailing ]
- Oh, Lord.
- [ dog barking ]
- Come on in.
She's right in there.
Go ahead.
Gwen:
I don't remember
any kind of time passing.
I just remember
a pair of blue pants
that kneeled down
on the other side of her,
and he told me
they'd take over,
and I stepped away.
Even when the--
when they said,
"We're flying her
to Rochester,"
you know, I waved
at the helicopter,
you know, thinking
everything's fine.
I had no clue.
[ beeping ]
[ machines
beeping rapidly ]
[ flatlining tone ]
You know,
when they told us...
that she didn't make it,
and I said, "I want to see her,"
and they said,
"You'd never recognize her
from what we've had
to do to her."
Because the flu
actually killed
all of her organs
long before
she actually died.
I still think
she ought to be
coming home.
[ chirping ]
Dr. Barbara Rath:
The biggest pain in the world
as a parent
is losing their child.
This is the most
unnatural thing
to happen
to a human being.
And you stand next to it
and you think, my goodness,
I am there to prevent this
from happening,
and sometimes I cannot,
and...
sometimes I don't know
why I cannot.
[ man speaking German
on radio ]
Rath:
The question of how and why
one particular person
may die from influenza
is the million-dollar question
that we absolutely
need to tackle.
Wright: It is surprising
how much we still need
to learn about flu,
a disease which causes
worldwide epidemics
every year.
Mother:
She had a little raspiness
in her chest.
Mother #2:
The flu test
came back positive.
Mother #3:
I actually remember saying,
"Okay, it's just the flu,"
like it was no big deal.
Wright:
It spreads across
the globe,
hospitalizing
three to five million.
Mother #4:
And within 24 hours,
she was intubated.
[ man speaking French ]
Wright:
Killing at least
200,000 every year.
Mother #5:
We went in as they
were coding her.
- [ machines beeping ]
- Mother #6: My baby girl,
Scarlet Anne...
- [ flatline tone ]
- ...pronounced dead.
Rath:
The majority
of adult influenza patients
have something
that we call a risk factor.
They have
very weak immune system,
or they have diabetes
or obesity.
Pregnant women
have a risk,
for both themselves
as well as the child.
Okay, we know
these factors.
But this is a virus
that can mess up your body
to a degree
that even the most healthy,
young and happy,
playful person
is taken away from this planet
within a couple days.
Wright:
Every year, we struggle
to fight seasonal flu.
But what experts
are really afraid of
is a new strain of flu,
one that the human population hasn't been exposed to before,
one that
almost no one will have
any immunity against.
Mark Smolinski:
When we think about
the threat of a disease
spreading around the world
as a pandemic threat,
obviously airborne infections
are at the very top.
Things like SARS and flu
are something
that we know
is difficult to control
because of the way
it spreads through aerosols.
Most people
become infectious
with the flu
before they even
have symptoms.
Anybody can travel
clearly across the world
with an infectious disease
incubating in them
without them even knowing
that they're sick yet.
Wright:
In 2009,
a new flu emerged--
H1N1, also known
as swine flu.
We now know
it first appeared in the U.S.
in the pig industry,
initially infecting people
at state and county fairs.
In a little over a year,
swine flu infected
around 1.3 billion people.
It was the most common
shared experience on Earth.
[ crowd chanting ]
Wright:
Flu poses a strong
pandemic threat
because it has the ability
to be both very contagious
and very deadly.
Yeah. Yep.
Smolinski:
What we're most worried about
right now is this bird flu
that we know
is highly pathogenic.
Paul Horwood:
Wright:
Currently, this deadly
new bird flu
doesn't spread easily
between people,
but it is spreading rapidly
among wild birds and poultry.
[ horns honking ]
Experts are afraid
this could be
a pandemic threat.
[ ducks quacking ]
Dr. Arnaud Taranola:
It's a live poultry market,
so the birds are alive.
And when they're sold,
they are sold alive
because people value the fact
that it's very fresh meat.
[ crowd chattering ]
Taranola:
So you buy your chicken
or your duck live.
And then it is killed...
and cleaned and emptied,
of course, eviscerated.
The viscera go into
some of these buckets here,
and then the birds
are put in hot water
and then put
in these drums
where these
little plastic tubings
help get rid
of the feathers.
And then when the birds
have been defeathered,
eviscerated, and cleaned,
then they're cut up
and they're given back
to the person who bought it.
The issue here
is that the water
is the same
to clean all the ducks
and chickens.
The other issue
is that these people
are wading in--
in viscera, feathers,
and the water that served
to clean them.
So, there's really
a lot, a lot of virus here.
Wright: In 2011,
when the Pasteur Institute
started monitoring
the wash water,
18% of the water samples
were positive for H5N1.
Four years later,
66% of samples were positive.
Smolinski:
We know that bird flu
is very, very deadly,
and we know swine flu
spreads very quickly.
What we worry about
is if those two reassort,
and then we could
have a new strain that
literally could spread
as quickly
as the swine flu did
but have the mortality rate
of bird flu.
That's the big fear,
that we have now
literally created
the petri dish
that we all worried about
and both of those viruses
are sitting in there
at the same time.
Sands:
Pandemics are one
of the biggest risks we face.
This is an issue
of human lives.
It should be thought of
in the same way
that we think
of terrorism,
protection against
natural disasters,
against national defense.
This is a human
security issue,
and it is also
an economic security issue.
[ overlapping news anchors ]
The outbreak of SARS could
trigger a global downturn.
Fear of the SARS virus
has caused
serious financial damage
to businesses,
cities,
even entire countries.
Sands: During the height
of SARS, nobody was going
to restaurants,
people didn't want
to go shopping.
At one point, at the peak
of the SARS crisis,
air travel into Hong Kong
was down by 80%
and retail sales
were down by 50%.
Businesses began to run
out of money.
Estimates of the impact
of SARS
have been an economic impact
of around 40 billion or so.
If a global pandemic
took place,
you're looking
at an economic impact
measured in the trillions
of dollars,
not tens or hundreds
of billions.
It has such a big impact
on business and life.
Garrett: You hope the world
has the capacity to see
an outbreak,
mobilize forces,
and contain it, right?
Unfortunately,
we rarely do that.
Especially
if the outbreak occurs
in a poor country.
Well, here we are
in Liberia.
That's Sierra Leone.
And this is
the border crossing.
Do you see security?
Do you see any military?
Do you see anything
that would stop someone
from coming across
this border?
And then,
it not only spreads
beyond the borders
of the original country
as occurred with Ebola
and West Africa,
but it crosses seas,
it crosses continents,
and that constitutes
a pandemic.
Endemic is your
worst-case scenario.
So you failed to control
the outbreak,
you failed to control
the epidemic,
and you failed to control
the pandemic,
and now that microbe
is a permanent feature
in the biological landscape
that humans are living in.
The worst example
of that is HIV.
We started off
with tiny outbreaks
in a handful of places,
and the world responded
completely incorrectly.
It became pandemic
and now endemic.
So we have 37 million people
living infected with HIV,
and there is no country
on the planet
without this virus.
Wright:
Before the devastation
of AIDS,
there was smallpox.
Smallpox killed
500 million people
in the 20th century alone,
more than all the wars
in that century combined.
Whenever an infectious disease truly catches hold,
it forces health workers
to make impossible choices
about the public's freedom
and rights.
Brilliant:
I was the youngest person
in the smallpox team.
And I was certainly
the only person
in the history
of the United Nations
recruited from
the Neem Karoli Baba Ashram.
[ horns honking ]
Brilliant:
We had eradicated smallpox
in Madhya Pradesh.
It's this big state
in the middle of India.
And we were about to do
our victory dance,
and then suddenly
across the border,
we started getting
new outbreaks.
And they all came
from one place,
a place called Tatanagar.
- First place we went to
was the railway station.
- [ train whistle blows ]
And it was a scene
from the worst nightmare
you ever had
in your life.
There were dozens of people
stretched out near the tracks,
in the waiting room,
on the cement,
dead from smallpox.
It smelled from the death.
[ train whistle blows ]
The Tatanagar
was the home
of the Tata
Iron and Steel Company.
So I just went
to the company's house.
It was almost midnight
when I got there.
I said, "I need Jeeps,
I need managers,
I need doctors,
I need vaccine."
The next day,
I had 100 Jeeps.
We set up
training programs.
We used maps
to develop a strategy,
and we took
the 100 Jeeps,
and we built
our little army.
We were doing great.
We found 2,000 cases
of smallpox.
We were stopping the disease
in Tatanagar,
but still,
as we're vaccinating
everybody,
the trains were carrying
people away.
It was still exporting
smallpox.
[ whistle blowing ]
We closed the railway station. We closed the buses.
We quarantined the city
of 600,000 people.
Nobody could leave the city
unless they were vaccinated.
[ people singing
in Hindi ]
We eliminated smallpox
in that entire area
around Tatanagar
in less than six months.
But it kept coming back.
We traced it to a tribal group called the Ho tribe.
So, I went
and visited the members
of that tribe,
and I said,
"Well, you've gotta take
smallpox vaccine.
You gotta stop
this transmission."
And he said,
"I won't take it.
I do whatever
God's will is, and...
if I'm to get smallpox,
I'll get it."
After a while,
more cases kept coming out
from the Ho community,
and we all agreed
that we were going to have to
forcibly vaccinate
these Ho tribesmen.
[ music playing ]
In the middle of the night,
we went out into the villages,
into the jungle,
and we surrounded them
and pulled them
out of their houses,
and we vaccinated them.
[ birds chirping ]
[ roosters crowing ]
And then after we had
broken into their house,
pulled them out of bed,
forcibly vaccinated them,
this dignified tribal elder
looked at me,
and reached over
to the vine.
And there was one fruit,
a cucumber, a kind of gourd.
And he pulled it off,
and he cut it,
and he put it on a leaf,
and he offered it to us to eat.
He said, "I don't like
what you did.
I think you're wrong.
But that's over now.
Now I see that you are
a guest in my house.
The only thing I have to offer
is this cucumber."
[ chuckles ]
And so,
you ask yourself...
"Were we right?"
We did
a lot of things that,
in their
individual isolation,
if I put the harshest light
of truth on it right now,
I would be begging to find
an alternative way to do it.
And I ask myself,
"Did I exaggerate
the importance of what I did?
Did I place myself above
some kind of moral compass?
Did I--
did I quit too early
trying to find a way
to accomplish
the same thing?"
But...
But that's sort of between,
right now, me and God
and me and my conscience.
Smallpox has been
eradicated.
And I'm thrilled
about that.
[ airplane buzzing ]
[ indistinct chatter ]
[ crying ]
Chicken pox.
[ seagulls screeching ]
[ subway chimes ]
Dr. Heidi Larson:
The idea of night raids
or forcible vaccination today
is just unthinkable.
There's a few big things
that are very different--
internal politics,
global politics, extremism,
the whole issue
of human rights.
You have to be transparent
because the wrong information
can actually contribute
to the spread of a disease.
I'm particularly interested
in looking at rumors.
The way that rumors
replicate and spread
are very similar
to how viruses spread.
They need a host.
They need to be supported
to stay alive and thrive.
- Man: Oh, there we go.
- There we are. Okay, hi.
Larson:
Rumors have been around
since man existed,
but I think right now,
what's changed with technology,
and particularly
social media and the Internet,
is the global spread
and the speed.
I mean,
look at Twitter.
You needed 140 characters
or something,
and that's all you need
to spread some of the rumors
and perceptions
that we're certainly tracking.
And one of the things we found
is that rumors thrive
in times of uncertainty,
they thrive in times
where people need an answer,
are eager for an answer.
Sands:
The old model
of how you respond
to an infectious disease
outbreak
is you issue some sort of,
you know, firm warning
to the public
and tell them
what they should
and shouldn't do.
That doesn't work anymore
because people
are responding
to rumors on Twitter
or Facebook,
and they want to engage
and they want to challenge
and they want to have
their own opinions about
what's going on.
I'll be back.
Okay, I have a pen.
I have my books.
The agenda.
Okay, go for it.
When an epidemic occurs,
there is a clinical management,
but there's also
the reactions of society,
and managing that
can be as important
as actually dealing
with the epidemic itself.
Okay, good afternoon,
everybody.
This is the third meeting
of our task force on Ebola.
And, John, would you
like to give an update?
Because where we are
with the epidemic,
I'm very worried,
to be honest.
[ overlapping news anchors ]
President Ellen Johnson Sirleaf
likened the outbreak
to a war.
Cases and deaths
continue to surge.
Riots are breaking out.
Wright:
As Ebola continued to spread
across West Africa,
the governments implemented
massive quarantines.
- [ crowd shouting ]
- Wright: Distrust exploded.
[ overlapping news anchors ]
Security forces blocked roads
with scrap wood
and barbed wire.
An angry mob forced open
an isolation ward.
Hundreds clashed
with the police,
- who fired live rounds
and tear gas.
- [ gunshots ]
Liberia has tried,
we've used our own resources,
but obviously
we have limitations,
and we hope that
the international community
see this
as an international
catastrophe.
[ overlapping news anchors ]
Two Americans who had
been infected...
...will be sent home
for care in Atlanta.
[ speaking Spanish ]
- William Pooley...
- ...became infected
whilst working as a nurse
in eastern Sierra Leone...
A news photographer for NBC
just diagnosed with Ebola.
Much like the other
Americans before him,
he will be flown back
to the United States
for treatment.
- Woman: That's him?
- Woman #2: Mm-hmm.
- Woman #3: That's him.
- Woman: Oh, my God.
- He's from West Africa, right?
- Woman #2: No, he's from
the States, from here.
- Woman:
Oh, he's from the States?
- Woman #2: He's an American.
- Woman: Oh, my God.
- Woman #3: I got here--
oh, my God...
Wright:
In a repeating pattern,
the world only really started
to pay attention
to the Ebola epidemic
when foreign workers
began to fall sick.
Male anchor:
The international responses
continue to ramp up.
Obama: We're going
to create an air bridge
to get health workers
and medical supplies
into West Africa faster.
David Cameron:
Over a billion euros across
Europe will be galvanized.
[ Franois Hollande
speaking French ]
[ overlapping news anchors ]
China is sending healthcare
professionals.
[ speaking Chinese ]
There are 84 flights a week
leaving these affected
countries.
For the first time,
the Ebola virus is in
the United States.
Thomas Duncan contracted Ebola in Liberia before flying to Dallas, Texas.
He lied on his exit form
so he could leave Liberia.
[ overlapping voices ]
Why not just shut down
the flights
- and secure the borders?
- A travel ban may make sense.
We should not be allowing
these folks in, period.
Brilliant:
As of today, one case
came from Liberia.
One.
Now, there'll be more,
but right now, one.
And in response to that
they say, "Let's close
the borders.
Nobody from Africa
will be allowed in."
They don't even
know where West or East
or South Africa is.
"Nobody from Africa
should be allowed in.
And close our airports."
I mean, that's a combination
of ignorance and arrogance
that could create
ruination
for our economic system,
our financial system.
Man: Please be advised
that a health care worker
who lives in your area
- has tested positive
for the Ebola virus.
- [ siren wailing ]
[ overlapping news anchors ]
Today, testing confirmed
that a patient here
in New York City had
tested positive for Ebola.
Craig Spencer treated
Ebola patients in Guinea.
12 hours before
he detected his fever,
he was in an Uber car,
he was on the L train,
he was on the A train,
he was on the 1 train,
he went to two bowling alleys, and he ate at a restaurant
as no quarantine
was required.
Late this afternoon,
the governors of New York
and New Jersey
decided to change that.
After returning from
treating Ebola patients
in Sierra Leone,
Kaci Hickox
was forcibly quarantined,
even though
she tested negative
for Ebola twice.
We have the legal
authority to do it.
Um, we're doing it.
Garrett:
It was pretty clear
that the United States epidemic
was overwhelmingly
an epidemic of fear.
We got a practice run
on how Americans will respond,
and, boy, we got an F.
Woman: In addition,
we have renewed
our determination
to remain vigilant...
Piot:
We're spending a lot of time
with the community...
Woman:
And we will rid
our beloved country
of this dreadful,
unwanted guest-- Ebola.
Piot:
...community leaders
with our colleagues
to assess
how to better handle
this Ebola epidemic.
My big question,
and I guess it is the concern
of everybody here, is--
is this a wake-up call
for you,
also the international
community,
to start looking
at other potential viruses
that may come to harm us,
as vulnerable as we are,
in the future
so that we start putting
things in place now for us to--
to prevent us getting
in those types of situations?
Well, to be honest,
in these 38 years,
we have
collectively failed.
And every time
when there's a big epidemic,
we say, "Oh, never again.
And we're going to--
you know, to set,
put in place mechanisms
to do this and that,"
and it doesn't happen.
And so we have
to now really fight
that this will happen
this time
and that there are
better systems in place.
[ beeps ]
Wright:
In the fall of 2014,
significant aid and manpower
finally started arriving
in the region.
In Liberia,
there were contingents
from Mdecins
Sans Frontires,
China, Cuba, Germany, Sweden,
and the United States.
[ members arguing ]
[ banging on table ]
Wright:
It was chaotic,
and coordination
was often difficult.
But makeshift ETUs
were finally replaced
with purpose-built
field hospitals.
Moses:
[ chatter ]
[ thunder rumbles ]
Moses:
He just dropped and died.
He just dropped
and died.
Yeah.
[ sniffles ]
[ horn honking ]
[ beeps ]
[ machinery powers on ]
Decontee Davis:
- [ car horns honking ]
- [ chatter ]
- Davis: A cat...
- Kids: A cat...
- Davis: ...a rat...
- Kids: ...a rat...
- Davis: ...on a mat.
- Kids: ...on a mat.
- A fat cat...
- A fat cat...
- ...sat on the mat...
- ...sat on the mat...
[ chatter ]
Moses:
How are you?
[ machine whirring ]
Wright:
The 21st century can be
characterized by a race
between the dangers
of modernization
and the advances.
Our only chance
of winning the race
is to use 21st century tools
to fight epidemics,
ideally even to prevent them
with vaccines.
Yes, he is.
Come right on in.
Garcia-Sastre:
- They sent the slides.
- Oh, yeah, okay.
Wright:
Currently, we create
a new flu vaccine every year,
adjusting it to match
the circulating strains of flu.
It takes months
to make that vaccine.
Yeah, it looks quite nice.
Wright:
What scientists
are trying to develop
is a universal
flu vaccine,
one that could work against
all strains of flu,
seasonal and pandemic.
Garcia-Sastre:
Gao:
Wright:
Better diagnostics
are critical
to preventing outbreaks
from becoming epidemics.
We frequently
misdiagnose influenza.
And initially
in the field,
we misidentified
both Ebola and Zika.
Confusing them
with other diseases,
we lost valuable time
to contain them.
[ lock beeps ]
Computerized voice:
Thank you.
You have been
identified.
This is the area
where we have a lot
of the diagnostic machinery
that we're working on.
So, the general idea
is your sample's gonna
get placed in here,
and it will run
across the chip.
You close it up,
and then the cartridge
can sit right here.
Right now, the run time
is somewhere in the order
of half an hour.
So what you can see
on the screen here--
this is the intact virus.
Maybe it's Ebola,
maybe it's influenza,
maybe it's Zika.
You could imagine it being
useful in your doctor's office.
You can imagine it
being useful in an airport.
Or you can imagine somebody
wanting to bring it
to a triage site
if there is some disaster
or some outbreak.
[ Dilma Rousseff
speaking Portuguese ]
[ overlapping news anchors ]
Today the President of Brazil
gave public health officials
the right to enter
any home or business
to try to eradicate
mosquito breeding grounds.
Cases of the Zika virus
have been reported
in dozens of countries across
Southern and Central America.
Already, Puerto Rico
is in the crosshairs
of the virus.
[ woman speaking Spanish ]
[ speaking Spanish ]
Wright:
Scientists are still
trying to understand
the full range
of neurological effects
the Zika virus causes
in both babies and adults.
Male anchor:
Florida officials have
finally found the Zika virus
in mosquitoes
in the Miami area.
David Jolly:
People are scared.
Cases of Zika rose
from 4,000
to, by some estimates,
over 16,000.
Can you imagine, colleagues,
the fear and anxiety
in this chamber
if these hundred mosquitoes
were outside this jar,
not inside this jar?
A lot of folks talk about
protecting Americans
from threats.
Well, Zika is a serious threat
to Americans.
Wright:
Zika is spreading rapidly
around the world.
At least 49 countries
or territories
in the Western Hemisphere
have local Zika transmission.
Garrett:
We're already seeing
mosquitoes transmitting Zika
in the United States.
It's really just a question
of how many states,
how widespread,
and how many people
will acquire infection
as a result.
We are not prepared
for Zika.
Every outbreak, we go
to the Capitol Hill folks
and beg.
And every outbreak,
it becomes very political.
[ dog barking ]
In the United States,
there are a patchwork of laws
that guide health.
There's no consistency
in the level of funding
or urgency or training
or expertise.
Am I allowed
as a public health official
to go on your front lawn,
your private property,
and spray insecticide?
In some cities, yes.
In some cities, no.
Am I allowed to force you,
compel you,
to drain a swampy-like
condition in your backyard
because it's breeding
mosquitoes?
Again, there's
no consistent law.
Public health
is a two-way trust.
I have to trust
that government's going
to do the job,
but government
can't do the job
of public health
unless the public is engaged.
If government says,
"Mosquitoes are here
and they're carrying
a really dangerous disease,
we need to come
on your property.
We need to have
access to ways
to eradicate
those mosquitoes."
And you say, "I believe
in the Second Amendment."
[ imitates shotgun cocking ]
"Nobody's coming
on my property,"
then there's no trust
and there's no public health.
And similarly,
if there's an epidemic
that involves a vaccine,
government doesn't line
your children up.
You line your children up.
And if you're not
willing to do so,
then you're not part
of the trust
that is the basis
of public health.
[ crowd chanting ]
Don't shoot, hands up!
- [ crowd shouting ]
- Garrett: If there's
one hallmark
of my lifetime
on this planet,
it is the erosion of trust
in government.
[ crowd chanting ]
And public health
is paying a price
at every level
for that erosion
of trust.
Gwen:
Each year,
Terry gets the vaccine.
I don't get it.
And we gave Shannon
the choice,
and she chose not to.
I'm trying to understand
the flu vaccine
because I want to know
if we had have gotten
Shannon vaccinated,
if it might have saved
her life.
There's so much information
on the Internet.
I can go
to 30 different websites
and get
30 different answers.
You don't know
who to trust.
Wright:
There is something
about the flu vaccine
that conjures confusion.
While not currently
a perfect tool
and varying in effectiveness
from year to year,
over the last decade,
the flu vaccine reduces
the risk of getting the flu
by at least 50%.
It also reduces
hospitalizations and deaths.
Gwen:
A little over a year ago,
a mom that lost a little girl
put together a Facebook page,
and she titled it "Flu Moms."
And when she hears
of another mom
or somebody finds us,
they join.
Here's a mom.
She had a booth at a fair,
and all of our children
were pictured.
[ crying ]
There's Shannon.
And...
when children came
to the booth
to get their faces
painted...
then the parents
standing there waiting
would get
the information.
They'd be told about
these children who have died
and the importance
of vaccination,
that kind of thing.
We have a new mom.
Julia.
"Not wonderful to be part
of a flu mom group,
but it's great
that we all are here
for one another."
Shoot.
We'll learn her story
pretty soon.
Rath: There's a huge amount
of parents that are just
utterly confused.
And that's a big
communication challenge
when it comes
to the vaccine.
So, the question is
does she have anything now?
Yes, you know...
Rath:
Vaccine hesitancy
is something
that we observe
to be on the rise,
which is quite alarming.
[ squeals, laughs ]
Influenza is actually
possibly preventable
with a vaccine.
That's great.
But nobody uses it.
That's not great.
One of the most
common misconceptions
about the flu vaccine
is that people
say, "You know what,
I'm in my best years.
I'm healthy.
I've never been sick."
But there's another aspect
to vaccines, obviously,
and that's not just me,
it's also the people around me
because of the potential of me
giving something to somebody
that may be
serious to them,
even if it may not be
serious to me at this moment.
And I may very well sit
in the subway next to somebody
who has a very weak
immune system.
And they may not even know it, and I may not know it,
but I may very well
give somebody the flu.
So, there's the question
of the common good
versus
the individual good.
If we want any effectiveness
of a vaccine,
we need to get
vaccinated.
[ indistinct announcement
on P.A. ]
[ crowd shouting ]
Brilliant:
The great influenza
of 1917, '18,
that virus
is said to have
gone around the world
four times
without an airplane.
That's 100 years ago now.
At the end
of the great influenza,
50 million or 100 million
had died.
That's against
a global population
at the time
less than two-sevenths
of what it is today.
Multiply 50 or 100 million
by three,
you're talking about
a number of deaths
that's totally catastrophic,
a hit to our economy
that's unimaginable.
In 2006, I brought
the top epidemiologists
from all over the world
together.
The vaccine needs...
Brilliant:
And the vast majority felt
that in the next
20 years, 30 years,
there will be a pandemic,
and it will have
the potential
to bring humanity
to its knees.
[ clucking ]
Wright:
New strains of influenza
are already infecting birds
in over 75 countries.
And the way we are interacting with the animal world
is putting us at risk.
[ screeching ]
We encroach on wetlands,
so wild birds
mix more frequently
with domestic poultry;
our food trade
is completely globalized;
and factory farms are growing
in scope and size.
With all influenzas,
there is some critical moment
when a virus circulating
in one species,
of, say, birds,
manages to mutate
in a form
that allows it
to get into, say, pigs,
and then from there
to spread easily
between people.
We've seen this
over and over.
It's going on all the time,
right at this moment.
Here's what
a truly horrible,
worst-case scenario pandemic
would look like.
First, there would
be a jump
from some animal species
to humans.
The first humans would be
the people close
to those animals.
And then their families
and the kids in the schools.
And it would not be
regionally confined
for long at all.
Days, that's it.
And let's assume
that it kills
5% of the people
it infects.
Well, 5% would be
hundreds of millions
of human beings.
Woman:
Pandemic flu will soon
reach this country.
Man:
If you become sick
while traveling, contact...
Garrett:
So, once the epidemic
has really begun to spread,
you can't even
begin to imagine
the scale of this.
Man:
You want to be as far away
from the city as possible.
Man #2: It's going to come
to your community...
Garrett:
You have huge numbers
of people
that are not
coming to work,
and that includes jobs
we consider essential
for public safety,
like the guys that turn
water systems on and off...
- [ siren wailing ]
- ...the police...
- [ helicopter whirring ]
- ...the fire department.
Then people start blasting
their conspiracy theories out
about where this disease
came from,
who caused it,
why is it here.
[ cell phone chimes ]
You would see
a whole wave of shortages
of goods and services
all over the world.
The stockouts
of every single kind of drug,
the overcrowding
of the hospitals,
the overcrowding
of the mortuaries,
the sheer numbers
of both sick and dying.
What a really severe
influenza pandemic
would look like...
- [ siren wailing ]
- [ explosions ]
...is something close
to social collapse.
Sands: We're not effectively prepared as a world for a pandemic.
We don't have effective enough
coordination and response.
But the biggest thing
is that the on-the-ground
preparation and preparedness
is full of holes.
There's a pattern here
of responding to an outbreak
rather than investing in
preparedness.
Preparedness
is so much cheaper,
so much more
cost-effective
than responding
after the event has happened.
Wright:
Major nations
around the world
currently spend
10 to 25 times less
on bio-security
than they do
on homeland security,
in spite of the likelihood
of an epidemic
causing even
greater loss of life.
We are overdue
for an influenza pandemic.
On average, they happen
every 20 to 40 years.
A lesser influenza pandemic,
one equivalent to 1968,
would likely now kill
up to two million people.
An influenza pandemic
like 1918
could kill
200 million people--
more than
the entire population
of Germany,
Great Britain,
and Spain combined.
[ horn honking ]
To prevent pandemics,
we need to do
a much better job
of controlling outbreaks.
- Morning!
- Morning.
Moses:
[ humming tune ]
...on my shoulder
I'll be your guide
Always be your guide
Won't you hear
my people cry?
Chickie-chickie-chickie!
Yeah.
It gives me joy.
- Woman: When you see
the power of God...
- [ group clapping ]
It is my ability
It has to be
the Lord working
It is my ability
- Tomorrow
- Tomorrow I escape
Will try to find my way
out of this again.
- Amen.
- Group: Amen.
I want to present
this certificate to you.
- Meyma. Meyma?
- [ laughter ]
Meyma,
please talk to me.
This is for you.
Take it from me
now, baby.
- It's for you.
- Yeah!
[ applause ]
Moses:
- [ babies crying ]
- [ chatter ]
[ Dos Santos
speaking Portuguese ]
[ laughs ]
[ crying ]
[ speaking Portuguese ]
Wright:
When an outbreak
catches hold,
it affects every part
of our lives--
business and government,
trust and freedom,
equity and security.
The fight against epidemics
can only be won
if each of us
does our part.
It turns out we are all
the front line.
I think it goes
on your left side.
- What if I don't
want to wear it?
- Oh, no!
- [ laughter ]
- Picture of you?
- A selfie.
- Oh, my God.
They created
a procedure
so that
when people look at--
open your iPhone...
It was in this hall
52 years ago
that my life
was forever changed.
I felt I had been drafted
into a different kind army
to fight for human rights.
In 1980, smallpox was declared
eradicated from the world,
and so far,
it's the only human disease
ever eliminated
by a public health campaign.
If smallpox could be
eradicated, we thought,
what about HIV/AIDS?
Can we stop SARS and MERS,
H5N1 at their source,
and never become
a pandemic?
I don't dispute it's hard
and complicated,
but we have the tools.
We know what to do.
It's merely the application
of public will.
Go out
and change the world.
- How are you?
- I'm fine.
Ohh!
Good morning,
Professor Piot.
Oh, Soka.
How are you?
- Fine.
- Good to see you.
What keeps me awake
at night now
is that we will deliver
on our promises
to the people
of West Africa.
Shall we have a seat?
That we will support
these countries,
to build the systems
to make sure that
when there's
another case of Ebola,
which will happen,
that it doesn't give rise
to a big epidemic.
- [ birds screeching ]
- [ car horns honking ]
The time has gone
that we lived on islands
or that we were protected,
and there's no way
to stop that...
- [ babies crying ]
- ...because fighting AIDS
or fighting the flu
and SARS in Asia
benefits people in Europe
and in North America.
So we need to act
beyond the boundaries
of our own countries.
Wright:
The networks that connect us
accelerate everything--
the spread of ideas,
conflict,
people, and microbes.
There is no running away.
There is no wall
high enough.
What's absolutely missing,
just not there,
is trust.
And so, coming up
with preparedness
that looks like
it could stand up
to the microbes
when the attack comes
is really about each country
carrying their own weight.
Yes, we always need
to be watching.
Vigilance is permanent.
Wright:
The hallmark
of the 21st century
is that our world
is simultaneously
more connected
and more fraught.
Epidemics are a test
of who we are.
We can use our connections
for good,
to make the world safer
and healthier,
or those connections
will turn on us
in an instant.
We cannot just continue
to be responding
to every outbreak
as it occurs.
If we do not invest
in better preparedness,
we are setting ourselves up
for future epidemics
and pandemics
that will cost
enormous amounts
in terms of both lives
and money.
Brilliant:
I constantly run into people
who are fatalists
and they say, "Well,
pandemics are inevitable,
so don't work on them."
Pandemics are not
inevitable.
Outbreaks are inevitable.
Pandemics are optional.
It's our option
if we will be lazy.
It's our option
whether we will deny
the risk.
It's our option
whether we will refuse
to face the consequences.
We have a chance
to stop something
that otherwise
could be horrific.
But it's going to take
all of us.
[ music playing ]
[ overlapping news anchors ]
Hello, good morning.
This is "Breakfast..."
Thanks for joining us,
everyone.
I'm Zoraida Sambolin.
It is 5:00 AM here
in the east...
Good morning, everyone.
Welcome to "Early Start"...
[ overlapping voices
in various languages ]
[ overlapping news anchors ]
The Centers for Disease Control
today issued a health warning
following a worldwide outbreak
of a mysterious form
of pneumonia.
The highly contagious
virus SARS killed nearly
300 people...
8,500 people around the world
have come down with SARS.
[ in Chinese ]
I feel very worried.
I feel anxious
for the health of the masses.
[ overlapping news anchors ]
The World Health Organization
has declared
a swine flu pandemic.
...spread
of the H1N1 swine flu.
The outbreak has spread widely and cannot be contained.
Woman:
I don't think we can contain
the spread of this virus...
Influenza pandemics
must be taken seriously.
[ overlapping news anchors ]
A big outbreak
of a deadly Ebola virus
has killed more than...
The Ebola outbreak
that started
in the West African country
of Guinea has now spread.
Our people know nothing.
There is no cure.
Man: They don't
have the resources
to actually contain...
Male anchor:
Governments around the world
are considering new measures...
Woman: I'm calling
from the New York City
Health Department...
...your temperature reading
from last night.
[ overlapping news anchors ]
The U.S. Department
of Agriculture
confirmed another case
of bird flu.
One and a half million
state turkeys
have been killed
to prevent the spread of...
Woman:
It is really critical
that they control this...
Man:
We have to respond
to the challenge.
Female anchor:
Three latest victims
of the new respiratory virus
called MERS
have come from
Middle Eastern countries.
They believe it originated
in bats or camels.
Man:
It causes pneumonia
and rapid kidney failure.
[ overlapping news anchors ]
As the Zika virus continues
to infect people
across the globe...
The outbreak
started in Brazil,
a suspected link
to severe birth defects.
Zika typically is transmitted
through mosquitoes.
Man:
When the weather
starts to warm up,
more of those mosquitoes
could start coming north...
Barack Obama:
Because I believe there is
such a thing as being too late.
[ overlapping news chatter ]
[ voices stop ]
- Jeffrey Wright: Our home.
- [ whispered voices ]
You can almost hear
the biological chatter.
[ overlapping chatter ]
Wright: Just when technology
and science were supposed
to make us safer,
we suddenly seem
more vulnerable to outbreaks.
[ siren wailing ]
[ crowd clamoring ]
Dr. Peter Piot:
Whether we like it or not,
our world
is globalizing evermore.
And that's not only true
for markets and for production,
but it's also true
for behaviors, for diseases.
So we're more vulnerable
because of our mobility.
Secondly, we are
far more people,
and we are also
living more and more
in very crowded cities.
That's fantastic
from the perspective
of a virus,
because in no time,
it can infect
hundreds of thousands
of people.
Dr. Larry Brilliant:
Over the last three decades,
there have been
about 30
newly emerging diseases
that have the potential
to be pandemics.
If we do nothing--
it's not a matter of "if"
there will be a global pandemic.
It's just a matter of when
and which virus
and how bad.
Wright:
The world changes around us
at increasing speed.
We cause
a lot of that change
migrating to cities,
stripping the Earth
of its resources,
and altering
primeval jungle.
Laurie Garrett:
We are seeing whole,
entire ecologies
that which you can see
with your eye
and that which
you can only see
with a microscope,
one system after another,
completely reshaped.
Is there a sense...
In every case,
this affords opportunities
for viruses and bacteria
to seek out new homes,
cause new havoc,
including disease
for human beings.
Wright:
When contagion happens,
life alters in an instant.
We don't feel safe.
We lose trust.
- [ baby crying ]
- [ siren wailing ]
Peter Sands:
Fear spreads very quickly
when you have
an infectious disease
outbreak.
Communication
is so much more pervasive.
People know what's happening
in another part of the world
so much more quickly,
so much more vividly
than ever before.
So the contagion of fear
moves faster
than the contagion
of the pathogen,
the disease itself,
and the fabric of society
starts to deteriorate.
Brilliant: There's something that destroys the soul of a community...
that happens when an epidemic
is out of control.
It's not just the large number of casualties and the deaths,
which are itself
unthinkable,
but it's what it does to a--
the social fabric
of a community or a nation.
[ distant horn honks ]
[ panting ]
Dr. Soka Moses:
[ panting ]
Ah?
Hmm?
[ man speaking
over P.A. ]
Man:
Ebola is transmitted
through bodily fluids--
saliva, blood,
urine, feces.
This is an invisible foe.
Wright:
Ebola first surfaced
in West Africa
in a remote
rural community.
But in our increasingly
connected world,
this Ebola outbreak
didn't stay in the countryside.
The virus quickly found its way to the region's largest cities
and health systems that were
completely unprepared.
Moses:
[ groaning ]
[ woman leading prayer
in native language ]
Moses:
[ chatter ]
Piot:
I think we all
underestimated,
absolutely everybody.
I know that one case of Ebola
is an emergency.
Every new case can give rise
to more cases.
So it's really act now
or pay later.
Christiane Amanpour:
Right now, the World Health
Organization and other doctors
are saying it is out of control
in this area of West Africa.
It's the worst outbreak
ever that they've recorded
in this part of the world.
It's unprecedented
for several reasons.
One, first time in West Africa
that we have such an outbreak.
Secondly, this is the first time
that three countries
are involved.
And thirdly,
it's the first time
that we have outbreaks
in capitals,
in capital cities.
This could explode
into a really mega-crisis.
I think so,
and it is already
a mega-crisis...
I really thought,
how can this epidemic
be controlled the usual way
when there are
so many outbreaks
in different places?
[ siren wailing ]
Piot:
The three countries
in West Africa
that are affected
by the Ebola outbreak
have some of the worst
health indicators in the world.
There are
not enough doctors.
There are not enough nurses.
It is a system
that is understaffed,
underfunded,
and where the infrastructure
is very, very old.
Let's go back to 1976
when you were a younger man,
and you actually
codiscovered this virus.
- It was in Zaire.
- Piot: Yes.
Amanpour:
Now the Democratic Republic
of the Congo...
Piot:
And they said that there was
a mysterious epidemic.
This was very lethal,
high mortality.
There were nuns
who had died.
A small group
would go to the mission
where the epidemic
had started, apparently.
They asked for volunteers,
and I think I was
about the first one
to raise my hand...
although I had
absolutely zero experience
in doing this.
[ speaking French ]
Our mission was to--
one, to put in place
some basic measures
to contain it
and using quarantine.
That's what we thought.
And two, to find out
how is this transmitted?
Because that's the key
to stop epidemics--
to know exactly
what the risk is.
How is it transmitted?
It's really
a detective work.
So we tested
whole villages,
talked to the population,
and then have
a very primitive
questionnaire.
How old,
where have they been,
have they traveled?
And what we found was that
there were very few survivors.
Very few,
and that indeed
the what we call
"case fatality rate"
was over 90%.
[ man speaking French ]
Nearly all new viruses
come from animals.
I mean, we are also
an animal.
We are, you know,
human primates.
So, during the outbreak,
we started collecting samples
from all kinds of animals.
I even took blood
from pigs
because a number of pigs
had died
at the beginning
of the epidemic,
so we said,
"You never know."
But we didn't find
any trace of Ebola.
My boss at the time,
Stefaan Pattyn,
had always told me,
"Watch out for the bats."
And it became
a bit of a joke.
But the old man
was right
because
the only reservoir
that we think
where Ebola is hiding
are some kind
of fruit-eating bats.
Dr. George Gao:
[ screeching ]
Garrett:
If we look around the world,
we can see that
bat populations
are being severely stressed
by climate change.
Some of them
because they live
in the upper tiers
of rainforests
and feed on wild fruit.
But the upper tiers
of the rainforests
are getting the most impact
of this heat increase
and increased
UV radiation.
Add to that
that humans are encroaching
into the rainforest,
into bat habitats,
precious caves.
They're very shy creatures.
They do not seek you out,
no matter what vampire movies
you ever saw.
[ thunder rumbles ]
As humans encroach,
we see more and more
bat populations starving
and coming into
human habitation areas
to feed on our
agricultural production.
And in the process,
they're passing their virus on
to other animals
and to humans.
We are imposing changes
in the microbial world
willy-nilly,
thoughtlessly,
and we do so at our peril.
Wright: We have dramatically increased our contact with animals
in a variety of ways:
through deforestation,
industrialization
of agriculture,
and vastly increased
consumption of animals.
HIV spread out of Africa
from a few monkeys
and chimpanzees
to infect millions of people
on every continent.
SARS jumped from a bat
to a civet cat
to a villager in China
to more than 30 countries
in a matter of weeks.
Animal and human health
are completely linked.
In the 21st century,
75% of all new
infectious diseases
have come from animals.
Sometimes directly,
in other cases,
through intermediaries
like mosquitoes.
If anyone had sat down
and done, you know,
a fantasy hit parade
of emerging diseases
that might
come to the Americas
from Africa
or from Asia,
Zika would never have
even been on the list.
Zika virus originated
in Africa
and had never been
off the African continent
until it started
making its way
across Asia
and South Pacific,
ending up
in French Polynesia
and Yap.
Yap is a small place
that most people
have never heard of,
but when Zika hit it,
70% of the population
got infected.
That was really
quite startling,
if anybody had been
paying attention.
Wright:
But they weren't.
Zika jumped
from the South Pacific
to Brazil in 2013,
two years before it was
identified there.
[ indistinct announcement
over P.A. ]
Wright:
The timeline corresponds
to an increase in travel
between the South Pacific
and Brazil,
including visitors
who attended a pre-World Cup
soccer tournament,
the Confederation Cup.
Male announcer:
Go-o-o-o-al!
Someone was carrying
the Zika virus,
and some mosquitoes
bit that individual,
absorbed the virus,
and that's the beginning
of this saga.
[ thunder rumbles ]
And then undoubtedly,
the El Nino weather event
provided the necessary
ingredients--
rainfall and drought--
that fundamentally changed
the conditions on the ground
and allowed for the spread
of this virus.
[ Veronica Maria dos Santos
speaking Portuguese ]
[ crying ]
Wright:
In 2015, the Zika virus
suddenly spread across Brazil,
primarily through the bite
of one type of mosquito.
The medical establishment
only began to comprehend
Zika's danger
as the number of babies born
with the birth defect
microcephaly
started to dramatically
increase.
[ Dr. Vanessa Van der Linden
speaking Portuguese ]
Garrett:
Since the alarm went sounding
around the world from Brazil,
we have seen
almost every day
another revelation
about this virus.
What we now know is that
this is a very dangerous virus.
We grossly
underestimated it.
It is malaria in that
it is transmitted
by mosquitoes
and can cause
enormous outbreaks.
It is HIV in that
it is sexually transmitted.
And it's worse
than all of the above
as we've come
to understand
what this virus
actually lives on.
Where does the virus go
in a pregnant woman?
It goes into this tiny
forming creature, the fetus,
and it feeds on it
and re-infects
back into the mother's
bloodstream over
and over again.
And what is it feeding on
in that fetus?
Baby brain cells.
And so, every single part
of the brain
of that developing child
is damaged.
Wright:
The Zika virus
affects its victims
in a completely different way
from the Ebola virus.
What they share in common
is how fast they can move,
randomly attacking some
while sparing others.
Some epidemics grab
our attention,
while others, in spite
of the larger number
of victims,
remain more hidden.
- [ signal bell clanging ]
- [ train horn blowing ]
[ music playing
on radio ]
Female DJ:
...oldies all the time
on your hometown station,
and of course adding in
some holiday music.
Oh, it's so close.
On a local note,
I'm gonna pass along to you
that those
in need of a flu shot
may still get them.
Walk-ins are welcome
at the Steele County
Public Health,
weekdays between
8:00 and 4:00.
Owatonna, Minnesota--
it's a beautiful town.
To me, it's like
"Mayberry R.F.D.,"
Opie Taylor's town.
Gwen Zwanziger:
The name Owatonna
comes from
an Indian princess
that was sick,
and the chief brought her here
because of the healing waters.
[ quacking ]
Terry:
When we moved here,
it just felt like home.
I think we got lucky.
The good Lord just gave us
two good kids.
- Woman: Three, two...
- Gwen: Do something.
Terry:
Sarah was always
the princess
and Shannon
was the opposite.
She was a tomboy.
She loved skateboarding
and she loved
video games.
- Gwen: Shannon, she was
a complete surprise.
- [ baby crying ]
Sarah was almost 16,
and I was 40.
She was a joy.
Right from the get-go,
she was a joy for everybody.
Whoa!
Terry: We were
a tight, tight family.
Gwen:
Her first time out
by herself.
Oh, my gosh.
Terry:
I remember
when she got her permit,
she was just so tickled.
Gwen:
There she goes, by herself.
Terry:
So, I was so proud of her.
Gwen:
Oh, my gosh!
Oh, my gosh!
Somebody's driving.
- Gwen: Catching snowflakes.
- [ dog barks ]
Gwen:
Hi, girl. Oop.
- [ dog whines ]
- [ laughs ] Oh, hi.
Gwen:
Shannon was in her
senior year of high school.
Terry:
She came home
Wednesday night,
said, "I think I got
the flu at school."
That was Wednesday,
and Thursday,
she just seemed to be,
you know, baseline
for being sick,
but she wasn't
getting better.
And that's when
Terry and I agreed
that we've got to take her.
Terry:
When I took her that Sunday
to go to the hospital,
we waited two hours.
It was that packed.
That's when I knew
there was a big epidemic
of flu going on.
And she's sitting next to me,
and she's got her head on me,
and I took a selfie,
sent it to her mom,
saying,
"We're still waiting."
The doctor said
it was just the flu,
that it had to run its course.
They gave her
some cough medicine
just for comfort,
and Terry went and got it
while I got her back up
in her bed.
[ clicking, chiming ]
[ wind whistling ]
Gwen:
It's about 5:00
in the morning.
I was sitting
in the living room
and I heard her
moving around upstairs.
I thought, "Wow," you know,
"she's getting out of bed."
[ sniffles ]
I got up, and I went
to the coffee maker,
and I saw in my peripheral
that she got up
and she went
into the bathroom.
She tapped
on the shower curtain,
and I said, "You want
to take a shower?"
And she nodded yes,
and I said, "Okay."
I was filling the water up.
I only got it about so full.
She laid back,
but her knees kept buckling.
You know, she kept pushing
on the end of the tub
to keep herself
from sliding under, and...
and then I saw her eyes.
And...
[ sighs ]
I pounded on the wall
and woke Terry up.
Said, "She's not breathing,"
and I come running down, and...
[ clears throat ]
I still remember her
on the floor,
her mom giving her CPR.
I never had to do that
before.
And it's nothing like
they teach you in class.
All I could do
was dial 911.
[ touch tones beeping,
line rings ]
Operator:
911, what's going on there?
Terry:
My daughter,
she's 17 years old.
- Gwen: She's not breathing!
- Terry: She's not breathing!
- Dispatcher:
She's not breathing?
- Terry: She's not breathing.
Dispatcher: Okay,
I'm sending the paramedic
to help you now.
Just stay on the line
with me, okay?
- Gwen: Come on,
breathe for Mama!
- Terry: Breathe, Shannon.
- [ sirens wailing ]
- Oh, Lord.
- [ dog barking ]
- Come on in.
She's right in there.
Go ahead.
Gwen:
I don't remember
any kind of time passing.
I just remember
a pair of blue pants
that kneeled down
on the other side of her,
and he told me
they'd take over,
and I stepped away.
Even when the--
when they said,
"We're flying her
to Rochester,"
you know, I waved
at the helicopter,
you know, thinking
everything's fine.
I had no clue.
[ beeping ]
[ machines
beeping rapidly ]
[ flatlining tone ]
You know,
when they told us...
that she didn't make it,
and I said, "I want to see her,"
and they said,
"You'd never recognize her
from what we've had
to do to her."
Because the flu
actually killed
all of her organs
long before
she actually died.
I still think
she ought to be
coming home.
[ chirping ]
Dr. Barbara Rath:
The biggest pain in the world
as a parent
is losing their child.
This is the most
unnatural thing
to happen
to a human being.
And you stand next to it
and you think, my goodness,
I am there to prevent this
from happening,
and sometimes I cannot,
and...
sometimes I don't know
why I cannot.
[ man speaking German
on radio ]
Rath:
The question of how and why
one particular person
may die from influenza
is the million-dollar question
that we absolutely
need to tackle.
Wright: It is surprising
how much we still need
to learn about flu,
a disease which causes
worldwide epidemics
every year.
Mother:
She had a little raspiness
in her chest.
Mother #2:
The flu test
came back positive.
Mother #3:
I actually remember saying,
"Okay, it's just the flu,"
like it was no big deal.
Wright:
It spreads across
the globe,
hospitalizing
three to five million.
Mother #4:
And within 24 hours,
she was intubated.
[ man speaking French ]
Wright:
Killing at least
200,000 every year.
Mother #5:
We went in as they
were coding her.
- [ machines beeping ]
- Mother #6: My baby girl,
Scarlet Anne...
- [ flatline tone ]
- ...pronounced dead.
Rath:
The majority
of adult influenza patients
have something
that we call a risk factor.
They have
very weak immune system,
or they have diabetes
or obesity.
Pregnant women
have a risk,
for both themselves
as well as the child.
Okay, we know
these factors.
But this is a virus
that can mess up your body
to a degree
that even the most healthy,
young and happy,
playful person
is taken away from this planet
within a couple days.
Wright:
Every year, we struggle
to fight seasonal flu.
But what experts
are really afraid of
is a new strain of flu,
one that the human population hasn't been exposed to before,
one that
almost no one will have
any immunity against.
Mark Smolinski:
When we think about
the threat of a disease
spreading around the world
as a pandemic threat,
obviously airborne infections
are at the very top.
Things like SARS and flu
are something
that we know
is difficult to control
because of the way
it spreads through aerosols.
Most people
become infectious
with the flu
before they even
have symptoms.
Anybody can travel
clearly across the world
with an infectious disease
incubating in them
without them even knowing
that they're sick yet.
Wright:
In 2009,
a new flu emerged--
H1N1, also known
as swine flu.
We now know
it first appeared in the U.S.
in the pig industry,
initially infecting people
at state and county fairs.
In a little over a year,
swine flu infected
around 1.3 billion people.
It was the most common
shared experience on Earth.
[ crowd chanting ]
Wright:
Flu poses a strong
pandemic threat
because it has the ability
to be both very contagious
and very deadly.
Yeah. Yep.
Smolinski:
What we're most worried about
right now is this bird flu
that we know
is highly pathogenic.
Paul Horwood:
Wright:
Currently, this deadly
new bird flu
doesn't spread easily
between people,
but it is spreading rapidly
among wild birds and poultry.
[ horns honking ]
Experts are afraid
this could be
a pandemic threat.
[ ducks quacking ]
Dr. Arnaud Taranola:
It's a live poultry market,
so the birds are alive.
And when they're sold,
they are sold alive
because people value the fact
that it's very fresh meat.
[ crowd chattering ]
Taranola:
So you buy your chicken
or your duck live.
And then it is killed...
and cleaned and emptied,
of course, eviscerated.
The viscera go into
some of these buckets here,
and then the birds
are put in hot water
and then put
in these drums
where these
little plastic tubings
help get rid
of the feathers.
And then when the birds
have been defeathered,
eviscerated, and cleaned,
then they're cut up
and they're given back
to the person who bought it.
The issue here
is that the water
is the same
to clean all the ducks
and chickens.
The other issue
is that these people
are wading in--
in viscera, feathers,
and the water that served
to clean them.
So, there's really
a lot, a lot of virus here.
Wright: In 2011,
when the Pasteur Institute
started monitoring
the wash water,
18% of the water samples
were positive for H5N1.
Four years later,
66% of samples were positive.
Smolinski:
We know that bird flu
is very, very deadly,
and we know swine flu
spreads very quickly.
What we worry about
is if those two reassort,
and then we could
have a new strain that
literally could spread
as quickly
as the swine flu did
but have the mortality rate
of bird flu.
That's the big fear,
that we have now
literally created
the petri dish
that we all worried about
and both of those viruses
are sitting in there
at the same time.
Sands:
Pandemics are one
of the biggest risks we face.
This is an issue
of human lives.
It should be thought of
in the same way
that we think
of terrorism,
protection against
natural disasters,
against national defense.
This is a human
security issue,
and it is also
an economic security issue.
[ overlapping news anchors ]
The outbreak of SARS could
trigger a global downturn.
Fear of the SARS virus
has caused
serious financial damage
to businesses,
cities,
even entire countries.
Sands: During the height
of SARS, nobody was going
to restaurants,
people didn't want
to go shopping.
At one point, at the peak
of the SARS crisis,
air travel into Hong Kong
was down by 80%
and retail sales
were down by 50%.
Businesses began to run
out of money.
Estimates of the impact
of SARS
have been an economic impact
of around 40 billion or so.
If a global pandemic
took place,
you're looking
at an economic impact
measured in the trillions
of dollars,
not tens or hundreds
of billions.
It has such a big impact
on business and life.
Garrett: You hope the world
has the capacity to see
an outbreak,
mobilize forces,
and contain it, right?
Unfortunately,
we rarely do that.
Especially
if the outbreak occurs
in a poor country.
Well, here we are
in Liberia.
That's Sierra Leone.
And this is
the border crossing.
Do you see security?
Do you see any military?
Do you see anything
that would stop someone
from coming across
this border?
And then,
it not only spreads
beyond the borders
of the original country
as occurred with Ebola
and West Africa,
but it crosses seas,
it crosses continents,
and that constitutes
a pandemic.
Endemic is your
worst-case scenario.
So you failed to control
the outbreak,
you failed to control
the epidemic,
and you failed to control
the pandemic,
and now that microbe
is a permanent feature
in the biological landscape
that humans are living in.
The worst example
of that is HIV.
We started off
with tiny outbreaks
in a handful of places,
and the world responded
completely incorrectly.
It became pandemic
and now endemic.
So we have 37 million people
living infected with HIV,
and there is no country
on the planet
without this virus.
Wright:
Before the devastation
of AIDS,
there was smallpox.
Smallpox killed
500 million people
in the 20th century alone,
more than all the wars
in that century combined.
Whenever an infectious disease truly catches hold,
it forces health workers
to make impossible choices
about the public's freedom
and rights.
Brilliant:
I was the youngest person
in the smallpox team.
And I was certainly
the only person
in the history
of the United Nations
recruited from
the Neem Karoli Baba Ashram.
[ horns honking ]
Brilliant:
We had eradicated smallpox
in Madhya Pradesh.
It's this big state
in the middle of India.
And we were about to do
our victory dance,
and then suddenly
across the border,
we started getting
new outbreaks.
And they all came
from one place,
a place called Tatanagar.
- First place we went to
was the railway station.
- [ train whistle blows ]
And it was a scene
from the worst nightmare
you ever had
in your life.
There were dozens of people
stretched out near the tracks,
in the waiting room,
on the cement,
dead from smallpox.
It smelled from the death.
[ train whistle blows ]
The Tatanagar
was the home
of the Tata
Iron and Steel Company.
So I just went
to the company's house.
It was almost midnight
when I got there.
I said, "I need Jeeps,
I need managers,
I need doctors,
I need vaccine."
The next day,
I had 100 Jeeps.
We set up
training programs.
We used maps
to develop a strategy,
and we took
the 100 Jeeps,
and we built
our little army.
We were doing great.
We found 2,000 cases
of smallpox.
We were stopping the disease
in Tatanagar,
but still,
as we're vaccinating
everybody,
the trains were carrying
people away.
It was still exporting
smallpox.
[ whistle blowing ]
We closed the railway station. We closed the buses.
We quarantined the city
of 600,000 people.
Nobody could leave the city
unless they were vaccinated.
[ people singing
in Hindi ]
We eliminated smallpox
in that entire area
around Tatanagar
in less than six months.
But it kept coming back.
We traced it to a tribal group called the Ho tribe.
So, I went
and visited the members
of that tribe,
and I said,
"Well, you've gotta take
smallpox vaccine.
You gotta stop
this transmission."
And he said,
"I won't take it.
I do whatever
God's will is, and...
if I'm to get smallpox,
I'll get it."
After a while,
more cases kept coming out
from the Ho community,
and we all agreed
that we were going to have to
forcibly vaccinate
these Ho tribesmen.
[ music playing ]
In the middle of the night,
we went out into the villages,
into the jungle,
and we surrounded them
and pulled them
out of their houses,
and we vaccinated them.
[ birds chirping ]
[ roosters crowing ]
And then after we had
broken into their house,
pulled them out of bed,
forcibly vaccinated them,
this dignified tribal elder
looked at me,
and reached over
to the vine.
And there was one fruit,
a cucumber, a kind of gourd.
And he pulled it off,
and he cut it,
and he put it on a leaf,
and he offered it to us to eat.
He said, "I don't like
what you did.
I think you're wrong.
But that's over now.
Now I see that you are
a guest in my house.
The only thing I have to offer
is this cucumber."
[ chuckles ]
And so,
you ask yourself...
"Were we right?"
We did
a lot of things that,
in their
individual isolation,
if I put the harshest light
of truth on it right now,
I would be begging to find
an alternative way to do it.
And I ask myself,
"Did I exaggerate
the importance of what I did?
Did I place myself above
some kind of moral compass?
Did I--
did I quit too early
trying to find a way
to accomplish
the same thing?"
But...
But that's sort of between,
right now, me and God
and me and my conscience.
Smallpox has been
eradicated.
And I'm thrilled
about that.
[ airplane buzzing ]
[ indistinct chatter ]
[ crying ]
Chicken pox.
[ seagulls screeching ]
[ subway chimes ]
Dr. Heidi Larson:
The idea of night raids
or forcible vaccination today
is just unthinkable.
There's a few big things
that are very different--
internal politics,
global politics, extremism,
the whole issue
of human rights.
You have to be transparent
because the wrong information
can actually contribute
to the spread of a disease.
I'm particularly interested
in looking at rumors.
The way that rumors
replicate and spread
are very similar
to how viruses spread.
They need a host.
They need to be supported
to stay alive and thrive.
- Man: Oh, there we go.
- There we are. Okay, hi.
Larson:
Rumors have been around
since man existed,
but I think right now,
what's changed with technology,
and particularly
social media and the Internet,
is the global spread
and the speed.
I mean,
look at Twitter.
You needed 140 characters
or something,
and that's all you need
to spread some of the rumors
and perceptions
that we're certainly tracking.
And one of the things we found
is that rumors thrive
in times of uncertainty,
they thrive in times
where people need an answer,
are eager for an answer.
Sands:
The old model
of how you respond
to an infectious disease
outbreak
is you issue some sort of,
you know, firm warning
to the public
and tell them
what they should
and shouldn't do.
That doesn't work anymore
because people
are responding
to rumors on Twitter
or Facebook,
and they want to engage
and they want to challenge
and they want to have
their own opinions about
what's going on.
I'll be back.
Okay, I have a pen.
I have my books.
The agenda.
Okay, go for it.
When an epidemic occurs,
there is a clinical management,
but there's also
the reactions of society,
and managing that
can be as important
as actually dealing
with the epidemic itself.
Okay, good afternoon,
everybody.
This is the third meeting
of our task force on Ebola.
And, John, would you
like to give an update?
Because where we are
with the epidemic,
I'm very worried,
to be honest.
[ overlapping news anchors ]
President Ellen Johnson Sirleaf
likened the outbreak
to a war.
Cases and deaths
continue to surge.
Riots are breaking out.
Wright:
As Ebola continued to spread
across West Africa,
the governments implemented
massive quarantines.
- [ crowd shouting ]
- Wright: Distrust exploded.
[ overlapping news anchors ]
Security forces blocked roads
with scrap wood
and barbed wire.
An angry mob forced open
an isolation ward.
Hundreds clashed
with the police,
- who fired live rounds
and tear gas.
- [ gunshots ]
Liberia has tried,
we've used our own resources,
but obviously
we have limitations,
and we hope that
the international community
see this
as an international
catastrophe.
[ overlapping news anchors ]
Two Americans who had
been infected...
...will be sent home
for care in Atlanta.
[ speaking Spanish ]
- William Pooley...
- ...became infected
whilst working as a nurse
in eastern Sierra Leone...
A news photographer for NBC
just diagnosed with Ebola.
Much like the other
Americans before him,
he will be flown back
to the United States
for treatment.
- Woman: That's him?
- Woman #2: Mm-hmm.
- Woman #3: That's him.
- Woman: Oh, my God.
- He's from West Africa, right?
- Woman #2: No, he's from
the States, from here.
- Woman:
Oh, he's from the States?
- Woman #2: He's an American.
- Woman: Oh, my God.
- Woman #3: I got here--
oh, my God...
Wright:
In a repeating pattern,
the world only really started
to pay attention
to the Ebola epidemic
when foreign workers
began to fall sick.
Male anchor:
The international responses
continue to ramp up.
Obama: We're going
to create an air bridge
to get health workers
and medical supplies
into West Africa faster.
David Cameron:
Over a billion euros across
Europe will be galvanized.
[ Franois Hollande
speaking French ]
[ overlapping news anchors ]
China is sending healthcare
professionals.
[ speaking Chinese ]
There are 84 flights a week
leaving these affected
countries.
For the first time,
the Ebola virus is in
the United States.
Thomas Duncan contracted Ebola in Liberia before flying to Dallas, Texas.
He lied on his exit form
so he could leave Liberia.
[ overlapping voices ]
Why not just shut down
the flights
- and secure the borders?
- A travel ban may make sense.
We should not be allowing
these folks in, period.
Brilliant:
As of today, one case
came from Liberia.
One.
Now, there'll be more,
but right now, one.
And in response to that
they say, "Let's close
the borders.
Nobody from Africa
will be allowed in."
They don't even
know where West or East
or South Africa is.
"Nobody from Africa
should be allowed in.
And close our airports."
I mean, that's a combination
of ignorance and arrogance
that could create
ruination
for our economic system,
our financial system.
Man: Please be advised
that a health care worker
who lives in your area
- has tested positive
for the Ebola virus.
- [ siren wailing ]
[ overlapping news anchors ]
Today, testing confirmed
that a patient here
in New York City had
tested positive for Ebola.
Craig Spencer treated
Ebola patients in Guinea.
12 hours before
he detected his fever,
he was in an Uber car,
he was on the L train,
he was on the A train,
he was on the 1 train,
he went to two bowling alleys, and he ate at a restaurant
as no quarantine
was required.
Late this afternoon,
the governors of New York
and New Jersey
decided to change that.
After returning from
treating Ebola patients
in Sierra Leone,
Kaci Hickox
was forcibly quarantined,
even though
she tested negative
for Ebola twice.
We have the legal
authority to do it.
Um, we're doing it.
Garrett:
It was pretty clear
that the United States epidemic
was overwhelmingly
an epidemic of fear.
We got a practice run
on how Americans will respond,
and, boy, we got an F.
Woman: In addition,
we have renewed
our determination
to remain vigilant...
Piot:
We're spending a lot of time
with the community...
Woman:
And we will rid
our beloved country
of this dreadful,
unwanted guest-- Ebola.
Piot:
...community leaders
with our colleagues
to assess
how to better handle
this Ebola epidemic.
My big question,
and I guess it is the concern
of everybody here, is--
is this a wake-up call
for you,
also the international
community,
to start looking
at other potential viruses
that may come to harm us,
as vulnerable as we are,
in the future
so that we start putting
things in place now for us to--
to prevent us getting
in those types of situations?
Well, to be honest,
in these 38 years,
we have
collectively failed.
And every time
when there's a big epidemic,
we say, "Oh, never again.
And we're going to--
you know, to set,
put in place mechanisms
to do this and that,"
and it doesn't happen.
And so we have
to now really fight
that this will happen
this time
and that there are
better systems in place.
[ beeps ]
Wright:
In the fall of 2014,
significant aid and manpower
finally started arriving
in the region.
In Liberia,
there were contingents
from Mdecins
Sans Frontires,
China, Cuba, Germany, Sweden,
and the United States.
[ members arguing ]
[ banging on table ]
Wright:
It was chaotic,
and coordination
was often difficult.
But makeshift ETUs
were finally replaced
with purpose-built
field hospitals.
Moses:
[ chatter ]
[ thunder rumbles ]
Moses:
He just dropped and died.
He just dropped
and died.
Yeah.
[ sniffles ]
[ horn honking ]
[ beeps ]
[ machinery powers on ]
Decontee Davis:
- [ car horns honking ]
- [ chatter ]
- Davis: A cat...
- Kids: A cat...
- Davis: ...a rat...
- Kids: ...a rat...
- Davis: ...on a mat.
- Kids: ...on a mat.
- A fat cat...
- A fat cat...
- ...sat on the mat...
- ...sat on the mat...
[ chatter ]
Moses:
How are you?
[ machine whirring ]
Wright:
The 21st century can be
characterized by a race
between the dangers
of modernization
and the advances.
Our only chance
of winning the race
is to use 21st century tools
to fight epidemics,
ideally even to prevent them
with vaccines.
Yes, he is.
Come right on in.
Garcia-Sastre:
- They sent the slides.
- Oh, yeah, okay.
Wright:
Currently, we create
a new flu vaccine every year,
adjusting it to match
the circulating strains of flu.
It takes months
to make that vaccine.
Yeah, it looks quite nice.
Wright:
What scientists
are trying to develop
is a universal
flu vaccine,
one that could work against
all strains of flu,
seasonal and pandemic.
Garcia-Sastre:
Gao:
Wright:
Better diagnostics
are critical
to preventing outbreaks
from becoming epidemics.
We frequently
misdiagnose influenza.
And initially
in the field,
we misidentified
both Ebola and Zika.
Confusing them
with other diseases,
we lost valuable time
to contain them.
[ lock beeps ]
Computerized voice:
Thank you.
You have been
identified.
This is the area
where we have a lot
of the diagnostic machinery
that we're working on.
So, the general idea
is your sample's gonna
get placed in here,
and it will run
across the chip.
You close it up,
and then the cartridge
can sit right here.
Right now, the run time
is somewhere in the order
of half an hour.
So what you can see
on the screen here--
this is the intact virus.
Maybe it's Ebola,
maybe it's influenza,
maybe it's Zika.
You could imagine it being
useful in your doctor's office.
You can imagine it
being useful in an airport.
Or you can imagine somebody
wanting to bring it
to a triage site
if there is some disaster
or some outbreak.
[ Dilma Rousseff
speaking Portuguese ]
[ overlapping news anchors ]
Today the President of Brazil
gave public health officials
the right to enter
any home or business
to try to eradicate
mosquito breeding grounds.
Cases of the Zika virus
have been reported
in dozens of countries across
Southern and Central America.
Already, Puerto Rico
is in the crosshairs
of the virus.
[ woman speaking Spanish ]
[ speaking Spanish ]
Wright:
Scientists are still
trying to understand
the full range
of neurological effects
the Zika virus causes
in both babies and adults.
Male anchor:
Florida officials have
finally found the Zika virus
in mosquitoes
in the Miami area.
David Jolly:
People are scared.
Cases of Zika rose
from 4,000
to, by some estimates,
over 16,000.
Can you imagine, colleagues,
the fear and anxiety
in this chamber
if these hundred mosquitoes
were outside this jar,
not inside this jar?
A lot of folks talk about
protecting Americans
from threats.
Well, Zika is a serious threat
to Americans.
Wright:
Zika is spreading rapidly
around the world.
At least 49 countries
or territories
in the Western Hemisphere
have local Zika transmission.
Garrett:
We're already seeing
mosquitoes transmitting Zika
in the United States.
It's really just a question
of how many states,
how widespread,
and how many people
will acquire infection
as a result.
We are not prepared
for Zika.
Every outbreak, we go
to the Capitol Hill folks
and beg.
And every outbreak,
it becomes very political.
[ dog barking ]
In the United States,
there are a patchwork of laws
that guide health.
There's no consistency
in the level of funding
or urgency or training
or expertise.
Am I allowed
as a public health official
to go on your front lawn,
your private property,
and spray insecticide?
In some cities, yes.
In some cities, no.
Am I allowed to force you,
compel you,
to drain a swampy-like
condition in your backyard
because it's breeding
mosquitoes?
Again, there's
no consistent law.
Public health
is a two-way trust.
I have to trust
that government's going
to do the job,
but government
can't do the job
of public health
unless the public is engaged.
If government says,
"Mosquitoes are here
and they're carrying
a really dangerous disease,
we need to come
on your property.
We need to have
access to ways
to eradicate
those mosquitoes."
And you say, "I believe
in the Second Amendment."
[ imitates shotgun cocking ]
"Nobody's coming
on my property,"
then there's no trust
and there's no public health.
And similarly,
if there's an epidemic
that involves a vaccine,
government doesn't line
your children up.
You line your children up.
And if you're not
willing to do so,
then you're not part
of the trust
that is the basis
of public health.
[ crowd chanting ]
Don't shoot, hands up!
- [ crowd shouting ]
- Garrett: If there's
one hallmark
of my lifetime
on this planet,
it is the erosion of trust
in government.
[ crowd chanting ]
And public health
is paying a price
at every level
for that erosion
of trust.
Gwen:
Each year,
Terry gets the vaccine.
I don't get it.
And we gave Shannon
the choice,
and she chose not to.
I'm trying to understand
the flu vaccine
because I want to know
if we had have gotten
Shannon vaccinated,
if it might have saved
her life.
There's so much information
on the Internet.
I can go
to 30 different websites
and get
30 different answers.
You don't know
who to trust.
Wright:
There is something
about the flu vaccine
that conjures confusion.
While not currently
a perfect tool
and varying in effectiveness
from year to year,
over the last decade,
the flu vaccine reduces
the risk of getting the flu
by at least 50%.
It also reduces
hospitalizations and deaths.
Gwen:
A little over a year ago,
a mom that lost a little girl
put together a Facebook page,
and she titled it "Flu Moms."
And when she hears
of another mom
or somebody finds us,
they join.
Here's a mom.
She had a booth at a fair,
and all of our children
were pictured.
[ crying ]
There's Shannon.
And...
when children came
to the booth
to get their faces
painted...
then the parents
standing there waiting
would get
the information.
They'd be told about
these children who have died
and the importance
of vaccination,
that kind of thing.
We have a new mom.
Julia.
"Not wonderful to be part
of a flu mom group,
but it's great
that we all are here
for one another."
Shoot.
We'll learn her story
pretty soon.
Rath: There's a huge amount
of parents that are just
utterly confused.
And that's a big
communication challenge
when it comes
to the vaccine.
So, the question is
does she have anything now?
Yes, you know...
Rath:
Vaccine hesitancy
is something
that we observe
to be on the rise,
which is quite alarming.
[ squeals, laughs ]
Influenza is actually
possibly preventable
with a vaccine.
That's great.
But nobody uses it.
That's not great.
One of the most
common misconceptions
about the flu vaccine
is that people
say, "You know what,
I'm in my best years.
I'm healthy.
I've never been sick."
But there's another aspect
to vaccines, obviously,
and that's not just me,
it's also the people around me
because of the potential of me
giving something to somebody
that may be
serious to them,
even if it may not be
serious to me at this moment.
And I may very well sit
in the subway next to somebody
who has a very weak
immune system.
And they may not even know it, and I may not know it,
but I may very well
give somebody the flu.
So, there's the question
of the common good
versus
the individual good.
If we want any effectiveness
of a vaccine,
we need to get
vaccinated.
[ indistinct announcement
on P.A. ]
[ crowd shouting ]
Brilliant:
The great influenza
of 1917, '18,
that virus
is said to have
gone around the world
four times
without an airplane.
That's 100 years ago now.
At the end
of the great influenza,
50 million or 100 million
had died.
That's against
a global population
at the time
less than two-sevenths
of what it is today.
Multiply 50 or 100 million
by three,
you're talking about
a number of deaths
that's totally catastrophic,
a hit to our economy
that's unimaginable.
In 2006, I brought
the top epidemiologists
from all over the world
together.
The vaccine needs...
Brilliant:
And the vast majority felt
that in the next
20 years, 30 years,
there will be a pandemic,
and it will have
the potential
to bring humanity
to its knees.
[ clucking ]
Wright:
New strains of influenza
are already infecting birds
in over 75 countries.
And the way we are interacting with the animal world
is putting us at risk.
[ screeching ]
We encroach on wetlands,
so wild birds
mix more frequently
with domestic poultry;
our food trade
is completely globalized;
and factory farms are growing
in scope and size.
With all influenzas,
there is some critical moment
when a virus circulating
in one species,
of, say, birds,
manages to mutate
in a form
that allows it
to get into, say, pigs,
and then from there
to spread easily
between people.
We've seen this
over and over.
It's going on all the time,
right at this moment.
Here's what
a truly horrible,
worst-case scenario pandemic
would look like.
First, there would
be a jump
from some animal species
to humans.
The first humans would be
the people close
to those animals.
And then their families
and the kids in the schools.
And it would not be
regionally confined
for long at all.
Days, that's it.
And let's assume
that it kills
5% of the people
it infects.
Well, 5% would be
hundreds of millions
of human beings.
Woman:
Pandemic flu will soon
reach this country.
Man:
If you become sick
while traveling, contact...
Garrett:
So, once the epidemic
has really begun to spread,
you can't even
begin to imagine
the scale of this.
Man:
You want to be as far away
from the city as possible.
Man #2: It's going to come
to your community...
Garrett:
You have huge numbers
of people
that are not
coming to work,
and that includes jobs
we consider essential
for public safety,
like the guys that turn
water systems on and off...
- [ siren wailing ]
- ...the police...
- [ helicopter whirring ]
- ...the fire department.
Then people start blasting
their conspiracy theories out
about where this disease
came from,
who caused it,
why is it here.
[ cell phone chimes ]
You would see
a whole wave of shortages
of goods and services
all over the world.
The stockouts
of every single kind of drug,
the overcrowding
of the hospitals,
the overcrowding
of the mortuaries,
the sheer numbers
of both sick and dying.
What a really severe
influenza pandemic
would look like...
- [ siren wailing ]
- [ explosions ]
...is something close
to social collapse.
Sands: We're not effectively prepared as a world for a pandemic.
We don't have effective enough
coordination and response.
But the biggest thing
is that the on-the-ground
preparation and preparedness
is full of holes.
There's a pattern here
of responding to an outbreak
rather than investing in
preparedness.
Preparedness
is so much cheaper,
so much more
cost-effective
than responding
after the event has happened.
Wright:
Major nations
around the world
currently spend
10 to 25 times less
on bio-security
than they do
on homeland security,
in spite of the likelihood
of an epidemic
causing even
greater loss of life.
We are overdue
for an influenza pandemic.
On average, they happen
every 20 to 40 years.
A lesser influenza pandemic,
one equivalent to 1968,
would likely now kill
up to two million people.
An influenza pandemic
like 1918
could kill
200 million people--
more than
the entire population
of Germany,
Great Britain,
and Spain combined.
[ horn honking ]
To prevent pandemics,
we need to do
a much better job
of controlling outbreaks.
- Morning!
- Morning.
Moses:
[ humming tune ]
...on my shoulder
I'll be your guide
Always be your guide
Won't you hear
my people cry?
Chickie-chickie-chickie!
Yeah.
It gives me joy.
- Woman: When you see
the power of God...
- [ group clapping ]
It is my ability
It has to be
the Lord working
It is my ability
- Tomorrow
- Tomorrow I escape
Will try to find my way
out of this again.
- Amen.
- Group: Amen.
I want to present
this certificate to you.
- Meyma. Meyma?
- [ laughter ]
Meyma,
please talk to me.
This is for you.
Take it from me
now, baby.
- It's for you.
- Yeah!
[ applause ]
Moses:
- [ babies crying ]
- [ chatter ]
[ Dos Santos
speaking Portuguese ]
[ laughs ]
[ crying ]
[ speaking Portuguese ]
Wright:
When an outbreak
catches hold,
it affects every part
of our lives--
business and government,
trust and freedom,
equity and security.
The fight against epidemics
can only be won
if each of us
does our part.
It turns out we are all
the front line.
I think it goes
on your left side.
- What if I don't
want to wear it?
- Oh, no!
- [ laughter ]
- Picture of you?
- A selfie.
- Oh, my God.
They created
a procedure
so that
when people look at--
open your iPhone...
It was in this hall
52 years ago
that my life
was forever changed.
I felt I had been drafted
into a different kind army
to fight for human rights.
In 1980, smallpox was declared
eradicated from the world,
and so far,
it's the only human disease
ever eliminated
by a public health campaign.
If smallpox could be
eradicated, we thought,
what about HIV/AIDS?
Can we stop SARS and MERS,
H5N1 at their source,
and never become
a pandemic?
I don't dispute it's hard
and complicated,
but we have the tools.
We know what to do.
It's merely the application
of public will.
Go out
and change the world.
- How are you?
- I'm fine.
Ohh!
Good morning,
Professor Piot.
Oh, Soka.
How are you?
- Fine.
- Good to see you.
What keeps me awake
at night now
is that we will deliver
on our promises
to the people
of West Africa.
Shall we have a seat?
That we will support
these countries,
to build the systems
to make sure that
when there's
another case of Ebola,
which will happen,
that it doesn't give rise
to a big epidemic.
- [ birds screeching ]
- [ car horns honking ]
The time has gone
that we lived on islands
or that we were protected,
and there's no way
to stop that...
- [ babies crying ]
- ...because fighting AIDS
or fighting the flu
and SARS in Asia
benefits people in Europe
and in North America.
So we need to act
beyond the boundaries
of our own countries.
Wright:
The networks that connect us
accelerate everything--
the spread of ideas,
conflict,
people, and microbes.
There is no running away.
There is no wall
high enough.
What's absolutely missing,
just not there,
is trust.
And so, coming up
with preparedness
that looks like
it could stand up
to the microbes
when the attack comes
is really about each country
carrying their own weight.
Yes, we always need
to be watching.
Vigilance is permanent.
Wright:
The hallmark
of the 21st century
is that our world
is simultaneously
more connected
and more fraught.
Epidemics are a test
of who we are.
We can use our connections
for good,
to make the world safer
and healthier,
or those connections
will turn on us
in an instant.
We cannot just continue
to be responding
to every outbreak
as it occurs.
If we do not invest
in better preparedness,
we are setting ourselves up
for future epidemics
and pandemics
that will cost
enormous amounts
in terms of both lives
and money.
Brilliant:
I constantly run into people
who are fatalists
and they say, "Well,
pandemics are inevitable,
so don't work on them."
Pandemics are not
inevitable.
Outbreaks are inevitable.
Pandemics are optional.
It's our option
if we will be lazy.
It's our option
whether we will deny
the risk.
It's our option
whether we will refuse
to face the consequences.
We have a chance
to stop something
that otherwise
could be horrific.
But it's going to take
all of us.
[ music playing ]