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Dr. Bob calls up author John Barry and TIME Magazine’s Jeffrey Kluger to talk about what the 1918 flu pandemic and the American polio epidemic can illuminate about COVID-19. In addition to the historical similarities and differences, they discuss what “the end” looked like and what, if anything, that means for us today. Plus, find out which of the three men was a Polio Pioneer! And get Dr. Bob’s take on the joint CDC and FDA decision to pause use of the Johnson & Johnson vaccine.

 

Follow Dr. Bob on Twitter @Bob_Wachter and check out In the Bubble’s Twitter account @inthebubblepod.

 

Find Jeffrey Kluger @jeffreykluger and John Barry @johnmbarry on Twitter.

 

Keep up with Andy in D.C. on Twitter @ASlavitt and Instagram @andyslavitt.

 

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Check out these resources from today’s episode: 

 

• Read the joint CDC and FDA statement in which the agencies recommend pausing use of the Johnson & Johnson vaccine: https://www.cdc.gov/media/releases/2021/s0413-JJ-vaccine.html
• Watch the news clip from April 12, 1955 about Jonas Salk’s polio vaccine: https://www.youtube.com/watch?v=2LlDn_MQDkc
• Check out John’s book, The Great Influenza, here: https://www.penguinrandomhouse.com/books/288950/the-great-influenza-by-john-m-barry/
• Here’s where you can learn more about Jeff’s book, Splendid Solution: https://www.penguinrandomhouse.com/books/291641/splendid-solution-by-jeffrey-kluger/
• Learn more about Dr. Bob Wachter and the UCSF Department of Medicine here: https://medicine.ucsf.edu/

 

To follow along with a transcript and/or take notes for friends and family, go to www.lemonadamedia.com/show/in-the-bubble shortly after the air date.

 

Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia. For additional resources, information, and a transcript of the episode, visit lemonadamedia.com.

Transcript

SPEAKERS

Jeff Kluger, Dr. Bob Wachter & John Barry

Dr. Bob Wachter  01:35

Welcome to IN THE BUBBLE. I’m Dr. Bob Wachter. Well, we’re taping this episode on April 12, 2021. What you just heard was the news of the day on April 12, 1955, so exactly 66 years ago to the day. That was the anniversary of the polio vaccine developed by Jonas Salk that was declared, quote, safe, effective and potent. A remarkable and joyous day around the world. So much about COVID seems unique. And yet, as Mark Twain famously said: “History doesn’t repeat itself but it often rhymes.” Last month, here on IN THE BUBBLE, we talked about the lessons from HIV AIDS. Today, we’re going to talk about two other horrible viral pandemics both of which took massive and tragic tolls on humanity. And both of which ultimately came to an end as COVID well, but in very different ways.

Dr. Bob Wachter 

One through some combination of herd immunity and mutations but mutations to a more benign virus, the other through a worldwide campaign to find a safe and effective vaccine, as you just heard. Well, before we get into the meat of today’s episode, which is going to be a fascinating discussion of the history of the Influenza pandemic in 1918, and the Polio vaccine rollout in the 50s’. I’d be remiss not to mention the big news of the last few days, which is the decision by the CDC and the FDA to suspend the rollout of the J&J vaccine. It’s a disappointment. And I do worry about it somewhat, because it may increase the rate of vaccine hesitancy or change. People’s decision making about which vaccine to take even if the J&J is ultimately put back into the mix, which I think is very likely to happen.

Dr. Bob Wachter 

But it’s prudent. This is the way the system works, it’s prudent to suspend the rollout when there is a possible safety signal. And just as with the AstraZeneca vaccine, there have now been a handful, I think 6 at last count of reported cases of unusual blood clots in recipients. Now, blood clots are common. And if these were just blood clots in the legs and people who have gotten the J&J vaccine, you know, there are several million people in the United States who have now received it, it would probably be the baseline rate of blood clots we wouldn’t think much of it, but these blood clots, if they are similar to the clots that we’re seeing in AstraZeneca. These are unusual blood clots occurring in unusual places, and associated with a low platelet count.

Dr. Bob Wachter  04:16

And the reports from the AstraZeneca vaccine are somewhat worrisome and do likely indicate that the clots relate to the vaccine. And so we’ll have to see what they find with the J&J vaccine, it may turn out to be this is the baseline rate when you vaccinate millions of people, even rare clinical problems may occur and may have nothing to do with a vaccine. And it is possible that this is a one in a million kind of side effect. It’s going to be important to figure that out. The early reports have this word that all of these clots, the worrisome clots that they’re looking at occurred in relatively young women.

Dr. Bob Wachter 

So it may be that what comes out of it is a stipulation that the J&J vaccines should not be used in women of a certain age group. It may turn out to be an association with birth control, in which case that may be what comes out of this do not use the J&J if you’re on birth control. But it’s worth understanding this and figuring it out. It’s worth taking, hitting the pause button on the J&J for now until we do. The good news is that the Moderna and Pfizer rollouts are going incredibly well, there’s absolutely no safety signals or concerns including blood clots in those vaccines. And they represent the vast majority of the vaccinations that have already been carried out in the United States.

Dr. Bob Wachter 

So even if J&J is completely taken out of the mix, it may slow us down by a few weeks, but shouldn’t change the ultimate penetration of vaccination in the United States. Unless and this is, I think, the biggest caveat, unless it leads to more vaccine hesitancy in people, I really hope it doesn’t, because what the FDA and CDC are showing now is that the system works when there is a concern, they’re going to take it seriously. They’re going to be honest and open and transparent about it. And as soon as they understand better whether this is a real side effect of the vaccine or not. We’ll know how to proceed. So I think it’s an important development. Something I am watching very carefully.

Dr. Bob Wachter  06:16

Having gotten the Pfizer vaccine, I don’t worry at all, I think about my family members, some of whom got Moderna, I don’t worry at all. If I gotten the J&J vaccine, yeah, I’d be I wouldn’t be super worried because we’re talking about a one in a million kind of thing. But I would be paying attention if, for example, I had new leg pain or a headache, I would go see my doctor about it. I think after a pause, we’re likely to see the J&J vaccine come back into use either full use with maybe a caveat that a one in a million uses, it can cause these kinds of side effects and be on the lookout for them.

Dr. Bob Wachter 

Or it’s used to being somewhat restricted in certain patient populations, or people receive a warning that if they’re, for example, a young woman or for example, on birth control pills. I don’t know that yet. But that’s possible. That will be the outcome that they shouldn’t use that vaccine and should prefer the Moderna and Pfizer. So if you’re set up to receive Moderna and Pfizer, please go full steam ahead. And for the J&J, I think we have to wait and see what comes out of the investigation. And personally, I’m pleased that the system is working the way it’s supposed to work, which is when there’s a concerning signal to stop, take a good hard look and then proceed once we know more.

Dr. Bob Wachter

I’m really pleased that we had a chance to talk to two esteemed authors of the some of the seminal historical books on the stories of the Influenza and Polio epidemics. The first is John Barry. John is the New York Times bestselling author of The Great influenza, the story of the deadliest pandemic in history. That was a best-selling book when it first came out a couple of decades ago and it’s a best-selling book again these past years. People have been interested in learning more about what happened 102 years ago. John is also an adjunct professor at the Tulane University School of Public Health and Tropical Medicine.

Dr. Bob Wachter  08:12

Our other guest is Jeffrey Kluger, who is editor at large for Time magazine and is the author of 10 books. most relevant to us is his book, Splendid Solution: Jonas Salk and the Conquest of Polio. Jeff was the co-author of the book that became the movie Apollo 13. And it’s been recently announced that his book about Jonas Salk is being turned into a movie with Jeremy Strong the sun on succession cast to play the great scientists Jonas Salk. So look forward to seeing that. So, much we can learn from studying the past scourges and also reflect on the fact that as horrible as they were. They did come to an end, as will COVID. So let us ring up. John Barry and Jeff Kluger.

John Barry

Jeffrey Kluger, I remember you from Katrina days.

Jeff Kluger 

From Katrina days. That’s right. How are you, John? It’s been a long time.

John Barry 

Okay. Good.

Dr. Bob Wachter 

Nice to see you both. Thank you for doing this. Really, really appreciate it.

Jeff Kluger 

Wow. Thanks for having us.

Dr. Bob Wachter 

So, alright, we’re ready to get started. Okay, well, thank you both for being here. I think one of the key issues in the pandemic has been, can we learn from history and it feels like the two most important historical analogies really are the Influenza, the great Influenza pandemic and the experience we have with Polio. So let’s start with John and ask you to sort of at a high-level talk about how has COVID been similar to the great Influenza and how has it been different at a pretty high level, go ahead John.

John Barry

First, I often quote HAGO but what we learn from history is we learn nothing from history. The similarities are, number one, you know, an animal virus jumps species. Number two, the modes of transmission is identical. I think the pathology is remarkably similar, the 1918 pandemic infected essentially every organ of the body. There are a lot of differences. There was a first wave in 1918, which was extraordinarily mild, you know, was obviously transmissible did spread many places, but it also had a tendency to peter out, it was not nearly as, you know, deeply penetrating as the second wave. The virus did pick up transmits the ability to transmit much better. And when it did that, it became vastly more lethal.

Dr. Bob Wachter  10:46

So the idea of a variant came about that made it more a better virus. That’s what happened in 1980?

John Barry

Clearly, I mean, the two waves are so different that, you know, Jeff Taubenberger, for example, is not yet willing to concede that they’re the same virus, even though he has sequenced the samples early as May, which is the same virus. So that’s pretty good evidence. And there are a lot of other reasons why I think it’s compelling that the first and second waves were the same virus.

Dr. Bob Wachter

And then just in terms of the aggregate death toll of COVID versus influenza, which one was worse?

John Barry 

Right. Totally different, not in the same ballpark. You know, the first person to come up with a number of 50 to 100 million was Macfarlane Burnet – Nobel laureate,  spent most of his life studying Influenza. If you adjust for population, that would equal 225 to 450 million deaths today. So you know, just the scale is entirely different.

Dr. Bob Wachter

So Jeff, I know you’ve written about the historical parallels between COVID and polio, why don’t you take us through some of them, and then maybe highlight some of the key differences as you see them?

Jeff Kluger

Well, in some respects, I think the differences are almost a little bit more compelling than the similarities. It was obviously a vastly more selective pathogen, and a cruelly selected pathogen, it attacked children, and it attacked the very aspect of children that most defines children, which is their exuberant kinetic energy that they have as at that stage in life. And suddenly, the polio virus would rob them of that. They went from being very mobile people to being unable to move from place to place without assistance. So there was a particular irony and a particular cruelty to that.

Jeff Kluger  12:45

In addition, the numbers were significantly smaller. Polio at its worst, its most deadly year was 1952 paradoxically, just a few years before the vaccine was developed, or when the vaccine was perfected. And that summer, there were some 52,000 boys and girls who were paralyzed or whose lives were claimed by the disease. That’s a horrific number. I mean, that basically is filling Yankee Stadium and then paralyzing or killing all of the children within it. I’ve often used that image in my own mind when I’ve tried to wrap my brain around just how ugly and just how cruel the disease was.

Dr. Bob Wachter 

As you think about the fact that it as you said, cruelly struck kids. One of the few saving graces of COVID has been that it preferentially kids are protected, and tends to strike elders. How did that change the national and international response to Polio?

Jeff Kluger 

Well, I think, paradoxically, a disease that strikes a little bit more broadly, the way that COVID does, did not engender the kind of public motivation and public zeal that polio did. We all react in a very primal and very loving and protective way when we see suffering children, it’s the reason that people rise up against wars when they see children suffering from wars. It’s the reason that appeals to people who are objecting to the way we treat immigrants at the southern border are much more powerful when we show children in cages than when we show adults in cages. So the idea that the children were the ones were being who were being afflicted was a very powerful motivator, both for fundraising and for the establishment of The National Foundation for Infantile Paralysis, which was the precursor of the March of Times.

Jeff Kluger  15:06

The great irony, of course, is that easily the most famous person to develop infantile paralysis was 39 years old when he contracted it. And that was Franklin Roosevelt. And if we believe that there’s a certain lyricism and a certain design in history, it was very fitting that a man with that level of charisma, and in that kind of position also became the face of the disease, a man who was in a position to do so much to help raise money and raise public awareness about the disease.

Dr. Bob Wachter 

We saw what Operation Warp Speed looked like last year, when the government put a shoulder into trying to find a vaccine, what was the process of trying to find the polio vaccines?

Jeff Kluger

The polio vaccine was done, it was a little bit more collaborative, Operation Warp Speed helped coordinate the independent work of various labs around the country and around the world. The NFIP, the National Foundation of Infantile Paralysis was, as its name suggested, a single coherent foundation in which the great leaders, the great thinkers, and virology were brought together, they received funding from identical sources. They shared their data at various conferences. So it was a little bit I mean, this sounds a little frivolous to put it this way, but it was the structure was a little bit like a sports league, it was independent groups who were pursuing their independent avenues, but work together under the ages of a single umbrella organization.

Jeff Kluger  16:48

And we’re sharing their data, which was very important, because, you know, if Jonas Salk hit a dead end in his lab, he did not keep it a secret, so that other researchers would not then have to learn that same mistake on their own. Instead, he was able to step forward and say, this did not work in my lab, it will not work in your lab. And obviously, it wasn’t just so good. We did that. All of the great minds at the NFL up, were sharing that information in that egalitarian way.

Dr. Bob Wachter

John, let’s turn back to Influenza for a second, you know, as we think about 2020, and maybe remember it in history, the political response will be one of the things that we talked about. And in reading your fantastic book, I was struck by the dysfunctionality of the political response in 1918. Can you describe that? And is it just that politicians are not good at pandemics or American politicians are not good at pandemics? Or do you think there’s just happened to be two unique circumstances that played out in surprisingly similar ways?

John Barry  18:06

They are unique situations. I mean, we were at war in 1918, as was most of Western Europe, and that had a dramatic impact on the response. So there was this existing infrastructure that once occurred, and that infrastructure was propaganda, there was this very, very conscious effort to control the way Americans thought there was more conformity, less freedom than at any other time in American history, including the Red Scare 1919, including the McCarthy period, and so forth. And I could go into greater detail, but that, that affected there was no Tony Fauci back then. So you had national public health leaders, saying things like this is ordinary Influenza by another name, it was referred to a Spanish Influenza wherever it did start.

John Barry 

We know it didn’t start in Spain. It was well established elsewhere before it ever hit Spain, but Spain was not at war, so it didn’t censor its press. So in writing about it, it picked up the name Spanish influenza, you know, that line was echoed in most places around the country, it’s ordinary influenza by another name, you have nothing to worry about and so forth and so on.

Dr. Bob Wachter 

To try to make people not panic or to try to ensure that everybody was focusing on the war like a laser and not get distracted, what was going on?

John Barry

It was a ladder in terms of not panicking. It was counterproductive. You know, this time around, we still have people who believe that COVID-19 is nothing serious or it’s even a hoax. Nobody believed that in 1918, you had deaths in 24 hours, you had massive numbers of deaths, deaths with horrific symptoms. So Everyone knew that it was deadly serious. And the only impact why I’ll give you one example in Philadelphia at a time, when they are literally having pre strike horse drawn carts down the street, asking people to bring out they’re dead. They’re digging graves with steam shovels, mass graves. And they finally belatedly in Philadelphia, close schools, saloons, theaters, and so forth. charges. One of the newspapers actually said, as a direct quote, this is not a public health measure, you have no cause for panic or alarm, unquote. I mean, why else you close in schools, theaters, churches,

Dr. Bob Wachter  20:44

What are the graves about?

John Barry

Yeah, so, you know, people knew they were being lied to. And that only increased panic. Early in COVID-19. I remember seeing pictures of, you know, like, 12 lanes of traffic in Beijing, completely empty cars. You had essentially the same situation occurring around the world here.

Dr. Bob Wachter

Right. But you didn’t have a war to explain the political response?

John Barry 

Well, I mean, in the level of fear, right, right, right. I’m saying the level of fear early in COVID before we really knew what we have. The sense of dread, you know, that emptied the streets in Beijing plus controls by the Chinese government. You know, so you cannot equate what happened in 1918. I mean, you can equate it, but the motivation was entirely different.

Dr. Bob Wachter

So how did you feel when you heard Trump talk about, you know, it’s gonna magically disappear? Or when you actually finally heard the Woodward interview? Did that just resonate? news just 1918 all over again in a way?

John Barry

Well, I mean, that, you know, his motivation was pure self-interest. And, in fact, you know, if he could look beyond the next hour, you would have seen it was in his self-interest to take it more seriously. Since I knew what to expect from this is anybody who’s ever, you know, been involved in pandemic preparedness, and anybody involved in that knew what was going to happen. So it’s just tremendously frustrating knowing that people are going to die because of politicians decision. The only time he cracked 50% of an approval rating his entire presidency, was a couple of days after he said, we were at war with a virus. If he had taken a more aggressive role, I think he might well have won reelection, it would have had a lot more support.

Dr. Bob Wachter  22:43

Yeah, I think that’s probably right. Jeff, this may be my airbrushed view of history. But the fight against Polio always feels like it wasn’t particularly partisan, that maybe because it was the kids and FDR, the country came together, said this is a scourge we have to fight it, we have to find a cure for it, or a vaccine for it. Once the vaccines came out, they were announced, everybody came to the streets and cheered and everybody took their vaccine the minute it was available. Is that not right? It must have been more complex than that, I assume.

Jeff Kluger

assume. It was more complex than that. Although you’re absolutely right, that it wasn’t quite so partisan. We were obviously a much less riven country 70 years ago, and while Republicans and Democrats certainly came to Death Grips over public policy issue. When it came to polio, there seemed to be a bipartisan agreement that this was a worthy cause. And under no circumstances, at least anywhere in my research, did I read of even the most partisan Republicans saying that the epidemic was being overstated in some way or the need for a vaccine and the need for vaccine funding was the partisan motivations of the Democratic president.

Jeff Kluger

To the extent that there was anything that made it less of a universal appeal, we did have the same kind of rumormongers that we have now. We did not have Fox News. We did not have QAnon. But we did have Walter Winchell and Walter Winchell was an openly acclaimed skeptic and even foe of the vaccine, and circulated a very dark rumor that the vaccine was experimental that in fact, the grade field trial, in which it was proved safe and effective and potent, was going to claim 10s or even hundreds of 1000s of children’s lives and at secret depots around the country.

Jeff Kluger  24:57

Small white coffins were being stockpiled in order to attend to all of the small children who were going to be killed as a result of it, there was skepticism, there was fear. It’s the reason that the children who stepped forward to take the vaccine first and the parents who encouraged them to or who permitted them to. So the children being labeled Polio pioneers, and they were given buttons that proudly proclaim that they were accorded respect and almost a hero’s status for being willing to step forward and take the vaccine.

Jeff Kluger

One of the great tragedies, of course, as history would later show was that shortly after the vaccine was approved, then went into wide distribution. There was one lab cutter laboratories in California, that had a quality control issue. And the vaccines that were manufactured by Cutter actually did in many dozens of cases cause Polio, so and that was within a month or so, of the vaccine being approved. So, in April of 1955, you had this great stampede toward the virus or toward the vaccine rather. And in May of 1955, you had this great terrified stampede away from the virus, that even then..

Dr. Bob Wachter  26:33

From the vaccine?

Jeff Kluger 

From the vaccine rather, yeah, people were always stampeded away from the virus. Away from the vaccine. And yet, even then, we were a more civilized or at least a better-behaved country, there was little skepticism, when the error was explained, when Cutter was taken out of the vaccine manufacturing loop. And the other companies that were doing the manufacturing proceeded with their safe and effective vaccine, people quickly returned to vaccine uptake.

Dr. Bob Wachter

It’s almost breathtaking when you think about how that occurred 70 years ago in the United States. It feels like the media is an important part of that there. You know, there was no social media there. You got your news through trusted intermediaries; Walter Cronkite and the like would tell you what the truth was. And people generally believed it, it’s such a different world from today.

Jeff Kluger 

That’s right. Yeah.

John Barry

That was a polio by an era. I remember getting a button. How old I am?

Jeff Kluger 

I’m not worthy. You have my respect.

John Barry 

It wasn’t really my choice. I don’t think. I believe my parents pushed me.

Dr. Bob Wachter 

Do you remember how old you were when you got the vaccine?

John Barry

You know, Jeff would actually probably know the date better than I but 54′ sticks in my mind. Would that have been accurate?

Jeff Kluger  28:03

54′ was yes, that was the year of the great field trial.

John Barry 

Okay, so I was seven years old.

Dr. Bob Wachter

John, how did the great Influenza end? People are wondering how this is going to end? You know, it is not like the New York Stock Exchange as someone’s they’re clanging in the bell, declaring the end of the pandemic, how did it end in 1918? When did people know it was, “over”

John Barry 

You know, a 1920 was fairly bad. But, you know, I would say it was, you know, certainly closer to the fall 1918 that was violent. The spring 1919 was still violent by any measure except the fall of 1918. Plus, for you to get two Influenza outbreaks within the same influenza season. That’s very unusual. That’s an indication that the virus had mutated riparian, the virus, Influenza mutates much more rapidly than COVID. You know, in 1920, was a pretty rough year. But it was actually closer to seasonal influenza, and then it then it calmed down quite a bit until 1928. When a resurgence again, nothing like 1918 or 1919. But it was bad enough that Congress established NIH in 1928. You might have thought that the 1918 pandemic would have led Congress to do something, but in fact, they largely forgot about it. People have short memories, particularly in politics.

Dr. Bob Wachter

Yeah. So as you think about what our next several years are going to be like in an increasingly post COVID world, what would you project about the endgame for us, based on the 1918 experience? And I guess I’m particularly thinking about the roaring 20s in terms of sort of the economics and societal attitudes is that what we have to look forward to?

John Barry  30:01

I don’t think that’s a precedent. For one thing to put in context, the roaring 20s was not just in the United States, that was in Europe as well. The United States lost 53,000 soldiers in World War 1. There were 20 million people killed in Europe in World War 1. So, you know, the war had so much more impact. And there was a sense, it was also called the Lost Generation wasn’t just the roaring 20s it was the last generation. So there was a certain sense of fatalism.

John Barry

Almost a survivor guilt in the roaring 20s. That is certainly nobody is going to go on a cruise ship next spring, and think that they’re lucky that they survived COVID. And therefore, they’re going on this vacation, you know, psychologically it’s totally different. The other thing is the roaring 20s did not follow the pandemic, immediately, there was a pretty intense depression for through 1920 and into 1921. You know, you had 4 million soldiers coming back from the war looking for jobs. America had been sending agricultural products and industrial products to Europe. That ended. So here we are going to see, I think, a pretty dramatic economic boom, we’re already beginning to see it. So, you know, psychologically, it’s radically different. And the timing is gonna be different.

Dr. Bob Wachter

Jeff, take us through kind of what the end game was like for Polio and how people felt and how did it change society as people sort of recovered with the vaccine?

Jeff Kluger  32:00

Well, the end game, it’d be in a very different disease. And a virus that behave differently was a bit quicker and crisper and cleaner, there were lines of demarcation, you could follow the sort of fever chart of the disease and the years that followed. And we went from 50 some 1000 cases in the summer of 1952, to something in the teens in the summer of 1953. And, or rather after the vaccine in the summer of 1955. And then in 56′, 57′, and 58′, we were down to 1200 or so cases, and then it basically just the numbers just fell off the table. And by 1979, Polio was declared eradicated in the US.

Jeff Kluger 

Now obviously, we continued to be vaccinated. And we continue to be vaccinated today, because Polio still exists in the world. And in fact, there was a small outbreak in an Amish community in the Midwest in the in the 2000, sixes-sevens. When there were a few outbreaks around the world, as a result of people refusing vaccine uptake, there was an eruption that cut all the way from northern Nigeria Cano, Nigeria, where Imam’s had declared the vaccine dangerous to Muslim girls. And it cuts sort of a swatch all the way down through the South Pacific, there were several 10s of 1000s of cases that year. But for the most part since 1988, when there were 125 countries in which polio has been was endemic, with about 350,000 cases a year, thanks to the Gates Foundation and UNICEF and Save The Children.

Jeff Kluger  34:00

And most walking point on this Rotary International which declared Polio its leading cause for the 1980s, 90s, 00’s and 10s. And now into the 2020s. Thanks to those efforts, we are down to polio been endemic in just two countries, Pakistan and Afghanistan. Last year, the last country in Africa, Nigeria, was declared Polio free, which essentially cleared the entire continent of Polio. So there is even though it’s been a slow end game from 1955 to 2021. It is a much crisper sort of march to extinction. And we are just dozens of polio cases away per year from making polio only the second disease, this second human disease after smallpox to have been fully eradicated.

Dr. Bob Wachter

Wow, what extraordinary thing.

Jeff Kluger 

Yeah. So we really are, I mean, we’re down to a few dozen cases a year. And ultimately, the goal is to render polio extinct.

Dr. Bob Wachter

So let me ask you the last both of you the last question, if you’re like me, I’ve written a few books in my life and your they are hugely challenging painful, you spend an immense amount of your time and energy on it, you put it out there, it gets a lot of press for a little bit, if you’ve done well, and then it goes away, and it leaves your life and you move on. And in both of your cases, you did really important works about these diseases now about 15 or 20 years ago, and they’ve come roaring back this year. So John, I think your book was back on the Times bestseller list for a number of weeks this year. How does that feel to have written about this? And then I assume not have heard or thought all that much about it for over a decade? And here it is, again. I know, Jeff, you’ve had sort of a parallel experience.

John Barry  36:01

Well, for me, I did think about it, because I got involved in the preparedness effort, you know, back in the Bush administration sort of stayed involved. So I never really left in terms of success in sales this past year, honestly. I live in New Orleans. You know, I had survivor guilt and Katrina. You know, my home was not damaged. I had friends who lost everything. And I kind of had a similar feeling. This past year, took a lot of the pleasure out of the martial success of the book and the attention that I got,

Dr. Bob Wachter

Yeah, I could see that sort of feeling a little guilty that the thing is profiting because of this horrible, horrible thing. Yes, but it’s really an important work. And as people, people don’t think a lot about history until they’re given cause to do that, and when they do, there’s so much to be learned from it. Jeff, I think you may be a similar experience away your book, splendid solution. Now, I understand is being made into a movie with successions. Jeremy Strong, who I just saw in the Chicago Seven movie set to play Jonas Salk. And I understand this is not your first book to become a movie, your book, was that the source of the spectacular movie Apollo 13. So how does this attention to Polio now and your work field in the context of COVID?

Jeff Kluger

Well, it is, it’s an exciting development. I’m trying not to get ahead of myself, because as with all things in Hollywood, it is not done until it’s done. So, you know, they’re a bunch of boxes to check yet before this happens, but it’s looking very promising. I have a, I must say, a bit less survivor guilt, which I think is a result of the fact that this is not quite the same disease, though. I completely sympathize with that notion that but for the profound suffering that is happening around the world, there perhaps wouldn’t be the same kind of recognition of splendid solution and what it represents. The timing was apt, it was one of the reasons the pandemic was one of the reasons the book received additional attention.

Jeff Kluger  38:26

So I too, am experiencing the joy in a somewhat measured and tempered way, grateful for the new attention and grateful for the adventure that another movie, should it indeed unfold. grateful for the adventure that will be but mindful of the great suffering that is the context in which this is playing out.

Dr. Bob Wachter 

Yeah. Very well said by both of you and absolutely true, but also equally true that these are important works. And learning from history is absolutely crucial. And as they say, it’s not exactly it’s not exactly the same, but it rhymes. And there are lots of things to be learned from these historical lessons. So thanks for sharing them with us today. Really appreciate it.

Jeff Kluger

Thank you so much for having me.

John Barry

Thank you.

Dr. Bob Wachter

Well, I hope you enjoyed that and learned as much as I did. It’s fascinating to think about the parallels and differences between Polio and Influenza, and COVID. With Influenza, I’m really struck by the fact that it too, was mishandled politically by the federal government. The evidence is that Woodrow Wilson never mentioned Influenza in a speech so focused, was he on winning World War 1 and of course you remember from our episode on HIV AIDS that President Reagan didn’t mention AIDS in a speech for the first 6 or 7 years. And of course, President Trump mentioned COVID plenty. But often the mentions didn’t really help matters any. So I’m just wondering, each one seems totally unique, the personalities of the president seemed unique.

Dr. Bob Wachter  40:17

And yet I wonder if there must be something in the American political DNA that gets in the way of a transparent and truthful process that effectively manages to engage the people in the battle against the virus. Polio seemed different; the whole country mostly came together. Despite, as Jeff pointed out some forces that might have led to the spread of conspiracy theories and misinformation. It’s interesting to think about what would have happened back then, if there had been social media, and all the alternative media outlets that we have today. But it was a much happier ending.

Dr. Bob Wachter

And through the development of remarkably effective vaccines that people celebrated and very quickly took the minute they had a chance. So hopefully, COVID will end more like polio with widespread uptake of the vaccines that we’ve been lucky enough to produce in record time. After hearing, hearing, Jeff talk, I didn’t have a chance to ask him this. But I went back and looked it up. And it looks like the polio vaccine was being worked on for more than two decades before Jonas Salk came to his discovery, so it makes it even more clear how remarkable the science has been and how lucky we were to have the effective and safe vaccines that we have available to us today.

Dr. Bob Wachter

Well, we have some other great episodes coming up here on in the bubble. We have I think our fifth installment of safe or not safe with Farzad Mostashari and Caitlin Rivers. This one on summer plans. You’ve sent in a wide variety of summer plans, ranging from domestic to international travel, to hotels to rentals, to water parks, summer camps, day camps, sleepaway camps, and summer romance. So we’ll cover all of that and find out what is safe and not safe with Farzad and Caitlin. We’ll talk with Nikki Lauria world expert on pandemic responses. Nikki has worked for the US federal government but has also worked for a variety of international organizations will talk about the global scene, what’s happening around the world with COVID what the prospects for vaccination are and why it’s so important to address the global scene on ethical and humanitarian grounds, but even also on practical grounds and what’s in our self-interest.

Dr. Bob Wachter  42:40

Because as has been said to the point of almost cliche, but it’s true, you know, if COVID is still spreading around the world, and there’s risk for everyone. And finally, we’ll do another toolkit about helping kids understand and cope with the pandemic. As they go back to their prior lives. They go back to school, maybe to camp, maybe start seeing friends and family members, and what’s that going to be like and how to counsel them and work through what they’ve experienced in the past 12 or 14 months. So I look forward to all of that. A lot of great episodes coming up here. I hope you’ll join us. Until then please stay safe, get vaccinated, and I look forward to talking to you soon.

CREDITS

We’re a production of Lemonada Media. Kryssy Pease and Alex McOwen produced our show. Our mix is by Ivan Kuraev. Jessica Cordova Kramer and Stephanie Wittels Wachs executive produced the show. Our theme was composed by Dan Molad and Oliver Hill and additional music by Ivan Kuraev. You can find out more about our show on social media at @InTheBubblePod. Until next time, stay safe and stay sane. Thanks so much for listening.