The Differences Between the Coronavirus and the Spanish Flu w:Michael Osterholm | Joe Rogan

For the average person that is sitting around reading these articles that say don't worry, or reading these articles that say this is the end of humanity, what could these people do? Like what could they do and what do they do if they get infected? Well first of all, neither of those kind of articles are correct and we have to make sure that we get that message out to people that are there. We need straight talk right now. Part of it is it's so hard to hear from people who are supposed experts what's going to happen or not happen. Let me just give you an example because we've heard a lot about it's going to go away with the coronavirus with the seasons. When it warms up it will go away. The other coronaviruses that we have that we've had to worry about was SARS which appeared in 2003 in China. When that came out of China in February 2003 it took us a little while to figure out that these people really aren't that infectious until day five or six of their illness and then they really crash and burn and many of them would die. But what we did was basically by knowing that identify these cases in their contacts quickly and so if they had symptoms brought them in, put them in these isolation rooms so they wouldn't infect anybody else and it took until June to bring out of their control. That had nothing to do with the seasons. MERS which is another coronavirus that's in the Middle East, it's in the Arabian Peninsula, the natural reservoir for that is camels. By the way SARS it was Palm Simmons and we, a type of animal food that we got out of the markets there. In the Arabian Peninsula we're not going to euthanize 1.7 camels to try to get rid of MERS. And there it's 110 degrees out and this virus is transmitted fine thank you. I mean it goes from animals to people, it goes in the hospitals, there's no evidence that's seasonal there. So that's a good myth to expose right away. This is not something that's going to cure up when it gets warm. You know if it does it won't be because there's a model for it. What will it be? Because how does something like SARS run through a population and then stop being around anymore? Well it wouldn't have but had we had good public health. Had we had you know the same kind of transmission we're seeing with this coronavirus for your infectious before you ever get sick where you're highly infectious. Remember with SARS now you didn't really get infectious until you're in six days of illness and you knew that you were in trouble. And then you could isolate you and we didn't understand that at first and the virus transmitted. So that's why SARS stops. MERS stops because we don't get rid of the camels so it keeps hitting humans day after day but then when they go to the hospital we no longer allow those individuals to transmit to others in the hospital because we do what we call good infection control. As soon as they get there they're in special rooms with special masks and all this kind of thing. And so in that regard these coronavirus can be stopped. This one's not. As I said at the top of the program this is like trying to stop the wind. Infowinds a transmission you never hear anybody saying in a bad seasonal flu year you know we're going to stop this one. If you don't have a vaccine that works you don't. It's just breathing that's all it is. So what's best case scenario here? Well I think as I laid out to you before you know this could be 10 times worse than a really bad seasonal flu year. And it outgrants you it will hit you know primarily the older population and those underlying health problems. But as I mentioned also you know we have a lot of people who have other risk factors obesity high blood pressure is another risk factor where you can have a really bad outcome with this. And so we don't quite know what it's going to do yet. I think you know we've been right on the mark predicting where it's going to be to this day. I think from here on out I can tell you it's going to stay around for months it's not going to go away tomorrow. We got to stop thinking about if we just get through tomorrow that's it. So if we're going to go to schools we're going to tell people not to go into public we're going to cancel big events. How long are we prepared to do that? What are we going to do? We have to ask ourselves that. I think the big thing is eventually enough people get infected where it'll be like putting reactors in the rods you know rods in the reaction I should say and then that stops it by itself. But because if you're if two of the three of us in this room are immune right now to it because we had it and recovered and had protection because natural protection then I couldn't transmit to anybody. So that's what's going to happen if you get enough people get infected ultimately then it'll slow down and stop transmission that way but that's a heck of a price to pay to get there. Is it safe to say that we're fairly fortunate that this isn't something like the Spanish flu or something that's really ruthlessly deadly? That's why I think we have to be really careful just to back up about 0.1% of people who get seasonal flu die and grandchilds mostly older or younger people okay that's one out of a thousand. With this one right now in China we're seeing between two and three percent of the people die and some say well that's way too high it's not going to be that high it's going to be lower but again and they say that because we didn't pick up all the milder illnesses okay. But on the other hand we have a lot of additional people in countries like ours that have even more risk factors for having bad outcomes in China. And so Spanish flu the one you mentioned 1918 that was about a 3 to 3.2% case fatality rate now it did preferentially impact 18 to 25 year olds they were the hardest hit group. Why was that? Well you know it has to do with your immune response again we think that what happened is when this virus got into you it created what we call a cytokine storm which is an antibody response in your body that's out of control and it basically you destroy yourself and it sets this thing up to trigger it off. So the healthier people had the more adverse reaction to it. Exactly or the other group that has had a real challenge with that are pregnant women and pregnant women have a very unique issue one is of course they have some constriction of their lungs just by the very physical mass but also their immune system is really at a heightened state at that point there's a part of that immune system and that woman says this is not all me get rid of this it's like a rejection of a graft and the other part saying this is the most precious cargo ever carry you know I got to make sure I don't lose it and when that virus got in between those two it started again that same kind of cytokine storm. Now the thing that concerns us about this what we saw in 1918 I mentioned this 3 plus percent this one could be as high as 2%. So it's somewhere between a really bad flu year at .1% and it could be as high up here you know getting closer to 1918 like and that's the numbers I just gave you a few minutes ago from the American Hospital Association of you know 480,000 deaths here in this country over the next 6 to 12 months.