Coronavirus, Explained (2020): Season 1, Episode 1 - This Pandemic - full transcript

Before closing their borders...

and locking down their citizens...

many world leaders downplayed
the new virus that was sweeping the globe.

The situation
is absolutely under control.

This is one of our enemies’ plots,

dragging the country to a shutdown.

We should be going about
our business as usual.

A lot of that is fantasy
when it comes to the coronavirus.

Nobody knew
there'd be a pandemic

or an epidemic of this proportion.

But many who work
in infectious disease



knew a pandemic like this was coming.

In fact, in the spring of 2019,

months before the first case of COVID-19,

we interviewed several of them
for this show.

Well, if you think of anything
that could come along

that would kill millions of people,

the pandemic is our greatest risk.

In terms of the death toll,

a pandemic would rival
even the gigantic wars of the past.

The economy will shut down,
the cost to humanity will be unbelievable,

and no country will be immune
from the problem this will create.

It really takes
an extraordinary act of political will

to say, "Yes, right now,
things don't look that bad,

but we're going to send funding
to public health anyway,



because we know that someday
it will be bad."

We estimate there are
around 1.5 million viruses in wildlife

that we don't yet know about.

Any one of those could be spilling over
into human population right now.

When a virus jumps
from an animal to a human,

it's called a zoonotic virus,

and for decades,

these kinds of new viruses have been
causing more and more outbreaks.

We know some pretty lethal ones,

but we expect that there are others
out there that are more lethal,

that are better at being transmitted,

where we've got no drugs and no vaccines.
They're the big risk.

That's what happened with SARS
in 2002,

which was a new coronavirus that spread
around the world, killing hundreds.

And it happened again with MERS in 2012,

which was also a new coronavirus
that killed hundreds.

These outbreaks caused panic
around the world,

for a brief moment.

But experts, they stayed worried.

There's a risk with something
like SARS or MERS,

that it'll be something
we're not ready for.

Could it be a coronavirus again?
Certainly.

And of course, it was.

So, of all the viruses
out there, why did this one

end up becoming the kind of pandemic
we haven't seen in more than a century?

And how does a pandemic like this end?

A virus can be just as destructive
as a bomb or a missile.

We're deeply concerned

by the alarming levels
of spread and inaction.

COVID-19 is a pandemic.

The cases continue to increase globally.

What we need to do is flatten that down.

We're going to have outbreaks
in developing countries

that are just going to be raging.

The campaign against
infectious disease can succeed

only if the public cooperates.

Viruses were one of the first
living things on Earth...

but they're not alive like we are.

They need to hijack other living cells
to reproduce,

and that's their only goal,

to survive and replicate themselves.

The official name of this virus
is SARS-CoV-2.

"COVID-19" is the name of the disease
it causes,

which stands for
"Coronavirus disease 2019."

Corona, as in "crown."

The virus is named
for its crown-like spikes.

It spreads through droplets
when we sneeze, cough, or speak,

and can enter us directly
through our eyes, nose, or mouth.

The virus can also live
on a lot of surfaces for hours,

so people can pick it up on their hands

and infect themselves
if they touch their face,

something the average person does
20 times an hour.

Once inside the body,
those spikes act as a key,

locking onto the proteins found
on the outside of many human cells.

Once it's broken in,

the virus gives the cell instructions
to produce more copies of itself,

potentially invading more and more cells,

which can lead to a fever, a cough,
and fatigue,

but not always.

And it potentially leads
to any of these symptoms, too.

Research is ongoing.

And you can be infected and spread it
without any symptoms,

or they can be mistaken for the flu.

That's what makes this coronavirus
so devious.

So the most significant diseases
are often caused by viruses that

are silent and slow, like HIV,

or move very rapidly and cause symptoms
like coughing and fever

that could be confused
with other diseases.

Going about their life,
a person with this coronavirus

likely infects a couple other people,

and each of those people
infects a couple more,

and so on, and so on,

which is why the number of cases
increases on an exponential curve,

doubling every several days.

Then some of those people will end up
with a severe lung infection,

and certain groups are especially at risk.

In one US sample, around three-quarters
of people who were hospitalized

had at least one
underlying health condition,

like lung disease, heart disease,
or diabetes.

And while the exact numbers vary
by country,

the risk of dying is clearly greater
the older you get,

as you can see in this data
that Hubei, China reported

two months after their outbreak began.

And for reasons
scientists don't fully understand,

the risk is also higher for men,

possibly because of some
biological factors,

or because they're more likely to smoke,

or because men, according to some studies,

aren't as good about washing their hands.

On that note...

Wash your hands as often as
you possibly can,

and I know you're not always in a position
to be able to wash your hands,

uh, but wash them as much as you can.

It's good advice.

Now, this coronavirus is just the youngest
in a whole family of seven coronaviruses

known to infect humans.

It's now famous, as are SARS and MERS,

because they've killed a lot of people.

But these four are actually
more successful viruses.

They cause up to a third of common colds.

They're everywhere.

Because viruses can actually
be better at spreading

if they don't make their host that sick.

Just look at bats.

They're teeming with viruses
because viruses don't really bother them.

But...

They can transform into a new virus
once they get into the human population.

That's what scientists believe
happened with SARS in 2002.

Just like this coronavirus,

SARS emerged in a live animal market
in China.

And since it was a new zoonotic virus,

there were no treatments and no vaccine.

But SARS was a lot less dangerous
than this coronavirus.

People could only spread it
when they had symptoms,

so it was easier to contain the virus
by just quarantining people who were sick.

SARS was also a lot more deadly,

which made it harder
for the virus to spread.

A disease like SARS,
it kills 10% of people it infects,

and then the survivors probably have
some immunity and can't be reinfected.

And eventually, the only people
the virus can find

are people who have immunity to it.

In the end, SARS infected
around 8,000 people

in at least 29 countries.

Seven hundred seventy-four of them died.

Since then,
a group called EcoHealth Alliance

has been coming to these caves
in southern China,

catching bats,

scanning them for viruses,

and flagging the ones that could
most easily make the leap to us.

And when we find them,
we raise the alert,

and the government of China comes in

and tries to reduce the exposure
of those populations to viruses.

They've found a lot so far,
including hundreds of coronaviruses.

And they label them
as high risk or low risk,

depending on how similar they are
to viruses that already infect humans.

And a few years ago,
they discovered one that they called

"bat coronavirus RaTG13,"

which met the criteria for low-risk.

When scientists sequenced the genome
of the virus behind COVID-19,

they found that 96% of it
was identical to that bat virus.

Scientists believe the bat virus
likely evolved into this new virus

that could infect humans.

So we had to go back to Dr. Daszak.

At the time, our goal was
to find SARS-related viruses.

This one looked too distant.

We didn't think it would be able
to get into people.

It didn't look like it was
a clear and present danger.

Unfortunate.

It's impossible to predict
all the ways a virus might evolve.

Scientists believe this one
may have mutated in another bat...

or it may have jumped to another species
before jumping to us,

like a pangolin or a snake...

or a fish.

That same kind of fluke happened
on a farm in Kansas over a century ago.

Experts aren't certain,

but they believe the 1918 flu pandemic
could have started

when a bird with the flu and
a human with the flu met the same pig.

The bird flu couldn't infect humans,

and the human flu couldn't infect birds,

but in one of the pig's cells,
those two viruses combined,

creating a new zoonotic virus,

H1N1,

and that new virus
definitely could infect humans.

It was unlike anything else in history.

For a disease
to become a pandemic,

spreading around the world in months,
leading to potentially millions of deaths,

it has to find an extraordinary balance...

of contagiousness and deadliness.

You can think of a disease
on those two scales.

And these are
some of the infectious diseases

that have been humanity's greatest foes.

Here's the seasonal human flu,

while this is the bird flu.

And somewhere in this range
was the 1918 combination.

It was airborne,

meaning the virus could hang in the air,
infecting anyone who inhaled it.

And it's estimated that it infected
one in every three people on Earth,

and then it killed anywhere
from three to 20% of those infected.

Medical record-keeping was not great
at that time.

But that was nothing compared to smallpox,

which killed 30% of the people who got it,

and was also more contagious.

That virus terrorized humanity
for thousands of years.

In the 20th century alone,

it killed hundreds of millions of people.

And then there's Ebola,
which is even deadlier.

But far fewer people have died from it,

in part because it's so deadly,

people who have it don't infect
too many others because they get so sick,

they stay home,

and then most don't survive.

One of the unexpected things
about viruses is that sometimes,

a virus that has really obvious symptoms,
that kills people at a very high rate,

doesn't become a pandemic.
It can't do that.

While a disease like measles,
which is far less deadly than Ebola,

used to kill millions of people a year.

So where does this current pandemic fall?

It's not clear yet,

but experts place it
somewhere around here.

Deadlier than the measles,
but less contagious.

Far less deadly than Ebola,

and nowhere near as bad as smallpox.

It's close to the lower estimates
for the 1918 flu.

So, it could be worse.

But its balance is just bad enough
to be devastating.

But that doesn't mean
we're doomed to repeat history.

We can end pandemics.
We've done it before.

In the 20th century,
we discovered antibiotics.

So the Bubonic Plague and all these other
bacterial diseases became far less deadly.

But antibiotics don't work against
this coronavirus, or any viruses.

We have effective drugs for some of them,
like HIV...

which can now be far less contagious
and deadly.

But safe antiviral drugs
are really hard to develop.

So the best way to defeat a virus
is through immunity.

When certain viruses spread
through a population,

some infected people die...

but others survive.

Their immune systems have learned
to recognize the virus and fight it off.

When that happens in enough people,
it's much harder for the virus to spread.

This is called herd immunity.

The rate of infection slows.

And the virus dies out.

But with COVID-19,

if the world just waited
to achieve herd immunity naturally,

millions would die,

and other coronaviruses
don't even give lifelong immunity.

For this one, we just don't know yet.

Which makes it even more crucial
that we create a vaccine.

If enough people get vaccinated,

it's a safe and life-saving shortcut
to herd immunity.

The first vaccine was created
to fight smallpox.

And in 1980, after a massive
global vaccination campaign,

smallpox was the first virus ever
declared eradicated from the world.

And these diseases don't cause
nearly the amount of deaths they used to.

But vaccines are also
really hard to develop.

It's gonna take a year to a year
and a half to really know if it works.

And while we wait,
the virus keeps spreading and killing.

So the best we can do is slow it down,

using a method that's
a lot more old school.

In fact, it was invented
seven centuries ago

during the Black Death:

quarantine.

Or its gentler cousin,
"social distancing":

avoiding crowds and
close contact with other people

so the virus has fewer chances to spread.

During the 1918 flu, one American city,

St. Louis, took that approach quickly,

shutting its schools and public places,

while Philadelphia didn't right away,

and allowed a big parade to go ahead.

This was the death rate in St. Louis.

And this was Philadelphia's.

St. Louis flattened their curve,

which means the disease killed people
for a longer period,

but fewer died.

Because, as Italy learned in March,

it's much harder for hospitals
to save lives

if too many people get infected at once.

I’m living in the hospital, literally.

I sleep in the office and I live here.

Such concentrated and intense suffering.

I've never seen this much of it
in my life.

People are critical.

When you arrive at this point,
you realize that you are not enough.

We obviously
want to avoid that,

which is why many world leaders
have made the same plea.

Go home and stay home.

You must stay at home.

During this time,

no Indian citizen
should step out of their home.

Hundreds of millions
of people around the world

have been waiting this out...

finding ways to cope.

So countries really have to go on
a hardcore national lockdown

to really suppress that curve,

and then we have to, at some point,

gradually and carefully
come out of that lockdown.

South Korea is one model.
As of early April,

they've managed to rein in their outbreak
without a lockdown

by testing widely and retracing the steps
of people who came back positive.

For other places to pull off
something similar,

they'd need to ramp up their testing.

At what point on the other side
of the curve do you go back to work?

There is no answer. I think
the answer's gonna be in testing.

If you could test, today,
millions of people,

you could send them
to work tomorrow, right?

The problem is if we're not careful,

that smoldering outbreak
can last a long time.

Remember St. Louis?

Right there, in November,

is when the city decided to end
their social distancing policies.

The death rate jumped,
and the city quickly locked down again.

In a pandemic like this,

until you have a vaccine,

you have limited options,

because the virus had a head start.

And this is a situation
that experts have always feared.

Mother Nature is
the ultimate bioterrorist.

There are always going to be things
that surprise us

and that take our detection by surprise.

We could be far more ready
for a pandemic like a flu or a SARS.

However, if a really fast-moving
respiratory pathogen came out,

no, we wouldn't be able
to hold those numbers down.

The World Health Organization
is meant to lead the global response

to a pandemic like this.

But it's actually
quite a small organization,

very dependent on voluntary contributions.

So they don't have planes
or teams standing by.

They don't have
a research and development budget

to make these tools.

In 2005, the WHO did draw up
a huge blueprint

for how the world should prepare
and respond to a crisis like this.

Among other things,

countries had to develop
the capacity to detect outbreaks

and quickly notify WHO.

One hundred and ninety-six countries
signed onto this,

but most never complied.

When a pandemic comes along of any size,

we always look back
and wish we'd invested more.

However, very quickly our memory fades,

and other priorities
are getting the resources.

A recent WHO report
even acknowledged,

"There is a very real threat

of a rapidly moving, highly lethal
pandemic of a respiratory pathogen.

The world is not prepared."

That was three months
before the first case of COVID-19.

And our healthcare systems
obviously weren't prepared.

Doctors and nurses around the world
have been forced to use makeshift masks.

In the last two days,
eight nurses have fallen ill.

Healthcare professionals
are sick.

We need to be protected first
so that we'll be able to help.

And in China,
many of the first people with COVID-19

appear to have caught the disease
at a hospital.

Well, the world spends a lot of money
preparing for war.

Military budgets are large,
and the new weapons get created.

This belongs right there with war,

as something that we plan for.

We also need to do more
to prevent outbreaks

from happening in the first place.

Live animal markets like this

have remained popular in parts of China
and other countries,

giving animal viruses all kinds
of opportunities to mix and mutate

and jump to humans.

And when there is an outbreak,
we need to respond faster.

Three weeks before China began any
containment measures against COVID-19...

a 33-year-old doctor
at Wuhan Central Hospital,

Doctor Li Wenliang,

sent a group chat to other doctors,

alerting them to the outbreak.

A few days later, the Wuhan police
made him sign a letter,

warning that he would receive
the full sanction of the law

if he "stubbornly persists"
in his opinions.

By the time the WHO declared
a public health emergency on January 30th,

Dr. Li Wenliang had likely
already contracted COVID-19...

because he died of it a week later.

And three weeks after that,

it's estimated that
114,000 people in China were infected.

If China had implemented its containment
measures just one week earlier,

researchers found
it would have looked like this.

Two weeks earlier, like this.

And three weeks earlier,

like this.

The number of cases could have been cut
by as much as 95%.

And while China was locked down
in February,

Italy wasn't,

and it became the next epicenter
of the virus.

And when Italy locked down in March,

the United States didn't,

and became the next epicenter.

And then cases started to rise
in poorer countries

where lockdowns are harder,

and healthcare systems, already fragile.

We need to get faster at containment.

Ideally, we want to catch more viruses
at the source.

It isn't just China,

and it isn't just bats.

These are the places where a new virus
is most likely to make the leap to humans.

The frontline for disease emergence
are places like

the end of the road in a tropical forest

where someone's just built
a new mining concession.

People have moved in,

there's no food supply,
so they go out and hunt wildlife.

Or it's a farm in Southeast Asia
that's been expanding and intensifying,

that has bats nearby that spread viruses
into the pigs in the farm.

The truth is, human behavior
all over the world

has made pandemics
like this one inevitable.

Deforestation is bringing more wild
animals into contact with more people,

and factory farming is pushing animals
closer together,

giving their viruses more opportunities
to combine into one that could infect us.

Then we give them more ways than ever
to spread.

I think one of the big lessons
about pandemics is,

we think that it's something happening
over there.

Well, we know from COVID-19

that what happens over there
can very easily get here.

But if viruses
were capable of thinking,

they should have also
learned their lesson.

If their goal is to replicate,

they shouldn't start killing us.

Because once a virus becomes a pandemic,

all of human ingenuity will be
brought to bear to bring them down.

We should have been more prepared,

but when it comes to technology,
science, and coordination,

we've also never been more prepared.

This new virus was identified within days.
The sequence was shared a few days later,

and because of that, testing began,

really, across the globe.

Scientists around the world are committing
entire labs to creating a vaccine.

The... the fastest vaccine
ever created, um, in history.

The world's
fastest supercomputer

has run thousands of simulations

and identified 77 drug compounds
that might effectively stop the virus.

It's amazing the way the scientific
community has gathered together.

We know what it takes,

because we've been in this race
since life on Earth began,

and a virus hasn't beaten us yet.