Pandemic: How to Prevent an Outbreak (2020–…): Season 1, Episode 1 - It Hunts Us - full transcript

[car door closes]

[car door closes]

[indistinct chatter]

To walk, I think we'll go on low setting.

We may end up surveying both, but...

[woman] Yeah.

[Dennis] This site is a forgotten place.

But it should be a warning to us all.

[man] We'll identify the anomalies
and mark those out.

So you're trying to narrow
the focus of the radar pulse, is that it?

[man] Yeah, we're looking for a change
in the density of the soil.



[machine beeping]

[man] There are some anomalies
sort of popping up.

This is a pretty strong one here,
there's one there.

At one meter in and then over at three.

[Dennis] Each stake
represents a probable body.

This is essentially a mass grave.

A hundred years ago,
a deadly influenza virus

infected hundreds of millions of people
around the world.

It overwhelmed hospitals.

It overwhelmed mortuaries.

So towns all over the world
needed a quick solution.

We could be standing
in any number of towns

across the US, or Kenya, India, Vietnam.

This grave site is a reminder
of the devastation



a flu pandemic can wreak.

This kind of carnage
is not relegated to history.

When we talk about
another flu pandemic happening,

it's not a matter of if, but when.

- [helicopter hovering]
- [sirens blaring]

[woman coughing]

- [man] Take the stethoscope, and...
- [Syra] Yes, ensure that the gown covers.

We have received reports
of an outbreak of respiratory illness.

Make sure you have a good seal.

Give me a thumbs up
once you know you have a good seal.

About eight other countries
around the world

are also reporting similar outbreaks.

- [woman] I can't breathe.
- [man speaking indistinctly]

[coughing]

[Syra] Unofficial case count
is about over 220 with eight deaths.

We don't know
what the case definition looks like

and we don't know the laboratory analysis
of this particular outbreak.

[coughing]

We know that we are dealing
with something novel,

we just don't know
exactly what we're dealing with,

but some of the patients
are not testing positive

for these normal seasonal flu viruses.

[coughs] I don't feel okay.

[Syra] Currently, the Emergency
Department at Kings County Hospital

is operating at 104%

and so we have set up
a mobile satellite emergency department.

[doctor] What's going on?

- I'm not doing well. I can't breathe.
- [doctor] Okay. Okay.

[Syra] I need intubation equipment.
There's no intubation equipment.

[machine beeping]

[Syra] Somebody get the ice. Ashley.

I wouldn't turn it off at this point,
I don't think we have time.

Can you check the X-ray on bed one?

[buzzing]

[man] Yeah, that's it.

[woman] The simulation is ended.

Let's go back to the debriefing room.

- Thank you.
- [man] Thank you.

[indistinct chatter]

[Syra] So all who participated,
please come to make a circle.

I think one of the things
that we tried to bake into the simulation

was just healthcare worker safety.

I think that was one of the biggest
takeaways in the previous outbreaks.

[woman] If I have to take the time out
to switch my gown

and someone needs to be intubated,

I'm gonna pick their life
over switching out my garment.

We're talking about
a severe respiratory disease.

Really big lesson learned,
and we mentioned this over and over,

is that healthcare workers
were disproportionally affected

in MERS and SARS,

and it shows us
where we need to improve on.

So if you're not protected,
if you can't protect yourself,

then how are you gonna help others?

[Syra] My job is to contain the virus
here in New York City.

What worries me is that it just takes
one person to start an outbreak.

We're basically human incubators,

we can host
a number of different diseases.

It's just a matter of time
where the next pandemic is going to start,

we just don't know where or how,
but we know it will.

I remember, at a very young age,
watching a movie called Outbreak,

and in this movie you had a novel virus

that started in California
that quickly spread.

Healthcare workers get suited up,
and I was like, "Oh, my God,

working in that high-risk environment,
this is amazing."

That was a formative moment for me,
and I have been pursuing a career

in infectious disease preparedness
ever since.

In even a small outbreak,
you have what we call "hoarding."

We saw this in the H1N1 outbreak

where vaccines were not made available
in the United States

in a timely fashion
because countries were hoarding it...

You know,
these infectious disease outbreaks

are scarier and more deadly
than conventional warfare.

[Syra continues indistinctly]

So this is something
that people should pay attention to,

but they forget in their day-to-day lives.

My job is to remind them.

[telephone ringing]

Hello.

Okay. Knocked out, okay.

Okay, I'll be there in a second. Okay.

[man speaking indistinctly]

Yeah, I can hear it, too.

[Holly] I wake up in this building.
I eat in this building.

I put my pajamas on in this building
and I sleep in this building.

[Juanita] How did I know
you'd be the one to make my night?

I'm telling you.

[Holly] Juanita.

When I came out of medical school...

in the back of my mind
I still had that vision

of what it was to be a small-town doctor.

Very old-school, the one doctor in town.

I want you to hold your breath.

Big deep breath in and hold it.

They saw patients in the clinic,

they were the ones
that were rotating through the ER.

They were the ones
seeing the patients in the hospital

and delivering babies.

I wanted to be that guy.

I wanted to be that one

who took care of the patient
when they were well

and took care of the patient
when they were sick.

- Stick it out and say, "Ah."
- Ah.

[Holly] And took care of the patient
when they were hurt

and ran into the patient
in different social situations

outside of the hospital or clinic.

You okay?

- I need to see what's under there.
- Yeah.

[Holly] I had other physicians
that talked to me

and I'd say,
"What advice do you have for me?"

And they'd say, "Reconsider."

But nobody could dissuade me.
I was gonna do it regardless.

Hi, there.

- So were you diagnosed with the flu?
- [woman] Yeah.

[Holly] They swabbed you?

- It was positive?
- [woman] Yes.

- Do you remember if it was the A or the B?
- [woman] I think it was the A.

- [Holly] A, okay.
- They did both of our noses.

- That was Wednesday.
- [Holly] You should be at the end of it,

but you're not feeling better...

[woman] Yesterday, my symptoms
started getting worse.

[Holly] Okay. Have you been feeling
sweats, chills?

[woman] Chills. He wakes up in a sweat.

[man groans]

[Holly] She said that you have
not been feeling well at all.

That you really haven't been
getting over the flu like you ought to.

Big deep breath in. Well done. Good.
Do that again.

I don't have every resource
that a large hospital has.

I honestly have no idea what I would do
in a situation like a pandemic.

We're gonna be lower on the totem pole

in terms of getting replenishment
of our resources.

Places that have higher populations

are gonna be the places that get
that lifesaving medication first.

I think that we would be overwhelmed.

We wouldn't be able to manage

should a flu pandemic
occur in our little county.

[chickens clucking]

[Dennis] We have to follow the virus.
Where is the virus located?

Very good.

And the virus is located in birds.

My job takes me all over the world.

My main responsibility
is trying to prevent, trying to detect,

and respond,
and control emerging viral threats.

There is no single,
more dangerous influenza virus

circulating in this planet today
than the avian flu in China right now.

60% of the people who are infected die.

[newscaster 1] Chinese and global
health authorities

are watching a new strain of bird flu.
It's called H7N9.

This is definitely
one of the most lethal influenza viruses

that we have seen so far.

[newscaster 1] Authorities in China

are at pains to say
they're on top of this potential outbreak.

[newscaster 2] At least 108 cases,
22 of those people infected died.

The recent H7N9 virus
has a very high mortality rate.

That said, it remains an inefficient virus
for infecting people.

So far, this virus
has not yet spread beyond China,

but it could happen at any time.

- When were these birds last vaccinated?
- [woman] Seven days ago.

[Dennis] So they had a problem
with neighboring farms having outbreaks?

[in Vietnamese] Yes, they did.

Some people bought
sick chickens at the market.

[Dennis in English] There are almost
endless variations of the influenza virus.

They're denoted by different combinations
of H's and N's, such as H5N1.

The H's and N's ultimately define

the physical characteristics
an influenza virus will have

and just how deadly
that infection might be.

The pandemic flus and the seasonal flus
are profoundly different.

A pandemic influenza
will likely come from an animal

and it will be a new and novel,
never-seen-before virus.

When a novel virus emerges from animals,
we will not have natural immunity.

Our systems will have no means
to fight the infection off,

which means it has the potential
for being very deadly.

That's why there are researchers
around the world

committed to developing
a universal vaccine

that will be effective
against any and all influenza viruses.

[Jake] I don't really get
stage fright anymore.

I used to do this thing where if I knew
I was about to go on the stage,

my heart would start beating
and I'd feel like I was gonna pass out,

but I knew
for the work that I wanted to do,

I had to be an effective communicator.

If I wasn't able
to communicate my science,

then it was almost
like the science didn't exist.

Can you get the slides up?

That's a different slide there.

All right, good afternoon, New York.

So, yeah, I'm the co-founder,
Chief Science Officer,

and the Chairman of Distributed Bio,

and this afternoon
I'm gonna share with you

the story of a slow-burning revolution
in biologic therapeutic discovery.

I never memorize a specific speech.

I think about the arc of the story
I'm gonna tell,

and really good storytelling,
those rules apply to science.

It's basically the same rules

that our ancestors
did around the campfire, right?

First you have to introduce
the terrible monster.

In this case, it's influenza.

The problem is that the virus
mutates so quickly

that your immune response
becomes obsolete by the next year.

We have created
these amazing vaccine technologies

that are arguably the greatest advances
since sanitation and fire,

and yet they don't work
on rapidly mutating viruses,

like the flu, for instance.

And for a while we thought
we were just stuck with this.

They're never really gonna be able
to solve the problem

of having a good single shot

that's gonna solve our risk
of being exposed to flu.

Then you present the hero.

That there's some new technology
that exists,

that could potentially
create a breakthrough.

We're making a vaccine that could treat
all future versions of flu.

So, fundamentally,
our approach was different,

because we tested
against future and past strains.

Under some circumstances,

some people end up producing
these nice antibodies

that hit all the strains
or many of the strains of flu,

and they enjoy broad protection.

You all might have those friends, right?

It's that annoying hippie friend of yours
who's like,

"I never take the flu shot and I'm fine."
Right?

- Some of them may be right. [chuckles]
- [crowd chuckles]

[Jake] But why the hell aren't we all
protected all the time?

Our approach was able
to neutralize viruses

all the way back to 1934

as well as protect
against future viral variants.

[crowd applauds]

[Sarah] I met Jake Glanville
in the fall of 2014.

He offered me a job.

He knew that I had skills
that he would need

if he wanted to launch
this vaccine program.

Okay, so I can add the antibody
to this one, then?

[woman] Yep.

[Sarah] Jake just thinks outside the box.

He thinks of these crazy ideas
that are completely out of the norm.

Okay, the NHS and EHC are added,
so clock's ticking now.

We've done multiple animal studies
so we know that this is reproducible.

What we're seeing is real.

I want to prove
that my research and Jake's research

could change the world.

This vaccine could eradicate influenza
as we know it.

[machines beeping]

This will not work at all.

[man in Hindi] Sir, this one
is expected H1N1.

So fast?

[newscaster in English] There has been
an alarming rise in the swine flu

or H1N1 cases in India this year.

The situation is turning rather serious
with the fatalities increasing by the day.

The North Indian State of Rajasthan
has been worst hit by the H1N1 virus.

- [man in Hindi] Negative. It's negative.
- [Dinesh] But, look.

The shadow is still here.

And there are some light ones here.

Let us see how you feel without oxygen.

[woman] Should we continue with Tamiflu?

[Dinesh] It's day six today, right?
Give it for one more day.

[woman in English] Tamiflu,
stop after seven days.

[in Hindi] We will stop it tomorrow.

[Dinesh in English] Swine flu is a very
rapidly progressing disease. Very rapidly.

In just a few days,
it can affect both of the lungs,

and it is a life-threatening disease.

Common flu.

All patients came with throat pain,
sneezing, fever, body ache.

But a patient who has nausea, vomiting,
along with breathlessness,

and he says "troublesome cough,"

always think "swine flu."

Always think swine flu.

[Dinesh in Hindi] Breathe normally.

[in English] If it's not diagnosed
properly at an early stage,

it is difficult to treat.

[indistinct chatter]

[Dinesh in Hindi] The problem is,
when she came here,

she had 60%-70% saturation.

If she had been on the road,
she would've died.

That is the fact.

[in English] We will shift to the ICU.
Then treatment will start.

[in Hindi] The later they come,
the more laborious it gets to breathe,

and it becomes
a matter of life or death.

[Dennis] Biggest challenge with flu

is not being lulled into acceptance
of seasonal flu

as all we have to worry about.

Because every once in a while,
there is a variant of flu that emerges

that poses an existential threat
to us as a species.

We go back to 1918...

and, you know, that flu profoundly
impacted this Earth.

It emerged at the very end of World War I.

Soldiers returning home from battle
helped spread the virus around the world.

We ended up seeing
a global event very rapidly,

even at a time when population movements
were a fraction of what they are today.

Far more people died
in the 18-month period of that flu

than died in all of World War I
and World War II.

Somewhere in the order
of 50 to 100 million deaths.

In 1918, there were 1.8 billion people
on the planet Earth.

Today, there are 7.8 billion people.

If a similar virus emerged today,
the result would be not 50 to 100,

but hundreds of millions of people
that would likely die.

And it's a guarantee that another version

of that killer flu will reappear.

We don't know when,

but we should always presume
it can be... soon.

When it comes to a pandemic,
there are many unknowns.

It's about the societal disruption.

The thing that will
immediately be threatened

is continuity of health services.

But also, you'll have severe issues
with normal infrastructure operating.

Electricity is dependent on power plants

and power plants
are dependent on a work force.

That work force becomes ill,
then you have huge vulnerabilities.

What are urban areas going to do

after a couple of weeks
of disruptive impact on food supplies?

You'll not only have people dying
from an influenza virus,

they'll be dying
from what are preventable deaths today.

It will leave its mark.

That's why I do what I do.

If we catch it early enough,
we may be able to save millions of lives.

But it's an uphill battle

because there are so many opportunities
for emergence,

and our resources for early detection
are limited.

[Syra] All right, good morning, everybody.

We'll go ahead
and get started with roll call.

As always, one person from each facility
can just state that they are on.

We started this weekly
system-wide seasonal flu activation call

with all hospitals
that we have across the system,

and the whole purpose of it is really,
as we progress with seasonal flu,

they let us know any impact
that they're having.

Influenza activity
is categorized as widespread.

This is the actual first week

that widespread activity
has been reported.

Last year's flu season

was one of the worst
that we've had in decades.

A record-breaking number
of hospitalizations and deaths.

Bellevue, any changes
to your current status?

[man 1] No changes
from the current status.

Great. Thank you.
Coney Island, any changes?

[man 2] No changes.

[Syra] Great. Thank you.

We started seeing impacts to staffing.
We started seeing impacts to flu supplies.

There were shortages of Tamiflu,

so much so that folks were coming back
to the emergency department

asking for their children to be admitted,
because they couldn't get this medication.

- Queens, any changes?
- [man 3] No changes.

[Syra] Thank you.

So we activated
an emergency operation center

to really get a bird's-eye view
of what's happening system-wide

and where we can provide the resources
and expertise that's needed.

And Woodhull, any changes?

[woman] Yes. We have four patients
on droplet precautions as of Monday

and seven positive flu tests.

[Syra] All right. Excellent.
Well, thank you all so much for joining.

We appreciate it
and we will see you next week.

Take care, everybody.

Part of emergency management is, you know,

you're not just at the facilities,
but just for me also worldwide.

Sometimes when I wake up in the morning
and I see 20 different emails,

not just internally but also externally,

I'm getting alerts of what's happening.
I just try to stay on top of it.

I'm gonna pull up her info so that...

On any given day,
it's meetings back-to-back.

First, thank you all so much
for meeting with us,

and then obviously,
for this collaboration...

I typically start, you know, 8:30 or so...

If this was a real world event,
what are some crisis standards...

...and then go on
for the duration of the day.

You wanna call the Department of Health.

They will walk you through
the case definition and they will...

This isn't Atlanta.
Anyone email back from CDC yet?

[cell phone ringing]

This is Syra.

A good chunk of my work
is actually done at night,

so it's not surprising at all

if you get an email from me, like,
11:00, 12:00 at night.

- [woman] Thank you so much.
- [Syra] Thank you for coming.

I'm perfectly fine with it.

I need to meet with these folks,
I need to see what's happening.

The threat of special pathogens
is constantly on my mind.

Things like MERS, SARS, Ebola, flu.

While these outbreaks
are happening remotely in distant areas,

we know that they're just one flight away
from coming here in the United States

and that's exactly why I do what I do.

What did you have for lunch today?

[Hassan] It wasn't halal, but I got...

- pasta pesto.
- Good job.

Special pathogens
don't respect any boundaries.

So I wanna make sure that I'm doing it
not just for my children,

but for the greater good of humanity,
'cause we wanna make sure people are safe.

[Jake] Back in 2012, I was working
at Pfizer doing antibody engineering.

I wasn't working on vaccines,
but I was learning a lot

about how the populations of antibodies
respond to their targets.

That technology really opened our eyes

to what was really going on
when someone gets vaccinated

or when we're trying to engineer
an antibody as a drug.

I had a BA when I was at Pfizer,
and I got promoted every year,

so I was a principal scientist
with a Bachelor's Degree.

And friends of mine were...
They thought I was crazy.

Some of them were like,
"Why are you leaving a job

where normally you need a PhD,
and a post doc,

and eight years of experience?"

But I was worried if I waited
another ten years,

I might start having children and then
I would be too scared to make a big jump.

I definitely was like, "I could be
messing up my career right now, but..."

I came up with this idea and I thought
it was too beautiful not to try.

More often than not,

startups are looking
for the quickest path to funding.

A lot of them have
a "fake it till you make it" approach.

[newscaster 1] Well, she was
a college dropout

who became the youngest
self-made female billionaire.

[newscaster 2] In 2003, then 19-year-old
Elizabeth Holmes founded Theranos

with the hope
of using small amounts of blood

to do what normally took numerous tubes.

- Does it work?
- Yes.

- You're confident in that?
- I am confident in that.

[Jake] In order to get funding,
they often have to convince investors

about ideas
that haven't been proven out yet,

and sometimes,

they do not have sound science
to back up their plans.

The company faces new investigations

from the Securities
and Exchange Commission

and a US attorney's office in California.

That's in addition to an ongoing probe

by the centers for Medicare
and Medicaid services.

[Jake] In bio tech, you need time

to cultivate your credibility
and your science.

on top of those plans.

[newscaster 3] Now Elizabeth Holmes is
facing some pretty serious prison time.

[newscaster 4] Holmes
and the company's former president

were indicted yesterday
on federal wire fraud charges.

So, eventually,
some of these companies realize

that the hype that they're built on

is not enough to support their quest
for the almighty dollar.

There are a million reasons
why an experiment can fail.

Ultimately, all that matters
is what the data says,

and so far, our data is very promising.

All righty.

Our goal here is that we want
to enable the world

to have access to our vaccines.

All the world...

including people who can't afford it.

That's obviously low on the list
for investors.

When you take venture capital,

you either lose control of your company
or you lose control of your vision.

Right now, we are funding this.

Everything up until this point
has been out of our own pockets.

We should not have been able to beat

major pharmaceutical companies
who have way more money than us

and have way more people than us.

But my experience in big pharmas
is they typically move very slow

and they're risk averse.

And so, there actually
aren't that many people

as you might think
working on new techniques.

So that's worked to our advantage,
but eventually,

we are going to need
to get this vaccine into human trials.

And we are not going to be able
to fund that by ourselves.

[in Hindi] Goochi, dear son...

Wake up, it's seven o'clock.

It's been 15 years since I received my MD.

[playing keyboard]

[Dinesh] It was my family's dream
to have a doctor in the family.

We are seven sons in the family.

They thought the first one
would become a doctor, he didn't.

[in English] Second, third, fourth...

[in Hindi] When it came to me, the fifth,
they found some hope.

[cell phone ringing]

Papa, your phone is ringing.

[Dinesh] Hello. Just getting ready.

Okay, okay, bye.

Come on, son.

I don't know
why they felt that I could become one.

I used to be poor in studies.

That is the truth.

But they knew that what little I studied,
I did it with all my heart.

I'm not in this profession for money.

I am extremely passionate
about this cause.

[machines beeping]

[Dinesh] Yes, Nisha, how are you?

Tell me this.

When we admitted you to emergency
three days back,

when you'd came here from Sikar...

how different
are you feeling since then?

A little bit.

[man] The problem was going on
for 15 days.

We admitted her
into a hospital in our area.

But it's not a big city,
most of the people are from the villages.

They are villagers,

so not many people there know about this.

Even the doctors don't know about H1N1.
So they didn't test her for this.

No one realized that it would become
such a serious disease.

[coughs]

[in English] The patient is not responding
up to the mark which I want.

[imperceptible]

[in Hindi] The problem is...

there are no facilities
in the outlying areas.

When they become seriously ill,
they head for the cities.

It is too late by then.

[in English] Any patient
who had immunity low

is a culprit for swine flu...

in dangerous form.

Child...

pregnant woman, old age.

A patient with diabetes.

A patient with kidney disease.

[man speaking indistinctly]

[Dinesh in Hindi] What's troubling you?

I'm tired.

- [Dinesh] What are you tired of?
- I'm really tired.

[Dheeraj in English] Generally,
we Indians think it's a small cough,

all you should do is take honey,
lemon, turmeric and it goes away.

But seems like it was something
very different this time.

Nobody realized it was swine flu.

[Dinesh in Hindi]
So, now the condition is guarded.

I won't say it's good.

[Dheeraj] His kidney and heart
have also become weaker...

[Dinesh] Right, right.

We will assume
the situation is now serious.

[in English] Until and unless he's in ICU,
he's critical.

[Dheeraj] At this point of time,
lungs have infection,

kidneys are not working,
heart is under constant pressure.

So, if these three vital organs
are not working...

I mean, it's really difficult.

That's why, whatever happens,
I'm outside always,

so he feels good about it,
that there's someone who's taking care.

I have to stay here, there's no one else.
I don't have a brother or a sister.

I'm all alone, so I have to be here.

He's an old kind of man,
"I want to go home,

I want to take a walk in the garden."

You know, do stuff like that.

I said, "Yes, you will be able to,
but just have some time off.

Just relax...

and soon you will be able to do
all of those."

As long as it takes, I will be here.

[Amar crying]

Take if off upstairs.

- Why you have a Band-Aid right here?
- [Amar crying]

- Because I got hurt.
- How'd you get hurt?

- I was bleeding.
- In school?

- No, at home.
- [Hassan shouting indistinctly]

Okay, go upstairs. I'll help you upstairs.
You can't... no. We can't do it over here.

Go upstairs. Just go upstairs.
I'll put your clothes on upstairs.

Amar, what are you doing?

I have a three-year-old
and I have a five-year-old.

No hitting.

It never stops.

There are some days
that are better than others

in terms of just how I can handle it.

- What happened? What happened?
- [Amar crying]

[Syra] Why don't you build something?
You guys wanna build something?

So help me build.

And then there's other days
where I'm just super exhausted,

'cause it's just been a really long
or a rough day.

Sometimes I actually put the kids down
a little earlier than I need to

so I can just relax.

- [Amar] Mommy.
- [Syra] Yes.

What are you doing?

- Mommy, look at me.
- Yes.

I actually don't tell them
exactly what I do

and I try not to also share that
with school friends or mommies,

'cause people's fear factor kicks in first
before logic.

If they think I had any remote
kind of contact with disease,

it's like, "Don't touch me,
don't come near me."

I do this because I have a passion for it.

I started to work
in the field of bio defense,

I did some work with FBI
related to bio defense.

My Master's thesis was on Ebola

and then the bio threat team
that I was part of in 2014

at the Texas Department
of State Health Services,

was the team that did diagnose
the very first patient.

[doctor] The patient admitted
to this hospital

has tested positive for Ebola virus

and we're taking every step possible
to manage this situation.

No one thought at that time

that this would ever reach
the shores of the United States,

and so, there was no active monitoring
or active screening in place.

[newscaster] While caring
for the first patient

to test positive for the Ebola virus

in US soil, a Dallas nurse
contracted the disease.

And then a number of questions then arose

of are all hospitals
in the United States equipped

and able to identify patients

suspected with these types
of special pathogens.

Amar, I'm proud of you...

For me, I wanna make sure
from a healthcare delivery standpoint

whether this patient's coming in with
Ebola virus disease or a pandemic flu,

they have the resources
to identify these patients.

- [Amar] I want to read the night squirrel.
- Okay.

All right, how about I read Hassan's first
and then I read yours.

Okay, which one should I read
in the superheroes?

When I was
part of the Ebola response team,

we had an appreciation ceremony.

I remember on the card someone wrote that,

"When everybody
was running away from this,

you ran towards it. Are you crazy?"

Like, "Ha, ha, ha."

But I think for me,

it really translates
into helping those around me.

He's saying to stop.

This kid is bullying her.
That's not nice to bully, right?

And yes, I may be putting myself
in harm's way,

but this is something
that I have knowledge of

and why wouldn't I do that?

"Whatever had changed him
in that gamma ray accident must have..."

These threats are never going to stop...

and we need to do something about it,
and that something is now.

So, I have an upwards of ten projects
happening at any given time.

I feel like there's so much more
that needs to be done.

- [Sarah] Shall we cheers?
- [woman] Yeah, let's cheers.

- [man 1] Start off with...
- [all] Cheers.

[woman] In the book, I read

you're supposed to make
eye contact with everyone.

[all laugh]

- [woman] I did, I read the book.
- [man 1] What?

[Sarah] We haven't been eating
very much of the food.

You guys need to do a better job.

Sometimes, when I get home from work,
I don't wanna follow recipes anymore.

I'm just like, "Fuck it.
I follow protocols all day."

I just wanna make some stuff up
and see what happens.

[man 1] This is basically
what you've been working on

the entire time we've known you, then.

[Sarah] Yeah, and we could have
a human vaccine ready by 2025.

We just need the money,
'cause the ferret study alone

is like over a million dollars.

[man 2] Have you thought
about crowd funding?

[Sarah] I have not thought about it.

My understanding was that crowd funding
doesn't get you that much money,

but maybe I'm wrong.

There's a lot of people in the world
that are affected by the flu.

- Yeah.
- [woman 1] That's true.

The thing is, for flu,
we really haven't seen anything

in our lifetimes,
or in our parents' lifetimes,

or even in our grandparents',
but the next flu pandemic is...

probably on the horizon.

We don't know if it will happen to us
or our kids,

but it will eventually happen.

It's scary 'cause in 1918,

it killed over 50 million people,
but we didn't even have planes,

and we didn't have people traveling

from Asia to North America
on a daily basis,

we didn't have factory farms

with thousands of pigs
and thousands of chickens.

But now we do.

So, it could be
hundreds of millions of people

that would die from the next pandemic

if it were as contagious
as the H1N1 in 1918.

Anyone want more wine?

[all laughing]

[woman 2] No.

You said it was two million dollars.

- That's all you guys need?
- Yeah.

[man 1] Robyn can send that to you.

- No, I don't. I'm just saying...
- [man 1] I got my checkbook.

So, my company just announced
our Series D yesterday.

- [Sarah] Yeah.
- We got a billion dollars.

- [Sarah] Holy shit.
- A billion dollars, like, "Okay."

We wanna maintain full ownership,
so we have to get government grants,

or like...

non-profit foundation grants,
like through the Gates Foundation.

[woman 2] So, you partnered
with this foundation,

Bill and Melinda Gates Foundation,

- and they said yes?
- Yeah, well, we...

We applied for a grant
and we've been waiting to hear back.

[crowd applauding]

Epidemiologists show through their models

that a respiratory-spread pathogen would
kill more than 30 million people

in less than a year.

And there is a reasonable probability
of that taking place.

[reporter] Research into
a universal flu vaccine

just got a big boost,
thanks to Bill Gates.

The Bill and Melinda Gates Foundation
is partnering with the CEO of Alphabet

to establish a $12 million fund
for research

into a universal flu vaccine.

He says the vaccine is needed
to help combat

possible future pandemics.

The Gates Foundation has an amazing record
trying to help global populations...

and they would enable communities
that can't pay for it

to be able to be beneficiaries.

I am trying not to sit on pins and needles
to wait to hear the results.

It's cool stuff, so I think
they're really interested in it.

It's just... [sighs]

It's taking a long time to hear back.

- [Sarah] Should we cheers?
- [woman 2] Yeah, let's cheers again.

[telephone rings]

[Holly] Jefferson County Hospital,
how can I help you?

I'm just answering the phone
'cause all my girls are...

They've got their hands busy.

So, Jefferson County Hospital,
where I work,

is in a rural setting.

We have about eight to nine thousand
people in the county.

Their access to healthcare is limited.

The closest other hospital
is 35 to 40 minutes away.

Any barrier to care
and care gets lessened.

And if you have to travel an hour
to get healthcare,

people are gonna say, "I'd rather not."

Do you wanna play
the ring toss game with me?

- Why not?
- [crying] They're gonna get me right here.

No, listen, listen, listen.

It's gonna feel just like a little pinch,
just like that.

[boy sobbing]

I don't want a shot! I don't want a shot!

[woman] I will... I will...

[Holly] When October, November come,
then I begin to think, "Okay, here we go."

We're gonna be busier
and we're gonna be having sicker patients.

[woman] Okay, let's got see
what they gotta do.

- [boy] I don't want any shot.
- [woman] You're not getting any shots

or no pinches. I promise, okay?

- You have a seat and wait for Mommy...
- [boy] I don't want to...

[Holly] By the 13th of January last year,

we'd already had over 70 Oklahomans
that had passed away from the flu.

Seventy people.

That is a lot of folks that died
from an illness that could be prevented

with a vaccine or that could be prevented
with good hand hygiene

or if the patient knew to come in earlier

and they didn't just say,
"Well, I just have the flu."

And then they die from "just the flu."
That's just tragic.

- [woman] Stop!
- [crying] I don't wanna get a shot!

[imperceptible]

[sobbing]

I know.
Do I look somebody that will hurt you?

- I really don't want a shot!
- I know. I know.

[woman 1] You ready for it, you want us
to do it, momma?

- [woman 2] Thank you, doctor.
- Uh-huh.

Going into the flu season this year,

what I have in my mind is,
"It's gonna be like last year."

The CDC is calling this
the worst flu outbreak in eight years

and if you've had the flu already,

guess what, there's a good chance
you could get it again.

[male newscaster] Can you believe that?
We are nearing record breaking numbers

in the state of Oklahoma
when it comes to flu-related deaths.

[woman speaking indistinctly]

- On that side? Okay.
- Mmm-hmm.

[Holly] Even one death in a tiny town
like ours is a pretty big deal.

Take another deep breath.

I don't want to lose a patient to the flu.

[Dinesh speaks indistinctly]

[in Hindi] Sit up, ma'am.

Are you feeling good overall?

See, your oxygen requirement...

- Was this connected last night?
- [man] No, sir.

It wasn't connected.

The ventilator was
not connected all night.

Before, you couldn't stay without it
at night.

There was no need for it now.

Oxygen was running at ten liters before,
now it is at one liter.

I don't think you have
any problem breathing now.

How much less is your coughing
than before?

- Huh?
- [Nisha] I only cough at night.

[Dinesh] Only at night, just a little,
but not as much as before.

Do you want to shift into a ward today?

You are getting bored here
all by yourself.

In the ward, you will talk to others,
converse with them, you will not be bored.

We are shifting her to the ward.

Now, there is no requirement of ICU.

If God will feel so,
she will be home in one to two days.

I feel a great joy easing
the suffering of others.

If I can save a patient's life,

and if I bring tears of joy
to their mother,

that is the most priceless thing for me.

But these are complicated cases...

[in English] When the body
is not responding to any treatment.

[in Hindi] Often, in the 15 years
of my professional life...

when a patient of mine did not survive...

I have wept for them.

The sadness I feel when I lose a patient
is more than the happiness of saving ten.

[cell phone ringing]

[in English] Hello.

[speaks indistinctly]

[in Hindi] I never switch off my mobile
for even a second in 24 hours.

[in English] Never.

[in Hindi] Only a person who has lost
a patient will understand this.

Even if others don't like it,
including my wife,

or my kids, I don't care.

[cell phone ringing]

There is still no respite from swine flu.

[newscaster 1 in English] Alarming rise
in the number of swine flu cases.

Over 9,000 people have tested positive
for swine flu across India

with 86 casualties last week.

The death toll has now jumped to 312.

The numbers are staggering,
over 9,000 people are affected,

which means that once it reaches
that level again,

the spread will be that much faster.

[newscaster 2] According to the CDC,
last flu season killed 180 children.

One of the worst flu seasons
in recent memory,

this new season
ushers in one big question.

Are we in for a repeat?

[newscaster 3] And everything indicates
that this upcoming flu season,

it's gonna be worse than usual.

[Bill Gates] As we've seen
various flu scares,

we haven't had a super good response.

And it's pretty surprising how little
preparedness there is for it.

Fortunately, there's some amazing people
who dedicate their life to this.

Like all global problems,
it's not easy to solve.

But this is the greatest risk,
and we're not ready.