Pandemic: How to Prevent an Outbreak (2020–…): Season 1, Episode 2 - Pandemic Is Now - full transcript

[child] Hurry up!

[children talking indistinctly]

[girl giggling]

[indistinct chatter]

[child giggling]

[Caylan] Nice job.
Nice flick of the wrist.

[Caylan] The focus of my life is to allow
my kids to be who they are.

Our lifestyle and the way
that I raise my kids

is just to continually be evolving,
and awakening,

and consciousness,
and awareness and mindfulness.

[ball thuds]



[Caylan] I believe a healthy child

has the ability
to build up immunity naturally.

[indistinct chatter]

So, Pearl, do you know
what the word consent means?

- No.
- Me, either. I don't.

It means you give someone permission.

Remember whenever we talk
about body parts and I'm like, we all...

we don't touch other people's
body unless we get permission,

and then there's even certain
places that we don't even touch...

- Don't say it.
- [chuckles softly]

Don't say it.

[Caylan] You know,
there can be people that you think

you should be able to trust.

- [girl] Yeah.
- Whether it's... a doctor,



or it's a pastor,

or it's an owner of a business,

even the president.

And no matter who it is
that we're in contact with,

we have the right to be
able to feel within our bodies,

does this feel safe and do I...

do I want to move forward? We should
all be given the freedom to do that.

And so we have to really
think through how,

if this bill passes,

what the effects of that will be
for all of us.

[crowd chanting]

[newscaster] Dozens of people
are rallying in Salem

against a bill that would eliminate
non-medical vaccine exemptions.

Now, if it passes,
most unvaccinated kids

would not be allowed to attend school
and daycare programs in Oregon.

Supporters say
the effort to limit exemptions

is about safe schools

and protecting children and adults.

Those against limiting exemptions
question vaccine safety standard.

A doctor today described the measles
vaccine as, "incredibly safe."

[Caylan] Where's Khalil?

Wait, you're right there.
One, two, three, four, five.

I still have to do the count.

This bill would require
that whether you go to private school,

or you're in public school,

or in a charter school,
you would have to get every single vaccine

that they say that you should have
at the timing that you should have it.

What does freedom mean, you guys?

- [child 1] Free!
- [child 2] Like, like...

You're just out there.

You don't have to do
what people say or...

I don't know, I have to think about it.
I've never thought about it.

[Caylan] For me, it's not about
whether you vaccinate or you don't,

it's us having the freedom of choice
to choose

what we think as a parent
is the best thing for our child.

Rumi, to calm us down,
roll this over your heart.

- [Caylan] Okay?
- [mumbles]

[Caylan] I am confident that no one else
can teach, direct and guide

my kids' hearts, minds and souls
better than me.

[Caylan] Everything
with this whole vaccine bill

is someone who believes
that they know what's better for you

than I do and what you do.

So, it's removing our choice.

[children cooing]

[Caylan] On my family,
this bill will have a very large impact,

'cause my oldest is passionate
about basketball.

She will no longer be able to play
on specific teams.

You won't be able to play soccer
and you won't be able to play basketball

if you don't get vaccines.

I don't feel comfortable
getting vaccines,

and if were to even muscle test them,
I don't know if your body

- would feel comfortable with it.
- You're making me cry.

- [Caylan] I'm making you cry?
- I don't want that.

[Caylan] It's kind of a lot
to take in, huh?

I am raising you guys to be
the 10% of the world,

which means you're not gonna fit in
with the 90% and that's okay.

[child giggling]

[Caylan] We're advocating to our children
"my body, my rules,"

and here, that is being stripped away.

As a protector of our children,
to not have that,

it's like,
"What are we stepping into next?"

[man speaking in native language]

[man grunts]

[woman speaking in native language]

[woman exclaims]

[newscaster 1] The commissioner
of US Customs and Border Protection

is ordering new steps
to protect children in US custody

after the death of an eight-year-old
Guatemalan boy.

[newscaster 2] Four days
after eight-year-old Felipe Gómez died,

new autopsy results show
that the boy tested positive for the flu.

Felipe now the second migrant child
to die this month in US custody.

[speaking in native language]

[woman in Spanish] My brother's
health was good before he left...

It was so hard for us to understand
why his death was so sudden.

Very sudden.

He was a mischievous little boy,
but he always did well in school.

"I'm going to the United States with Dad,"
he said, excitedly.

[sniffles]

"But I'll come back for Mom."
That's what he said when he left.

[woman 2 in Mayan]
I do regret that he left...

but we just did it
because of how poor we are.

[rooster crowing]

[woman 2] I'm very scared

of the flu and of its lethal outcomes.

If another of my children dies,
I'd lose all will to live.

[newscaster 3] US Border Patrol agents

apprehended a group
of more than 1,000 migrants,

who illegally crossed the southern border
near El Paso, Texas.

[newscaster 4] A decade ago,

90% of immigrants
caught crossing illegally

were single adult men from Mexico.

Today, nearly 90%

are families and unaccompanied children
from Central America.

[Susan] When I heard that Felipe died...

I mean, I was angry
because it's all such bullshit.

We have horrible things that happen

with the different hurricanes,
with the tornadoes.

We don't need any man-made catastrophes.

And that's exactly what this one is.

[child] Mama. Mama.

- [door closes]
- [child whining]

[child cooing]

[indistinct chatter]

[Susan] I volunteered 9/11
and went down the day after.

And then I went down to Katrina.

And I worked down there
for almost two months.

If you're able to help, you have to go.

[indistinct chatter]

[man in Spanish] Good afternoon.

[man speaking indistinctly]

[Susan in English] In Tucson,
people have rallied.

[man in Spanish] I want to make sure

the children get to eat first
and then the grown-ups.

[woman] Tangerine, perfect!

[Susan in English] They make sure
they're fed.

We give them two sets of clothing
and then they have the to-go bags

where they have food for their bus rides.

It's a little group here, doing this.
It's amazing.

[Susan] I'm so happy
to be able to give the flu shots

because I really, really believe in them.

And I think it's up to 36 cases this year
of children that have died from the flu.

This is preventable.
It's ridiculous not to get 'em a flu shot.

- [man] Okay.
- It's okay.

[man in Spanish]
Look, look. Like this, look.

[Susan in English] I kept my license
after I retired,

because I knew I was gonna still be doing
volunteer work.

But I hadn't given any shots
since Katrina.

It's pretty hard to do.

Yeah, I was up all night.

I just couldn't sleep. I kept thinking,

"I'm gonna hurt these kids tomorrow."
[chuckles]

That's... quite a large needle.

So, they're not gonna like me today.

[scoffs]

- [Susan] Hi.
- [man in Spanish] Hi.

[man in English] That's it. Okay, okay.

[Susan] I don't want to
open all of them yet.

[man] Yeah, let's focus.

[child sniffles]

- [Susan] Oh, silly. You're a silly, silly.
- [laughing]

[Susan] You silly!

Okay, honey, I'm gonna pinch.

- [gasps] So good!
- [man] That's all.

Okay? You want your Band-Aid?

[man speaking in Spanish]

[Susan in English] I would hate to have
a baby or a child die

just because I didn't think
about doing a flu shot,

I didn't want to go through the hassle.

Why take that chance?

[typing]

[Jake clears throat] There's a risk

that somehow having a bunch
of complementary DNA

and their synthesis process
might cause weird issues.

Okay. Yeah, right on. Done. Cool. Bye.

My vision for Distributed Bio

is that I wanted to build
fundamentally new things.

I wanted to create a space

where innovation and a willingness
to not be trapped by the past

would allow people
the bravery or the foolishness

to try something new
that hadn't been tested before.

So, when we have young scientists
that come here,

we give them really hard problems
and then see what happens.

- How's it going, folks? I'm Jake.
- [woman] This is Jack.

[Jake] Nice to meet you.

Cool, thanks for coming out.

Come and step into my parlor,

- I'll give you an update.
- [man] Sounds great.

[Jake] As you probably already know,

if you receive a vaccine for flu
on any given year,

you get some protection
and it lasts a little while,

but the virus keeps mutating

and making your vaccine obsolete,
so you need a new one, and this sucks.

So our strategy

was instead of make one vaccine
you'd have to keep changing all the time,

take all the different versions
of the virus

and load them in a shot,
all at once.

That would teach your immune system
to respond to parts of the virus

that have never changed over 100 years
and you provide a longer protection.

But the way engineering works,

you can't do these things
all at once, right?

If someone's trying to go
for the Apollo Program,

you're trying to go...

take a rocket,
put a bunch of people in it,

send it up to the moon,
that thing's not gonna make it.

So, the way you succeed in science
is through iteration.

Kind of like our Apollo 1,
Apollo 2, Apollo 3...

The early tests, we just wanna ask,
"Is the theory correct?"

If we could take 100 years of flu,
give a little bit of it all at once,

would that teach the immune system
to provide protection?

Let's just keep boosting it
over and over again.

I'm gonna stop drawing syringes,
but you get the idea.

You end up giving them seven shots.

After giving the same vaccine seven times,

then we've got these gorgeous responses
that were great,

but that's a ridiculous vaccine
because nobody wants to get seven shots.

But we wanted to prove
that the principle was sound,

and we could create neutralization
against future viruses.

So the next one is,
"Can we make it more practical?"

Less shots, higher, tighter,
more broad response.

And that's the next experiments.
They're gonna be live challenges.

That's the ultimate test
and that's why we're pumped.

I was asking them earlier,
from an evolutionary perspective,

why don't our bodies
attack this naturally?

- Isn't that strange?
- [Jake] Yeah. That is...

That is the single most fascinating
and annoying thing about flu viruses,

and that's what got me into it.

The virus hides its Achilles heel

in an ocean of things
it can flexibly change.

We're teaching the body
to help focus on the Achilles heel

and ignore that ocean of nonsense.

In the end of it, it's elegant and simple.

That could apply
to any rapidly mutating pathogen.

We can go after flu,
but we can also go after HIV,

dengue, Zika, SARS, MERS
and a whole bunch of others, so...

It's a big platform
we're contemplating here, right?

You build one thing at a time,

but it's a good idea to have a big vision
of where this could go.

If this just kept growing,

could we have a big dent
in making a pathogen-free humanity?

Which I think should be not just us,

but collectively a consequence
of the biotechnology revolution.

I know that sounds like a big dream,
but it's good to have big dreams.

Big dreams got us to the moon.

[birds chirping]

[Syra] I live and breathe being a Muslim.
It shapes my daily life.

I don't drink.

I don't eat meat that's not halal.

And, of course,
one of the Pillars of Islam

is making sure that we pray.

Prayer is not for God. It's for me,
making sure I remember God day-to-day.

And also, in my way of life,
making sure that I do no harm

and help others.

So, I pray every morning
before I leave for work or start my day.

[both] Syrup.

[both] Syrup.

[both] Syrup.

Syrup.

Yeah! [giggles]

[Syra] I think it's very hard for me
to distance myself from my work.

I struggle with that at times.

[child 1] Mommy, mine is dripping.

[Syra] For my kids, I actually
don't tell them exactly what I do.

I think it's a little bit hard to explain.

They know Mommy works
in a hospital environment.

My five-year-old is more concerned about,

"How come other mommies don't work
and you work?"

[child babbling]

[child] Can you...

[Syra] Your brother's with you.

My name is Dr. Syra Madad,

I am the senior director of New York City
Health and Hospitals'

system-wide Special Pathogens Program.

I deal with preparedness and response

to these types of high-consequence
infectious diseases

across the entire enterprise
of New York City Health and Hospitals.

Like, Ebola, SARS, MERS... Seasonal flu
is a big one that we see every year.

Anyone know what the definition is
of a special pathogen?

There is actually no definition, right?

There is no defined definition
of a special pathogen.

However, there are characteristics.

So, think about Ebola.
What are some characteristics of Ebola

that make it a special pathogen?

- [woman 1] High mortality?
- High mortality.

High morbidity, high mortality, right?
So it is deadly.

- What's another one?
- [woman 2] It causes panic.

Causes panic, exactly.

It is something
that can cause public panic.

It's something that creates a lot of fear.

There's two more.

[man] Hard to treat.

[Syra] Hard to treat, that is a third one,

that you have no prophylactic treatment,
or vaccine,

or therapeutic intervention,
so that's a third.

- The fourth?
- [woman 3] Very contagious.

[Syra] Very contagious,
there is a high likelihood

of person-to-person transmission,
so you have a lot of secondary cases.

Influenza is extremely hard to predict.

It just takes one person, one host,

and then you can start a whole outbreak
that can lead to a pandemic.

Over 3,000 commercial flights

pass through New York City airports
every single day.

If a passenger arrives in New York City
with a novel disease like H7N9 flu,

it can very well
begin to spread undetected.

This is an airborne virus,

so things like coughing and sneezing,
mere fact of just breathing,

is a way of spreading this disease.

Because there is no prior immunity...

the outbreak would proceed
very aggressively.

There's 8.6 million people
here in New York City.

Every day, hospitals operate
at over 100% capacity.

In a matter of weeks,
a novel virulent influenza strain

will incapacitate our city.

The demand for burials
will become overwhelming

and morgues will begin to overflow,
just like we saw in 1918.

Within one month, the virus can spread
throughout the country,

and within a month after that,
could be widespread throughout the world.

And all it would take is just one person.

[machine beeps]

[beeping]

[indistinct chatter]

[newscaster] Eastern parts
of the Democratic Republic of Congo

are struggling to contain
the second-worst outbreak

of the deadly Ebola virus in history.

More than 1,100 people have died
from the deadly virus

in two provinces
along the borders of three countries.

Experts fear the outbreak is increasing
and that the virus could soon spread.

[Michel] In Ebola, you miss one case,
it can trigger six more and then multiply.

For us, it's the worst scenario.

[man] There's the ETC visit. Um...

There's also hopefully time
to stop by an ITC training.

Mmm-hmm. They want to know for the UN,
what we are doing...

and what are the key challenges
and how we address them.

[Michel] Goma is a very dense city.

Because of population movement,

the risk of Ebola moving towards Goma
is very high.

The outbreak started
in a place called Mangina,

with a family,
and from there it moved to Beni city,

and from Beni people moved to Butembo,
where the situation has exploded now.

We are hoping that it doesn't reach Goma.

We have two million people.

With a high-density population,
actually, Ebola can become incontrollable.

And the risk that it can actually spread
to other countries is very high.

[in French] Hello, everyone, hello.

[people speaking indistinctly in French]

People with a high temperature.

A high temperature,
we will direct them to here.

All right.

Let's continue.

[Michel in English]
To survive from this virus,

the objective in Ebola is to move faster.

- Detect the first case,
- [beeps]

isolate the case...

and then stop the chain of transmission.

One patient moving from these
Ebola-affected places to Goma...

and it can easily be...

a disaster.

[Dennis] Ebola virus
is one of those viruses

that is largely spread
by direct physical contact

between one person and another.

When there is an outbreak,

it's largely contained
within a defined geographic area.

Influenza and respiratory viruses

are the ones
that you're most concerned about,

in terms of being able to spread rapidly
from one human to another

and spread around the world very quickly.

By way of example,

the Ebola virus that spread in West Africa
from 2014 to 2016,

the worst Ebola outbreak in history,

largely stayed within the three countries
in West Africa.

One traveler went to Nigeria,
one traveler went to Dallas,

but they never spread.

And 30,000 to 50,000 people were infected,

as opposed
to H1N1 pandemic influenza virus,

sometimes referred to as swine flu,
that emerged in the spring of 2009.

Within 12 months,

it had spread around the world
and infected two billion people.

The 50,000 versus two billion

tells us the challenges
of dealing with an influenza-like virus,

simply by virtue of how easily
and rapidly it can spread.

It was just a matter of luck

that the swine flu variant of 2009
wasn't more lethal.

Had it been, hundreds of millions of men,
women, and children would have died.

[children giggling]

[child in Spanish] We were traveling
along with the Honduran caravan,

and...

we crossed over a fence
that was in the way

and we ran into an officer
further up the road.

He caught us.

We were taken to...

it was like a prison.

We were kept there for two days
and transferred to a different one,

until we finally got here.

[Susan in English] It's hard for me
to listen to them

tell about how they walked, and walked,

and how some of the Mexicans
took advantage of them

and stole their money,
and how the women were badly treated.

I can't get in my head
what they've been through.

All I can do is make them feel better now.

[Susan] Hey, little one.

[gasps] Boom!

Boom, boom, boom...

Here, you've gotta watch
where you're going.

How's that? Better?

Well, see ya.

[chuckles]

[woman] You've got a little one.

[indistinct chatter]

[man in Spanish]
Good afternoon, how are you?

Please come with me this way.

Hi! Say hi to me, how are you?

Come stand here with me, come.

These papers

that you have here
are the most important thing you have now.

This is your legal status in the US, okay?

With this,
you can take your kids to school.

You can take them
to the doctor if you need help.

I want to make it clear,
you are no longer detained.

You are free.

- We are free, right? I think we are...
- [people laughing]

[sniffling]

[baby crying]

Now, you're okay here...

[muffled crying]

[woman] You're good, okay?

[man] Please, try to relax,
I know you're still very tense.

But not anymore, okay?

[woman 1] You're all from Honduras?

[woman 2] Yes, all of us.

[woman 1] How much time did you spend
at the ICE center?

- [woman 2] Two weeks.
- Two weeks.

How many days were you traveling?

- Twenty-two days.
- [woman 1] Twenty-two days?

[Eve in English]
Does she want any ibuprofen?

[in Spanish] Do you want something
for the pain?

Yes, because it itches... Yes.

[in English] When people have been
experiencing adverse circumstances

such as inadequate food and water,
dehydration and particularly stress,

all those factors would increase risk
in terms of getting flu

and other illnesses as well.

[woman] She didn't fall,
didn't hurt herself.

Is it getting better?

Is she able to eat right now?

[Eve] We knew that these refugees
had been kept all together

in some kind of facility for a few days
under less-than-ideal conditions,

then brought to us,

and then they would be scattered
across the country.

And I thought, "This is a public health
issue disaster waiting to happen."

- [woman] Cough drops, anything else?
- [Eve] The tongue blades.

And they don't have to be sterile ones.

[Eve] I said, "We gotta do
something about this.

We just need to get some flu vaccine
for these people."

- [Susan] It's Juan and Juan.
- [woman] Juan and Juan.

Juan and Juan. Come on in,
you're next on The Price is Right.

[Susan] The flu vaccine
is about 50% effective.

But it also,
even if it doesn't prevent it,

generally modulates it
so that it'll be much milder,

so your risk of having
a serious consequence is much less.

- [laughing]
- [Eve] He laughs.

[Eve] I had a professor
in pediatrics who said,

"Why take care of people
at the end of their lives

when you can take care of them
at the beginning of their lives

and have an impact
for the rest of their lives."

[in Spanish] Take a deep breath.

[inhaling deeply]

[breathes deeply]

- Cough.
- [coughs]

[Eve in English] Okay.

There are tens of thousands
of deaths every year from the flu.

I'm not sure
why that doesn't impress people.

People got freaked out
about the Ebola virus

when there was one case
in the United States,

but the flu virus, which can kill
thousands of people,

for which we have a prevention,
people don't get it.

So, for us in the medical field,
sometimes it becomes very frustrating.

[chanting] Kill the bill. Kill the bill.
Kill the bill.

[all chanting and cheering]

[Jaclyn over microphone]
My eight children are healthy,

happy and vaccine-free.

[crowd cheering]

We're a responsible family that takes care
of our immune system

by living a healthy lifestyle.

[crowd cheering]

[Jaclyn] We are in charge of our children,
not the government.

- [both] We do not consent.
- [all] We do not consent.

[crowd chanting]

[Caylan] The rally today
at the courthouse...

There's something really powerful
about a physical body showing up

to say enough is enough
and I want my freedom of choice.

Our specific beliefs,

whether it be religion,
personal views, health...

We are standing together,
fighting for our rights in Oregon.

- Are you informed?
- [all] Yeah!

- Do you consent?
- [all] No!

[man] Thank you for turning up.

[Elizabeth] I don't want you guys
harassed by these people.

I don't think they're gonna cause
physical damage to our office.

I just don't want them
getting in your faces.

So, it is World Immunization Day,
actually.

- The radio told me today.
- [Elizabeth] Are you serious?

No, it is not!

- It's World Immunization Day?
- It is.

I had no idea.
We could not have planned this better.

All right.

- We're gonna take that as a good sign.
- Yeah.

You know, there are certain things
that push people's buttons.

Um, guns, gun bills... Turns out
immunizations is one of them.

There were already 42 voicemails
when they came in this morning.

[Elizabeth] We've had a large number
of protests. People are pretty grumpy.

A lot of hate mail

that eventually descended
into death threats

against me and my children.

I think the stairs
are safer than the elevators.

[woman] Mmm-hmm.

- [Elizabeth] Good morning.
- [man 1] Good morning.

[man 2] Morning, Senator.

[protesters chanting]
Stop 3063! Stop 3063!

[protester over microphone]
It's your job to storm this building

and tell them to stop this over-reach.

[protesters cheering]

[protester] Freedom now! Health now!

Freedom now!

[protesters chanting]
Health now! Freedom now!

[Elizabeth] I didn't come here
to do easy stuff.

That isn't why I came to legislation.

I came here to protect Oregon's children.

[newscaster 1] The US is now dealing

with the worst outbreak of measles
since 2000.

There have been nearly 700 cases confirmed
in 22 states this year.

[newscaster 2] Measles is clearly

one of the most contagious viruses
known to man.

[newscaster 3] The measles virus
causes high fever and rash

and can lead to serious complications.

[newscaster 4]
Health officials are blaming

the outbreak on misinformation
about vaccines.

The vast majority of cases
have occurred in children

who have not received the vaccine.

[newscaster 5]
The problem's so widespread,

the World Health Organization
is calling the refusal to vaccinate

one of the biggest threats of 2019,
right behind Ebola.

[Elizabeth] Vaccine hesitancy
is one of the largest threats

to human health there is.

The complications
of a serious viral illness like measles

can be very profound,
up to and including death.

House Bill 3063, at its heart,
does one thing.

If you have a child

and you want that child to attend
a licensed school

or childcare provider in this state,

that child either has to have
a medical exemption

or they have to get
all the required immunizations.

If I don't want to immunize my child,
I'm putting my child at risk.

You could make an argument

that as a parent, I have that choice,
and that right,

but do I have a right
to put your child at risk?

Any baby under the age of one

and people whose immune systems
are suppressed,

are really being placed at risk
by people not immunizing their children.

The vast majority of people who choose
not to immunize their children,

do choose to obey traffic laws.

For example, immunizing your children
is like stopping at a red light.

It's a pretty good idea
so you don't run into somebody

who's going the other direction
with a green light, right?

We all have to make a series of choices
when we choose to live in society.

I mean, this is a public health emergency.

At some point,
we have to take some tough votes.

[Sarah] There are times where I do feel

like people look at me
that either I'm too young

or I'm a woman and out of place or both.

It motivates me to work even harder
to be successful.

For those of you who have joined
us recently, this is a good opportunity

to see what we've been working on
for the vaccine program.

Vaccines have been hugely successful

in nearly eradicating many pathogens
that have once plagued humanity.

However, they have failed
in rapidly mutating pathogens

such as influenza and HIV and others.

Many groups have tried to find
a universal influenza vaccine.

All of these previous attempts have failed

at producing a broadly-neutralizing,
universally-protective flu vaccine.

More complex but also brilliant solutions
have been attempted

and failed for various reasons
that maybe no one really knows.

So we just had
to completely turn it around and say,

"What kind of barriers exist
and how can we do it differently?"

Our approach is new,
and then we tried it out in pigs.

The immune systems between pigs and humans
are actually remarkably similar,

so if it works in pigs, we can be
reasonably sure it will work in humans.

What Jake did is he figured,
"Okay, well, it's gonna be too expensive

for me to run a pig study in the US,

but I really wanna see this through
and see if my idea is gonna work."

So I wanted to do pigs and Guatemala
became a way that I could do that.

Guatemala has a pretty big pig industry
and I grew up down there.

My father still has a hotel
and restaurant, so we had property nearby

that I could use to set up a facility.

It turns out it's only about $40 or $50
US to buy a pig in Guatemala.

[Jake] And suddenly, this whole thing
lined up where I realized

there was an opportunity to go run
these animal studies in Guatemala

and then having nice labs in the States
to analyze the results.

[Sarah] We paid a fraction,
a tenth of the cost

it would have been
to run this study in the US.

And these are some pictures of us
in Guatemala with our baby pigs.

We had a group of all-female pigs so we
tried to give them all pig-related names.

Oh, it's Squeeyonce and Jennifer Hamiston
and Kim Kardashioink,

Spamela Anderson, Hamon Biles,
Katy Porky, Squeeanna,

- and then the list goes on.
- [all laugh]

And right there was the moment
when we realized that it was working.

[Sarah] I've flown down to Guatemala
16 times in about three years.

Right now, we're prepping to go back
to Guatemala for one final test.

We're really confident in our data
and we know that the vaccine works.

However, the vaccine requires seven shots
to get the response that we like to see.

Nobody likes to go to the doctor
to get shots,

especially shot after shot after shot.

So we had to figure out how to get
the same protection that we had before,

but with fewer shots. Ideally, one shot.

So that's our next big milestone.

We also need to move on
to human clinical trials.

There is a lot of pressure
leading up to this trip,

because this is our final animal study
in Guatemala.

What we want is for Centivax to be
the last flu vaccine you'll ever need.

[woman in French over microphone]
Thank you for giving me time to speak.

We have 1,023 cases,
of which 958 are confirmed cases.

638 deaths, 321 healed.

[Michel in English]
Ebola is a very contagious virus.

It's going to kill the whole family.

The whole village.

The whole city.

[in French] The first confirmed case
is a 23-year-old woman.

The second case
was a three-year-old child.

[Michel in English] It's a very painful
disease, like a severe flu.

You have muscular pain.
You have fever.

[woman in French] For the fourth
case, it's a 33-year-old man.

The fifth case is
a five-year-old female child.

[Michel in English] And when it reaches
organ failure, then you start bleeding.

I can see the patient suffering
and dying with a lot of pain.

I have to solve this issue.

I have to stop the outbreak,

and stop the suffering
of all these people.

[woman in French]
The sixth case is a 16-year-old girl.

The seventh case,
is a 56-year-old man.

[Michel in English]
This is the main motivation.

[Sam] When do you wanna schedule that for?

[Michel] It takes a lot of heart, really,
to do this kind of job.

[indistinct chatter]

[imperceptible]

Michel is able to engage people
and build trust in people,

in a way that cuts through
any kind of hierarchy.

And really cuts through
a lot of the different communities,

cultures, nationalities
that we have coming here.

[Michel in French] His Excellency.
His Excellency is handsome.

[Sam in English] Michel has a great
respect, both for other people,

but also other people for him,

and I always was struck
by his immediate ability

to make people calm
in a very stressful environment,

and that's a real skill.

But we have not yet been able
to overcome a lot of the lack of trust

and the deficit of trust
that communities have in us.

People are terrified,

and they're terrified
for a number of reasons,

but this is a scary disease.

[interviewer in French]
Okay, can we start?

Doctor, how do you respond to views
that vaccines against the Ebola virus

are a means used by the West, Americans,

to infect the population with the virus,
to perpetuate the epidemic?

[Michel] This vaccine
doesn't have the Ebola virus.

It's a vaccine that stimulates immunity.

I've taken exactly the same vaccine.

There are rumors, notably in Goma,
which are spreading,

that a person has died
from the vaccine inoculation.

That's not the case.

[Michel over radio]
To date, I can guarantee

we don't have any major incidents

directly linked to the vaccine.

[Michel in English] In influenza,

during the crisis,
you may have to change vaccine,

because the flu virus can mutate easily.

At least, the good thing for Ebola
is that we have actually one vaccine.

It's an experimental vaccine

that the manufacturer cannot produce
in huge numbers.

At the beginning of the outbreak,
we had 300,000 doses,

and this is for worldwide.

We cannot afford to do a mass campaign.

We don't have enough vaccine.

So, in this case,

the appropriate strategy
is to vaccinate frontline workers.

[Michel in French]
Okay, this doesn't scare you?

Are you still okay with this?

Okay, Doctor.

We will vaccinate the young lady.

[Michel in English]
This vaccine will protect

the health workers from the disease.

But, unfortunately,
Ebola is not the only danger they face.

[wailing]

[newscaster] A new spike
in deadly violence

has gripped
the Democratic Republic of Congo.

Armed rebel groups are targeting
Ebola health care teams

in the country's eastern region.

Two aid workers were killed in one attack
over the weekend.

[Michel] Two days ago, we had
one of the vaccination team members

being beaten
and even thrown into the river.

We are experiencing attacks
from different armed groups.

We became the target.

This is quite hard.

It's like fighting two armies.

The outbreak itself...

and the groups that fight Ebola teams.

[woman in Spanish] Good morning!

[child] Do you have a pill
for my ear pain?

Are you in a lot of pain?
Does your throat hurt, too?

[child] Yes.

- Thank you!
- [child chuckling]

[gagging]

[woman] Now, you can eat the lozenge.

[continues gagging]

- Does it taste funny?
- Yes.

[woman in Spanish] We're coming
from Poptun, Ixobel, Guatemala.

[imperceptible]

I didn't want to leave my country
and my mother behind, but I had to.

I might lose a family member
or even my girls,

the most important people in my life.

I decided I'd rather leave.

- [woman 2] Mmm-hmm.
- [woman sniffles]

But I know I'll be back with them someday.

Here's the one where they threaten
my husband.

[child] Said they'd turn her
into ground pork and kidnap us.

Until they get rid
of every single person in the family.

That's what the message says.

- Were you scared when you saw it?
- Yeah.

[woman] But, yeah, we're already here.

Things will be different once we are
with our family, God willing.

Uh-huh. [sniffles]

[Eve in English] People don't like
to leave their countries.

They have relationships there.
They have a feeling about the land.

I'm sure if it was a safe environment
and they could make a living,

they would be happy staying there.

You really feel you wanna do
everything you can

to make up for the horrible circumstances
under which they've come here.

And I think everyone at the facility
feels that way.

[Susan] I got two of them.

Both from Alia.

My one daughter, she's in North Carolina.

She's helping me out.
She sent the boxes for the kids.

I can't believe
she got ten coats in here, but...

Oh, one of the little girls
will love that.

That's so nice.

I hate giving out second-hand stuff
that's all yucky.

[groans]

[Susan] For everything
these families have been through,

and some have been through so much
that we don't even know about,

and then they come up to this country,

and to die from anything,
much less the flu, something preventable,

it's inexcusable.

We're gonna do whatever we can
to make sure that doesn't happen.

[Susan] Is it okay? Oh, oh...

[wailing]

[Susan] Oh... Oh...

Oh, baby.

[Susan] Oh...

Oh... Hey, baby.

[Eve] The acceptance of the vaccine
among the refugee families

was very shocking, because I felt,

after their experience,
why would they trust us?

But they did.

And when we said
we are offering the flu vaccine,

they basically all came to get it,

and it was such a nice change

from having to struggle with people,

to fight with them
about getting a vaccine.

That was very rewarding.

The challenges we're facing is maintaining
a steady supply of the vaccine.

Somebody has to pay for it,

and there is no money in any budget,
really, to provide that.

I personally don't think a county
should be responsible for this.

This should be
a federal government response.

We are getting somewhere
between 50 and 80 people a day.

There have been a couple of days
where they had up to 100.

When it was clear
that the vaccine was running low

over the last few days,

we've really been prioritizing
just children and pregnant women.

We haven't been able
to give it to adults.

And I feel bad turning people away,
'cause they come wanting it.

They say, "But I'm leaving tomorrow.
Can't you give it to me?"

And we say, "This is what we have.
We have ten doses left."

- [woman] Okay.
- [woman 2] You know this guy?

[woman 3] Okay.

[Eve] Okay.

[Eve] So I think we only have, um...

five or six doses left of the vaccine,

and obviously we won't get any tomorrow,
it's Sunday.

Who knows about next week?

- Yeah.
- So we're probably gonna be out.

They do understand that this flu season
is now, and it's kind of...

- Yes.
- This is the time.

That's crazy, okay.

[Eve] Unless we get something on Monday,

we won't be able to give people
the vaccine.

[Jake] My family owns a bed and breakfast
in Guatemala,

and because we had a little piece
of extra property away from the bungalows,

we were able to use that to build
an animal facility to test the vaccine.

[Jake in Spanish]
What an old hotel! [laughing]

- [Jake in English] How's it going?
- How you doing?

- It's good to see you, man.
- Hey, a long ride, huh?

They're paving both sides
of the road at once.

That's smart.

We had to retreat an hour and a half...

It took a special engineer
to figure that one out.

- Hola.
- [Jake] Hey, hey, what's up?

[Jake in Spanish] How are you?

[man] I'm fine, thank you.

- [Jake] What's up?
- [man] Hey, man, how are you?

- All good, all good.
- Good?

[Jake in English]
I love coming back to Guatemala.

It will always feel like home to me.

But it also feels, every time I come back,

like I'm one step closer
to achieving our vaccine goals.

- [Sarah] Ooh, fresh paint.
- [Jake] Nice.

- Looks really good.
- Yeah.

[Sarah] They are so freaking cute.

[pigs oinking]

[Sarah] They look really good.

- They look healthy.
- [Jake] Yeah.

Hi.

Hi, piggy.

- [pig farts]
- Oh...

Did a poop.

[Jake] I remember
when I did the first vaccine study.

I was scared the whole time.

Imagine cooking a cake,

where you're gonna spend six months on it
and bring all your friends in,

and you don't know if the whole thing's
gonna be a mess at the end.

This is really
one of our most important experiments yet,

because if we're successful,
it'll be a huge step towards human trials.

[clicks]

[Jake cooing] Who's gonna help us
solve influenza?

Who's gonna help us solve influenza?
You are.