Misinformation about COVID-19 seems to spread faster than microbes. In this episode, Emmy-award winning journalist, author, professor and epidemiologist, Dr. Seema Yasmin, helps separate the fact from the fiction.
Jeffrey Freedman: Hello and welcome to the RP HealthCast by Rooney Partners. I’m your host, Jeffrey Freedman. For several weeks on this podcast, we’ve been learning more and more information about the Coronavirus in terms of the disease, things to be aware of, potential ways to stay safe, and drugs and development to treat it. I keep saying that the more we find out, the more we realize what we don’t know. While I still believe this is absolutely accurate, there’s something else we need to be careful of. With the amount of new information that’s being put out into the public, sometimes that information gets misunderstood or twisted to meet different agendas. Part of the problem we’re having in this country right now is that at times we don’t know who we can turn to for unbiased truth and we start to question some of the information coming from our leadership. Our guest this week has spent her entire career searching for and communicating the unbiased truth about diseases ranging from Ebola to the Coronavirus. Dr. Seema Yasmin is a trained medical doctor, an epidemiologist, a university Professor, a sought-after lecturer, an on-air medical analyst for CNN, an author and she hosts a YouTube series for wired that debunks myths about diseases such as the Coronavirus. Dr. Yasmin has spent her whole career researching diseases and communicating about them today. Seema, it’s a privilege to have you here with us today.
Dr. Seema Yasmin: Thank you so much.
Jeffrey: Now, before we start discussing the Coronavirus and your work in the space, I’d like to spend a couple of minutes talking about your journey into science journalism. Your professional journey is just fascinating and you were or are a medical doctor and then you went into public health at the Centers for Disease Control and Prevention where you studied outbreaks of diseases in prisons, border towns in American Indian reservations, can you share with our listeners this part of your career journey?
Dr. Yasmin: Yeah, sure. So I trained in medicine. I went to medical school in England, worked as a hospital doctor there, and became really interested in epidemics and so about ten years ago, I moved to America just for this job at the CDC. I served as an officer in the epidemic intelligence service. So what I was doing then was I was part of a team that was deployed whenever there was an epidemic and that could be in the US, it could be in other parts of the world and my job really was to try and contain an epidemic before it became really really bad and to try and understand how it spread, why it spread, and who it was affecting. So, interestingly, a lot of what I do now, I think people are more familiar with because they know terms like contact tracing, for example, people know more about epidemic investigations right now because of what we’re going on, but that was the bread and butter of my work. But then what I noticed is every time I got sent to a Hot Zone whether it was a viral outbreak, a bacterial one, I had a very singular focus on containing the disease and what I saw each and every time was that disease was not spreading alone; disease was spreading alongside misinformation and disinformation. So that it could be a virus that was contagious but there were also these medical myths and health hoaxes and rumors that were just as contagious and helped diseases spread. So I thought why in public health are we not very good at addressing that part of it when information can fuel viral contagion? Why do we kind of dismiss the information part of it? And I became really interested in that. I had a big eureka-moment during an outbreak of flesh-eating bacteria in the Navajo Nation. And I thought, “I think I need to train as a journalist because I think I need to understand how journalism is part of the public health ecosystem and besides just being a public health doctor, I need to know how I can make a compelling argument to make people care about these epidemics, make people care about public health.” So I felt a bit weird at that time, so I thought medical school, then being an EIS officer, and then going to journalism school like that last part, that’s not a normal trajectory. But I told my supervisors at CDC, don’t write me a reference on my next job, write me a reference for journalism school and actually people were really really supportive. So I went to journalism school. I then got hired straight out of j-school as a newspaper reporter, moved to Dallas, Texas, a place I never thought I would live and arrived there just as Ebola arrived in Dallas. This is in 2014, so that’s a small part of my journey.
Jeffrey: That is something movies are made of. That’s unbelievable. So, then, all right, so let’s fast forward. So you got into communications. You became a reporter. You were a medical analyst or maybe still are for CNN. You were a professor at the University of Texas, not just working there. I think you gave a TEDx Talk and then I believe now you move from Texas to California. You’re at Stanford now. Can you tell us a little about the Stanford Health Communication Initiative and your work as Director of Research and Education there?
Dr. Yasmin: Yes, so I direct the Stanford Health Communication Initiative where we run educational programs and do research around health communication. So we do the micro which is how can a doctor be a better communicator with their patient in a one-on-one interaction, but then how does all of this information factor into how diseases spread on a global level? And so it’s really amplifying my discoveries as an EIS officer, kind of, amplifying the work I’ve been doing as a health and science reporter to kind of plug-in all those different pieces. Because, journalists play a really important part in how we understand disease, how we understand our own bodies and our health. Journalism is part of the public health information ecosystem and you may have even heard people talk about journalism as the immune system of a democracy. So we study that, we support that and we’re really tracking not just disease but also my interest, which is misinformation and disinformation about disease, and then trying to figure out innovative ways to counter it. Because as I said in public health, we’ve been really good at focusing on disease, but not at the medical myths and the health hoaxes. So we’re trying to change that.
Jeffrey: Right. So, speaking of this, I guess in your part-time job now since you sound like you have so much free time, you were nominated for an Emmy, right?
Dr. Yasmin: I won an Emmy.
Jeffrey: You won an Emmy, okay. That’s for the Chagas disease?
Dr. Yasmin: Yes. I did a TV news series as well as a written series about neglected tropical diseases in the US, the kind of diseases that you think would happen in faraway places but actually are infecting Americans and are not being counted because public health agencies don’t think they are a concern and therefore aren’t doing surveillance. So, yeah, I was very, very surprised to win an Emmy for that but really happy that public health work was kind of getting that platform and something as important as neglected diseases in the US was being profiled.
Jeffrey: Yeah, that’s incredible. You’re also an award-winning author and you have a new book that’s coming out. It’s on pre-order on Amazon and also at Johns Hopkins University Press. I love it. So, the new book it’s entitled, “Viral BS: Medical Myths and Why We Fall For Them.” It explores how as you said misinformation can spread faster than microbes. Now you started a little, you talked a little bit about this but explain the thesis, and what prompted you to write this book?
Dr. Yasmin: So this book started off as a regular newspaper column I used to write, where readers would send in all sorts of questions about, should I starve a fever and feed a cold? Should I be worried about chemtrails? Do vaccines actually cause autism? And so every week I get to dig into these questions and say, “Look, here’s the evidence, here’s how you can make up your mind about this.” And then an editor was like, “This is really cool and it’s reaching a lot of people, turn it into a book.” So I started working on this about three, maybe even four years ago, you know before we thought a pandemic would hit us. It just kind of gets into the nitty-gritty of about fifty very common, very relevant questions, whether it’s to do with taking a Statin, whether it’s to do with the “detox cleanses” we keep hearing about. But really at the center of the book, we’re asking “why is it people often don’t trust science and scientists.” Because being in the scientific world, you can get kind of very prideful and a bit complacent that we have science on our side, we have facts, we have evidence. And you can see just during COVID-19 how that can fall flat, how you can have incredible evidence and really good studies and still people will refuse to wear a mask. So even though I started working on this a long time before the pandemic, it really gets to those central questions of what are facts? Who develops facts? And why is it the facts don’t always work at countering misinformation?
Jeffrey: Yeah, and I guess even to emphasize this, I’ve been watching you on YouTube, and you have a series with Wired about medical myths and about coronavirus myths, and some of these things are addressed on the YouTube series, correct?
Dr. Yasmin: That’s right.
Jeffrey: Yes, so, I think it’s great. Let’s talk about more of these Coronavirus– I don’t call them myths but for the purpose of this, more about misunderstandings and communication and things that are going on that people don’t necessarily hear about or haven’t heard about yet. Let’s talk about this one thing that I’ve been tracking, which is the coronavirus mutating. There’s a doctor, Michael Worobey, he’s an evolutionary biologist at the University of Arizona. He said a second, like a mutant second virus, may have been responsible for the spread that we’re currently witnessing there. And also, virologists at Scripps Research from Florida, they found a mutation of the Coronavirus called D614G, which they said is far more infectious. Can you share your understanding of the existence of mutant variants of the Coronavirus, have you seen this? Have you been shown this? And what could be the issue or the effects of these?
Dr. Yasmin: So the first thing to know is that this is really predictable because viruses replicate at such a high rate and as they make more copies of themselves, they make mistakes if you want to call it that. So that’s how you end up with these viruses that are almost like cousins of one another instead of absolute clones and what we’re seeing primarily is some of this research coming out of the US and out of Europe as well, where scientists are looking specifically at the spike protein of the Coronavirus. That’s that bit that sticks out and gives it that halo shape which is why we call it Coronavirus because Corona is Latin for Crown and it’s that spike protein that is really good at latching on to some of our cells and enabling the virus to get inside. The spike protein, in doing that, in that latching process and getting in, sometimes can break and what some scientists have found is a version of the Coronavirus where there’s just one amino acid chain in that spike protein. So the spike protein is made up of about 1,300 amino acids, which are the building blocks of proteins. And in this version where there’s just one amino acid that’s different, it makes this spike protein a bit stronger and a bit tougher. So it doesn’t seem to break as easily. And what scientists are saying is that in some experiments, this slightly mutated version of the Coronavirus, it can be about three to eight times more infectious. But that doesn’t necessarily mean that people infected with that type of the virus are getting more sick. And in fact, there isn’t data to support that. So I think we need to do a lot more research. I want to make sure people don’t get scared, you know, the term mutant virus can sound a bit sensationalist and frightening, right? A very Hollywood. But as far as we know at the moment, this slightly evolved version of the virus doesn’t seem to be increasing hospitalization rates or increasing the severity of the disease. So, it’s to be watched for sure but right now we think it might make for a more infectious version of the virus, but maybe not a more serious one.
Jeffrey: Okay, that’s scary, fascinating, scary. New topic – super spreaders. Okay. Now I’ve read different reports that suggest an average, let’s say 2% of the people could be responsible for 20% of all Coronavirus infections, right? Why is that? You know, why are some people more infectious and are they doing anything different, and is it their fault? What’s the information with this?
Dr. Yasmin: So, again, this is not anything new. We see this in some diseases that about 20% of the infected people are responsible for about 80% of the infections, and we don’t fully understand why that is and I think it’s because it’s complicated. Partly, it’s probably to do with some biological factors. Maybe in some people, a virus is able to replicate more efficiently. Maybe in some people, the immune system doesn’t control the infection as well. But then I think that there are more behavioral and less biological factors at play too. Maybe some people are able to transmit more infections because of the kind of lifestyle they have. Maybe they are like kindergarten teachers or maybe they’re really popular and they’re always going out, versus somebody who’s really reclusive. So I think probably there are these multiple things at play, but I do want to say that the term “super spreader” has been criticized by some anthropologists as being a term that we should be careful about using because it already adds some stigma to this idea of a person as being responsible for so many infections perhaps through no fault of their own. The reason we worry about that is because stigma can be very harmful to an individual person but also to public health efforts, because the last thing you want to do is single-out people for being infected, for being contagious. That often can make it more difficult to do public health containment work. But add to that the fact that as I said, we don’t fully understand what it is about some people that could mean that they transmit the infection on to many more. It’s just a phenomenon we’ve seen over and over again. In fact, we saw it with SARS and MERS and from an information perspective, I’ll tell you something really interesting because I’m very interested in the parallels between how disease spreads and how information spreads. Actually you see in the same way that a virus is transmitted from person to person so is information and actually, in the context of information, you also have people who can be “super spreaders”. Maybe it’s because they are a celebrity, they have a massive platform. Maybe it’s because they’re an influencer and they have a lot of Instagram followers, but there are some people who also are really good at getting misinformation out very far and very wide.
Jeffrey: So that’s incredibly interesting. So super spreaders. We don’t know why it could be genetic but what about if we turn it around a little bit. Why have we found that there’s a hugely disproportionate impact on people of color? And why would people of color or minorities be more affected by the Coronavirus?
Dr. Yasmin: So this is also something that’s not surprising. Unfortunately, in fact, if you’d asked scientists and sociologists and anthropologists like a year ago if a pandemic virus, a respiratory pathogen was to hit America, where would infection rates and death rates be highest? It would have been very easy to find evidence to say actually it’ll be people of color or be queer people, disabled people, people living on the margins of society who will suffer the most. And it’s exactly what we’ve seen and so it’s actually really tragic I think that we haven’t fixed those kinds of societal problems that caused so much suffering and so much needless death during the pandemic. I saw one analysis that showed: had there been equity across the death rates in the US, if equal proportions of White Americans and Black Americans had died, then something like 15,000 Black Americans would still be alive, but they died from COVID-19 because of these disproportionate rates. Overall, we’ve seen from The New York Times and other researchers have also published data that shows that in the US, Black Americans and Latinx, people are about three times more likely to get infected and get sick with COVID-19 than their white neighbors and twice as likely to die. But actually it’s a lot more serious and a lot worse in some places. In Kansas, black Kansans are about seven times more likely to die from COVID-19 than their white neighbors and a lot of this comes down to structural inequality and racism. Unfortunately, people often don’t want to hear this or they think that that sounds like not a reasonable explanation, but we have so much evidence of how it is that systemic racism causes people of color and black people and indigenous people to suffer disease more, to receive treatment a lot later, to have really poor health care experiences where doctors dismiss their pain and dismiss their suffering which explains exactly what we’re seeing now.
Jeffrey: Now, to combat misinformation, we need data. You mentioned this before about the New York Times and about the article that they wrote and the data that they’ve been provided, but they were only able to receive that data from the CDC because they had to sue the CDC to get the data.
Dr. Yasmin: Right. So. all that talk about transparency of the Chinese scientists and Chinese officials, which is a question I was getting a lot early in the pandemic – are Chinese scientists sharing all the information? But then you look here at the US and we haven’t had transparency in terms of data, very basic data. So as you mentioned, the New York Times had to sue the CDC to get about one and a half million case records of people who had had COVID-19, but even after they sued and they got the information, there were only race and ethnicity data for about half of those, one and a half million records. So even at that level, we’re still missing these really important data points that help us figure out in the crisis, who needs help? How do we respond to the crisis? And then, afterward, helps us look back and make sure this kind of thing doesn’t happen again. But we are sorely lacking in even the most basic access to data.
Jeffrey: Do you have any insight as to why that would be from CDC?
Dr. Yasmin: I think we’re seeing it’s not a secret and you don’t have to look very hard to see how much political pressure is being exerted on scientists across the board, but especially scientists employed by a federal agency, the CDC. We’ve seen a few times, CDC scientists spend hundreds if not thousands of hours developing reports and guidelines to help lawmakers make policy and then we’ve seen their reports censored. We’ve seen their reports delayed or be sent back for revision. So I think that’s what’s happening is that the scientists at the CDC do about 11,000 of them within the US are trying to do the best work with the best available data, but politicians especially the administration has its own agenda and so isn’t letting scientists do the work and is exerting this political pressure so that they can spin the information and it’s very dangerous and detrimental to the public health response. It’s partly why we’ve seen America continue to smash records in terms of the number of new cases and deaths.
Jeffrey: Okay. All right. So then about vaccines, what’s your opinion on the likely timeline of a vaccine reaching the global population, and do you think it’ll be just one vaccine, or do you think it will be a one and done shot? Or do you think it’ll be an annual vaccine like the flu?
Dr. Yasmin: I think the fastest we’ve ever developed a vaccine previously is for mumps and that took four years and that was a record but we are working at a massively accelerated rate. It’s just amazing to me how far we’ve come along in the vaccine development process already, which is what happens, I think when you have more than a hundred groups of scientists looking at like a hundred and something different vaccine candidate and you have drug companies using completely brand new, never before approved technology and strategies for developing a COVID-19 vaccine. However, none of that is a guarantee that we’ll have even one successful vaccine. Although I hope we have multiple vaccines that make it through clinical trials and that are approved. I have to think about things like malaria and HIV where we just haven’t after decades of work been able to develop safe and efficient vaccines. Like I said, I hope that’s different now because we desperately need one and I’m looking very closely at Pfizer’s work, also the University of Oxford in the UK seems quite the furthest along I would say. If you ask those scientists, I’ve been interviewing different Drug Company CEOs and vaccine scientists around the world. If you ask them, some of them will say, “We plan to have a vaccine available by the end of the year, even or by early 2021,” and the US government itself has Operation Warp Speed which has a very ambitious goal of developing millions of doses of vaccines by January 2021. I’m hopeful and cautiously optimistic that that happens, but I think we have to be really open with people that vaccine science is tricky and sometimes what happens is you end up with something that’s amazing in clinical trials. But then you stumble at the stage of scaling up to millions of doses that in itself can take years and millions of dollars. So my hope is that we end up with a few vaccine candidates that give a long-standing immunity but there’s just no guarantee of that. What we wanted to see is governments, especially collaborating and continuing to invest in vaccine research.
Jeffrey: All right. Last question, somewhat related though. We’ve heard the term herd immunity as this relates. Can you explain what this means? And do you think we can ever achieve that in the United States?
Dr. Yasmin: So, herd immunity is this concept where when you have a specific proportion of a population whose immune to a disease, it stops outbreaks of disease occurring in that community just because there are so many people who are immune, the virus can’t get a hold of that community and cause an outbreak. The proportion of people that need to be immune to achieve herd immunity, that proportion is different for different diseases depending on how contagious they are. So measles is like one of the most contagious viruses on the planet for humans and you need to have like more than 90% of people immune in a population to have herd immunity to measles. For COVID-19, we’re thinking it’s more like 60 to 80% of people need to be immune. It’s unlikely we’re going to get that with natural infection, because what we’re seeing is that with people who get COVID-19 when you check their blood a few months afterward, the levels of antibodies are dropping. That’s not to say they don’t have any immunity, but we still need to understand what level of protection that gives them. On the other hand though, vaccine-induced immunity can be quite different to natural immunity. So say you get COVID-19 and then you have antibodies but they go away versus you get a COVID-19 vaccine and hopefully it gives you so many antibodies that they stick around for a really long time. So we still don’t know which vaccine will be able to do that. With Pfizer, we saw some very early data that showed that people who get their vaccine end up with antibody levels that are higher than people who get the infection naturally. So that is promising but in terms governments early on saying, “We’re going to have a herd immunity approach.” The British government even said, “We kind of let the virus just run through.” That clearly doesn’t work and also it’s really dangerous because then people suffer, get sick and we have no treatment for this disease. So we do really need a vaccine. But time will tell if that’s possible and also what kind of immunity and for how long a vaccine will confer.
Jeffrey: Thank you. This has been incredibly educational, informational, and highly interesting. So thank you so much for joining us today.
Dr. Yasmin: Of course. Thanks for having me.
Jeffrey: We hope you’ve enjoyed this week’s podcast. If you have any question, comments or future story suggestions, please reach out to us on social media. Thank you, and we hope you enjoyed the RP HealthCast.