This Podcast Will Kill You

This marks the second installment in our Anatomy of a Pandemic series, in which we discuss the various aspects of the COVID-19 pandemic. In this second chapter, we explore what we currently know about the disease itself, from symptom progression to incubation period and the role that asymptomatic individuals play in the transmission of disease. Our firsthand account, told from the perspective of a respiratory therapist, illustrates the severity of this disease and the frightening, yet very real, prospect of running out of medical equipment, protective gear, and hospital beds. We then discuss what we currently know about COVID-19 from a clinical disease perspective. We are joined by Dr. Colleen Kraft (interview recorded March 19, 2020), whose voice you may recognize from our first episode on coronaviruses. She helps to break down some of the disease-related questions sent in by our listeners. We wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below:

1. What does "respiratory droplet" transmission mean, and how is this different from something with "airborne" transmission? (15:08)
2. What are the symptoms of COVID-19? (16:48)
3. How long is the disease course, and how does this vary between mild vs severe symptoms? (18:45)
4. What does "supportive care" mean in the context of caring for people who fall severely ill from COVID-19? (19:40)
5. How much does viral load correlate with the severity of symptoms? (20:47)
6. What is the incubation period of this disease, how long do people remain infectious, and are asymptomatic people contributing to the spread of disease? (22:22) 
7. What are the groups that are particularly at risk for severe disease? (24:00)
8. Why do children seem to be more resistant to this infection? What about children who are immunocompromised, are they at risk? (27:40)
9. What is the case fatality rate, and how might we expect it to change throughout the course of this pandemic? (29:09)
10. Are there long term complications associated with COVID-19? (31:58)
11. Is it possible to get re-infected if you get this virus and then recover? (32:54)

The full article our firsthand account came from can be found here: https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients

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To discuss the ongoing COVID-19 pandemic, we are introducing Anatomy of a Pandemic, a series in which each episode tackles a particular aspect of COVID-19, from virus biology to clinical disease, from control efforts to epidemiological patterns, from vaccine development to mental health coping strategies during this uncertain time. And we’ve got a quarantini (and placeborita) recipe for each installment! In the first episode of this series, we tackle some of your questions about SARS-CoV-2, the virus that is responsible for COVID-19 (aka COronaVIrus Disease-2019). Our episode begins with a firsthand account from Tiziano, a schoolteacher in northeastern Italy who has been living under the strict movement restrictions imposed by the Italian government in an attempt to limit the spread of the disease. Then, we review some of the basics about SARS-CoV-2 and RNA viruses in general. To help us discern fact from fiction, we seek the expertise of a virologist, Dr. Angela Rasmussen (interview recorded March 15, 2020), who answers some of the listener-submitted questions about the virus itself. We wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we have listed the questions below:

1. What are the origins of this virus? Where did it come from?
2. How can we tell whether this virus originated from one spillover event or multiple?
3. What do we know about the mechanism of how this virus causes disease in humans?
4. Are there multiple strains of SARS-CoV-2, and how do different strains of virus affect disease severity? 
5. Is there a risk of SARS-CoV-2 mutating into something more deadly? 
6. What is Remdesivir and how does it work? 
7. How does handwashing work to reduce transmission risk?
8. How long can SARS-CoV-2 live on surfaces? 
9. What is the minimum infective dose of SARS-CoV-2?

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Everyone loves a good poop story, don’t they? We certainly hope so, because our good friend Katie shares a fantastic one to kick off our episode on lactose intolerance. In this episode, we explore what lactose is and the symptoms that lactose non-digesters experience when they eat some sneaky cheese or ice cream. Then we explain that this episode is actually flipped - turns out that not being able to digest lactose is the normal state, and those of us who can are actually the mutants! We trace the origins of this mutant allele and how the persistence of pastoralism spread milk drinking far and wide. Where do we stand with lactose intolerance today? Tune in for that answer and for an abundance of milk facts to arm yourself with for the next pub trivia night.

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From its discovery only 30 years ago to the recent development of an effective treatment, the short life of the Hepatitis C virus certainly has been action-packed. This week, we take you through the biology of this deadly virus by exploring its cancer-causing qualities and pondering the plural of hepatitis. Then we take a stroll through the often bizarre and disturbing history of blood technology, discussing how a lack of sterilization and screening allowed for the proliferation of the Hepatitis C virus around the world. Finally we ask, “what’s going on in the world of Hepatitis C today?” Spoilers: it’s not all bad! As long as you can afford the treatment of course...

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[TRIGGER WARNING: see below] Whooping cough, that terrible childhood scourge, has been making an alarming comeback due to lapses in vaccination coverage across the globe. And in this episode, we’ll tell you why exactly its return is a cause for concern. From the devastation it wreaks on the body to the untold tragedy of past epidemics, pertussis is a dreaded disease that was nearly relegated to the past thanks to the amazing efforts of three incredible researchers, Pearl Kendrick, Grace Eldering, and Loney Gordon. But as the provider of our firsthand account illustrates, pertussis is still very much present today. We are joined by the incredible Catherine Hughes, who does us the honor of sharing her story about her son Riley and her efforts to raise awareness about the importance of childhood vaccinations.

 

Read more about the Light for Riley campaign and the Immunisation Foundation of Australia to see the hugely important work being done.

 

Trigger Warning: The firsthand account of this episode features the death of an infant. If you do not wish to hear this, skip to 5:10.

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What better time to explore the world of coronaviruses than amidst an outbreak of the 2019 novel coronavirus that brings to mind memories of SARS and MERS? On this very special episode of This Podcast Will Kill You, we’ll take you through what we know about this diverse group of viruses, from the mild strains constantly circulating to the epidemic ones that make headlines with their lethality. Want to know how exactly these royal viruses make you sick? Or what went on during the 2002-2003 SARS epidemic? Don’t worry - we’ve got you covered. And to help us get a grasp on the current 2019-nCoV outbreak that’s got the world’s attention, we’ve brought on four experts from Emory University to give us the lowdown: Dr. Colleen Kraft, Dr. G. Marshall Lyon, Dr. Aneesh Mehta, and Dr. Carlos del Rio.

*Please keep in mind, we recorded this episode on Sunday, Feb 2 and conducted the interviews between Jan 29 and 30, 2020. Since recording, the statistics on 2019-nCoV that we and our guests reported have changed as the epidemic continues to evolve. The figures are changing fast, but the basic info is still relevant.

To follow the 2019-nCoV outbreak, our experts recommend the following as reliable sources of information:

1. WHO 2019-nCoV website, especially the Situation Reports
2. Map Dashboard of 2019-nCoV Cases by Johns Hopkins Center for Systems Science and Engineering
3. CDC 2019-nCoV website

And to learn more about the amazing work that our special guests do on the regular, follow them on Twitter!

Colleen S. Kraft, MD, MSc (@colleenkraftmd)

G. Marshall Lyon, MD, MMSc (@GMLyon3)

Aneesh K. Mehta, M.D., FIDSA, FAST (@AneeshMehtaMD)

Carlos del Rio, MD (@CarlosdelRio7)

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Our first vector-borne disease episode of season 3 and our first mosquito-borne pathogen in quite some time, dengue virus proves itself to be more than a worthy topic (and quite a formidable adversary in terms of public health). This week we are joined by Dr. Alex Trillo who drops some firsthand knowledge on the excruciating symptoms that give dengue its colloquial name “breakbone fever”, and then we trace the virus’s path from its evolutionary origins in ancient forests to the inevitable emergence of dengue hemorrhagic fever following modern war. We round it all out with some truly horrifying stats on the prevalence of dengue today as well as some promising research on reducing the prevalence of dengue tomorrow.

To find out more about Alex’s incredibly cool research, check out her website at www.alextrillo.com and follow her on Twitter at @Trillo_PA.

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Have you missed learning about plant poisons? Well, it’s your lucky day! Today is our first crossover of season three with our friend Matt Candeias of In Defense of Plants. In this episode we delve into the castor bean plant Ricinus communisand its two notorious products: castor oil and the star of the show, ricin. Join us as we learn about ricin’s storied history, which leads us through political assassinations and efficiency in engines, the biology of ricin, which horrifies us with its lethality, and finally, the ecology of the plant, which surprises us with its strategic partnerships.

Looking for more ways to cure your plant blindness? Check out In Defense of Plants at indefenseofplants.com and follow Matt on twitter @indfnsofplnts.

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In 1518 a strange sight could be seen all over the town of Strasbourg. Crowds of people dancing unceasingly, unable to control their movements, seemingly heedless of their blistered and bloodied feet. As the contagious dance grew, so did the body count as the frenzied dancers succumbed to exhaustion. Over 500 years later, this dancing plague leaves us with many questions, first among them being, “What in the heck?”. In this episode, we try to get to the bottom of this mysterious infectious dance by investigating several different hypotheses, which lead us down some wild roads. Tune in, put on your best dancing shoes, and drop that beat.

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You’ve seen the headlines: could this cat-associated parasite be controlling your every move? Is the love you have for cats pure or merely a manipulation? Join us as we discuss Toxoplasma gondii, the feline-associated parasite that infects a whopping one third of all humans. Yes, you read that right. From the behavior-altering effects on rodents to the ancestral origins of the domestic cat, we dive deep into all things toxoplasmosis, the disease that sounds like it comes straight out of a sci-fi novel.

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