Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Triple E and Public Health in 2024

Episode Date: September 3, 2024

A rare but deadly mosquito-born illness called Eastern equine encephalitis is prompting some local governments to limit evening play for kids. But after the COVID public health crisis, the discussion about how to best protect people has gotten much more complicated.Music: ""Medicines"" by The Taxpayers https://taxpayers.bandcamp.com/

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, this one is about some books. One, two, one, of misguided medicine.

I'm your co-host, Justin McElroy. And I'm Sydney McElroy. And I'm so... Listen, everybody, ring the warning bells. Everyone freak out. We're back. Public health nightmare crisis, super crisis. I had to bring it to Sydney's attention.

Don't say that. Because it's a massive super crisis. No, no. Okay. had to bring it to Sydney's attention because it's a massive super crisis. No, no, okay. Can I just say that even in cases where we have had public health, I mean crises, like I think it's fair to look back retrospectively and say we have all maybe collectively experienced those in even recent years, as well as distant history,

it's usually not a good idea to start out with there is a public health crisis, super crisis. Super crisis. I think I said a super emergency, but. In an alarming way, like that's not. You should tell people the truth always, but you shouldn't. But hear my reasoning, right?

I know what you're saying, but when COVID happened at the beginning, you and I were like, maybe it won't be so bad, here's hoping. But then it was. So my plan is, if we get ahead of this one early, and we say, hey, ring the alarm bell. If this goes fine, no problem. If it does turn bad, even though science says it won't,

then we're gonna come out smelling like roses. We're gonna look like the smartest podcast on the market. I do not. There is no one in public health who believes that this is a super crisis on the level with COVID. What? No one is making that statement right now.

It is something to be taken seriously. And can I just say, well, yes. Technically, what qualifies in a medical sense, I'd love to ask, what qualifies as a super crisis? Okay, let's see. Or a mega emergency. I fell into that trap. I accepted the premise of the question and I shouldn't have.

I wish I had, this is why, by the way, doctors do so bad in depositions. The one time I've ever had to do that, the lawyer gave me this advice. He said, listen, you doctors like to talk and talk because you think you're so smart and you never want to sound stupid. And so you just keep talking and talking and you just need to answer the question and shut up. And if you sound stupid, you sound stupid. And that is true. We do. We do like to keep talking. And I know super crisis is not a def like quantifiable public

health thing. And so I,- Nor is a mega emergency. Nor is a mega emergency. I refuse to accept the premise of your question on those bases. No, I wanna talk about Eastern Equine Encephalitis, EEE, which you may have heard about in the news. And it is, well, this is, yes, a serious thing that we should all talk about and be aware and be informed

so that we can make educated choices in our lives, which by the way, when you say like, we got it wrong on COVID, we did think it wasn't going to be the pandemic that it was initially. We didn't get it wrong. We got it in line with medical science. We didn't change to like, right. Well, but also I think there is something to be said

for the way that our country, the United States of America, chose to handle or not handle our response. My memory... So I do think that the course of history could have been very different. My memory is that we beat it by Easter. I very clearly remember then President Trump saying that it would be done by Easter and that we would be, the churches would be full by Easter. So in my memory, if I remember right, we had it pretty much wrapped up by Easter. Well, he had different graphs than everyone else.

No one was ever sure how that happened. So Eastern equine encephalitis, if you live in certain areas of the country, especially right now, if you live up in the New England area, if you're in Massachusetts, if you're in New Hampshire, you're probably very familiar with this. That's not the only place that it's present. It's also, we've had a lot of cases in Michigan and Florida,

so other states as well. But that's where I think all the news reporting is happening right now, and where it may even be affecting your local community in terms of public health measures and discussions that are happening. I heard one resident that they were interviewing, I believe in Oxford, Massachusetts,

who referred to it as Triple E several times. So I wonder if that's like, I have not. That's so weird. That is literally the grounds that I was about to set for you and I, like what we're gonna call it, like Triple E, the trip. I guess, well, we're gonna call it, like triple E, the trip. I guess, well, I would not call it the trip. E!

E! That's how it reads, that's how it scans. If we asked Cooper to read it, she would say, E! As you might guess, there is a Western equine encephalitis, so that is what distinguishes the Eastern equine encephalitis. But I guess triple E works. That's an easy way.

Yeah, cause I don't wanna say that every time. And EEE is a weird. And EEE. EEE. It's about as bad as mega emergency. You probably know about other mosquito borne illnesses. I feel like West Nile virus got a lot more press, which to be fair, it is more prevalent. It is present in more states across the US.

I think like 33 different states have reported cases of West Nile. It can be similar in that it's carried by mosquitoes and it causes neurological problems. And I think a lot of those sort of overlap. We did a Zika virus back in 2016. Also another Arbovirus. The Arboviruses are viruses that affect us

that are carried by ticks and mosquitoes. Yellow fever? Yellow fever, is that one? Yes. We did an episode by yellow fever. Ticks, mosquitoes and sand flies. And if you look at them, like you break them down, there are different like categories,

Eastern equine encephalitis and also the Western version and a couple other ones like Chikungunya, which we may have mentioned on the show before, are in the Toga Verde family. There's the Flava Verde family where you find West Nile virus and Zika is over there. Dengue, you may have heard of. And then there's also the Bunya Verde. Come on, y'all, let's kill all the mosquitoes.

We could do this. Let's work together. And there's a bunch of them. And there are different kind of like groups. There are some that tend to cause these sort of, like an encephalitis is inflammation of the brain. Anitis is an inflammation of something. And encephal refers to central nervous system, the brain.

So encephalitis, it's an inflammation of the brain is what's happening. And so that can be a variety of neurological symptoms, seizures, and obviously very severe illness, even death. And there are a whole bunch of different, some of these viruses are more prevalent. They usually are carried by some sort of vector like a mosquito, but they don't,

like that is not where they primarily live. They live in some other animal and then they get carried to us. And we are not the best host necessarily for these viruses, but they end up in our bodies. These are these- We're kind of like a red roof fin. No, don't.

Why you gotta knock red roof fin? It might be there when you need it. Yeah. I don't know. I don't even wanna say it is. It just might be. So basically in this case with EEE, birds primarily have this virus in them and then a mosquito bites a bird and gets infected with it.

And then the mosquito bites something else like a horse or a human or a pig or a pheasant. And there's a specific mosquito that we initially thought carried this one because there are different kinds of mosquitoes, of course. Lots. Different mosquitoes are hosts for, well, are vectors, not hosts, for different viruses. The culicida melanura mosquito is the primary vector for this, which is like different than when we talk about malaria. But we've also found evidence

that there are other kinds of mosquitoes who have adapted to carry it as well. Which, I mean, like these things change over time and the spread of mosquitoes change and the kinds of mosquitoes that carry them change. And so, so this is, that's expected. Humans are actually considered dead end hosts for this virus.

Meaning we're not gonna transmit it to other people. Exactly. Or other stuff. To other stuff. And this is- It stops with us. We're the ball wrong. Which is interesting because if I have, let's say that in this case I have Triple E and a mosquito bites me and then bites you, are you going to get it? No, because-

Do you know why? You're a dead host. But do you know why? Because you would think, I mean, why not? This is an interesting question. So you've got it, the mosquito doesn't. The mosquito bites me, it gets it. I understand conceptually, but I don't know mechanically.

Well, the mosquito would bite me and you would think it would get it, right? That's what you would assume. They can't catch it from us. No, because we do not get enough of a viral load in our bloodstream to efficiently infect a mosquito. Viral? So a mosquito biting someone with it,

just the chances that the mosquito would then ingest enough of the virus to carry it and give it to someone else is just not happening. Viral load is one of the wildest concepts that I walked away from COVID with. I did not have an awareness of this idea of viral load before COVID,

and I'm sure you, I hope, knew about it before COVID. But it is, it's really interesting to me. Like, I think I always thought of it as a much more binary thing, like you either have something or you don't. The idea that you have some of it, but not enough of it or whatever is a very new concept for me. It is. Well, and I mean, I think that, I think we have an easier time with bacteria because we can like see them on a petri dish. Like we probably all at some point have seen bacteria growing on a petri dish in like a picture or in a science class or something. Right. And it feels like something tangible and so when we talk about like how much bacteria like you've

got bacteria in your bloodstream like we picture something. I think viruses are harder for us because they are, we've talked about this a lot on the show, they walk that line between a living and dead organism. And they look wild like space alien ships. And so I think it's harder to imagine like a viremia, which means virus present in the bloodstream is a weirder concept to us than for some reason than a bacteremia is, I don't know. They're also smaller, so maybe it's just that.

You're drawing it, love, love. You're drawing a distinction that I'm not sure the layman is drawing on a day-to-day basis. This may be down into sort of like more of a doctoral thinking pattern. Okay, well, the only, in the, the point I was gonna make. I too have oft wondered why the bacteremia is confused with the, sorry.

The only point I wanted to make is that the one human-to-human case, the only human-to-human transmission that I found was an organ transplant, which I- isn't what we think of as human-to-human. You can see how that would happen, yeah. But yes, there was a case in 2017 of somebody getting EEE from an organ transplanted from someone who had it. So, you could give it to someone that way, but generally speaking, you're not gonna give it to household contacts.

It's not gonna spread in a classroom or something. Kind of like when you get a gift from your granny and she's a smoker and it's like, I really appreciate these pants, but I wish they didn't smell like smoke quite so much. The incubation period after the mosquito bite is like four to 10 days. And the reason we're talking about it right now

is because this is the peak time that we see cases of EEE, which we do generally every year, but some years we get more than others. So you can get it year round, but this is the time of year, especially like late August, it's mosquito season. I mean, you just got to think about when are the mosquitoes and when are they at their peak and this is when we tend to see them, late August. EEE, while it is not as, we don't have as many cases,

like for instance with West Nile, we tend to have a lot more cases. But the reason I think we talk about EEE is because it tends to be among the most fatal. We see a higher mortality rate, and so it's, I think, I mean, yeah, that's scary. It makes headlines, for sure. The mortality rate we think is around 30%.

There's no vaccine for humans right now. There is one for horses though. The first cases we saw were in horses. In the late 1800s, we started to see these cases. Well, there had been sporadic cases of what we look like in encephalitis. The horses, I assume, were not behaving the way that horses behave.

They were acting differently. Not majestic. Not, no. They didn't in any way seem elegant as they glided through the den. They got very sick. They died, and then they did, you know, autopsies on the horses, tried to figure out what happened,

and they found all this inflammation in the brain. That's an encephalitis. And so we knew there was something happening in horses in the late 1800s, and we suspected that it was this mosquito-borne virus, but it wasn't until 1938 that we knew it could happen in humans. And that was when it had been a particularly rainy July

in Massachusetts in 1938. And there were, of course, more mosquitoes than usual as a result. Mosquitoes lay their eggs in standing water, pools of standing water. So puddles or if you have things that sit around like buckets or something that would collect water and it would stand for a long period of time, small ponds, whatever. Mosquitoes lay their eggs there so you get more mosquitoes when it's raining. Do you think that's why you almost never see bird baths anymore?

I feel like that was a really common thing to see when I was a kid. I feel like we're more aware now of standing water and mosquitoes than we used to be, maybe. I don't know. I mean. You know what I'm saying? Like the stone with the circle, like the bird baths? I haven't seen a bird bath in 20 years.

I don't know. And I don't know what it's like to grow up in an area that has a lot of this. West Virginia, although I would question our disease surveillance ability with this, but. Oh. Chilling. We don't think a lot about mosquito-borne illnesses

in West Virginia, do we? I mean, do you remember that being a thing that we've ever discussed? But I think if you grow up in New England, you probably do talk more about this. And certainly now you're going to. But anyway, that year it had been a particularly rainy July. There were more cases of encephalitis among horses they had already observed.

And then children started getting sick in Massachusetts. In August, they started to see these cases of children being admitted to the hospital, severely ill and unfortunately some of them passing away from what was initially reported as encephalitis lethargica, which was they seem to have some sort of neurological problem. Their brains are inflamed, they're having seizures, but we don't really know what's happening. Over the next month, 25 people died, mostly children, of this new, what they eventually were able to isolate

from autopsy specimens, an infectious encephalitis. And then they tied it to the horses. Well, the horses are getting something, this looks like the same thing we think that humans can get it to. So it took them a while, they figured out, I was reading the case report actually from December of 1938 from a public health official in Massachusetts at the time.

It's so interesting when you can find like the original case reports of this written up, like the original epidemiological work that was done to trace them and everything. But they knew it was this virus. They now knew that humans could get this thing, horses could get. They knew that there was something like this in the West, but the Western version did not appear to be nearly as dangerous, as severe, or as fatal as this new Eastern version appeared to be. And at the time, it's interesting if you read the end of the, I read this entire article that was published, they say it appears that, or they were trying to figure out, were these humans near horses?

Did they have contact with horses to get it from the horses? And they didn't because of course we know that the mosquito was carrying it. Right. But then the other thing they say is, we have to assume the horse is a reservoir, but that really doesn't make sense because it kills horses too. So the horses aren't a good place to store the virus,

so to speak, because it dies. Exactly. And so it's interesting to see that kind of from a historical perspective. At the end of the article, they pose this idea that there must be something else that has the virus, but they don't know what it is yet. And eventually, of course, they'll figure out it's birds. But at the time, it's like you're watching the discoveries happen. So we had this big outbreak where we diagnosed it back in 1938. And that's a particularly high number of deaths, even looking all the way up to now, to the present. So it was like an aberrationally bad year for it.

This was a particularly bad year. And I think if you wanna know like, okay, why? Well, one, we didn't really understand how it was transmitted or anything yet. And so as you're looking into like mosquito control, what measures are we taking? Nobody would be doing any of that. You didn't know you could even get it.

We knew horses could get it. We didn't know we could get it. We didn't have a vaccine for horses. We couldn't prevent it in horses. We didn't even really understand that as humans, I don't wanna say invade, but as we expand into more areas. Infect more areas.

We, Mr. Anderson. This is part of how we contract these illnesses that were originally in animals. Other animals is that we show our species into their, you got any cool diseases here? And so like, so you're going to see that initially, and then there's this peak of understanding, and then we can start to control things a little better within reason. So what is happening now? That sort of takes us to today.

I was seeing all these distressing headlines. That's why I brought in Dr. McElroy in the case. Okay, I wanna tell you that, but first we gotta go to the billing department. Well, is there anything I need to know, like life or death stuff? Wear long sleeves. Okay, let's go to the billing department. Well, is there anything I need to know, like life or death stuff? Wear long sleeves. Okay, let's go to the billing department.

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about how to protect my family and me from this. So first of all, let me just, let me walk you through what happens if somebody contracts this. I think it's important to know what we're talking, like what does it look like? What happens if somebody gets sick, right? Okay, 96% of people infected with EEE

are gonna remain asymptomatic. They're not gonna have any symptoms, you wouldn't know you were. So this is part of why it can be hard to trace these things, right? Like what exactly is happening or to diagnose them right away. You have to have a high index

of what we call clinical suspicion, meaning that doctors in the area need to be aware this is out there and this is what it looks like because so many people are gonna get infected and have nothing, and then there are gonna be people who do have very nonspecific symptoms. They've got a fever, they got a headache, they feel like the flu.

Like it would look flu-like at first. You get some nausea, maybe some vomiting. Less than 5% of people who are infected are going to actually develop any inflammation of the spinal cord meningitis or inflammation of the brain encephalitis. You said infected, do you mean symptomatic? No, infected.

So like 5% of the people who are infected? Less than 5% are actually going to get super sick. Super sick? Yes. Okay. 96% are gonna have no symptoms. Okay, but 4% are gonna have a lot of symptoms? They don't know exactly.

Okay. Do you understand what I'm saying? I understand why you're asking this. One thing that is really hard in something like this is how many people who have fever, headache, blah, blah, blah, are gonna go in and get tested for anything at all? Not a lot.

I mean, how often does that happen in our family? And we, other than COVID, I mean, let's take COVID out of the equation because that changed a lot of things. But do you generally- You don't let us go to the hospital for anything. So we're probably not good. Well, but most people don't.

Most people, if your kid gets a fever and feels sick for a day or two, or if you do, most of us don't go to the doctor. Yes. So we wouldn't get tested for anything at all. Right. Let alone how many people are they gonna test for EEE? Because it's rare.

You're not gonna be thinking about it. And so with diseases like this, it gets really difficult to pin down statistics. How many people get infected? How many of those people have any symptoms? How many of those people have any symptoms? How many of those people have severe symptoms? Those numbers are really difficult, right? We don't have a lot of numbers to draw from

and we're kind of guessing based on who gets tested. Which would be obviously a lot more terrifying and challenging if it was something we were transmitting between ourselves, right? Because the inability to track it would be really tough. And that's why you see statistics like right now of the cases we're aware of in the US, they're all severe. Well, it's because they're the ones where, I mean,

we aren't aware of all the not severe, you know? It's not that every kid, right now it would look like 100% of the cases in the US are severe. Well, no, it's 100% of the cases we know about are severe. And why do we know about them? Because they're severe. Does that make sense? Yeah.

So if you do get the neurological symptoms, they're gonna appear pretty fast, like usually within the first five days. You can have seizures, there can be confusion. You can have some stroke-like symptoms at times, but that's less likely. It's more just like, you know, the entire brain is inflamed.

So it's a problem everywhere, not just in one part of the brain, like a stroke would be. If you get, if obviously 30% can die from this, of those who do survive, half are gonna have some long-term damage from what the virus did. Okay, can you clarify something else for me? 30%? Of the severe cases. Of the virus did. Can you clarify something else for me? 30%?

Of the severe cases. Of the severe cases, so 30% of the, roughly 4%. Yes, exactly. So it's a small, I mean, it's a small number. But any, as I often think with human life, any number that is one or more is a big deal. Is a big deal, it's a big deal, especially if there's a way we can prevent it,

which is the question. And this is what I've been curious about, right? Because I get these like news briefs in my email, like a lot of people. And I saw like two discrete headlines about this. And it was enough when I see a health thing like that pop up, it makes me wonder. But I find myself wondering if it's this hard

to figure out how bad it is, how is it making headlines? Okay, here is why it's making headlines. One, a person unfortunately died of EE this year, triple E. A 41-year-old man in New Hampshire passed away on August 19th after a very short, rapidly progressive severe illness. He was previously healthy according to his family. And so I think when a younger person passes away from a severe, rare illness, I think that makes headlines.

And I think that escalates the amount of fear we have associated with it. And in New Hampshire, this was their first case of it since 2014, not in the US, but in New Hampshire it was. The other reason, the last year that we had major transmission was 2019. There were 38 cases in the US of triple E in 2019. We don't know how many we're going to get this year. As of the time of this recording, and this may change by the time you listen to this,

but as of this moment, there have been five cases in the US. So it's not a huge number, right? But obviously, one of them has been fatal, which is scary. And I think that part of why we're seeing these headlines is that in reaction to this, the recommendations from the CDC and then from local health departments are some basic things when you're outside, wear long sleeves and pants so that you don't get mosquito bites there. Where an EPA approved mosquito repellent,

which by the way, you can go to the EPA website and look up lists of approved mosquito repellents if you're not sure. Or you can go to McElroy Merchant by our Richard Stink cologne. I have been told it works as a everything repellent. It is not a mosquito repellent. I just wanna put that disclaimer up there. It's not as a everything repellent. It is not a mosquito repellent. I just wanna put that disclaimer out there.

It's not an approved mosquito repellent. You can make sure you remove mosquito breeding grounds around your home. If you've got standing water around your home, dump your buckets out or whatever. Listen, if you have a bird bath and you're like, what's the matter, bird baths are cool, go outside, smash that bird bath right now.

They're doing aerial spraying in some of these communities. They take planes around and like, kind of like crop dusting spray to kill mosquitoes. So like all of those measures can be taken on a wider scale or on an individual scale or the public health professionals can do that. But then they're also saying, we would recommend, don't go outside between dusk and dawn.

And then some local governments are taking the steps of closing maybe a public park or playground or a field where people play sports between dusk and dawn, or maybe proposing that we move evening sports to afternoon before the sun goes down to prevent, especially children from contracting this illness. This, I think, is why you're seeing the headlines. And if you read, I've read some of the articles around it, they're very much discussing this. We do not currently, as a society, and I don't know if it's a U.S. thing, I don't know if this is a, listen, I'm not from Massachusetts, so you can tell me if you are,

I don't know if it's a Massachusetts thing. Our appetite for government restrictions on our activities to protect us from the spread of a deadly virus seems to have waned. And there were in preparation for the local board of health, I was reading an article about Oxford, Massachusetts, in preparation for like a local board of health meeting to discuss should they put restrictions on public park access or curfews or just recommendations. There were already parents and local people

who were ready to go fight. I think that they were ready for sort of the, you remember the school board fights over masking during COVID. I think there were a lot of people prepared for those arguments again, because we have kind of codified this idea now because of COVID, that somehow taking public health measures to prevent the spread of an illness

automatically infringes with our American idea of individual freedom, always. That the two cannot coexist somehow. And I will say in Plymouth, Massachusetts, they actually did put some of these measures into place and there's like a petition circling. Like they moved Friday evening football to Friday afternoon football, and there's already people like petitioning,

like no, move it back to the evening. Because I mean, the idea is like, these are my kids. I want to take, like, I get to take whatever risks I want to or don't want to. I will mitigate the risks to them, and I don't need the government to tell me how to mitigate risk for my children or myself. I mean, it's, I obviously would not want to, I mean, we've made it pretty clear our stance about public health and, and that stuff. So I hope that this is all contextualized to that lens. would not want to, I mean, we've made it pretty clear our stance about public health and that

stuff. So I hope that this is all contextualized to that lens. I will say, I mean, I would want to, I don't have an opinion about whether or not it's a good idea to do that because I had been look at the science. I'm assuming that people in positions of authority are looking at that and making the best decisions they can. Yes, those are the public health recommendations from the both federal and local levels. I will say though, part of the picture of this might be

that a lot of public health was really wilding out when COVID started. There was a lot of recommendations that weren't necessary, that didn't turn out to be like that helpful or that important and they changed a lot and they shifted a lot. And I think that when you've been through that scenario, I think it's, and you do have to like, you are put in a position where you are having to make those decisions for your

family, which everybody was put into that position in 2020, then I could see why you would have a natural inclination to want to have some sort of like agency there. Because we were all taught that for three years or whatever. We all had to make the best decisions because the government by and large was not looking out for us. It's interesting though, because I don't know, I mean, I certainly did not trust a lot of- That's a Trump-led government response to COVID, by the way, which if you went through

that and your takeaway was, man, it's really hard for public health to manage something like this. I don't think I could fault you for that. I understand that. And I mean, I felt the same way, of course, but I do trust the CDC. And I do, I mean, if you look at the public health recommendations that are evidence-based, that come out of entities like the CDC,

and then are spread down through your local departments of health, they make sense, they're evidence-based, they're smart to follow and they have nothing to do with any past or present, right? The idea of personal freedom and like, I don't want to live in fear, has been, I think, generally applied to, I shouldn't have to do anything that someone else suggests is a good idea for me. I should make every decision based on my own personal morals,

values, ethics, and what I think is right. And that's a wild thing to say when so many of us don't, I mean, I don't do mosquito surveillance. I don't know how many mosquitoes in these various counties in Massachusetts have been surveyed and found to contain EEE. But there are government officials who do, and you can like check. They have a whole workbook, I was looking at it, where you can like check. They have a whole workbook. I was looking at it where you can, and it's updating constantly,

just updated again as I was looking at it, where you can look at the risk map and the reporting and in your area, what is the risk level? And there's colors. And you can look at all that and it's based on science. It's based on going out and catching mosquitoes and checking them for this virus. I mean, it's not based on what political party you belong to.

Right. And I'm obviously not arguing whether or not, again, I'm just saying that I think there's a more nuanced thing than like there's a whole half of the country that is always going to be anti-public health initiatives. And I understand that there is definitely a stripe of that. What I guess the point that I'm trying to get to is, if you live through a public health crisis that was so badly mismanaged

as the COVID-19 pandemic in America, if you had a lack of faith in public health institutions, I can understand where that would come from. I mean, yes, that's a valid. I mean, I guess at the end of the day, you could argue public compliance, right? But that is part of public health, messaging communication, like not not overreaching and not just throwing out, you know, things that seem like good ideas, because we want to be doing something. I'm saying if you if

you were in a situation like COVID, where it was so badly mismanaged, and then by the way, the management just kind of stopped, like everybody just kind of like, there was never like a, okay, we're stopping it. There was like, even though the government, I remember there was an announcement like, hey, we're done, you know. Mission accomplished.

We got a vote coming up soon, like we're done with COVID. Like it was, I don't think that public health officials get a free, like, well, now you always have, like, that loss of trust is going to affect everybody, even people who did their jobs brilliantly, like, as part of it. Like, we live through a really crappy public health debacle. And these conversations are going to be crappy to have for a really long time. Well, and I think that's why you're seeing the news reports about it, because it seems

to me, and granted, I do not live in an area of the country where this is particularly prevalent, although, I mean, there are other mosquito-borne illnesses that, like I said, West Nile virus, we had 2,200 cases last year and 182 people died in the US. Did anybody talk, nobody's talking about that. So like the idea that- But that's what I'm talking about, right? So what's the difference, man? Like what's the difference, why are we shutting down?

Well, but listen, part of the problem is that West Nile is more widespread and the season for it is longer. We are talking about a season that if you just keep kids from playing football or whatever other sport in the evening for like another month, you're out of the peak risk. And so what they're saying is why wouldn't we just play these sporting events in the afternoon? Um, okay. Well, I could think of one thing in that the past couple of afternoons here it's been a hundred degrees. But what's the, I mean, I could think of one thing in that the past couple of afternoons here, it's been 100 degrees.

But what's the, I mean, I think that what you're bumping up again, okay, well. Heat stroke for kids is like a real threat. But you're, I think there is a major difference between don't leave the house and don't see your loved ones, which those were our recommendations for a while with COVID, right? Right.

Don't go anywhere. And that was hard for all of us, right? It was hard, whether it was the right or wrong thing to do, it was hard. And what they're saying is playing outside at this very specific time of day during this very specific time of year, probably you'll still be fine,

but there is a rare chance that your kid gets bitten by a mosquito and then gets a fatal brain infection. Right. What do you want to do with that information? I mean, I very much can see the logic of if I think you remove people's agency by having events, you know, if you can move the events, great. That's all I'm saying, just move the events. I know, but I'm not, I am not trying to debate with you the specific like wisdom.

Again, if the public of health officials there say it's the right thing, it's the right thing. I I'm not questioning that. I don't, I'm married to you and I do this show. I'm saying that you, you got to like, that was kind of a mess. Oh, it was kind of a mess. And like people have a lot of really strong feelings that I think are again, not a failure of any one person except for the obvious, like, I think that it's going to

be if you go into it, deciding that anyone who is bridling to this is just like an anti vax, like anti government overreach antiatever, I think that you lose the people in the middle who are like, are we, I'm trying to think about my family in the same way that the government forced me to for several years because it did not look out for me in an effective way during the COVID pandemic. Well, I think that the problem is what we've done is crystallize the absolute most difficult part of, I mean, right now we're talking a lot about parenting

and not individual risk, which I think is a different thing, by the way. I think that's why what you're hearing in a lot of these articles are people who are upset about limitations being put on what their kids can do and not necessarily what they can do. Right. And I think it's because if you get right down to it, limitations being put on what their kids can do and not necessarily what they can do. And I think it's because if you get right down to it, every time as a parent, you let your kid ride in a car,

you're taking a risk. But are you gonna never let your kid ride in a car? And that question is the thing that keeps me awake at night. It's the thing that from the moment we became parents, it's why I can never fully relax. And I don't know if I ever will, because what risks do you take with the most important thing that you've ever had in your life?

What risks are okay? And COVID made us ask that question constantly for every single thing we did. Right. And COVID made us ask that question constantly for every single thing we did. To just as simple as leaving the house. And to put that in focus for people is traumatizing. It's horrifying, it's traumatizing. And every time you make us do that again, we are going to have a natural impulse

to get angry and defensive and not want to engage with it. Because I mean, it's too hard to touch. It's just so hard to touch constantly. Yeah. I'm taking, I'm really am trying to, I'm trying to be more charitable towards people because no matter how you reacted to it, we all went through it.

Like everybody experienced it, right? To a person, everyone experienced it. And I guess what I'm trying to, I'm trying to say that no matter who is talking about stuff like this in the future, it is going to be a conversation. But I don't think that it can be a conversation of the public health system telling people, here's what you need to do to stay safe. Because I think that the idea of public health

lost a lot of credibility during COVID. So I think that that is going to be, and if public health officials don't have the sensitivity to that, and if they don't understand that those conversations have to look different if you want, you know what I mean? Because I'll give you an example, right? Five years ago, if someone had said this, the average person probably wouldn't have ever in their life looked at a freaking chart every day to see the number of infections, to see if it was safe to let their kids go to the mall. You know what I mean?

Like, it's always gonna be thorny. It's always gonna be a conversation, but I don't think if you are a public health official that really wants change, you can just stick to what I think was the talking points during the thing, which is here's exactly what you need to do, and it keeps changing, but like, we're not really gonna manage it. In crises situations, you're supposed to be open and honest, give information as it's

available and share what you do and don't know. That is how you gain trust in the people around you, trying to withhold information, hide things, keep things that might be scary or alarming from people, eventually people will find out and they're going to be less trustful of you because you didn't tell them to begin with. We didn't have that, right? We didn't have transparency. We didn't have honesty.

And we also, I mean, it's a top-down thing, government officials from our elected leaders to people appointed to the scientists who work in offices and everything have to not only be transparent, but have to do their best to not allow politics to guide public health policy. And I mean, they're going to be part of it. You can't remove it. We're humans. You're not going to remove politics from public health.

There's always going to be things that brush up against our own personal values and that aligns with our politics, whatever. But this is gonna become more and more important that we have leaders who try their best to stick with, here's the truth, here's what we know, here's what we don't know, here's what we're doing to find it out,

here's what we recommend right now, here's what we're looking into that might change. It's really important that we do that because part of why we might see, and I don't know how many more cases of EEE we'll see. Nobody knows right now. We'll see. But if we do see more and we start to see that trend as years come, it is because climate

change is part of this story. And climate change is another area of, I mean, it isn't just public health, but public health is intrinsically connected to climate change. And climate change has become so politicized that you can't even say we're going to see more mosquito-borne illnesses in parts of the U.S. where we haven't seen them before because of climate change, that statement isn't even widely accepted because of how many people refuse to accept the scientific truth of climate change. And so we can undo the damage,

but it is gonna take a long time. I mean, I don't give up that COVID completely decimated our ability to make smart public health decisions. But I do think that scientists will often say, I shouldn't say will say, I think there is a belief in the scientific community that if we have the truth and we have the facts and we just present it clearly, that's enough. And that is not enough.

It will not be enough. And that is not enough. It will not be enough. You gotta sex it up. Maybe that's why people in Massachusetts have started calling it Triple E because that's... A little more catchy. Yeah, it's a catchier name than Eastern Equine Encephalitis. But I think that's why you're seeing the stories about it. It is something to take seriously, especially if you're in those areas. There's tons of information seeing the stories about it. It is something to take seriously, especially if you're in those areas. There's tons of information

from the local public health officials in those areas about what you should do and how you can mitigate your risks and all that kind of stuff, recommendations, mostly not rules, but things that they advise you to do. So obviously we should take these things seriously, but I think that it's the conversations we're gonna have about this post-COVID world, in this world where COVID exists. I guess what I was trying to get at, if I can distill it down a little bit, because

I'm worried about how I've sort of presented my viewpoint here, I think that if we as a nation had had a robust and effective long term response to COVID that meaningfully was able to respond to it, I think that these conversations would be a lot more different. Because I think that if we had had leadership in that moment that had united us in this thing, instead of made it a divisive thing, like that it might be a much easier, different conversation. But like those saying like that, that isn't what happened,

but that's not the fault of the people who were burned by it. And the people who got like misled or, or, or whatever, they can still be part of a public health response. It's just that conversation is gonna look so much different than it would have if things had gone a different way. Yeah. I mean, I don't disagree with you at all.

And I mean, it's not fair to just expect everybody to forget everything that's happened since 2020. I mean, you can't just, it doesn't go away. Yeah. I'm assuming that silence was shortened in the edit. Thanks so much for listening to our podcast. I didn't mean for it to be that heavy, but I think it's, I mean, you asked the question,

why is everybody talking about it? And as I started digging into the research, I was like, well, I mean, we've definitely seen cases, but it doesn't sound like so far we're seeing a ton more or something than we normally would. Certainly someone dying from something that, and I mean, when I say preventable, I mean, these are hard measures to take, right? Staying inside and wearing long sleeves, especially when it's hot out. I mean, like preventable to an extent, but not, I don't know, preventable is a tough word in this case, right? And so, but I mean, obviously that is something

to take seriously and obviously for the people affected, it's horrible, I mean, it's a tragedy. Obviously, yeah. That's the problem with public health, we bump into constantly with public health, right? If you're talking about public health, it's very hard to, you start to elide the tragedy of like an individual death as you're talking

about like statistical pumps. Right, but the loss of that life is absolutely tragic and horrible for the people affected. But when you asked me and I'm looking at the numbers, I'm like, well, this is not, I wonder why there's all these stories about it. It doesn't seem like a particularly standout year in terms of numbers. And then, I mean, I really think that's why, because we're going to be, every time something like this happens, the shadow of COVID is over us. Thank you so much for listening to our podcast.

We hope you have enjoyed yourself, is it right? But maybe had some provoking thoughts. Is that it was thought provoking? That's good. Just, you know, my main thought provoking? That's good. Just, you know, my main thought is like, kill all the mosquitoes. Kill all the mosquitoes, man. Just screw mosquitoes.

We did that podcast up at the bug people's spot, up at WVU. Entomologists. The entomologists, I kept bringing up like, y'all think we should kill mosquitoes? And I expected every one of them to be like, what are you kidding? God's beautiful. No no a lot of people I talked to you there were calling yeah man maybe we kill all the mosquitoes

all the mosquitoes sick just get rid of all the mosquitoes hey thanks to taxpayers for use their song medicines is the intro and outro of our program thanks so much to you for listening that That is going to do it for this week. Until next time, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head.