Sawbones: Triple E and Public Health in 2024

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.

All right, tomorrow meetings about some books.

One, two, one, two, three, four.

We came across a pharmacy with its windows blasted out.

We saw through the broken glass and had ourselves a lucky round.

The medicines, the medicines, the escalat macabre

Hello, everybody, and welcome to Sawbones, a marital tour 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.

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.

Okay.

You should tell people the truth

always, but you shouldn't.

But hear my reasoning, right?

I know what you're saying, but when covet 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 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 this is 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

technically, what qualifies in a medical sense, I'd love to

say

that

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

quantifiable public health thing.

And so I'm a mega emergency.

I will, nor is a mega emergency.

I refuse to accept the premise of your question on those bases.

No, I want to talk about Eastern equine encephalitis, EEE, which you may have heard about in the news.

And it is,

while 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, we got it wrong on COVID, we did think it wasn't going to be the pandemic that it was.

We didn't get it wrong.

We got it in line line with medical science.

We changed it to like

well, but also I think there is a 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, I do think that the course of history could have been very different had

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 full by Easter.

So in my memory, if I remember right, we had it pretty much wrapped up.

Yeah, well, he had different graphs than everyone else, and no one was ever sure how that happened.

So Eastern equinox 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 a, I have not

so weird.

That is literally the grounds that I was about to set for you and I, like, what we're going to call it, like Triple E,

the trip.

I guess, well, I would not call it the trip.

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 Enceladus.

That one's fun.

Equine encephalitis.

But I guess Triple E works.

That's an easy way.

Yeah, because I don't want to say that every time.

And EEE is a weird thing.

An E-E.

E-E-E.

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 U.S.

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.

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 sandflies.

And if you look at them, like you break them down, they're 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 viridae family.

There's the flavaveridae family where you find West Nile virus and Zika is over there.

Dengue, you may have heard of.

And then there's also the the Bunyavir day.

Come on, Law.

Yo, let's kill all the mosquitoes.

We could do this.

Let's kill it.

And there's a bunch of them.

And there are different kind of like groups.

There's some that tend to cause these sort of, like an encephalitis is inflammation of the brain.

An itis is an inflammation of something.

And encephala 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 were kind of like a red roof in.

That don't, why you got to knock red roof in?

It might be there when you need it.

Yeah.

I don't know.

I don't even want to say it is.

It just might be.

So basically, in this case, with Triple E,

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, and different mosquitoes are hosts for, well, are vectors, not hosts, for different viruses.

The

Culicetta melanura mosquito is the primary vector for this, which is, it's 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 this is, that's expected.

Humans are actually considered dead-end hosts for this virus.

Meaning we're not going to transmit it to other people.

Exactly.

To To other stuff.

To other stuff.

And it stops with us.

We're the ballrog.

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

you're a dead host.

But do you know why?

Because you would think, I mean, like, 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 the mosquito would bite me, and you would think it would get it, right?

That's what you would say.

And it 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.

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 could have some of it, but not enough of it or whatever is, 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, and 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 it's, it's, 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

I 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 what out the point of thet wondered why the bacteremia is confused with the vi

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 organ transplant, which I isn't what we think of as human to human.

But yes, there was a case in 2017 of somebody getting triple E from an organ transplanted from someone who had it.

So you could give it to someone that way, but generally speaking, you're not going to give it to household contacts.

It's not going to 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, 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.

Triple E, while it is not as, we don't have as many cases, like for instance, with West Nile, we tend tend to have a lot more cases.

But the reason I think we talk about Triple E 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%.

Wow.

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 looked like an encephalitis.

the horses i assume were not behaving the way that horses behave they were acting differently not not majestic not no they didn't in any way seem elegant as they glided through the den they got very sick i i i 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, you know, 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.

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 don't know.

Do 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.

Like this isn't 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 like i think if you grow up in new england you probably do talk more about this um and certainly now you're going to uh but anyway that year it had been a particularly rainy july there were more uh cases of encephalitis among horses they had already observed and then they and then children started getting sick in massachusetts um 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 the horses are getting something.

This looks like the same thing.

We think that humans can get it too.

So it took them a while.

They figured out it's, 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 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

up looking all the way up to now.

So it was like an aberrationally bad year for it.

This was a particularly bad year.

And I think if you want to 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, you know, I don't want to say invade, but as we expand into more areas,

infect more areas.

Mr.

Anderson,

this is part of how we contract these illnesses that were originally in animals, other animals, is that we push our species into into their hey, you got any cool diseases here?

Look at that,

and so, like, so you're gonna 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's sort of that takes us to

I was seeing all these distressing headlines, that's why I brought in Dr.

Macro in the case.

Okay, I want to tell you that, but first, we got first, we got to go to the billing department.

Well, is there anything I need to know, like life or death stuff?

Um,

wear long sleeves, okay?

Let's go to the billing department:

the medicines, the medicines that escalate my god for the mouth.

Oh, these shorts?

You've noticed them.

Yeah, these are sort of a transitional short.

They go from the warmer months to the more formal short-wearing months of August and September.

When you need a classier short, where did I get them?

Yeah, thank you.

It's very flattering.

Quince is where I get most of my semi-formal shorts like these.

With the great prizes at Quince, you can get the perfect short or pant or any other garment or other item for whatever occasion, but you're going to get them with a great price and really wonderfully sourced.

Listen to this.

Quince has all the elevated essentials for fall.

Think 100% Mongolian cashmere from $50.

Washable silk tops and skirts.

Perfectly tailored denim.

By partnering directly with ethical top-tier factories and cutting out the middlemen, Quince delivers luxury quality pieces at half the price of similar brands.

I've really been impressed with all the garments that I've gotten from Quince.

I'm going to keep buying for them as a regular customer, even after the ad, because I've just been so impressed by these, and everything I've gotten from them has fit great, and I've felt great about buying it.

Keep it classic and cozy this fall with long-lasting staples from Quince.

Go to quince.com/slash sawbones for free shipping on your order and 365-day returns.

That's q-u-i-n-ce-e dot com/slash sawbones.

To get free shipping and 365 day returns quince.com/slash sawbones.

You want to eat smarter, you want to eat faster, though.

You don't have a lot of time to make these delicious meals, but you want to be putting all the things in your body that you love, that you crave, that you need with a great taste and not a lot of time commitment.

You got to reach for factor.

I keep a few of these in my fridge at all times.

Anytime I want a real actual meal, you know, not some bar that I've ripped open, but a real hearty meal, and I don't want to wait more than two minutes to do it, then Factor is there for me with over 65 weekly meals to choose from.

The variety here is really unreal.

If you were already a Factor member right now, you might have in your fridge garlic herb chicken with a vegetable risotto and roasted green beans.

You can just heat up and eat it, no problem.

You want charred corn and shredded chicken cavatopi?

No frigging problem.

Oh, but Justin, I don't have two hours to make.

Aren't you listening?

Two minutes, you could be eating eating a delicious meal from Factor.

They are very, very tasty, very easy, and they're, you know, you could tell these are made by people that care about your body and your tongue.

Is smart at factor meals.com slash sawbones50 off and use code sawbones50 off to get 50% off your first box plus free breakfast for one year.

That's code sawbones50off at factormeals.com for 50% off your first box plus free breakfast for one year.

Get delicious ready-to-eat meals delivered with Factor.

Offer only valid for new Factor customers with code and qualifying auto-renewing subscription purchase.

Hey everybody, I'm Jeremy.

I'm Oscar.

I'm Dimitri.

And we are the Euro Evangelists.

We're a weekly podcast spreading the word of the Eurovision Song Contest, the most important music competition in the world.

Maybe you already heard Glenn Weldon of NPR's pop culture happy hour talk up our coverage of this year's contest, but what do we talk about in the offseason?

The rest of Eurovision, duh, there are nearly seven decades of pop music history to cover.

We've got thousands of amazing songs, inspiring competitors, and so much drama to discuss.

And let me tell you, the drama is juicy.

Plus, all the gorillas and bread-bacon grandmas that make Eurovision so special.

Check out Euro Evangelists, available everywhere you get podcasts.

And you could be a Euro Evangelist too.

Ooh, I want to be one.

You already are.

It's that easy.

Okay, cool.

Most of the plants humans eat are technically grass.

Most Most of the asphalt we drive on is almost a liquid.

The formula of WD40 is San Diego's greatest secret.

Zippers were invented by a Swedish immigrant love story.

On the podcast Secretly Incredibly Fascinating, we explore this type of amazing stuff.

Stuff about ordinary topics like cabbage and batteries and socks.

Topics you'd never expect to be, the title of the podcast, Secretly Incredibly Fascinating.

Find us by searching for the word secretly in your podcast app.

And at maximumfun.org.

Okay, you've kept me in suspense 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 about.

Like, what does it look like?

What happens if somebody gets sick, right?

Okay.

96% of people infected with EEE are going to remain asymptomatic.

Okay.

They're not going to 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 going to get infected and have nothing.

And then there are going to be people who do have very nonspecific symptoms.

They've got a fever, they've 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 going to have no symptoms.

Okay, but 4% are going to have a lot of symptoms.

They don't don't know exactly.

Okay.

Do you understand?

I understand.

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 going to 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.

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 going to test for triple E

because it's rare.

You're not going to 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 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 would be really tough and that and that's why you see statistics like right now of the cases we're aware of in the u.s they're all severe well it's because they're the ones we're i mean

we aren't aware of all the not severe you know it's not it's not that every case right now it would look like a hundred percent of the cases in the U.S.

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 going to 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 going to have some long-term damage from the virus.

Can you clarify something else for me?

30%

of the severe cases.

Of those severe cases, so 30% of the

less than five.

40%.

Yes, exactly.

So it's a small, I mean, it's a small number.

But any, as we, as I often think with human life, any number that is one or more is a big deal.

It's 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 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 EEE this year, Tripoli.

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 U.S., 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 U.S.

of Triple E in 2019.

We don't know how many we're going to get this year.

We've had, 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 U.S.

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.

Wear 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 Macro Emerge and buy our Richard Stink cologne.

I have been told it works as an everything repellent.

It is not a mosquito repellent.

I just want to put that disclaimer up 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, you know, dump your buckets out around.

Listener, 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 can, you know, 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.

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 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.

Well,

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, I obviously 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 through that lens.

I will say, I mean, I would want, I don't have an opinion about whether or not it's a good idea to do that because I didn't 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 wild and out when COVID started.

There was a lot of recommendations that weren't necessarily, 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,

you know, I could see why you would have a natural inclination to want to be 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

that's a trump-led government response to covet 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 i i mean i felt the same way of course but i 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 president 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 triple E.

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, 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, it's not based on what political party you belong to.

Right.

But I'm, and I'm obviously not arguing whether or not, again, I'm not, 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's definitely a stripe of that.

What I, I guess, the point that I'm trying to, 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,

at the end of the day,

you could argue public compliance, right?

But that is part of public health messaging, communication, like 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, you know, I remember there was an announcement like, hey, we're done.

You know,

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, it's 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 U.S.

Did anybody talk?

Nobody's talking about that.

So, like, the idea that- But that's what I'm talking about, right?

Like, so what's the difference, man?

Like, what's it?

Why are we shutting down?

Like,

this up,

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?

Okay, well, I could think of one thing in that the past couple afternoons here, it's been 100 degrees.

But what's the, I mean, I think that what you're jumping up against is 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.

Right.

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 i 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 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 wisdom.

Again, if the public of health officials there say it's the right thing, it's the right thing.

I'm not questioning that.

I don't.

I'm married to you and I do this show.

I'm saying that

you got to like, that was kind of a mess.

With Taylor,

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 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, anti-whatever,

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.

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.

Right.

But are you going to 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.

From, I mean, to just as simple as leaving the house.

Right.

And to put that in focus for people is traumatizing.

Yes.

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 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 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, it's always going to be thorny.

It's always going to 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 going to 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, you know, 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 going to 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 triple E we'll 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.

Sure.

And climate change is another area of friend.

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 going to 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.

You got to sex it up.

I mean, 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 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 going to have about this post COVID world in this world where COVID exists.

I guess

what I was trying to get at, if I could 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 going to 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 is not, 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.

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 mean, I don't know.

I think

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, say, physical bonuses.

But the loss of that life is absolutely tragic and horrible for the people affected.

But when you ask 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 a had some provoking thoughts is that it was thought provoking is good

just you know my main thought is like kill all the mosquitoes

man just screw mosquitoes.

We did that podcast

up at the Bug People's spot,

up at WVU.

The entomologist.

The entomologist.

And I kept bringing up like, y'all think we should kill all the mosquitoes?

And I expected every one of them to be like, what are you kidding?

God's beautiful.

No, a lot of people I talked to there were kind of like, yeah, man, maybe we kill all the mosquitoes.

What if we did kill all the mosquitoes?

That'd be sick.

Let's just get rid of all the mosquitoes.

Hey, thanks to taxpayers for use of their song medicines as the intro and outro of our program.

Thanks so much to you for listening.

That is going to do it for this week.

Until next time, my name is Justin McElroy.

I'm Sydney McElroy.

And as always, don't drill a hole in your head.

All right.