John Hockenberry, The Takeaway: Here are the numbers: The outbreak has killed more than 100 people in Mexico. There are 22 confirmed deaths specifically from swine flu, that’s from the New York Times. More than 1,600 people are believed to have contracted the virus in Mexico. And around the world there are cases reported, from New Zealand and all around the world, especially here in the United States where there are 20 confirmed cases in the United States, from California to New York, Ohio, Texas. Six cases in Canada. It’s too early to say this is a pandemic. It’s even too early to say it’s an epidemic in Mexico. It is an outbreak. What does that mean? Tom Skinner, spokesperson for Centers of Disease Control joins us from Atlanta, where we can hear the activity going on behind him. Tom, thanks for being with us.
Tom Skinner, Centers for Disease Control and Prevention: Absolutely. My pleasure.
John Hockenberry: First of all let’s talk about the numbers in the United States. Twenty at this hour, but is that likely to rise?
Tom Skinner: It is. We’ll most likely be reporting more cases this afternoon, but as of right now we have 20 confirmed cases in five states, but because we’ve increased surveillance here in the United States, we fully expect to see more cases in more states. Some of those cases might be severe, and we probably won’t be surprised if we actually see some deaths associated with this.
John Hockenberry: That’s pretty alarming, Tom. The Homeland Security secretary declared a state of emergency, a public health emergency, and then backed off or qualified it by saying it’s standard operating procedure. Can you give us some insight on what a public health emergency declaration means?
Tom Skinner: Actually, it allows the public, when you state a public health emergency, it allows the government to exercise certain actions that normally aren’t allowed. It allows for the use of investigative laboratory tests. It allows for release of medicines out of the stockpile to be used by people who may need them. It broadens the authority of the federal government to take the necessary actions that it needs to take to protect the public health and that’s really what it’s all about.
John Hockenberry: So it fast-tracks preliminary steps of preparedness. Finally, before we go, remind people what they need to know to take their own preventive measures to possibly avoid contracting this disease whatever the circumstances are.
Tom Skinner: Those things that Mom taught us as children really do work. Washing your hands does work as a step to protect others. We want to make sure we’re not sending our children to school if they’re sick. If we’re sick, we don’t want to be going in to work and infecting others. There really are steps that we can take to protect ourselves, but also protect others. And we really are in this together, so we need to take the appropriate steps to protect others as well.
John Hockenberry: Alright. Tom Skinner, spokesperson for the Centers for Disease Control, speaking to us live from Atlanta. Thank you, Tom.
Tom Skinner: Bye-bye.
John Hockenberry: Again, he’s saying that the numbers in the United States will rise. They’re expecting to make announcements at the CDC later on this morning, and that there may be some deaths or at least a reporting of severe cases in the reports later on today. Dr. Richard Wenzel is an epidemiologist and is the immediate past president of the International Society for Infectious Diseases and chairman of the Department of Internal Medicine at Virginia Commonwealth University. He joins us from Richmond, Virginia. Dr. Wenzel, thanks for being with us.
Dr. Richard Wenzel, Virginia Commonwealth University: Good morning. A pleasure.
John Hockenberry: Now, you know, based on what Tom Skinner just said, what your mom told you really works in this instance. Wash your hands, is that the best effort that can be made to prevent infection of this disease by people who are listening and watching this morning. Or should we actually be putting on the masks like the people we’re seeing in Mexico City?
Dr. Richard Wenzel: That’s a good question. We haven’t had a big scare about influenza for a long time. In looking back, some studies in SARS show that masks were protective in the Far East. So it may be that if this really gets out of hand, masks will be useful. Certainly in hospitals we use masks as clinicians when dealing with patients.
John Hockenberry: Now you said if this really gets out of hand we’re going to put on the masks. As a clinician, what does that mean.
Dr. Richard Wenzel: What we’re saying is that most influenza is acquired by very close contact with people, within three or four feet, where if they talk loud or sing or cough, the droplets that are very large most of the times with flu can get on our own respiratory track. Now, rarely there are occasional instances where flu looks like it may even be airborne, like tuberculosis. When somebody coughs, instead of large droplets that fall to the ground, very small droplets, like microscopic hot air balloons encasing the virus can hang in the air and then later find its way all the way down into the lungs.
John Hockenberry: Now that we don’t know yet, but that would be a disturbing implication if we do discover that that is a mode of transmission. What makes a flu virus deadly? What is it that it does that can be fatal even to people in the prime of life.
Dr. Richard Wenzel: Well, it’s likely that when young people get influenza, their robust immune system actually takes over and exaggerates the response and actually harms us that way. That’s one thing. The second…
John Hockenberry: Let me just stop you there. So people with healthy immune systems are at risk because of the overreaction of the immune system actually resulting in fatality.
Dr. Richard Wenzel: Well, certainly we saw this with avian flu. Primarily young people with what was called cytokine storm, a storm of our own reaction to the virus. And it’s possible that’s what’s going on in Mexico.
John Hockenberry: Let’s go to number two, and then we have to go to Mexico. We do have someone live standing by there. What’s the second instance you were about to mention?
Dr. Richard Wenzel: Well, sometimes the virus itself or a secondary bacterial infection, such as with staff, can actually get into the lung and cause severe pneumonias.
John Hockenberry: Dr. Richard Wenzel, thanks so much for putting that in context for us and telling us both to worry responsibly, but also telling us that this hasn’t gotten out of hand yet. Dr. Richard Wenzel is epidemiologist at the Department of Internal Medicine at Virginia Commonwealth University. He spoke with us from Richmond. Joining us next is Ioan Grillo, who is Mexican correspondent for Time Magazine. He’s in Mexico City. Ioan, it seems as though this disease and the reports of the 103 deaths has really gripped the city psychologically. What evidence do you see on the street that people are really taking matters into their own hands and changing their behavior?
Ioan Grillo, Time Magazine: Well, you see it everywhere. This city is like a big nightmare everyone is waking up to. Suddenly you’ve seen all the schools shut across the entire urban area of 20 million people. That’s the first time you’ve seen that kind of action since the 1985 earthquake. And people are realizing that the government’s really taking things seriously by doing that. That means everyone’s families are being affected by this straight away. People are told to take their children out of daycare. Again it’s affecting people right across the area. The bars and discos have been forcibly shut down to keep people from going out and spreading the disease. On the street you’re seeing a lot of people wearing facemasks which soldiers are handing out on street corners. It’s been a real change over a few days in the atmosphere of the city here.
John Hockenberry: Broadly, outside of Mexico City, is there a sense that the nation is gripped by this or is it pretty much in that city of about 16 million or so, a huge megalopolis Mexico City is?
Ioan Grillo: There’s increasing problems with the virus across the whole country. It’s now in about 17 states, or about 31 states in Mexico. One state called San Louis Portusi is particularly badly hit. But every day we’re seeing new cases, two, three, four cases erupting up and down the country, even up to Baja California, up to the border of California.
John Hockenberry: Wow. So who is dying as far as the government is disclosing at this point? Do we know what particular populations, age groups, conditions of people in terms of their general health are most vulnerable right now? Or is it pretty much up in the air?
Ioan Grillo: No, we do have a good idea about this. I’ve been down at the Center for Respiratory Diseases, I was down there last night, that’s where many of the people suffering from this disease are being held. And we’re seeing, I talked to family members down there of people in isolation down there, the doctors said most of them are young men and women, particularly young men in their prime. People 30 years old, 35 years old, who would seemingly be very healthy. People who would cycle back and forth to work, who had physical jobs, and should have been in good condition. The families who are outside very disturbed and very puzzled because it’s the key breadwinners, their healthy members being struck down by this condition.
John Hockenberry: Wow. Ioan Grillo. Disturbing developments and we’ll wait to hear more from you. Thanks for joining us. Ioan Grillo is Mexican correspondent for Time Magazine, recapping the story in Mexico, the outbreak of swine flu that has killed at least 103 people.
