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Melissa Harris-Perry: You're listening to The Takeaway. I'm Melissa Harris-Perry. In July, an unvaccinated man showing signs of paralysis was diagnosed with polio in Rockland County New York. Officials say that polio has been in the county's wastewater since May and New York City officials detected polio in the city's wastewater earlier this month. Other countries that have not detected polio in decades also have confirmed new cases this year. It's raising concerns about a disease we thought was all but gone.

The first documented polio outbreak occurred in the US in 1894, but scientists didn't realize that polio was contagious as a virus until 1905. They couldn't even see the virus until the 1950s with the advent of the electron microscope. During the 1916 outbreak of polio, 6,000 people died in the US and thousands of people became permanently paralyzed. Our 32nd President Franklin D. Roosevelt was 39 years old when he contracted polio in 1921. Then in 1938, celebrity Eddie Cantor took to the radio and encouraged listeners to send their dimes to help end the polio epidemic. Listeners sent 2,680,000 dimes for what Eddie Cantor coined as it were the March of Dimes.

Eddie Cantor: I said why not have all of America send 10 cents to the White House? I said we may lick in for top paralysis one day with this March of Dimes. President Roosevelt said, "Eddie Cantor, you may not know it, but you just got yourself a slogan". That ladies and gentlemen was the birth of the March of Dimes.

Melissa Harris-Perry: What followed was more research and a global effort to eradicate polio.

Speaker: Here scientists usher in a new medical age with the monumental reports that proved the sole vaccine against crippling polio to be a sensational success.

Melissa Harris-Perry: In 1955, the polio vaccine became widely used in the US. According to the CDC between 1979 and 2021, no cases of polio originated in the United States. Here to help us understand what this all means for us is Apoorva Mandavill. She's a reporter at The New York Times. Welcome back to The Takeaway Apoorva.

Apoorva Mandavill: Thank you for having me.

Melissa Harris-Perry: All right. What do we know about the polio discovered in New York?

Apoorva Mandavill: What we know is that it didn't originate in the United States, and we know that because it looks different than the kind that we would see if it was a wild poliovirus that we would see in the United States. We have been using inactivated polio vaccine which means that our vaccines in the United States have dead virus. If something comes in, we know that it did not originate here in this country.

Melissa Harris-Perry: All right. What does this mean? Does this mean polio is back?

Apoorva Mandavill: It doesn't mean polio is back. What it means is that polio was never fully gone. It was gone from the United States. It's been gone for most of the world, but I think this is really a reminder for us that when a virus like polio is there anywhere in the world it will come to us. We've seen that now with so many things. We've seen that with the coronavirus. We've seen that with measles. We've seen that with monkeypox most recently. It's really just a reminder that if we don't want to have to ever worry about polio we have to eradicate it from the entire world.

Melissa Harris-Perry: In a world where we have spent a lot of time worrying about public health in recent years in the COVID during the COVID pandemic that we're continuing to live in, during the rise now of monkeypox let me just understand this as clearly as possible. Is there a serious threat to the general public from polio?

Apoorva Mandavill: There is not if you're vaccinated. I think that is the really, really important message here. The polio vaccine that we use in the United States is incredibly protective. If you've had all four doses as you're supposed to according to the CDC, you are fully protected and you have nothing to worry about. When we hear about these cases is usually because somebody who is unvaccinated has been exposed to the virus.

Melissa Harris-Perry: Right. What about those of us who got our polio vaccines let's say in the '70s, I'm walking around mad because I can't get another booster for COVID. I want to have a talk about why 12 months make such a difference, but I can't get another booster for COVID. I haven't had a polio vaccine since the '70s. Am I really still okay?

Apoorva Mandavill: You're still really okay. What we know of this vaccine is that it's incredibly protective and protective for decades. We should really be fine. I was vaccinated in the '70s as well. I assure you we are both fine

Melissa Harris-Perry: Now help us understand what the wastewater testing is. We've talked about this before, but I just want to be clear what it means that this is found this way. Does this mean we found it earlier than we might have otherwise?

Apoorva Mandavill: We actually don't look for polio in wastewater. Maybe we should. The other countries do, the UK does and Israel does, but it means that we found it in wastewater now looking back at samples from the spring is that the virus was probably circulating even back then means that this virus has been around now in New York for weeks and months.

Melissa Harris-Perry: New York is fairly good on this large-scale testing of wastewater having some of those municipal resources that maybe smaller cities and communities don't have, are there lessons that we could already start to draw from how we might be using wastewater in smaller spaces?

Apoorva Mandavill: We weren't really using wastewater very much before COVID anywhere in this country. I think COVID really taught us that wastewater can tell us a lot. It can give you a pretty early signal that a virus is starting to circulate. You can start to take steps. You don't have to wait until people start showing up at hospitals, but we don't do enough of it across the country. The CDC started to look at what's happening countrywide and every state does it differently. Every county does it differently. In New York, you're right we do do it.

Once you have this whole setup for wastewater, it's not that complicated to add on another layer to look for another virus. Because polio had not been seen for so long, the last case that we saw imported into the country was in 2013. We haven't seen wild poliovirus as you mentioned since 1979. Polio just has not been on our radar in the same way. We had not been tracking for it. I think this is a good reminder that if we do have wastewater analysis set up, why not also monitor all these viruses that maybe we haven't seen in the US in a while, but we know are still out there and could come back here.

Melissa Harris-Perry: All right. Apoorva, one of the things you said is it helps us to see that polio was never fully gone. What does it mean to eradicate a disease? I think many of us thought polio was in fact gone.

Apoorva Mandavill: Yes. We wouldn't be blamed for thinking that because we haven't seen it here. When a virus like polio is gone from one part of the world, but not others, it's just called eliminated. It's been eliminated from the United States but eradicated is just a much, much higher goal. That means that it's gone everywhere in the world and has to stay gone. Even if you see one case in one country in one day and never again, it doesn't matter. That means it's not eradicated. It's just a really high bar.

Melissa Harris-Perry: Public health I suppose always has had an aspect of the political after all it is in the public realm but certainly during this COVID era, public health has become not only political but highly partisan ideological. As this news about polio has emerged, we've already at least in my social media feeds, I've already started to hear the blame games. "Oh, this is happening because these people didn't vaccinate their children, or these people chose not to get vaccinated." What should we understand about how to understand what is at the root cause of this?

Apoorva Mandavill: There's no doubt that as long as you have pockets of unvaccinated people, a virus does have room to move around. As you said, blaming people never works. They're not going to suddenly go and get vaccinated because you blame them. If anything it just increases the mistrust. It increases the distance between communities that we actually need to convince people to get vaccinated.

I worry particularly that after COVID with all of the politics that played around vaccines, that there are a lot of people who've forgotten how important vaccines are. We mandate the polio vaccine in this country which is why we have such high rates. 93% of kindergarteners in the United States are vaccinated, but that's because you need the vaccine to go to school. What I worry about is that that vaccine misinformation and disinformation we saw during COVID will filter across to these other diseases for which we used to take for granted, you take a vaccine you're protected.

It's just a very tricky thorny place to go to talk about these things. This is really showing us that we have to find a way to convince every pocket of unvaccinated people.

Melissa Harris-Perry: Convincing people is one piece of it, access is the other. Some research shows that during the COVID pandemic, we saw a decline in childhood vaccinations in part because of simply access or fear. Not so much fear of the vaccine but simply fear of being in public with small children not making this a time when one would get vaccinated. Do we have any sense of how that may have long-term public health consequences for the young people who were quite young during the COVID pandemic?

Apoorva Mandavill: It's a huge, huge issue and not just for polio for really all routine vaccinations. We saw just a horrific backslide in all vaccinations during COVID. Some of that we have caught up, but in some countries, the countries especially where it's so important to vaccinate against polio because it's still circulating there, it's been really hard to get to people, it's been really hard to reach the families that you need to reach to make sure that those kids are vaccinated.

It does raise the possibility that we have missed pockets of people not just for polio, but maybe for measles and other routine diseases that we don't worry about so much anymore and that we will start to see those pop up more. Hopefully, we are caught up for the most part in this country, but as I said if it's somewhere else and we don't stay on top of it, we don't stay vigilant, it could still become a problem here.

Melissa Harris-Perry: In the context of doing research for this conversation, I was struck by the idea that 6,000 people died in this country of polio. Although, during the 1916 outbreak, 6,000, there were times during the COVID pandemic when there were thousands of people dying per day in this country. Again, being vaccinated in the '70s, growing up with the March of Dimes, the continuing work of the March of Dimes, I kept thinking about that collective effort to eradicate polio. In addition to the disease vector that is polio, I'm wondering, are there other lessons that come from that collective effort 100 years ago versus again our divisions around so many public health questions now?

Apoorva Mandavill: It's actually really depressing to think about. When you think about how entire countries, the entire world came together to get rid of certain diseases, how everybody rallied behind vaccination to now look around and see that there are vaccines that are perfectly good to prevent COVID and yet so many people haven't taken them, so many kids haven't been vaccinated. It's just we've lost a real sense of faith in these vaccines and collective action as you put it.

Think about the fact that we eradicated smallpox, that took collective action on the part of every country in the world, everybody vaccinating all of their populations in order to get there. At this political moment, seeing how divided we are, it just seems really hard to visualize a scenario in which we can convince every child to get vaccinated or every family to get their children vaccinated. It almost feels unfortunately like we need to have some of these diseases come back and be a real problem before people start to realize that vaccines are so miraculous and that they are so important.

Melissa Harris-Perry: Vaccines are one part, there are other diseases which it's not necessarily a question of vaccination it may be about treatment or prevention and we know there's some private philanthropy that have made it a real priority to address some of these diseases, what kind of global progress are we making on some of these key public health concerns.

Apoorva Mandavill: We have been seeing a lot of quite depressing things about polio so let me speak positive too, and say that there are six global health partners that banded together, these large aid organizations, and they formed what's called the Global Polio Eradication Initiative. They have brought down together the number of cases to a very, very small number. We had something like 350,000 cases of paralysis in 1988 and now this year, so far, we've had 254.

That is a huge, huge improvement and we can't really brush past that. It's just that that last few, that's where it's really difficult. They've made progress similarly in HIV, in tuberculosis, in malaria. We haven't gotten rid of all those diseases but we have made a lot of progress towards eliminating them from most parts of the world.

Melissa Harris-Perry: Malaria, that's not a disease that's obviously about vaccines, that's about prevention, right?

Apoorva Mandavill: Bed nets, prevention, and treatment, we don't actually have a malaria vaccine that's available everywhere yet. There is one that was developed, which is amazing, but it's not fully been rolled out everywhere it needs to be.

Melissa Harris-Perry: Apoorva Mandavill, thanks for bringing us some good news and some tough news, a reporter for The New York Times. As always thank you for joining us on The Takeaway.

Apoorva Mandavill: Thank you for having me.

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