Jonathan Cohen (2:27)

She shares fascinating information about the transmission, how these farms work, what they're doing properly and what the risks are.

Maya Bialik (2:36)

Currently, also at the end of this episode, we're going to talk to you about how your understanding of the bird flu can save you possibly close to a thousand dollars a year.

Jonathan Cohen (2:46)

If you've never thought about it or you've heard a lot about it in the news, this will be eye opening. We are excited to welcome Dr. Seema Lakdawala.

Maya Bialik (2:55)

We've brought you here to talk about something that's apparently very important that I've been ignoring and that many of us have been ignoring. So if one were to pull up the current CDC stats, apparently bird flu is a thing that we should be caring about. It is widespread in wild birds worldwide. That's something that, like, when I hear those things, I hear those things on the news a lot and I'm like, oh, that's nice for scientists to think about. I don't know, it probably affects people who are farmers, but now it's infecting cows and beyond that it's infecting humans and it's infecting. We're seeing human cases in dairy and poultry workers. And there's this very disturbing, you know, graph or chart on the CDC website which basically shows like wild birds, chickens, cows and humans. And there's all these arrows showing all the different things that can happen in terms of transmission. And then there's a cat. And that's where I was like, we need a doctor.

Dr. Seema Lakdawala (4:02)

Yeah, I was about to say, like, you're missing out on cats. Cats are a big thing here.

Maya Bialik (4:06)

So I'd like you to sort of help us understand what's going on.

Dr. Seema Lakdawala (4:10)

Yeah. So I think you've, you've laid it out really well for, for folks, I would say what's happening right now where most of us in the, in the world of like pandemic influenza emergence really started to sit up and be like, hey, we need to do something about this was in April of last year when it was introduced into cows. And I will tell you why that's a really important thing that happened. So typically, influenza, you know, we could talk about all the different flavors of influenza.

Maya Bialik (4:41)

So this is a flu.

Dr. Seema Lakdawala (4:42)

This is a flu.

Maya Bialik (4:43)

Birds get the flu.

Dr. Seema Lakdawala (4:45)

You know what, birds get flu. Horses get flu. Dogs get flu. Whales get it. Seals get it. Every animal species we have tested has some type of influenza virus. Cattle typically have something called influenza D. Okay, so you and I. D for dairy. D for dairy. You and I. And there's also a C, but that's not for cattle. Okay, but you and I get influenz. Influenza A and influenza B.

Maya Bialik (5:08)

That's what's like I once had them at the same time.

Dr. Seema Lakdawala (5:10)

Oh, that's fun.

Maya Bialik (5:11)

My ENT was like, you're very, very special.

Dr. Seema Lakdawala (5:14)

It doesn't happen often. So. So influenza A. So H1N1, we kind of all. We've all heard about it.

Maya Bialik (5:21)

That was a bad one. We had that.

Dr. Seema Lakdawala (5:22)

Yeah, no. So right now H1N1 and H3N2 are co circulating. Right. So we're having a lot of cases of both, but that's what we have in our vaccine. Right. And then we've got flu B. Okay. So cattle had this other flu D. Little flavor Flu A is what happened. And what spilled over in April into is bird flu. And that spilled over into cows.

Maya Bialik (5:39)

When you say spilled over, I want you to be really specific about this.

Dr. Seema Lakdawala (5:42)

Oh, my God. I wish I totally could understand the introduction. From cows into birds into cows. And I'll tell you, I've spent a lot of time thinking about this and I still am like formulating different hypotheses that we're testing the best scenario we have right now. And I'll tell you why we think this is the best. But it's. I'm sort of shifting my opinion a little bit, is that perhaps there was a bird that pooped onto the milking equipment in a dairy in Texas. So a lot of these dairy farms, I'm happy to tell you all about them, are open air barns. And the milking equipment gets attached onto the udders of these lactating cows. And there is like, it's like a breast pump, Right. Positive negative pressure. So some things can go back up. So if the milking equipment is not cleaned right, you can have things going back up the teats of these animals. So not only is influenza A now in cows, so in wild birds, influenza is fecal oral. So that means it's typically replicating in the gastrointestinal tract.

Maya Bialik (6:37)

Okay.

Dr. Seema Lakdawala (6:38)

Of wild birds. And so they deposit it in water lagoons, you know, like places like that water. And then they feed. And this is how they like, spread it to each other typically. Right. That's the thought. Like shared water feeding holes and things like that. How it gets into the cows is really fascinating.

Maya Bialik (6:55)

But there's contamination of some sort that allows this virus. Then. Now why does the cow's immune system not say this is bird flu? It's not mine.

Dr. Seema Lakdawala (7:05)

It does, Right. So they do make antibodies against it. But what happens when the cow gets sick? The way they found this is that some of the cows and not all of them. This is really interesting, right? It's not very severe in cows. So when we talk about bird flu, we're talking about highly pathogenic avian influenzas. This is hpai. This is the one where everyone's like, oh, this is really bad, especially in chickens, which we'll come to. Right. We've had 166 million chickens die in this country during this outbreak right now. And that's because it is lethal in chickens. And so we kill them before they, like, die from the disease. And so in cows that's not happening. But what does happen is that they stop producing as much milk and the milk they do produce sometimes becomes what's called mastitis. So it's typically a bacterial pathogen. It's like chunky yellow. And so the way this was diagnosed was this very bright veterinarian went onto a dairy farm in Texas, noticed dead birds, weird acting cats, and said, and this like mastitis was like, we need to check for bird flu. And lo and behold, it's bird flu. So not only did we not expect the virus to go into cows and typically respiratory, maybe that's what influenza D is in cows, but it's in the, it's in the, it's in the mammary gland of cows. Okay, so this is where all of us get really concerned because cows, like pigs, are these animals that we have a lot of interface with in terms of domestic agriculture. Right. We work, humans work with cows.

Maya Bialik (8:32)

I mean, we literally made them to work with them.

Dr. Seema Lakdawala (8:35)

Absolutely right. And so like somebody works and milks these animals every day, all day long.

Maya Bialik (8:41)

I worked in a dairy. My family lives on a dairy. Did you really? Yeah, so like, I, I've spent many years experiencing the dairy. Yeah. You have to have direct conscious contact with your cow.

Dr. Seema Lakdawala (8:53)

Yes. And like every teat is full.

Maya Bialik (8:55)

You're touching everything.

Dr. Seema Lakdawala (8:56)

You're touching everything. Right. And so especially in the process of milking. Right. It's not even just like, oh, with feed and with like, you know, in their respiratory. No, it is like, because it's in the milk. And not only are we talking about some virus in the, in the milk, like, it is 10 to 100 million infectious virus particles, particles per milliliter of milk in some of these infected cows.

Maya Bialik (9:18)

Say that again.

Dr. Seema Lakdawala (9:19)

Yeah, 10 to 100 million. And that is more than we can actually probably even grow with this virus in the lab. So, like, vaccine people are probably like dying because, you know, they want to, like, the higher the stock, the better the vaccine prices. Right. But like, the virus is growing so well in cows. So.

Jonathan Cohen (9:37)

Well, when we talk about how much virus is in that little amount of milk? How much virus makes you very sick?

Dr. Seema Lakdawala (9:45)

Oh, not a lot. Right, so we don't know what you're referring to as a human infectious dose. 50 so in animal models. So we use ferrets a lot as a surrogate for humans when we think about pandemic risk of flu viruses. And in ferrets you can give them like 10 to the 2, so 100 or 1000 virus particles and they'll get really sick and die. If they have some pre existing immunity, but which is some work that we've been doing, like humans, we have preexisting immunity. We'll talk about why it's not very severe. In over the 70 cases that have become infected in the U.S. we like have some level of preexisting immunity. How much virus they need to become infected is actually not that much more. They just don't get us severely ill. And so, yeah, you don't need that much.

Maya Bialik (10:28)

Okay, so hold on one second. I want to talk more about the birds, but I also really need to talk about the cows right now because is that milk infected?

Dr. Seema Lakdawala (10:37)

Yes, the milk is infected the way that we are testing. So this is something that I think is like people don't know and I really wish people would know. So when you look on the USDA website, it tells you that 970 some odd herds in the US are positive for H5N1. Now you worked on the dairy farm. How many cows did you have on your herd?

Maya Bialik (10:56)

We had hundreds.

Dr. Seema Lakdawala (10:57)

Yeah. And that's a small dairy?

Maya Bialik (10:59)

Very small.

Dr. Seema Lakdawala (11:00)

Yeah. Some had three pens. Yeah. Dairies have thousands. And what we are not doing is testing individual cows. So when I say 976 herds, it does not tell you how many cows are actually infected because we are not testing individual cows.

Maya Bialik (11:15)

Okay, so one thing I want to ask. I'm kind of hung up on the cow thing because, well, I want to get back to birds. But one of the things that I knew from my time on the dairy is we would have a list of cows that had infections. And those were cows that we had to. Sorry everyone. We had to put antibiotics on their teats before we would milk them. These are cows though. Like can you drink that milk and not get sick? Because like I haven't heard about milk. I'm hearing about eggs.

Dr. Seema Lakdawala (11:46)

Oh, oh yeah, no, you should have been hearing about milk too. So, yes, pasteurization will inactivate the virus. The USDA and the FDA did a very nice study where they mimicked all of the conditions of pasteurization, including, like, the way the virus, the way the milk moves through the different types of diameters of stainless steel pipes for the different times of temperatures and cooling. The process is actually quite complicated. There's a lot of homogenization steps and they spiked in a lot of virus and it did become inactivated. However, that was a one point study. We have not done repeat sampling of. What would be really nice is looking at viral load, infectious virus load in silos at grade A facilities before and after processing to ensure that we're actually inactivating everything. I will say my coffee today has milk in it. I am still drinking milk. Are you crazy? I know. And I give milk to my kids, so. But only pasteurized milk. Nobody should be drinking raw milk.

Maya Bialik (12:43)

So this is a raw milk question.

Dr. Seema Lakdawala (12:44)

Oh, absolutely.

Maya Bialik (12:45)

I mean, I'm a vegan person. We're the only mammals that drink the milk of another mammal. So, like, to me, it makes no sense and it's strange, but more power to you. Let's go back to the birds for a second. Wild birds. The picture on the CDC website is, I believe, a quail, a lovely little bird. And what kind of birds are infecting the chickens? Oh, what do we know about.

Dr. Seema Lakdawala (13:09)

We don't know. There's lots of different. So surveillance in wild birds is really hard, as you can imagine. How are you going to go around and trap all these, like, songbirds that we see? We have isolated and identified H5N1 in songbirds. Wild, Wild condors. So typically when we talk about migratory birds and like, the.

Maya Bialik (13:26)

And you can't stop them from flying around.

Dr. Seema Lakdawala (13:28)

You can't stop them from flying around. And when you think about, like, what our reservoir for influenza is, we always say it's like, you know, migratory birds like mallards and like, these are like, you know, we talk about ducks, a lot of ducks, right? The ones that, like, they fly all over.

Maya Bialik (13:41)

I love a duck pond.

Dr. Seema Lakdawala (13:42)

Yeah. Who doesn't? But don't get close.

Jonathan Cohen (13:47)

When you say don't get close to a duck pond, like, I think let's talk about what the transmission looks like. What is the risk? Because obviously we want to talk about chickens and the risk to the food supply, but just to think about the transmission and the pathways. Should you be afraid of a bird? And how close is too close?

Dr. Seema Lakdawala (14:08)

Absolutely. So. So one of the things is that migratory birds do not display symptoms of infection. Right? So when we talk about, like highly pathogenic avian influenza viruses, it is lethal in chickens.

Maya Bialik (14:23)

Like, chickens get sickens, get very Sick. What does it look like when they get sick?

Dr. Seema Lakdawala (14:27)

You know, I haven't infected a chicken. I think it looks really bad. Like, it's bad and you have to cull them. They have to, like, be destroyed. They do not get, you know, sent to, like, go to your grocery store. Like, that's not happening. So, you know, so that, because. And we've known about bird flu, right? So one thing I think important to note is that, you know, bird flu was first identified in the late 90s, early 2000s. You know, there was an outbreak in Vietnam and in mainland China. And so, you know, we have been on the radar. Bird flu has been on everyone's radar for a long time, but it's mostly.

Maya Bialik (14:58)

Been on your radar because you're a doctor who studies these things. Because I hear about a lot of things that happen and I'm like, not my problem, not my problem. And even when Covid started, I was like, it's a thing on the news. And then all of a sudden it was like, oh, you're on lockdown. So this is what I'm also trying to understand and I think what we're trying to ask in terms of transmission, I'm happy for you to know all the things about songbirds and condors and all these, because that's your job. But as a, as a, as a layperson, what do I need to know? Like, is this like a thing that I should have been more aware of last year? And only now that egg prices are being affected, people are learning about it.

Dr. Seema Lakdawala (15:35)

So I think what's important for people to know is if you see a dead animal or a sick acting animal, do not get too close. Especially at duck ponds. Going back to this, right. Bird feces, you know, don't get too close to bird feces. We do not know the extent of the outbreak in the wild bird population. So it's always best to keep a safe distance from wild animals. I think that is like universally always true.

Jonathan Cohen (15:58)

Just clarifying that statement. To be super tactical, are we saying that potentially in bird feces that may be laying next to a bird, a duck pond, or in on your path that breathing that in if you are too close?

Dr. Seema Lakdawala (16:15)

Yeah. So this is a good question, is like, how long is the virus stable in feces? We don't know the direct answer to that. Right. My lab works a lot on how long the virus stays alive on surfaces and in the air. And so also when we talk about inhalation of H5N1, this is an important point. Right. What size aerosols are you breathing in and how much? So most of the time, you. We breathe in. Every breath we take, we breathing in hundreds of pathogens that have been expelled into our environment from other people, plants, or animals. The vast majority do not make us sick. So there is an important aspect of how much do you have to breathe in, where does it land, how much of it is infectious, and what really initiates an actual, like, substantial infection.

Maya Bialik (16:57)

And look, we had all of these conversations around Covid that nobody wanted to listen to scientists because, you know, people were like, whatever, I'm not going to get into it. But when people were, like, with the envelopes and the fruits and vegetables and, like, it was getting insane, and, like, I had to explain to my children, like, if something is dry and, like, viruses need a substrate, they need fuel.

Dr. Seema Lakdawala (17:17)

Right? Because I think that there is a. There's an interesting sort of caveat here of, like, how are humans getting infected with the virus? Right. So is inhalation and walking through a park a huge risk right now? No, most of the. Most of the infections said that about.

Maya Bialik (17:30)

COVID And then they were like, oh, guess what? It's everywhere.

Dr. Seema Lakdawala (17:34)

Everywhere.

Maya Bialik (17:35)

And you have to wear a mask all the time. And then they were like, okay, no, we were actually wrong, and that was overkill. So this is where I don't know how hysterical to be.

Dr. Seema Lakdawala (17:43)

Okay, this is. This is, like, so interesting. Right? So what I study is obviously transmission. And can I just tell you that I have been studying transmission for over a decade, right? Since 2009. This is like when I started influenza transmission. And I will tell you that we know so little how transmissible. So let's say you and I were both infected with flu and we both were shedding it in our nose. You could be way more transmissible than me. Like, the amount that you're expelling into your air, that's infectious, could be more than mine, even though our viral loads are exactly the same. Why that is, we do not know.

Maya Bialik (18:18)

Well, I mean, I have a couple ideas, and I'm sure you do, too.

Dr. Seema Lakdawala (18:20)

Yeah. Okay. But, like, that's my point is I don't. We don't know when someone is infected what their forward transmission potential is.

Maya Bialik (18:28)

And that's why being conservative is what our government tried to help us do, and that's what we may be told to do. In this case, the conservative route would.

Dr. Seema Lakdawala (18:38)

Be that assume everybody who is infected has the forward transmission potential and that all environments in which there are birds potentially could have H5.

Maya Bialik (18:47)

What do you mean, all environments that Have. Every environment has birds.

Dr. Seema Lakdawala (18:51)

We've had a number of humans get infected that have backyard poultry.

Maya Bialik (18:56)

So let's go into chickens.

Dr. Seema Lakdawala (18:57)

Yes, let's talk about chickens.

Maya Bialik (18:59)

We got the cow teat. Potential transmission of how it got to cows, but sounds like pasteurization, homogenization, like that whole process is, in theory, not placing us at risk in terms of cows. However, human interaction with cows who might be infected may be more of a concern.

Dr. Seema Lakdawala (19:17)

And.

Maya Bialik (19:17)

And what seems to have happened, birds of a feather flock together. It seems that wild birds have somehow gotten into the chicken jam. And what happens when you have chickens in factories is you have a tremendous amount of animals in a very small space, which is not natural. Right. They can't get away from each other. If one of them's sick, they're all likely gonna be sick. And in addition, again, you have animals that have, in many cases, been bred in ways that maybe don't make them as naturally able to defend themselves from things. They may have different kind of immune systems. And being in the conditions that they live in may also change a little bit about how they would fight things off. So if one gets sick, you potentially have a lot getting sick. What else do we need to know about how the chickens got bird flu?

Dr. Seema Lakdawala (20:06)

Yeah. So there are a lot of biosecurity measures on most commercial poultry farms. Clearly, migratory birds, as you just said. Right. They will fly over these farms. They could probably poop on the air ducts going in and out. Like, the direct sources are unclear. We just know that they're getting sick. The other thing that is happening is that poultry farms are getting infected from the cows. So shared workers seem to be a potential transmission source. Whether it's on their boots and they're not cleaning them before going in, Whether it's them themselves that are infected and transmitting, it is unclear.

Maya Bialik (20:41)

Human transmission could also be part of the.

Dr. Seema Lakdawala (20:44)

Yeah, like a human source. A human. A human like person. Yes, that's right. I did not grow up on a dairy farm. And so every farm I visit, I'm just like, wait, you do what with the sick milk?

Maya Bialik (20:54)

So for those who need us to fill in the blanks, there are many places and many opportunities for liquid poop to gather. And birds, being what they are, will fly about.

Dr. Seema Lakdawala (21:08)

So what happens on farms is that the water that's used on farms to clean the corrals, sometimes flush the barns, definitely clean the dairy parlors. All of that is not put into our wastewater system. Right. That goes separate. It gets stayed on the farm. What happens when cows are sick? As you mentioned, they have antibiotics that does not make it into our milk supply. Right. Those cows are milked separately and that milk can either get fed to baby calves that are on the property or it gets poured down. And all of that liquid then goes into holding tanks and then eventually make it into different manure lagoons based on where you are. These manure lagoons can then be used like the solid stuff is separated and gets used as fertilizer. The liquid stuff is then used sometimes for irrigation. And, and what we're learning now is also sometimes to flush the barns themselves, they reuse that water. So now imagine I mentioned 100 million virus particles per milliliter. Let's say a cow makes, what would you say on average, like 10 liters, 30 liters? Uneasy.

Maya Bialik (22:12)

That's a big animal.

Dr. Seema Lakdawala (22:13)

It's a big animal per milking session. Okay, so now you've got 10 sick cows, you're making like 100 liters of this twice a day, pouring it down. Even dilution factor, you still have a lot of infectious virus and it's not being treated. This is like what I'm learning now. We're not doing anything to treat the milk before it gets disposed of because.

Maya Bialik (22:34)

I'm sorry, with all due respect, the notion of treating infected milk sounds crazy. Meaning you're treating infected, potentially infected milk that's not even going to be used. But I mean, you have to use resources though to do that.

Dr. Seema Lakdawala (22:51)

Yeah, yeah. So you need resources to do it. But I think that my point was, is that because we're not treating it, it's just going into the environment. So what we're talking about is like, why are, how are the birds getting it? There are birds at every single manure lagoon. Right. They feed there, they stop there. It's very easy to imagine that they just pick up the virus that's remaining infectious because it's not being inactivated. The PH of these manure lagoons is about neutral, you know, and like, yeah, there's heat, but we don't know if that's affecting the persistence in the milk.

Maya Bialik (23:20)

So this is a multi step problem.

Dr. Seema Lakdawala (23:23)

Yes, it absolutely is. And I feel like this is what's hit. This is why everybody in my world was like in April and maybe like, wait, wait, hold on, what's going on? Like we should be really concerned here because you're right. When it's in the wild birds, we know it's in wild birds. We watch these, we get worried about the poultries and we like, you know, highlight for the usda, like Everybody is supposed to be, like, taking better, more precautions on poultry farms to ensure that their flocks are stay safe. When it started spilling over into seals in 2022, this happened in Chile. Everyone's like, huh, that's weird. But again, humans, we're not around seals so much, so it's okay. Let's not take too much care. We don't need to freak out the public. People like me can think it's interesting, but no big deal.

Maya Bialik (24:03)

Right. What did it look like in seals?

Dr. Seema Lakdawala (24:05)

Oh, they were getting very sick. And it was primarily in, like, seal haulouts. A lot of birds there at the same times with the seals. Like, again, like, there's a lot of interaction of these. Like, and we care because seals are mammals. Right. And so there are adaptive mutations the virus can do.

Maya Bialik (24:20)

Let's move from chickens to the reason that we keep chickens. So what happens if a sick chicken lays an egg? Do you have a sick egg?

Dr. Seema Lakdawala (24:30)

I don't think the chicken, once it gets H5, can lay an egg.

Maya Bialik (24:32)

Oh. Oh, yeah.

Dr. Seema Lakdawala (24:35)

It is actually really devastating in chickens, this virus.

Maya Bialik (24:39)

Huh. So we're not. The issue is not that we might be getting any infected eggs. The issue is chickens are dying. And then there's also an active culling process to try and stop the spread, which has led to less eggs.

Dr. Seema Lakdawala (24:57)

Yeah. And really high prices. Yes.

Maya Bialik (25:00)

So what is the scale that we're talking about that has led to prices going up? A local restaurant where I eat a lot has a sign that says, if you order eggs, we will be charging an extra $2 because they just can't. They can't afford it. What's the scale like when 500 chickens were killed, nobody knew eggs weren't affected. When 5,000 chickens were killed or dead, I'm assuming we didn't know. What scale are we talking about of sick chickens?

Dr. Seema Lakdawala (25:30)

It's 166 million.

Maya Bialik (25:33)

It's like, I don't know that I can picture that number anymore.

Dr. Seema Lakdawala (25:35)

What number is massive?

Jonathan Cohen (25:36)

How many chickens do we have?

Dr. Seema Lakdawala (25:38)

That's a good question. I don't actually know the denominator of, like, how many there exists in the US So that's a very fair question. But this is a very massive scale of chickens dying.

Maya Bialik (25:51)

And is this happening all over the.

Dr. Seema Lakdawala (25:52)

US Every state is affected. They've found it in poultry farms in every state.

Maya Bialik (25:57)

Is it just affecting. It's obviously affecting eggs. Is it also affecting other poultry farms? Is it affecting the price of chicken?

Dr. Seema Lakdawala (26:08)

I. That's a good question. I. Not an economist, so I don't know.

Jonathan Cohen (26:12)

Google tells us that at any given point, there are 1.5 billion chickens in the US 1.2 billion broiler chickens and 374 million egg laying chickens. So out of 374 egg laying chickens, we don't know how many of that 26 million are egg laying versus broiler chickens.

Dr. Seema Lakdawala (26:37)

166 million. Yeah, there are. There have been both outbreaks in boiler chicken farms and egg laying producers for these animals.

Maya Bialik (26:44)

They're producing a lot of eggs. And so the detriment in terms of consumption is going to be more evident with eggs rather than chickens themselves.

Dr. Seema Lakdawala (26:56)

Yeah, potentially. Yeah. Because you would never be able to like, sell those chickens and. Right, right. Yeah.

Maya Bialik (27:00)

And there you could be losing hundreds of millions of eggs.

Dr. Seema Lakdawala (27:05)

Yes.

Jonathan Cohen (27:06)

Can you tell us a little bit about the context? Because people have heard bird flu before. It's spiked. There have been times in history where it's been in the news. This seems different. How is this different than previous times?

Maya Bialik (27:19)

Why should we care now? Now, I think is also the question.

Jonathan Cohen (27:23)

Besides the price of eggs.

Maya Bialik (27:24)

Because also I'm gonna be. I'm being super honest. Part of me is like, oh, because of COVID 19, everybody's acting all uppity about some flu that only Dr. Seeman. I don't need to think about it. It seems like that's not true. So how worried should we be and what should we be practically doing about it?

Dr. Seema Lakdawala (27:41)

Yeah. So I'm going to break this down to two parts. So, Jonathan, your first point about like, how. How bad is this in terms of the poultry? You know, we had a very large outbreak in 2017, 2018, I think. And I think we're a little bit. We're worse than that, but it is containable and most likely steps are going to be made and egg prices will, you know, rebound because they're gonna bring in more chickens. Right. Cause that's what you do. The reason I think people like me are worried is because of the cows and the cats and all of the mammals that are infected. And the fact, and I think we'll come to this about like, what is being done to contain the spread. There is so much H5N1 currently out there because of the manure lagoons, cause of the milk, cause of the cows, cause of the. Now, like you're seeing it in paired domestic animals. So like mice are getting it right or catching like deer mice, prairie vowels. There have been llamas infected. How widespread is this? We just do not know. And that is.

Maya Bialik (28:44)

But apparently if it's jumping from Birds to cows. There's no reason immunologically to believe that it's not gonna jump to. I mean, it can go to cats, it can go to humans.

Dr. Seema Lakdawala (28:56)

Yep. And so the question now, of course, is, like, as you mentioned with COVID 19, right. Are we just freaking out about this because we're just on the heels of COVID 19 and everybody is just, you know, like, a little bit anxious? I totally get it. Right. We all lived through that pandemic. I lived through it, too, just like everybody else. And I do not, under any circumstances, ever want to go into lockdown again or have virtual school. Right. I got two young kids. That is not fun for anyone.

Maya Bialik (29:17)

No one wants to recreate the confusion, the hysteria, and the politicization of science, which never should have happened, which has led to a tremendous distrust of the medical establishment. Even when I went to the CDC website, I'm like, I don't know. CDC's let me down before, and they said a lot of things that they've now been like, whoops, we were wrong. So, like, even that level of trust, I don't want to deal with that again, you know?

Dr. Seema Lakdawala (29:41)

Right. And even for the cdc, they give feedback and give advice with one brushstroke. And we know that everybody's situation is unique. Everybody's making their own risk calculations. And so much what we need to do is meet people where they are, and we fail at that. We do not know how to meet people where they are to implement things that make sense for them, that they're able to do, that are feasible, that will make an impact. And I think about this a lot with. When we. When we go to dairy farms or when I talk to dairy farmers, like, one of the voices we don't hear enough at the table right now are people who own dairy farms because they're not the ones who are implementing the interventions that are feasible. Right. That's coming from the CDC or the USDA or the state. Right.

Maya Bialik (30:31)

Okay. So. So let's talk about that. What are farmers being told? What are they being told to do? How are they supposed to be monitored? The reason that we're actually here with you in person is because just you're visiting farms.

Dr. Seema Lakdawala (30:46)

I think it varies by state. Right. And this is, again, where it's the Achilles heel of all of this. Right. We can blame the USDA and can blame the cdc, but the reality is, is that so much of what's happening because these are commercial entities is being driven by state Department of Agricultures and Food. So it depends on the state. So in California, there is bulk tank testing every week. The scale is massive. What we haven't done, which is surprising to me, is we knew about this in April, right? This was like, first emerged in April. And so by now we're about almost a year. Right. You would think we would have in place ways to like, say, hey, if you're a farm, like, there's no time.

Maya Bialik (31:28)

You don't have time. We don't have time for the government to try and figure out what to do. We need to be doing it already.

Dr. Seema Lakdawala (31:34)

We need to be doing it already. And so what should have happened is maybe like. And again, because it's state by state, not every state is even testing. Right. So there's some states that are opting not to test.

Maya Bialik (31:44)

So what, they're just killing their chickens and hoping it doesn't come back?

Dr. Seema Lakdawala (31:47)

Yeah, they have to kill the chickens because that's a USDA mandate for poultry farms. But on dairy farms. Yeah, no, I'm talking about dairy farms. Like, they don't even know how many herds are positive in their state. So Missouri, perfect example, they had two cases of H5N1 in people without any known exposure. So this was back a few months ago. And these individuals said they didn't drink any raw milk, but it was the dairy clade of this virus, very similar to the stuff that's coming out of cows. And so they. But Missouri did not implement any dairy testing. They didn't know. They were like, nope, we don't have it.

Maya Bialik (32:25)

Those people could have infected other people.

Dr. Seema Lakdawala (32:27)

They could. Well, so they did. Like, so the CDC went in and did ring surveillance. And so they tested their hospital workers. So these were two, like, it was a couple. They lived together. They think it was a common exposure. But again, by the time it was caught, because we didn't have everything in place, it was weeks, like three or four weeks after they were first tested positive.

Maya Bialik (32:45)

Are there just too many people and is there too much bureaucracy for us to effectively manage an outbreak of a contagious and dangerous virus?

Dr. Seema Lakdawala (32:56)

We have so many plans in place. So I would have said yes if we were starting from nothing.

Maya Bialik (33:01)

Plans in place and a dime will buy you a seltzer in 1950.

Dr. Seema Lakdawala (33:07)

Okay, fair, right. So do I think it's feasible? Of course, the CDC actually does have a really great infrastructure for capturing influenza cases in most states. What they do not have and what they don't have purview on is the cows, right? So they can say, hey, if you catch it in a clinic, then, you know, and you test flu positive, then we need to subtype it. Right. Particularly if you work in a dairy farm. But most dairy farms, most poultry farms, use migrant workers. And so they are not gonna potentially wanna get tested. They are a vulnerable population. And what we haven't touched on yet is that most people are not getting severely ill. We have had 70 human cases.

Maya Bialik (33:47)

So this is the other thing. Like maybe like people get the flu all the time. It's on my table right now. People get the flu all the time. But what is the concern? Why is the fact that people are getting this flu even if they're not getting severely sick? Why should that concern me?

Dr. Seema Lakdawala (34:03)

Yeah. Okay, so in 2009, H1N1 pandemic, right. So previous to 2009, we had a different H1N1 that circulated the, you know, easy way, spilled over, caused the pandemic. Wasn't that many deaths. About 16,000 people died in the US that year, 200,000 cases nationally or more. And so it wasn't bad, but it wasn't that bad. But that virus now has co circulated, it continues to cause a problem. So this introduction, this virus will come in, if it can get a foothold and it can succeed, we will not just be dealing with it now. It's like Covid, it's going to be there, it's going to be another virus that we contend with. And then what happens? So you're a little flu virus, right? This is going to be where we use demonstration. You see these little specks on the inside?

Maya Bialik (34:47)

Yes.

Dr. Seema Lakdawala (34:47)

There's eight of them. Okay. So flu has eight genomes. It's like chromosomes. Okay. So inside of an infected cell, those eight segments have to come together to make another virus. Now let's say you've got H5 and H1. Right. Because now it's like it's just everywhere. You're just getting infected. Now you have an H5 and an H1 mixing. This is what happens in birds. So birds have so much diversity of viruses because they're just constantly mixing and creating new things that overcome our immune systems, overcome vaccines, can overcome antivirals. Right? Like we just open ourselves up to so much more diversity that, okay, yeah, maybe it's not so bad now, but like, maybe in five years it's going to be really bad because all of a sudden we're going to have a reassortant. That's just going to go gangbusters. And the reason H5 has always been a concern is that initially when it emerged, and it's a much different strain than it is now. This was back in 2003. So when the bird virus was first identified, H5N1, it was an outbreak. Vietnam, Cambodia, and some other places in Southeast Asia. And of the cases that we identified, 30 to 50%. So almost half, One third to a half of people who were infected got so sick that they died.

Maya Bialik (36:01)

That's a very, very high percentage.

Dr. Seema Lakdawala (36:03)

Yes.

Maya Bialik (36:04)

What's the percentage of people that die from the common flu?

Dr. Seema Lakdawala (36:07)

Let's say, oh, maybe like 0.1%, 0.1%.

Maya Bialik (36:11)

A percentage that most people who didn't do more than high school math would be like. I don't even know what that means. It's so small.

Dr. Seema Lakdawala (36:16)

Yeah.

Jonathan Cohen (36:17)

Back in 2003, when those people were getting that sick and the mortality rate was that high, was it spreading? Did we find. Clearly it didn't. It was contained. So it was only a very select group of people. So I think that is also the question that people are asking is who is getting sick and how sick are they getting now? And what is the likelihood of the virus mutating in order to be widespread? And if it does get widespread, does that automatically mean that it reduces its lethality in order to get widespread?

Dr. Seema Lakdawala (36:51)

Yeah. Okay, so fair. So currently the CDC is reporting 70 cases. We know that's an underestimation based on sera surveys, which means we've looked for people who have antibodies against H5, particularly dairy farm workers, and we know we're missing maybe like 7 to 10%. And of the 70 people that have become infected, one person has died. There's been one fatality in Louisiana from age 5. N1, that person had a lot of comorbidities. They got infected from their backyard poultry flock. You know, they were tending it. The birds got sick, died, and they were working with the carcasses. We've had a number of severe cases. So there was a case just recently reported in Wyoming also from a backyard poultry. And that person was in the hospitalized. The teen in British Columbia was hospitalized for, I think, over a month. Also unknown exactly. Their exposure, but it was thought to be with a dead bird in the backyard. Again, wild. And so, yeah, so all of that is to say that, yes, most of the cases are mild. I think we definitely would see the signal if it was more severe. We are missing cases, but if those cases were severe, we would see the signal because people would go and seek some help. You know, right now, the main manifestation is pink eye and some respiratory symptoms.

Jonathan Cohen (38:13)

And we're not seeing human to human transmission.

Dr. Seema Lakdawala (38:16)

We have no documented human to Human transmission.

Maya Bialik (38:18)

But why wouldn't human to human transmission be possible?

Dr. Seema Lakdawala (38:22)

It would absolutely be possible, particularly in close range scenarios. So I also want to make a distinction between, you know, because during the COVID 19 pandemic, everyone became like, oh.

Maya Bialik (38:30)

How contagious is it? Is the question.

Dr. Seema Lakdawala (38:31)

Yeah, so definitely close range transmission. Things like in households, like with kids, all of the things that we do as families in these close scenarios, definitely you can have sporadic infections from human to human. Right. Does that mean it's sustained human to human transmission? Which is like the difference between something being sort of an epidemic, you know, something that's just like sporadically emerging versus something that's being successful in the human population. The virus wants to get in, make more of itself, get out and keep going. Right. Like, that's what they love to do. And so, yeah, we're gonna definitely. I expect to see more of these, like, sporadic introductions and like household close range transmission events.

Jonathan Cohen (39:12)

We haven't seen any pet to human transmission, have we?

Dr. Seema Lakdawala (39:16)

There has been a. There was a study that was just released in the MMWR from the CDC of a transmission event from a dairy farm worker to their pet cat. And then potentially there was an adolescent in the house that also became ill but did not test positive or wasn't tested. I can't remember the exact detail. And so this becomes complicated, right, because people, when you have a pet cat, the cats seem to be very susceptible to H5N1. And so there's a number of instances of cats getting it.

Maya Bialik (39:43)

Presumably outdoor cats you'd be more worried about.

Dr. Seema Lakdawala (39:45)

This is an indoor cat. Yeah.

Maya Bialik (39:46)

Right.

Dr. Seema Lakdawala (39:47)

That's not a good story. No. And so, yeah, so outdoor cats, you know, on dairy farms, definitely licking things, licking the milk.

Maya Bialik (39:54)

Dogs. I'm thinking of dogs, all the dogs in America that run around and sniff birds.

Dr. Seema Lakdawala (39:59)

Well, it's interesting. So dogs haven't been like, at least, I don't know if they're getting tested. But dogs have their own influenza. It's canine influenza. And H3N8 is like a big thing a few years ago and it happens. So you get like these sporadic, large outbreaks of canine. But it doesn't kill them. Right. Again, it's like common flu in dogs. And it hasn't seemed to spread from dogs to humans. It actually went from horses to dogs, interestingly.

Maya Bialik (40:26)

Are cats getting sick and dying?

Dr. Seema Lakdawala (40:28)

Yes. Oh, some cats can get very severely ill. I think in the report, most cats we've heard about get severely ill. Most dairy farms that you go on, you're like, oh, you're A positive. They. They always talk about how, yeah, we had some cats, but now we don't see them anymore. Like they've, you know, or like they buried a bunch of cat. Dairy cats, definitely. Cats are getting sick and they get ill. They get neurological symptoms. Some cats seemed to have recovered. So one of the cats in the MMWR did get sick, but then recovered and didn't have to be euthanized.

Maya Bialik (40:56)

But it could have already spread it. I mean, this is the point of trying to contain something like this. Like, how do you contain it? Right.

Dr. Seema Lakdawala (41:04)

What I have been advocating for a long time now is that we need to know how widespread the outbreak is. Like, number one. Like, number one, how many cows, not herds, like individual cows, are actually infected in this country? Okay, how well is it spreading in the cows? Is what we're working on now by trying to understand the transmission on herds between cows. And how do we block that? How do we prevent all of this virus one in the cows, in the milk, in the lagoons, in all of. Like, the FDA had a really interesting study where 30% of dairy products they tested on the shelves have H5 RNA in it. Like, the virus is inactivated. Yeah. So the virus is inactivated, but there is virus.

Maya Bialik (41:53)

It was in there.

Dr. Seema Lakdawala (41:53)

In there. 30% of dairy products on the shelves.

Jonathan Cohen (41:57)

Is there risk to having inactivated virus? Like, does that interact with our immune system in some way?

Dr. Seema Lakdawala (42:03)

So people are trying to figure out whether is that gonna boost an immune response? Not likely, because it's going to go to the stomach. So it's.

Maya Bialik (42:12)

No, but it's a proportional statistical sample of what's going on.

Dr. Seema Lakdawala (42:16)

Absolutely. It just tells you there's so much. And one of the things that I get really concerned about is like, okay, yes, most of it's going to get inactivated by pasteurization. One of the things that sort of strikes me is that we, you know, we ensure that there are no antibiotics in our milk. Right. So if a cow is on antibiotics, even if they've recovered, that milk cannot go into processing. We also test for, like, other somatic cells and things. We test all of the milk for grade A. What makes them grade A. Why can't we demand that There is no H5 in our grade A milk?

Maya Bialik (42:47)

We're humans. We're used to things being introduced all the time to our bodies. It's not a big deal. Like, who knows how many other different types of inactivated RNA is already in the milk. And let's not be hysterical. I mean, that's just like the devil's advocate, you know, perspective but also, people thought that we were nuts when people were like, maybe we don't want to eat meat that's been pumped full of hormones, or maybe we don't want to feed our kids milk that's been pumped full of hormones, or maybe we don't want to eat food that contains genetically modified particles that we actually don't know what they do to our bodies. Right. I mean, people thought that was crazy.

Dr. Seema Lakdawala (43:19)

Right.

Maya Bialik (43:19)

So it's actually not that crazy.

Dr. Seema Lakdawala (43:21)

Not that crazy to say, I want. I want to ensure that the milk we're drinking doesn't have bird flu in it.

Jonathan Cohen (43:27)

If you have to summarize a message for people who are paying attention to this, maybe not fully digesting the full ramifications, what's sort of a last either message of hope or concern or of safety that you would want to leave people with.

Dr. Seema Lakdawala (43:42)

Yeah. So I think that the message of hope that everybody is relying on here is that influenza is an agent. We know. Right. So let's say we continue down this path and the virus keeps spilling over into humans. It keeps evolving, and we have a pandemic of an H5. We do have licensed influenza vaccines that are updated constantly. Right. So there's four licensed influenza vaccines. We have three to four licensed antivirals that would all be effective. The most important thing is that people don't understand that our vaccines are not tested to block infection. They are tested and licensed to block severe disease. And that's.

Maya Bialik (44:23)

Say that again.

Dr. Seema Lakdawala (44:24)

Yeah. So our vaccines are not tested to block infection. They are tested and authorized to block severe disease. That's it. Right. So when you go in for licensure for a vaccine, it is that you've shown it protects from lethality to the.

Maya Bialik (44:40)

Best of its ability.

Dr. Seema Lakdawala (44:41)

To the best of its ability. Okay, so the next phase of vaccines, what we need to do, and this is something that my lab has really been thinking about a lot, is trying to get vaccines that block infection. Because that is what we have sold the American public. And everybody. People think they get vaccinated, and they're like, during the COVID 19, this is amazing. People be like, I got vaccine. Why'd I get infected? I was like, well, yeah, like, you can still get infected. You're just not gonna get really sick, and you're not gonna go to the.

Maya Bialik (45:04)

Hospital, and you can get sick to the point that you miss work and you're laying in your bed for four days not eating, and you're moaning. Just speaking from experience.

Dr. Seema Lakdawala (45:12)

Yes. No, it can happen. And so sometimes you have to be like, well, how bad could it have been?

Maya Bialik (45:16)

Well, and this is the thing also, it's like, I want you to talk about comorbidity, because this was something that, you know, got very politicized. And when we talk about comorbidity, how much of this can we try and stack in our favor? Is some of it genetic? Is it just a genetic luck of the draw? Is it diet and exercise and all these things? Like, how much can we control around. I hope that I'm not that person who gets very sick from a virus.

Dr. Seema Lakdawala (45:42)

Yeah. So comorbidities are fascinating. Right. So we talk about comorbidities as being anything that can for influenza, diabetes, obesity, you know, anybody with any sort of immune diagnosis. You know, you've got lupus or you've got any sort of autoimmune disorder.

Maya Bialik (46:00)

Thyroid conditions.

Dr. Seema Lakdawala (46:01)

Thyroid conditions. Okay. What that means is that when you get.

Maya Bialik (46:04)

Most women.

Dr. Seema Lakdawala (46:04)

Yes. You get vaccinated, you don't make a really strong antibody response the way that we can test it. Right. So in your blood. And I'll be honest, we have. You know, people don't tend to always appreciate how little antibodies we potentially could even be making to viruses or vaccines, because we're not testing everybody after you get vaccinated to be like, how much antibody did you raise? Right. We know this from cancer patients during COVID that, you know. Yeah. You could get three shots and you could still have a titer that looked like you hadn't gotten anything.

Maya Bialik (46:36)

Why?

Dr. Seema Lakdawala (46:37)

Yeah, I. I wish I. Like, I don't think we know the answer. You need to bring on an immunologist.

Maya Bialik (46:42)

Right. But. But. But just the. Just for us to sort of formulate it a little bit. What we're talking about is that if you are in any way immune compromised and immune compromised doesn't just mean you have an autoimmune condition, and it doesn't just mean that, God forbid, you have cancer, you're receiving chemotherapy that depletes your immune system. If you are in a state of compromise because you are fighting blood pressure, you are fighting excess plaque and cholesterol in your body, your body's not efficiently running at its optimal health. That is immune compromised. Because, as we know. I mean.

Dr. Seema Lakdawala (47:17)

Or your stress.

Maya Bialik (47:18)

I was just gonna say, like, I mean, the.

Dr. Seema Lakdawala (47:20)

The amount of.

Maya Bialik (47:20)

Described. 90% of people in the world have anxiety and stress, which lowers our immune response.

Dr. Seema Lakdawala (47:26)

Which lowers our immune response. It lowers our ability to fight infections off. It could potentially decrease our ability to really respond rapidly to a new insult.

Maya Bialik (47:36)

So being a human is a comorbidity.

Dr. Seema Lakdawala (47:39)

I mean, yeah, I guess, like especially being in your mid-40s as a woman. Sure.

Jonathan Cohen (47:44)

We know there are levels to it. I think we need to ensure that while everyone does have their everyday stressors, understanding that there are new diseases that are introduced to our environment all the time, it can be motivation to take those extra steps to do the things that we know, reduce stress, to even get the walk around the block to go to bed half an hour or more sooner and to take the small measures that will help support the immune system. Because we need our immune systems. Maybe like let's not only rely on western medicine to solve this problem for us.

Dr. Seema Lakdawala (48:21)

Yeah, absolutely. But also one thing that I should have said is that influenza, even a new strain is coming in the context of all of this other pre existing immunity in the human population. You and I have experienced influenza for our entire lives. Everybody has their first infection, typically by the age of five. And every time you get re exposed to influenza, you make an immune response against that original strain and the new strain. So you get boosting of your antibodies. And so what we have done is we've shown that pre existing immunity against the 2009 H1N1 actually can reduce the severity of disease against this bird flu.

Maya Bialik (48:59)

When you are a parent and your child gets a virus, for most people, they want the doctor to fix it and make it better. And they want to give medication that immediately lowers the fever, reduces the symptoms, allows you to not have to lose work, allows them to go back to school. But what you just described is what people who understand viruses and the this kind of approach, like there's a reason the body produces a fever. Right. A fever is a symptom of a sickness that is the body's way of trying to raise the temperature to kill pathogens. Right. There are people who do not take a flu vaccine because they believe that if for the most part, you will not get lethally sick, that the body is allowed to experience an immune challenge that allows them to produce antibodies that will support the system. I know many people who are pro vaccine who don't take a flu vaccine.

Dr. Seema Lakdawala (50:02)

Yeah, I mean like most of the U.S. population. Right. So the vaccine uptake rate is like 40%. So you're right, like 60% of Americans are not taking the flu vaccine every year. I will say what I do want to caveat here is that tens of thousands of people die every year in the US from human seasonal flu. So it's not nothing.

Maya Bialik (50:21)

Correct.

Dr. Seema Lakdawala (50:21)

But we did talk about this. It's a 0.1% mortality rate.

Maya Bialik (50:25)

I'm not asking you to encourage people not to take a vaccine. That's not my interest. But the way that you just very casually described what happens when the body gets a virus should not be ignored. The solution is not to eliminate sickness. We are organisms that need to have an immune system to fight off new things.

Dr. Seema Lakdawala (50:44)

I absolutely agree. I am pro pre existing immunity. Like we study it, we really believe in it, we think it's important for the emergence potential. It's real. It is real. We all have prior immunity against influenza viruses, whether it's from vaccination or natural infection. Even if we've gotten vaccinated, we've all been infected with influenza because like, you know, sometimes the vaccines aren't well matched and there's a variant that's circulating that we get infected with anyways or because the vaccines are not to block infection again.

Maya Bialik (51:16)

And no one should lie to us or keep that information from us.

Dr. Seema Lakdawala (51:19)

And we should say that very openly to everyone.

Maya Bialik (51:20)

Correct. And we should also say, I mean, and again, a lot of this is socioeconomic. It's political, I get it. But in a culture, when we had more parents able to take care of children, we had less of a hysteria around sickness. And I don't want to bring up chickenpox, but I'm going to bring it up, it can wipe out an entire classroom, which is really inconvenient and bad and bad things can happen from chickenpox. But when you look at proportional statistics, what we have is we have a culture that's intolerant of sickness for a lot of important reasons. And it does take away in a lot of cases from understanding what your body needs to also learn when a virus is introduced to it.

Dr. Seema Lakdawala (52:02)

I think one thing is really important we talked about before, which is like meeting people where they are again. You have to meet people where they are even in terms of vaccines. And I think what we need to appreciate and people need to understand is that because we don't test them against infections, that one, they can still get infected. They get vaccinated, especially with H5 or with flu. But that brings me to this H5 outbreak, right? So when we talk with people with socioeconomic or language barriers or ways in which we communicate the impact that vaccines will have. So one concern is telling every dairy farm worker, go get your seasonal flu vaccine. They then interpret that potentially as I'm not going to, it's going to protect me against this virus that's circulating in my cows. And it's not, it's very different. It's not in the human seasonal vaccine. There's no H5 component in the shot that you'll get this fall.

Maya Bialik (52:55)

So is the solution that we should all get vaccinated against this bird flu?

Dr. Seema Lakdawala (53:00)

No, I actually think that vaccines. So it's interesting, right? So I've been long been advocating about releasing the vaccine from the stockpile. So because we've known about H5 for a long time, we actually have candidate vaccine viruses in our stockpiles. In the event of a pandemic, when this was emerging, like any emerging outbreak, our most vulnerable people should be getting vaccinated, which are state veterinarians, people who are going on and taking care of these sick animals. Dairy farm workers should have it available if they want to enroll. I thought about this a lot. If I was a veterinarian and there was a vaccine, I'd be like, give me the vaccine. Currently, the H5 vaccine is not being offered to anybody. That's still happening.

Maya Bialik (53:39)

Do you agree with that?

Dr. Seema Lakdawala (53:40)

I do not. I think it should have been offered to state veterinarians. The people on the front lines, dairy farm workers, managers, and veterinarians should be offered the H5 vaccine because they are, and poultry workers because they are, again, at the front line of this. And. And the way. The reason I say that is because, one, I want to limit their susceptibility. So when I talked about this, even with COVID right, okay. So, yes, vaccines do not prevent you from getting sick, but you have to think about transmission prevention as a multi layered approach. Okay? So the vaccine. We're in a war against a virus. Especially for me, we're in a war against H5. Like, I do not ever want H5 to be successful in the human population. And so the vaccine is like your armor, okay? It's gonna prevent you from getting badly beaten, but it's not gonna prevent you from taking some blows. Okay? Your mask is your shield. It's gonna block you from, like, some severe attacks. But again, you can be beaten in with just those two things. And then you need a sword. You need some other level of intervention. And so for Covid, I always talked about, like, ventilation and air exchange rates and ways of, like, eliminating viruses in the environment and in aerosol contaminants. And the same holds true here, right? We talk about the amount of virus just in our environment. So, yeah, we need ppe, we need vaccines, and we need other interventions to reduce the exposures. Is it cleaning the milking equipment between milking sessions? Because that's not cleaned, right? The cows are cleaned.

Maya Bialik (55:09)

It's a very, very big process.

Dr. Seema Lakdawala (55:11)

It's a very big process. But let's think about ways that we can do this. Or is it isolation and identification of cows that are sick to reduce the amount of exposure to other cows? Is it, you know, ways in which to enhance biosecurity on poultry farms? Like, this is not. This is not a single solution problem.

Maya Bialik (55:32)

What, what. What level of vigilance do you feel kind of the average person needs to. To have right now? And besides finding alternatives for eggs, which we have some, you know, clever informational aspects of that, what. What do you think people should be thinking about right now?

Dr. Seema Lakdawala (55:49)

What I am trying to get everyone to advocate for is, yes, I know the egg prices are high and potentially agricultural prices might get high if that happens. Is that is to communicate now, is to say now to our state departments of health and our state departments of food and agriculture, start working together to control these outbreaks, to get a handle on how widespread it is and to implement measures. Get everybody, all the stakeholders at the table and start moving these things forward. Because I haven't seen it. We're having huge outbreaks. California again, I think it was like 10 cases in the last 30 days in California. Different herds are positive. We don't know the extent of migratory. Of this presence of this virus and migratory birds. Definitely it's there. Is it 100% there? No, but there are upticks in all of the populations. It's just. It's, again, just, I think, what people need to appreciate. And I think we did this during the COVID 19 pandemic because we were in such a very unique situation. Mentally. We were all like, oh, my God, where is this virus? Right? And like, you know, we. And I would talk to a lot of people, talk to my. My neighbors, and I would just be like, hey, this is what I'm doing. Like, what are you concerned about? Let's talk about what is feasible for you. So let's everybody think about what's feasible for them. Yes, there is virus in the birds. There's probably virus in your ducks. Probably virus in that water. Don't drink the duck pond water.

Jonathan Cohen (57:12)

Last question. Should I be concerned about the small flock of chickens in my neighbor's backyard? Should I not go near that flock?

Maya Bialik (57:23)

Yeah. What about people? I mean, a lot of people have chickens in their backyard. Is this, like, a thing?

Dr. Seema Lakdawala (57:29)

I think this is a big concern, right? Because commercial poultry farms have at least a lot of biosecurity ways of, like, containing the chickens, such as they have little interaction with Migratory birds, but then they still get it. As you said, there are much more intense situations and they've been bred for a certain type of chicken. Backyard poultry is a little bit different. However, there are massive amounts of backyard poultry farms that are becoming infected because there is so much virus in the migratory bird population. PPE and like, you know, handling of birds. If you have backyard poultry, do not handle them barehanded. Wear a mask and wear gloves.

Maya Bialik (58:06)

Okay. That's important, right?

Dr. Seema Lakdawala (58:08)

Okay. So like again, protect yourself from, you know, the potential of contamination. These individuals who had backyard poultries, it's unclear whether they use any ppe. It's unclear how many, you know, dead birds they had on their premise. But again, if you do have dead birds on your premise, do not pick them up without any proper ppe.

Maya Bialik (58:28)

Also, and this is just, you know, this isn't just like, oh, I'm a vegan person and this is, you know, a chance to have this conversation. But one of the things that, that we do want to sort of put out there is that while eggs are delicious and you like them to make an omelette, there are many cases when people use eggs, when there are replacers that actually take the place of eggs, do exactly the same thing. It's not a labor. And you save. We did the calculation. You save, you can save 500 to a thousand dollars a year, like depending on your intake of eggs. But things like if you're making pancakes, if you're making waffles, if you're making, if you're baking, that's actually a time that you can finally learn what people who don't cook with eggs have already known. You don't need eggs for all those things. So if you're still going to be using eggs, use them for what you actually need them for when they serve their eggy purposes. Omelettes, frittatas, quiches. I don't know what else people are doing with them, but this is a great time to learn to save money and use other resources without needing to rely on eggs, especially if it's in something. I, I promise there are many, many alternatives out there and we've talked about some of them. Thank you so much. Thank you for your expertise. Thank you for being part of this conversation and thank you for my three dimensional bias.

Dr. Seema Lakdawala (59:43)

You're welcome so much.

Jonathan Cohen (59:45)

Obviously, the health concerns are of primary importance, but people's lives are being affected by the lack of eggs. You see on social media and in the news, the images of grocery stores with bare shelves. Eggs are so integral into people's lives, both for eating directly, but also for baking. You have an alternative?

Maya Bialik (60:05)

Actually, here's something fun. I'm going to take you into my kitchen right now, and I'm going to show you a few options. Hey, everyone. I'm very sorry that there's a bird flu, and I'm really sorry that it's caused an extremely disturbing spike in egg prices. But I want to share a little something with you that vegans have been doing for years, and that is using things instead of eggs in baking. So if you want an omelette, I can't really help you. Yes, there are vegan egg products that will try and create an omelette or a quiche. It's not really my jam. It's not something that I feel the need to deal with. I can live without it. But when I bake, when I make pancakes, when I make anything that you'd normally just, like, throw an egg in and stir it up, here's the deal, people. You don't need to use an egg. I know this might sound shocking. It's not going to taste any different. It's not going to look any different. It's not going to bake any different. You don't have to spend all those money on eggs, and you don't have to kill that many baby chickens to make things. I promise. So I'm gonna go over three ways to avoid using eggs when you are baking. This works in breads. It works in cookies. It works in any dessert product that's not like a meringue. It also does work in things like pancake mix. Think about the money you will save if you don't have to keep buying eggs for these purposes. And I know you want your eggs. You want them over easy. You want them scrambled, you want them all. The boiled, poached, I don't care. You will need eggs for that. And you will be paying a lot of money because of what's going on with the bird flu. But you do not have to suffer, nor do the baby chickens. If you're baking or making pancake batter or anything like that, waffles, anything. Okay, so we've got three ways we're going to do it. The first way is so easy. Do you see what this is? It's applesauce friends. And you're gonna be like, ew, it's gonna taste mushy. It doesn't. I use applesauce as an egg replacer, specifically in things like banana bread, things that have a long baking time. It literally holds the consistency binds all the other ingredients. It's just applesauce, folks. Just like a quarter cup of applesauce. That's like literally all you need. Applesauce instead of eggs, that's number one. Number two is a product that goes by various names. I use Bob's, but you can also use. There's a company called Energy. And what this is is it's a powder, as you can see. It's a powder. And the powder is made of, like, potato starch and things that when water gets added to them, they get kind of gelatinous, for lack of a better word, meaning they form a consistency that binds just the way eggs do. This is what I use when I make latkes, for example. So, like when you shred onions and potatoes, you normally, like, throw an egg in there to bind everything together. This does exactly the same thing. I'm going to show you how easy it is. You take one tablespoon of the powder, you add two tablespoons of water, and I'm taking a little whisk. You can also use a fork. But this is one of my favorite things, is my little metal whisk. That's it. What happens is if you let it sit, which I will let it do, it will thicken and then it takes the place of eggs. So it literally looks like this. It looks like that. It has. Oh, look. Kind of looks like an egg. A third way that you can make egg replacer is with ground flax meal. So you can buy this in a bag at any market. It looks like this. Flaxseeds are. They're really cute. They're kind of the size of, like sesame seeds, but you can grind them yourself and if you'd like, or you can go ahead and splurge and buy them ground. The way that you use a flax egg is extremely easy. You take one tablespoon of ground flax and you add two and a half tablespoons of water, mix it up, it will look liquidy and the same thing. Flax will absorb the water. You can put it in the fridge and it will get gelatinous. And you'll be able to use it as a binder. So a little bit looser, but also still holds once you bake it, because the flax again then absorbs more liquid. But that absolutely takes the place of egg. The flax is going to take a little bit longer. Sometimes you put it in the fridge for a couple minutes. Those are three ways to use eggs without eggs. Think of the money that you'll save. I'm happy to help you. Think of the money that you'll save because that's like one of my favorite parts of this. Yeah, I hope that that's helpful to people. And it's very hard when a staple such as eggs has risen to the prices that it has. And I get it. So hopefully these three options will help you and maybe you'll like saving money and you won't care that it doesn't taste different and you'll just become part of the flax, egg replacer, applesauce revolution. Let us know how it goes.

Jonathan Cohen (64:47)

The Average American spends $194 on eggs a year. $775 for a household of four. Your alternative?

Maya Bialik (64:57)

One of my. One of my alternatives is flax meal, which is not good for everything. But the calculation that that Valerie prepared for us has you saving for a household of four. You could save between 500 and $1,000 a year depending on your consumption. If, if you're an egg eater, like, if I was raising kids who were egg eaters, I wouldn't want to be like, you can't have omelets today because I wanted to bake cookies for the postman. You know, like, I'd want everybody to have all the things that they need. But it's a great time to start experimenting.

Jonathan Cohen (65:28)

My other takeaway from this episode is about, you know, those comorbidities. And yes, people are stressed, yes, people have health conditions. But I think many of the guests that we speak to talk about changing the mentality of there will be a medicine, a shot, something that is going to fix and protect me from the world. We are in the world and amongst it, viruses do come up. And one of the best things that we can do for ourselves are these small micro life changes to help us in whatever way we can.

Maya Bialik (66:00)

Well, in addition, as Dr. Lakdawala talks about, you don't have to pick one thing to do to try and prevent yourself from getting sick. So the notion that we've been told, do whatever you want, eat however you want, live however you want, just get a vaccine. As she told us, that's actually not even accurate and it's not the way that we should even be understanding what vaccines are there for. So even if you choose to get vaccines, you still don't want to be one of those people who is a comorbidity statistic as as much as you can can prevent it. So all of the things that you hear on all of our episodes still hold true and, and can also, you know, boost your body's ability to fight off the viruses that we're going to encounter anyway. But yeah, things like sleep, anything you can do to support your immune system, reducing stress and you know, seeing what changes in your life you can make, that don't kind of make you check off those comorbidities is is really important.

Jonathan Cohen (66:58)

If you like this new format of MBB reports, check out our episode on microplastics and the impacts on health. You can find that on the YouTube channel or anywhere you get podcasts. We also do an MBB Reacts where we tackle can science explain supernatural abilities where we explore the telepathy tapes and extrasensory perception that is Also on the YouTube page or anywhere you get podcasts.

Maya Bialik (67:27)

A lot of ways to break things down. We'll see you next time.

Jonathan Cohen (67:29)

It's Maya Bialix breakdown.

Dr. Seema Lakdawala (67:31)

She's gonna break it down for you. She's got a neuroscience PhD or two non fiction and now she's gonna break down so break down. She's gonna break it down.