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- [00:03]
Jessica Melody Rivera
We are seeing this disease spread in a way that we probably don't have a good handle on exactly how much it's spreading. It's very reminiscent to the conversations we had about COVID 19 and how it seems almost undetected because we're not testing enough. We're not testing enough. We're not testing enough. I feel like I've never said a sentence more in my life than we're not testing enough.
- [00:27]
Al Edson
Coming up on More to the Story, I talk with epidemiologist Jessica Meloti Rivera era about the likelihood that we could be stumbling into another pandemic at the same time that the Trump administration is dismantling and reshaping the very agencies responsible for keeping us safe.
- [00:55]
Unknown
This episode is brought to you by Progressive Insurance. You chose to hit play on this podcast today. Smart Choice. Make another smart choice with Auto Quote Explorer to compare rates from multiple car insurance companies all at once. Try it@progressive.com, progressive Casualty Insurance Company and affiliates. Not available in all states or situations. Prices vary based on how you buy.
- [01:24]
Al Edson
This is more to the Story. I'm Al Edson. This month marks the five year anniversary of the COVID 19 pandemic, and I gotta tell you, it feels like we didn't learn our lesson. I can't help but get a little anxious when I hear all the stories in the news these days about the threats to our health. There's a bird flu and measles and an unknown disease in Congo. Meanwhile, in the US the new health secretary still questions the use of vaccines. It all seems to be colliding at once. So I brought in Jessica Melody Rivera, a health and science expert, to help me make sense of it all. She spent the last 15 years studying emerging infectious diseases and regularly speaks about public health. Jessica, how you doing?
- [02:09]
Jessica Melody Rivera
Hi, Elle. I'm okay. How are you?
- [02:11]
Al Edson
I'm good now that I'm talking to you. It's been forever since we've been on the microphone together.
- [02:16]
Jessica Melody Rivera
It has.
- [02:17]
Al Edson
So the last time we talked, you were a part of our series that we did on the COVID 19 tracking project. On the main reveal show, you were focused on how unprepared the US Was to deal with COVID And now we find ourselves in an interesting place because it seems like the United States is going to be even less prepared in the future for any kind of public health emergency.
- [02:47]
Jessica Melody Rivera
Yeah, it's unfortunately what we feared and what we were sounding the alarms for back, you know, back in 2020, even on how our data systems weren't ready how our public health infrastructure wasn't ready and how if the election went a certain way, the odds were going to be that it would only get worse. And it's, it's happening in real time now.
- [03:13]
Al Edson
Is it fair to say that even in a Biden administration, the system still was not operating the way it should?
- [03:23]
Jessica Melody Rivera
That's correct. I mean, some would say that sometimes things felt indistinguishable between the administrations, but we didn't have direct antagonism to science coming from the executive branch and the agencies themselves, the public health agencies themselves, like we are seeing now. So there's a difference between public health being politicized and therefore the consequence of that can be policies that are not ideal or changes in recommendations that feel not really aligned with the science, which we saw a few times during the Biden administration. This is different. This is a science denialism that has fully penetrated the federal government.
- [04:05]
Al Edson
When I think about the stories that I have read recently about public health or about outbreaks, I really like get this queasy feeling that, like, oh my goodness, here we go again. And it feels like our infrastructure is being broken down to deal with these things.
- [04:27]
Jessica Melody Rivera
Yeah, yeah. I mean, it's hard to not feel that queasy feeling as a person living in this information ecosystem because I do think we are getting inundated with a lot of bad news. I think you can probably make a parallel to what's happening with aviation in the United States. You know, it seems like everything bad is happening, public health emergencies happen. But I will say there are some unique things about some of these public health emergencies that are something we need to be paying attention to, particularly this measles outbreak. This measles outbreak is unprecedented. It is the worst in 30 years that Texas has had. It started with a under vaccinated and unvaccinated community that was very tight knit in West Texas and has exploded. We have seen a trend of vaccine refusal, vaccine exemptions increasing, and when that happens, this virus very quickly reemerges. And we've had two things happen in the government that are just so shocking in that the acip, the Advisory Committee for Immunization Protocols, canceled their scheduled meeting. And then vertpac, which is a similar group that is based in the FDA that meets every March to discuss the recommendations for the upcoming flu season vaccine. This is based on collective data that is shared because it takes about six months to get that going. That meeting too has been canceled. And all of these things are connected to each other. And so I don't think that the bad news is behind us, Al. I think that we are kind of going to be seeing it more. There is a lot to be said about our stake in the global health space too, and us attempting to withdraw from WHO and what that means for outbreaks like what's happening in Congo, this mystery illness that has claimed over 53 lives. And that's why we're part of these groups. That's why we have this partnership and this very symbiotic relationship with entities that are responding to real time public health events all over the world. Because public health is fragile and it requires a lot of coordination.
- [06:28]
Al Edson
To your point, it feels like part of what is spurring this is kind of the idea that we are all individual islands and we're not all connected. And so therefore, if this little outbreak happens there, it's fine, because I'm over here, I'm gonna be okay. If something happens in the Congo, that's in the Congo, I'm fine, I'm in America. I think that it comes from this idea of the rugged American individualism. It feels like that's where we're at right now, is that the United States is in a very much an isolationist type of view. And not just isolationists when it comes to other countries, but each individual has to figure out their own guidelines for themselves when it comes to their health instead of the government helping us along with that.
- [07:18]
Jessica Melody Rivera
That's absolutely correct. You know, an infectious disease in a remote area across the globe can be on US soil with one person on one plane. You know, globalization has made us super, super connected. And individualism was truly one of the things that made our response to Covid so, so fraught with conflict and with politics. And honestly, the outcomes that we saw. This idea that, you know, you can't tell me what to do completely misunderstands the premise of public health. I mean, public health at its core is about community. It's about the altruism of our choices that not only benefit us, they benefit each other. That it's part of a social contract. I mean, public health is why we have speed bumps. It's why we have grades on restaurants. To say if the place is healthy and clean and all of these things require us to abide by them, right? Because they make society healthier, stronger, better together. Vaccines only work if we all sign up to do it right, that we do it not just to protect ourselves, but to protect others. And those who cannot protect themselves the least among us, those who are immunocompromised, are the first to Suffer. I just don't understand this hype or hype or individuals. And it's so deeply American. It's so deeply incongruent with public health, too.
- [08:36]
Al Edson
So talk to me a little bit about measles itself, because as a kid who was born in the 70s and grew up in the 80s and 90s where. Listen, sure, there were debates about vaccines, but as far as I knew, vaccines were just. You didn't even question it. It was just a thing. So measles has always been like. It was like, oh, like chickenpox. And hardly anybody gets it anymore because you get the vaccine. So now these outbreaks, how serious are they?
- [09:09]
Jessica Melody Rivera
We use this figure called R Naught, which refers to the number of people that one infected person can get sick. So for comparison, the R naught of COVID was between 1. That meant one person who's sick with COVID could get one to three people sick with it, and flu, it's like 0.9 to 2. For measles, it's 12 to 18. That means one person can infect up to 18 people, and that's exponential growth, right? So that's 1 to 18 and then 18 to 18 more. And so when we talk about this disease exploding and having extreme risk, that's why if one person has measles, 90% of the people close to them who've never been vaccinated will become infected with measles. And it's a disease that is highly, highly airborne. That's why you probably see these public health memos saying somebody at LAX between the hours of 2pm and 4pm with measles passed through. And people wonder, why is it so specific? It's because measles lingers in the air for hours even after a person with measles has been in that room. So if you've been in the room hours after somebody with measles, you can still get it, especially if you're not protected. And measles can lead to a number of serious complications. About 20% of kids who get measles end up in the hospital. It causes pneumonia, which is the most common cause of death for measles. It can cause encephalitis, blindness, pregnancy complications. If a pregnant person gets it, it can cause dehydration from diarrhea, all kinds of complications. But the most scary thing to me al, is this thing that it can cause called immune amnesia, which essentially is wiping out your body's memory of all previous infections, meaning it's as if you've never had antibodies to anything else. So you are now immunologically naive and susceptible to any disease, even diseases that you've been vaccinated for or had in the past and no longer get sick from. So when we say it's severe, it's because it can be so widespread so quickly. And we have the most effective vaccine probably to date in that if you get two doses of this vaccine, vaccine, it prevents 97% of cases. So, you know, outbreaks like this are not normal, but they're increasing because we're seeing people refuse the vaccine more and more out of these misconceptions that the vaccine is unsafe, that it contains heavy metals, that it could potentially be linked to autism, all of which has been proven to be false. Unfortunately, many kids are now having to experience measles because they have been refused the vaccine.
- [11:46]
Al Edson
Can you break down a little bit the movement to refuse vaccines? Like, where did it come from and why is it so strong?
- [11:55]
Jessica Melody Rivera
Yeah. The MMR vaccine, the measles, mumps, and Rivello vaccine particularly, became kind of the center point of the anti vax movement when a doctor whose license has since been revoked, named Dr. Andrew Wakefield, published a paper for which he was paid to publish, trying to make a correlation and a causal relationship between vaccination and the incidence of autism. The paper was actually published in the Lancet and then retracted. It is not true. It has been proven to be not true. This has created this idea that we often refer to as chemophobia or a fear of chemicals or a fear of ingredients that we don't know how to pronounce or understand what they are. And the wellness community has really latched onto this idea that. And it really appeals to a lot of fallacies, including the appeal to nature fallacy, where I don't want to put anything in my body unless it's natural. Well, I hate to break it to you, but water in toxic doses is fatal. Formaldehyde is natural. You know, arsenic is natural. There's lots of natural things in this world that will kill us, you know, and so. But that these ideas have penetrated so deeply amongst parents and caregivers and wellness people that it has warped their understanding of harm and risk. And I would say it's one of the most difficult things, as a science communicator, to talk about is risk. Risk is very personal, and vaccines have risks. Anybody who denies that is not being truthful. But when you look at the data, the benefits far outweigh the risk.
- [13:31]
Al Edson
One of the things that came out in RFK's confirmation hearing for health And Human Services secretary was about how he profits off of all of this. Specifically, Senator Warren accused him of making millions through his work related to anti vax lawsuits. So this isn't just this movement of a lot of people who deeply believe that they are doing the right thing, trying to protect their children. In their minds, they are making the best decision they can possibly make for their children. But beyond that, there's somebody profiting off the fact that they don't get vaccinated. Can, can you walk me through that?
- [14:08]
Jessica Melody Rivera
Yeah. And you know what, Al? We've actually stopped really calling it a movement because it's really an industry because of how well funded it is. It is an anti science, a science denialism industry that is, that has spread its kind of branches across a number of things. Food safety, vaccine safety, you know, anything you can imagine that has to do with the harm reduction that public health encourages. And it's concerning because it is a grift. It is a very, very lucrative, lucrative business.
- [14:43]
Al Edson
One of the things that I think about when we're talking about issues like this, like anti vaxxing, is that it also, you know, you definitely have the individualism. But I think there's a general distrust of big Pharma because I know I have that mistrust. I take blood pressure medicine and I resisted it for so long because I just don't trust big Pharma. There's something in me that just feels like I should naturally be able to get over this. And I tried everything I ate, right? But genetics will not let me out of the clutch of high blood pressure. I mean, all the holistic things that my friends sent me, I tried all of it. None of it worked to the point where it was like, okay, you gotta get on the meds or else you're gonna stroke out. So I got on the meds, they're fine, whatever. I'm not crazy that I'm on the meds because again, I just don't trust it. And I think that's a part of it too, Right?
- [15:42]
Jessica Melody Rivera
It is. And I don't want folks to hear me say that. I'm just here defending pharma, you know, blindly. Pharma has a lot of problems. I mean, they are responsible for the opioid crisis. They are responsible for price gouging and for profit margins. Illogical pharmaceutical companies make in the billions of dollars. The wellness community, as of data that came out earlier this year, makes trillions of dollars. The last estimate I saw was nearly $2 trillion. I mean, you can't even Compare the money that comes out of wellness misinformation to pharmaceutical companies. Again, that's not me defending pharmaceutical companies, but let's like, call it what it is. When it comes to unethical profit margins and people making money off of other people's harm, you know, I think it's. You can. Two things can be true. You can be very skeptical of pharmaceutical companies, their pricing structure, their. The way that they manage insurance, the way that they keep people addicted to medication, the way that medication can sometimes be, you know, not accessible globally and cause things like the tuberculosis crisis in all over the world to continue. When we have drugs and vaccines, that should mean that there should be no tuberculosis in this world. I mean, it is truly unfathomable that TB is still a disease that kills people today. Two things can be true that they also create products that prevent people's death. I mean, in the last 50 years, vaccines have saved 154 million lives.
- [17:16]
Al Edson
So tell me, what do you think so far about how RFK Jr. Is reorganizing the department and how it's responding to these public health threats?
- [17:29]
Jessica Melody Rivera
It's deeply concerning, and that's the politest way I can say it. It's hard to not feel despair, but it's also hard to not say, we told you so. We knew this was going to happen as soon as he came into power. The eyes were on our vaccine schedule, the pediatric vaccine schedule, ACIP and vrpac. And he went after all three the second he got into office. And this sets a really dangerous precedent. I mean, as you mentioned, there are a lot of things happening in public health that are very concerning, including this H5N1 outbreak. Bird flu that is currently spreading all over the United States on a number of dairy farms and poultry farms is really concerning. H5N1 is a virus that is typically in wild birds and poultry, but it has jumped a number of species. We always worry about anytime a disease jumps to a different species, because when that happens, it's happening because of mutation. Viruses are a little clumsy when they make copies of themselves. They make mistakes like. Like a typo. Those mistakes make it so that they can change the way that they attach to a cell. So it jumped to cows. Cows are mammals. That's a concern because we are also mammals and we're trying to figure out does it have the type of adaptability to attach to us. And so people have gotten sick from cows, but it is not spreading from human to human. That's really the threshold that we worry about, because when that happens, then it can really take off. We are seeing this disease spread in a way that we probably don't have a good handle on exactly how much it's spreading. It's very reminiscent to the conversations we had about COVID 19 and how it seems almost undetected because we're not testing enough. We're not testing enough. We're not testing enough. I feel like I've never said a sentence more in my life than we're not testing enough.
- [19:22]
Al Edson
Is it conceivable that we could enter into another pandemic in the United States and not know is?
- [19:33]
Jessica Melody Rivera
It absolutely is. And it's because, again, we are flying without a full radar visible. We have so many blind spots because we're not testing enough, because we don't have good data systems to aggregate it all and to share it transparently. I mean, without good data, we can't make good, informed choices. And it is conceiv that it can be happening and brewing right underneath our nose and us not. Pick it up.
- [20:08]
Al Edson
When we come back. How our collective failure to mourn those we lost to Covid is affecting how we respond to public health emergencies today.
- [20:17]
Jessica Melody Rivera
Covid is just far enough out of people's mind because life is, you know, it's air quotes back to normal that the severity of it, the trauma of it, are very easy to reprogram in your brain as, oh, I mean, it was just a flu.
- [20:37]
Al Edson
There's a lot more to talk about with Jessica, but before we do that, I want to remind you that there is a really easy way you can keep up with all the important work we're doing here at Reveal. You can sign up for our free newsletter. Just go to revealnews.org newsletter to receive your weekly email reminding you about all of our good reporting. We have to stay connected now more than ever. Okay? So don't go anywhere. There's more to the story.
- [21:11]
Jessica Melody Rivera
Imagine if every person in Texas, New York, and Florida suddenly lost their home. That still wouldn't equal the 120 million people who've fled war and persecution. Right now, the UN refugee agency is responding in 136 countries. But as violence escalates, your help is needed. Donate today and critical relief will reach a refugee family within 72 hours. While we can't rebuild their home overnight, your gift will provide food, shelter, and hope for the Future. Go to unrefugees.org donation to make your gift.
- [21:42]
Unknown
This program is brought to you by audible. Listen to the new Audible original, the Big A Jack Bergen Mystery, starring Jon Hamm as the hard boiled private eye cracking his latest case of murder and mystery. Four years after he left the FBI, Jack Bergen is pulled back into the fray by an old flame who persuades him to investigate a homicide and clear the name of an immigrant accused of murder. Conspiracy abounds as a Mexican American community is pushed out in order to build Dodgers Stadium. And in this story inspired by the real life battle of Chavez Ravine, co starring Ana de la Regera as an activist out for justice, Omar Epps as Jack's partner in solving crime, and Alia Shawkat as an intrepid reporter racing to break the story. Plus a cameo from John Slattery as a shady executive. Created by John Mankiewicz and directed by Aaron Lipstadt. Listen to a gritty and winding tale that delivers both meaning and mayhem with a solid punch. Go to audible.com the Big Fix and listen now.
- [22:44]
Al Edson
Hi, this is Sean Worley from the communications team here at the center for Investigative Reporting. And I'm talking to our genuine fans out there. You never miss an episode. Maybe you're rocking the T shirt right now. You know who you are. Well, the show you love is non profit and listener supported, which means we need fans like you to become members. Just text the word give to 88857 Reveal. That's 888-577-3832 or visit revealnews.org donate a gift of any amount. Since you care about this show and you've got our back. So thanks. It's more to the story. I'm Al Letson and I'm talking with epidemiologist Jessica Michael. I want to pull back a little bit and go back in time and like, really look at the COVID pandemic. The thing that I think about a lot is that whenever there's a tragedy in this nation, we kind of rally around it and mourn it together. For example, like 9, 11. You know, wars can be divisive, but we definitely try to give, especially after the Vietnam conflict, you know, we try to give soldiers and veterans their love. We didn't do any of that for Covid, and Covid, like, killed so many people. I just think a lot about how the fact that we did not grieve as a nation makes it so much easier for disinformation about what it actually was. Like, all those people who died are kind of forgotten because if we're not talking about them, if we're not. And not just them, but like what they died from, if we're not talking about that, then what they died from just kind of goes away and we freak. Cause everybody wants to forget the pandemic. Everybody. Like, you know, we want to get away from it, but it feels like we have to look it in its face or else we're going to keep returning to it.
- [24:53]
Jessica Melody Rivera
Yes. I'm so glad you brought this up, because somebody mentioned this to me the other day when I was talking about the child who unfortunately died of measles. And they said, you know, never forget that 1.2 million people in the United States died of COVID And people are still mad that they couldn't get the haircut that they wanted when they wanted it, or that they couldn't go on the trip that they planned when they had hoped to go, because to them, Covid was a overreaction and the mitigation policies were unjust or unconstitutional. And we often say that amnesia is deadly because you forget things like something catastrophic like this. I mean, the last generation that was touched by polio is dying off, right? The. The generation that was, you know, lining up for polio vaccines and afraid of it constantly, they're dying away. And because when things are out of sight, they're out of mind. So polio doesn't seem like a threat because nobody's dying of polio in the United States anymore. Well, because of vaccines. Right. Covid is just far enough out of people's minds because life is, you know, air quotes back to normal, that the severity of it, the trauma of it are very easy to reprogram in your brain as, oh, I mean, it was just a flu. It was just this. It was, you know, not that serious. Or I've had Covid multiple times, and look at me, I'm fine. The long Covid community has been completely abandoned in the sense. And the folks who've lost family members and loved ones from COVID it's like their people died in vain. The way that people are acting today, and it is deeply, deeply upsetting. I think it goes back to your point about individualism. I think people don't look at the collective responsibility we have to reduce harm and to protect each other and to do it so that we all thrive. The two biggest reasons why kids are not dying before the age of 5 and why people don't have to have 10 kids for or an odds ratio of survival is because of clean water and vaccines. Public health provided these things so that people can live together longer. And now we've kind of gone back to, well, I don't care if you live long. I just want to live. And that's super sad.
- [27:09]
Al Edson
Yeah. Let's talk a little bit about the world itself. So what do you see as the effects of the Trump administration withdrawing from international health organizations like the who? What kind of effect do you think that could have globally?
- [27:27]
Jessica Melody Rivera
It can have a huge effect. You know, I was just recently in D.C. talking to lawmakers about this very thing because, you know, the WHO has been very unfortunately politicized by the COVID 19 pandemic. And a lot of people have just wild misconceptions about what it is and what it isn't. I think a lot of people who are very government averse just assume that it's some governing body that has control over us or over how we live. And that's just simply not true. It is the hands and feet of how we can do things like diplomacy in the form of public health. I don't think people realize that public health is a national security issue and that protecting our borders is for more than just weapons. It's from pathogens as well, that can cause massive disruptions, often bigger than war. And the WHO helps us achieve a lot of those goals. Now, we can't just withdraw. It takes about 12 months to do that. And so we are hoping that we can somehow reverse that decision. But doing so means millions of children will die. Millions. I mean, they'll die from vaccine preventable illnesses, they'll die from aids, they'll die from hunger, they'll die from conflict because it is so inextricably linked with our goals for security. And I don't think people realize that the way it affects everything can't be understated. And it will be a regrettable decision if it actually comes out that we withdraw.
- [28:55]
Al Edson
Organizations in public health across the board are seeing massive cuts. Do you have a sense of what's happening in those agencies?
- [29:06]
Jessica Melody Rivera
Chaos. Chaos is happening and confusion is happening there. This shock and awe tactic of just slashing jobs and slashing research budget items is a way to cause what we call a brain drain in this country. You know, the brain drain that has, that we have benefited from for many years, where, you know, very, very talented scientists end up immigrating to the United States because this is where research and opportunities exist. We're about to experience our own brain drain with this kind of slash and burn tactic. It is absolutely chaotic. Al. I can't believe the things that I hear on a daily basis. Cheaps being removed. Not just the young early scientists, people who have been career researchers at entities like NIH, CDC, HHS, with RFK Jr being the head of HHS. He has so much power. I mean it is a massive budget that he controls and multiple entities fall under hhs. And when you have a person who is a known vaccine skeptic and science denier at the helm, that is going to have a trickle down effect.
- [30:21]
Al Edson
How much misinformation and disinformation are you seeing right now when it comes to public health?
- [30:27]
Jessica Melody Rivera
It's unbelievable how much mis and disinformation there is right now. And what's the most frightening about it is that it's not just coming from the folks on the Internet and the talking heads and the expected culprits, it's now coming from dot gov websites. That's what's the most concerning. And when that is normalized and protected by the government itself, on top of the fact that social media groups have now, because of the government, stopped fact checking and stopped any sort of content moderation about mis and disinformation for the spirit of free speech. We are probably in one of the most dangerous information ecosystems that I've ever.
- [31:06]
Al Edson
Seen as a health and science communicator. And you're seeing these forces align against you. Sometimes it's from people who just don't know any better, but sometimes it's a concerted effort to lie to the American public. How do you continue doing your job? How do you get the truth out?
- [31:33]
Jessica Melody Rivera
It's hard. And I would be, I'd be remiss if I didn't mention the fact that it comes at a huge cost. You know, I started doing a lot of public facing communication during COVID A lot of the stuff that I did before was more behind the scenes with organizations that I worked with. And I realized that there was an opportunity to speak with my identities front and center as a woman of color, as a mom of three young kids, as a researcher, as an expert in this space. But I have been maligned and attacked and threatened excessively for the last four years. And I think it's only going to get worse. I feel very much back on the front line in that sense. But I also know that the good outweighs the bad because I've seen it. I have seen people transform their minds on things related to science and health and public health and vaccines in particular. And I think that, that it is only going to be more necessary. But it's costly. And I think that it's something I have to kind of check in with myself to make sure that my mental health is okay. Because it's not easy to be doing it in a time right now where people, keyboard warriors in particular, feel so brave to say the things that they do online.
- [32:46]
Al Edson
Yeah. Yeah. Jessica Melody Rivera, my favorite science communicator. Thank you so much.
- [32:54]
Jessica Melody Rivera
Thanks, Al.
- [32:59]
Al Edson
I have a feeling this won't be the last time we talk about public health. In the meantime, I wanted to recommend another show that we did last Saturday on Reveal. It's called the Plague in the Shadows about the early days of the AIDS epidemic and how research and public policy overlooked some of the groups most vulnerable to the disease disease. We'll put a link for you in the show notes. Lastly, consider donating to Reveal. We're a non profit and our journalism is listener supported. We're celebrating our 10 year anniversary right now and to be here for another 10, we need you. Please donate. Just go to revealnews.org 10 Again, that's revealnews.org 10. This episode was produced by Josh Sanburn and Kara McGurk. Allison theme music and engineering helped by Fernando My Man Yo Arruda and Jay Breezy. Mr. Jim Briggs, I'm Al Edson and let's do this again next week. This is more to the story from prx.