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Jessica Melati Rivera
Lemonade.
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Amazon Health AI presents painful thoughts.
Chelsea Clinton
Why did I search the Internet for answers to my cold sore problem? Now I'm stuck down a rabbit hole filled with images of alarmingly graphic source in various stages of ooze. I can clear my search history, but I could never unsee that.
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Don't go down the rabbit hole. Amazon Health AI gets you the right care fast. Healthcare just got less painful.
Podcast Host / Narrator
Welcome to that Can't Be True, a show that sorts fact from fiction, especially on issues impacting our health. I'm Chelsea Clinton, and today I'm thrilled to have Jessica Meloti Rivera here with me. She's an infectious disease epidemiologist and science communicator who turns complex public health challenges and questions into clear, actionable insights for all of us. And with hantavirus in the headlines, she's just the perfect person to talk to this week. I want to note, though, that we had this conversation on Monday, May 11, since this is an evolving story, although we talk about a lot of things beyond hantavirus, that I hope is, well, always relevant, helpful, informing and empowering.
Chelsea Clinton
Jessica, thank you so much for being here, but particularly this week.
Jessica Melati Rivera
Yeah.
Chelsea Clinton
I thought, though, to get us into this conversation, we could start with what we call that can't be true segment where we play some tape that's been circulating of late and get your reaction and then kind of use that to segue into the conversation.
Jessica Melati Rivera
Let's do it.
Chelsea Clinton
All right.
Social Media / Public Commentator
What do you mean the hint of virus could possibly be in Georgia? I thought I was supposed to stay on that cruise ship. I hope this doesn't turn into a pandemic because we'd be usually can only get the antivirus from rats, right? It goes from rats to people, but people can't usually give to people. But there's one strand that can go from people to people, right? And that's the one that they think that this is because. Of course. Right, of course. A lot of, like, doctors I follow because I follow a lot of them and I'm like, please calm my anxiety. Honestly, it's nothing being alarmed about because it's like, really hard to spread from one person another. It's not a huge, you know, issue. And unless it's mutated. And unless it's mutated. If it's mutated, we're off. Not doing this again. I am not doing this again.
Jessica Melati Rivera
Sorry about.
Chelsea Clinton
I just ending on the hand sanitizer. Let the record reflect I think we both probably would agree it is important to wash your hands always and to use hand Sanitizer always like, that's just a good habit.
Jessica Melati Rivera
Basic. I have people asking me, do I still need to do the whole happy birthday song? I'm like, that wasn't a Covid thing. That was like a hand hygiene thing.
Chelsea Clinton
Good hygiene, basic hygiene, Basic hygiene. Whether we're living through a pandemic or not, 100%.
Podcast Host / Narrator
Sue, when you watch that clip, listen to that clip, how do you react?
Jessica Melati Rivera
I mean, I hold a lot of empathy for the very real collective PTSD that people have from the pandemic. I'm very careful with my words. I don't say from COVID because Covid is not over. Covid is a persistent virus that still disables and harms people. But the pandemic is over. That acute time is over. And that was a very difficult time for a lot of people. And I understand this knee jerk reaction to I'm not doing that again. But I want to be so clear that we're not asking anybody to do any of that again because truly, truly, the risk to the public is low. You cannot even compare a disease or a virus like contovirus to a coronavirus that spreads much more prolifically from person to person. Again, he is correct. And he's saying there's one strain, the Andes virus, that is known to spread from human to human, but it doesn't do so really well or efficiently. I mean, if we look back at historical data, there was an outbreak that happened in 2018. It affected 34 people. 11 people died. Yes, the case fatality rate is pretty high.
Chelsea Clinton
And it's a horrific way to die.
Jessica Melati Rivera
It's a terrible way to die because we don't even have treatments for it. And yes, those are real things. There's no vaccine, there's no treatment. It's quick and ugly if somebody dies from this disease. However, we're not talking about something that has pandemic potential. Like truly, truly. If I were to zoom out a bit, I feel like what this is actually causing me to get anxious about is the one that does disease X. Call it whatever you want. The disease that is inevitably going to come and cause another pandemic that we are wholly unprepared for. Coronavirus, SARS, COV2, the virus that caused COVID19 was new. We did not know about it, we didn't know how it transmitted, we didn't know how it affected people. We know a lot more about hantavirus and yes, there are potentials for mutation. It is an RNA virus and they, they mutate, but there's nothing about this outbreak that is causing alarm to folks. Like responding. Exactly. I mean, we are concerned and we're watching it, but I have not seen anything unusual. I have not seen anything that is outside than what we would expect.
Chelsea Clinton
When would you get concerned if the outbreak exploded?
Jessica Melati Rivera
Right. If there were many more cases? I think, you know, as of Today, there are 10 confirmed cases. And this has been an issue since early April. You know, there isn't an active outbreak that's happening in Argentina either, which is where the outbreak that happened in 2018 happened. There was a rare exposure in a remote area among people who were on a very specific excursion, who then went on a ship with a number of other people who were doing very unique remote excursions too. So it, it feels pretty. Feels pretty isolated in that sense.
Chelsea Clinton
And Jesse, what advice do you have for people who now might be thinking, is it okay if I get on a cruise ship? Is it okay if I do a remote excursion? Is it okay if I, you know, I think we believe at least some of them were bird watching. Like, is it okay if I go bird watching? Like, how do you. How do you help people answer though, like, is it okay? Or how do I keep myself safe? Questions. Because I imagine there are a lot of people who are thinking about doing at least some of those things and want to clearly be able to do those things and also keep themselves and their families safe.
Jessica Melati Rivera
My DMs are full of questions like these and I think they're very valid questions. I'm probably the worst person to ask about cruises in general because I'm personally very anti cruise just for the norovirus effect of it all.
Chelsea Clinton
Well, explain what the norovirus is for
Jessica Melati Rivera
people who say that no. And the other is a very contagious virus that causes gastroenteritis or vomiting and diarrhea.
Chelsea Clinton
I'm sure many of our fellow parents are familiar, deeply aware. I'm deeply aware of this, having had these experiences in our house.
Jessica Melati Rivera
Many. It is linked to poor ha. Hand hygiene, going back to my hand washing. And because cruise ships are contained spaces where people are exposed to each other for long periods of time, the incidence of norovirus is quite high on cruise ships and you're dealing with lots of shared spaces for food and entertainment and high contact surfaces. So that's just me and my personal bias.
Chelsea Clinton
So if people do want to go on a cruise, just wash your hands a lot and have really good personal hygiene.
Jessica Melati Rivera
Exactly.
Chelsea Clinton
I imagine there are people listening to us, were like, I love cruises totally
Jessica Melati Rivera
and you can love cruises and Be fine and healthy. My in laws love cruises. I'm not going to, you know, yuck their yum. But I do think that folks are perhaps connecting dots that are unconnected. I don't think that there is a unique or a new risk to cruises that is now hantavirus. I think this is again, a very unique situation.
Chelsea Clinton
I think it's really important that you explain that more because it would be terribly unfair, extremely. If there were linkages made that are not science.
Jessica Melati Rivera
Yes. There is not any reason to associate cruises now with hantavirus. There was a cruise that was affected by a very rare disease and a very rare outbreak of hantavirus. I think there were in the beginning there was lots of rumors about perhaps there was a rodent infestation on the ship. That was not the case. There is not a situation of rodents that carry hantavirus that somehow end up on cruise ships. Again, we're talking about a very remote excursion for birdwatchers. Now, again, let's think about the overall prevalence of this disease. You know, in 30 years in the US we've seen less than 900 cases, which is like a 30 cases per year. Most of those cases occur in the four corners. So like Arizona, New Mexico, Utah, Colorado and in the southwest, arid dry regions, usually among a specific type of rodent, the deer mouse. So we're not dealing with all rodents everywhere have hantavirus.
Chelsea Clinton
So we're talking here in New York City. As someone who goes for early morning runs, I may or may not see
Jessica Melati Rivera
a latter two, may or may not
Chelsea Clinton
see a rat on occasion. I shouldn't be worried about this? No. Okay.
Jessica Melati Rivera
Now, should you be aware and cautious of ways in which you can reduce your risk should the outbreak or should the disease be more prevalent in the rodent population? Sure. And there are ways to do that. There's, you know, making sure that food is sealed, making sure that when you're cleaning up the droppings or places in which a rodent may have been and left urine, feces or saliva, that you dampen the area before you sweep it up so you don't inadvertently aerosolize it and then inhale it. Cause that is the route of exposure, not just persistent in our environment. It's not lurking about. It's not, if you see a mouse, you're exposed, or if you see a rat, you're exposed. Rats and rodents are everywhere, you know, even if they're not visible and their droppings are too. But the presence of this virus is not ubiquitous in the whole world. And so if you like bird watching, Go bird watching, you know. But there are places like this Andes virus is known to exist in places like Argentina and Chile. And that's where they happen to be,
Chelsea Clinton
where the Andes mountains are, where Andes
Jessica Melati Rivera
Mountain, hence the name, just to be
Chelsea Clinton
clear about where the name comes from.
Jessica Melati Rivera
Exactly, exactly. So, you know, I have a lot of people asking, oh gosh, like if my, if my cat brings me a mouse, do I need to do like a full decontamination or if my.
Chelsea Clinton
It's a great question.
Jessica Melati Rivera
It's a great question. And I've answered these questions because I don't think there are dumb questions. There are so many unknowns about this.
Chelsea Clinton
And how thankful am I listening to you now that people are asking you these questions instead of the random influencer or who may have wonderful things to say about like kids, sports or your skincare routine, but likely doesn't have your
Jessica Melati Rivera
qualifications or even AI. You know, prompting a chatbot to answer these questions could potentially cause a lot of harm because it's sourcing all kinds of information, including this. I will say the information ecosystem went crazy. And so a lot of what I'm doing right now is triage from the correlations that people are drawing from the events, the confirmation bias of it all. People are wondering, well, if I'm going to be going on this vacation, should I cancel it? If I have this type of animal, should I do this? And so I'm answering every single question.
Chelsea Clinton
So tell us more about some of the questions that people have asked you. And what misinformation, especially in the last days or a couple of weeks around antivirus, do you find most concerning?
Jessica Melati Rivera
Yeah, so two that were almost immediate were treatments and ivermectin was of course.
Chelsea Clinton
Isn't that extraordinary? It really is, it really is. It really is. Like ivermectin actually a great drug, great
Jessica Melati Rivera
drug, amazing drug, love it.
Chelsea Clinton
For very specific use cases, I really, I would read a very long article or I would watch a documentary about how and who shall we say, positioned ivermectin as a panacea for all things.
Jessica Melati Rivera
It's truly amazing.
Chelsea Clinton
It's amazing.
Jessica Melati Rivera
It's amazing because you're asking for evidence
Chelsea Clinton
based study and it's not a new
Jessica Melati Rivera
drug, it's not new at all.
Chelsea Clinton
So presumably if it had any of these effects around, shall we just say like Covid or Honda, since those are the two things we've talked about so far, we would know that.
Jessica Melati Rivera
And don't you think I would want people to take it, like if I get accused of Telling people to take drugs and vaccines. I'd be screaming from the rooftop, ivermectin works. It does, but it doesn't. It's an anti parasitic drug that's used for parasites.
Chelsea Clinton
And it's great at that.
Jessica Melati Rivera
It's great at that. Let's use it for its use. And also let's have people understand the science of it, too. I mean, a lot of folks are saying, but why couldn't it. Well, you know, there's data that's from a petri dish, in vitro studies, and then there's data that would be required for a human in vivo. Not the same. The amount to have the effect in those petri dishes would actually hurt you. And again, we are trying to prevent toxicity.
Chelsea Clinton
I mean, it sort of goes back. I just had a ricochet of memory about the bleach. Yes. I'm like, bleach could. Maybe it would.
Jessica Melati Rivera
It would kill things, but it would kill you too. That's a deep cut because we actually wrote a paper about the spike in poison control calls after that press release, after that press hearing. And There was an 800% increase in Google searches for that and for phone calls to local poison control offices. Because people want to reduce harm. Of course we want to reduce harm. That is the public health, like 101. But I'm also telling people there are some things you're being actually sold that could cause more harm. And I do think the WHO and the why is pretty obvious. I mean, at this point, we're dealing with not a movement, but an industry of people who are making a ton of money off of monetizing a crisis. And I think the folks who are shilling right now Ivermectin have not missed an opportunity.
Chelsea Clinton
Nope. All right, so ivermectin1 that you've been asked a lot about you. There's another one that's also been.
Jessica Melati Rivera
Did you hear this one? That it's a side effect of the Pfizer COVID 19 vaccine?
Chelsea Clinton
I did not hear this one.
Jessica Melati Rivera
Oh, this is a good one. Yeah. Somebody scrolled, I think, to page 37 or 38 in one of the trial study designs for the Pfizer vaccine. And as a company would do, it asks for reporting of anything that happened while a person was in a trial. Not as a adverse event of it, but events that happened concurrently with the trial, which can include everything like a car accident.
Chelsea Clinton
Yes. Or you got pregnant or you got
Jessica Melati Rivera
pregnant, or you had a miscarriage or
Chelsea Clinton
you fucked her pinky.
Jessica Melati Rivera
Which I did during a trial.
Chelsea Clinton
No. During the marathon. But I'm not going to blame the marathon.
Jessica Melati Rivera
You're not going to blame the marathon. There was perhaps a report of hantavirus infection in one of the trial participants and somebody scrolled down, circled it and did this, you know, well, we're just asking questions. We're just asking questions. I'm like, are you asking questions or are you correlating and making a causal claim about something that was reported during a vaccine trial that had nothing to do with the vaccine itself? Two things can be true at the same time without one causing the other is a very difficult thing for the human brain in general. But then when you see it listed in a clinical trial description, it's very hard to understand that what that is is not a consequence of being in the trial, it's an event that happened during it. And so that has been one I've been very patiently debunking and explaining.
Chelsea Clinton
What other misinformation, perhaps not at the level of those two, have you either noticed or that's been brought to your attention that you also would like to debunk?
Jessica Melati Rivera
Yeah, there's a lot of misinformation about how we're managing the cases. I think that folks are thinking this is just some willy nilly dropping passengers off at ports and letting them be in the population. There's a protocol as defined by the international Health regulations controlled by the WHO that is very precise about what is required for isolation, what is required for quarantine, who is high risk, who is low risk. And it's being managed, I think, in a really thoughtful way. It's perhaps imperfect and perhaps humans will still be humans and not do them as strictly as we'd like. But again, we're not dealing with a disease that is just like measles, per se. You know, measles is one of those diseases. You could be in a room hours after an infected person and be exposed to the virus. That's not the case with hantavirus. And we want to explain to people that these protocols are defined based on what we know about the transmission dynamics of this disease. And there's a lot of paranoia being spread about where these people went. So we just heard that the Americans who were aboard are now here, that one just tested positive, they're in Nebraska. They're going to be doing their proper isolation and quarantine protocols. But there's a lot of people saying it's not enough. There's some somebody in Santa Clara and there's somebody here. And what do you think about that? And do you think that I need to cancel my trip to whatever location that might be in the, in the vicinity of a person who was a passenger or close contact? And this is why I kind of have to keep saying that the risk is low. You know, we're not dealing with somebody that is just going to be spreading it to hundreds of people. And it also just causes a lot of, I think perhaps dangerous thoughts, xenophobic thoughts, othering of people that I think could cause more harm than we need. And it's diverting attention and emotional energy on something that I just don't think is that acute.
Chelsea Clinton
I also found it Quite moving that Dr. Tedros, the head of WHO, is going to Narif, perhaps already is there and the United States is no longer part of who. How concerned are you or how concerned do you think Americans should be that we're no longer part of the international organization that as you just said, is managing this thoughtfully based on truly like centuries of now knowledge around quarantine and decades of codified international health regulations. How worried should we be that we're not part of WHO any longer?
Jessica Melati Rivera
Very. I mean I, I think that you and I probably share the kind of grief of it all that for years we would say our public health agencies were the premier public health agencies of the world. Historically the US would have been involved in the sequencing of the hantavirus that was discovered here. That we would have been at the forefront of that, but it happened elsewhere. We would have been doing things like sending out a health action network, you know, alert to the community. We would have probably sent people directly to the response. And instead we've kind of been looped in at the end and now are participating in a limited way. But we need multilateral partnerships to manage global health because regardless of people's political affiliation, our national security is directly connected to global health security. A threat over there, wherever there is, can be a threat here in a matter of one passenger on one plane. You know, and it's like we've learned nothing from other outbreaks in the past, including COVID 19, that our borders don't care about pathogens. Pathogens are just gonna cross no matter what.
Chelsea Clinton
They don't have passports.
Jessica Melati Rivera
They don't have passports. All they need is a vessel, a person to jump on, to be in. And so it is a revelation to how impaired we are for the next big one. And I do actually, I mean that to me is not fear mongering, that actually is probably more balanced level setting that there will be another one. It will probably bring us to our knees because we are just unprepared. We don't want to talk about pandemic preparedness anymore because it's too triggering for folks. We don't want to talk about, you know, MRNA vaccines and how they could be a really great tool for the mass.
Chelsea Clinton
Perhaps for Hanta too.
Jessica Melati Rivera
Perhaps for Hanta it's an RNA virus. It'd probably be a great opportunity. But again, you know, people are asking, are we gonna get a hantavirus vaccine? Probably not. One, because the disease burden is not very high. And two, have you looked at MRNA vaccine funding? Right now we can't even get people to agree that it's good for pandemic potential viruses like flu or coronavirus, let alone a rare disease like hantavirus. And something that could happen quickly, very budget friendly and very successfully is now being re litigated. We're now having to redefend some of the most basic science that helped, I think, create one of the most powerful tools we've ever seen in modern day science.
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Jessica Melati Rivera
go downtown and tell a receptionist I'm here to talk about my downtown.
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Chelsea Clinton
You've mentioned a few times, like the next pandemic, what are you most concerned about and what do you think we should be doing to reduce the risk of harm?
Jessica Melati Rivera
The collective trauma is very real and I think is going to have a very real whiplash effect. I think when, when, when there is an actual threat that has a much wider risk to the general population that has the potential for pandemic. I don't think we're going to see dissimilar videos from what you shared. I think we're going to see people immediately respond with I will not comply. I'm not doing that again. I'm not taking a vaccine. I'm not staying home from work. I'm not doing six feet of social distancing. All the things that were helpful mitigation efforts, not perfectly applied, for sure, but helped reduce harm, but were part of something that made people feel bad, whether for reasons that you know are very unique to them or just like the collective trauma of seeing so many people get sick, masking, not seeing people's faces. People are really upset about that. I think we're gonna see people have that same response and I think it's going to be very difficult to overcome because when we do ring the alarm bells, I fear that people are gonna accuse us of crying wolf and perhaps being hyperbolic about something because there's still people right now who don't believe that Covid was as harmful as it was. There are people now who don't believe the death count was 1.2 million. And even that 1.2 million was an undercount. There are people who think that it was.
Chelsea Clinton
And that was just here in the United States.
Jessica Melati Rivera
That was here in the United States.
Chelsea Clinton
That's we're sitting here in New York city. More than 1 in 400 New Yorkers
Jessica Melati Rivera
died of COVID It's unbelievable, truly. I mean, the massacre that happened in long term care facilities, I think they represent 2 to 3% of the population and 40% of the burden of death. I mean, that was a massacre that
Chelsea Clinton
happened among eligible people in public health and a public policy failure.
Jessica Melati Rivera
Truly, truly horrendous management of that population. And it will be A stain on our history forever because of it. But I worry that the next one could be worse than COVID 19. COVID 19 was bad, but it had a mortality rate of like 1 to 1 to 2%. What if the next one is bigger? What if it's bird flu? Bird flu would be so much worse. It could be catastrophic.
Chelsea Clinton
Jessica, you mentioned measles earlier, and it certainly is both painful and worrying to see just the number of measles outbreaks that we've had around the country and that we're likely on the precipice of losing our measles elimination status, and that there are, I think, a lot of people, including people with very large platforms, saying it's actually better for you to get measles. Right. It's better for you. It's going to prove what your immune system can do instead of actually prevent cancer, erase your immune memory. So what are you most worried about for measles specifically as a pathogenic threat and also kind of the mis and disinformation swirling around it?
Jessica Melati Rivera
Yeah, Measles is one of those diseases that feels like a bit of a canary in a coal mine because you're seeing, again, a little bit of revisionist history about it all, and people are trying to reframe it as just a childhood disease, just a rash, just something that you got in the same way that people were saying chickenpox. I think also people confused chickenpox and measles, and I think that was a narrative that happened on a very popular podcast that the person was basically describing chickenpox and was talking about measles. But measles is not benign. It is not just a rash. It's not just a childhood disease. The complications can be so severe. I remember I shared a statistic once that before the measles vaccine was available, before MMR was available in the U.S. 500 children would die a year in the U.S. and I got responses like, well, that's not that many kids.
Chelsea Clinton
What if that were your child?
Jessica Melati Rivera
And I just, I was like, if it was one, it would be too many. Yeah, if we, if we can prevent it, yes. You know, I mean, it's. But it's the same kind of. It's the numbing of it all. It's the, It's. I mean, you had people on the. This recent ACIP saying that 250 deaths of childhood flu was a modest number. Like, one child dying is a horrific tragedy. 250 is a failure.
Chelsea Clinton
It's an indictment.
Jessica Melati Rivera
It's an indictment. And I just feel like people are. It's a cavalier attitude about disease and a downplaying of the science. I mean, there are people saying it is good for you, it prevents cancer. There are people saying that it strengthens your immune system. And like you mentioned, it can cause a rare complication called immune amnesia, wiping out your body's ability to remember other pathogens, too, making you so much more immunologically naive and vulnerable to other diseases. It can cause a complication that can happen years later called SSPE that is a neurological, 100% fatal complication. And there was just a case recently reported about a tween, I think, that died of that complication. A very, very acute encephalitis that killed the child. It can cause respiratory distress. It can cause blindness and deafness. I mean, I talk a lot about my child's experience needing supplemental oxygen because of an RSV hospitalization, and it very much informed my very low risk tolerance to things like Covid. And I've tried to explain to folks like, you don't want to see your child in respiratory distress. You don't want to see them with pneumonia, which can happen from measles. You don't want to see them needing to be hospitalized and managed for very, very acute neurological issues that can happen from this type of infection. And even if people look at this and say, well, the mortality rate is so low, death is not the only outcome we're trying to prevent. And I think that's where a lot of my messaging has to go into, is that disease is not your friend. We're trying to reduce harm. And this disease can cause a lot in a population that just does not need to be suffering anymore. You talk about you don't want to close schools and keep kids home, then let's keep measles vaccinations high. And I think that, again, losing our measles elimination status would be an absolute indictment, too. It would be deeply embarrassing to do. And I think it's inevitable. I think it's going to happen this year.
Chelsea Clinton
I also think our messengers at the top matter. You know, we already talked about the bleach press conference. I know that you recently celebrated that the Trump administration withdrew the Surgeon General nominee, and I wonder if you can talk about why you think that was so important.
Jessica Melati Rivera
Credentials matter, and I think training matters, and I think that it is so.
Chelsea Clinton
And having someone who's not a licensed physician as the nation's doctor would have been bad. Bad. We'll just go with that bad.
Jessica Melati Rivera
In the most simple term, it would have been bad.
Chelsea Clinton
God bless Dr. Jerome Adams.
Jessica Melati Rivera
I know.
Chelsea Clinton
I mean, really. Thank you. If you ever listen to this.
Jessica Melati Rivera
Really. Thank you. Thank you. Thank you, Dr. Adams. It was not ad hominem to call Kasey Means a wellness influencer. That was her intended pivot from medical school to naturopathic, you know, wellness stuff. And she made a lot of money doing it and positioned herself as she
Chelsea Clinton
still was actually making a lot of money while she was in the confirmation process.
Jessica Melati Rivera
Still was, yeah. I mean, it's incredible to me. People are like, what about the conflict of interest? I'm like, let me show you the conflict of interest that exists right now in this administration. Unchecked, Casey Means was incapable of answering some of the most basic questions. And like you mentioned, this position is the nation's doctor, probably the chief science communicator of the country, responsible for understanding and contextualizing things like risks and hazards so that the people, the public, can make informed choices. I think back at Dr. Vivek Murthy, who really took that to heart and talked about misinformation being a health issue and also loneliness and loneliness. It was just incredibly emotionally intelligent of him and astute to say, these are not things you would usually associate with public health or the Surgeon General's role, but it is having direct impact on people's health outcomes. And basic, basic questions were not answerable by her during the confirmation hearings. But we knew that that was gonna be the case, and we just thought the evidence was just abundantly clear. We also just saw what happened with RFK Jr's confirmation, which felt like writing on the wall. Bill Cassidy was lied to. Right. He was given a ton of Dr. Bill Cassidy. Dr. Bill Cassidy, licensed Dr. Bill Cassidy was lied to and believed lies that were promises intended I think, from the very beginning to never be kept. And so we were just trying to say, like, let's not do this again. It's too consequential to have both the head of our Health and Human Services and the. Of our national public health workforce as a US Surgeon General, be people who cannot affirm that flu vaccines prevent hospitalizations and deaths, that measles vaccines are the only way to prevent measles, that chronic disease is inextricably linked to infectious disease. You know, just basic, basic things that could not be affirmed. Now, again, I. I kind of worry about the jump scare of who's next, you know, whenever there is a switch that might be in the favor of science and public health, because I don't think that this administration is intending to reinstate anybody from previous positions, like Dr. Jerome Adams, who I think would be amazing as surgeon general again, and he has served under multiple presidents, isn't that right? He was.
Chelsea Clinton
He. He was Trump's first surgeon general.
Jessica Melati Rivera
Right. And so I think that it's. At this point we've become so polarized politically, and public health in particular is kind of in the collateral damage of that fall that it's red team versus blue team. We've lost the purple that existed with public health. And I think what we're seeing right now with these positions is a reflection of that. Are they for the red team or are they for the blue team? I mean, the Senate help committee could not make a decision about her. And I think it's because they were all worried about what this meant for the red team. You know, they were worried about if they would get primaried, if they fell against party lines, if they sided with science instead of party. And I hate that with every cell in my body, because this isn't about red team versus blue team. This is about public health in America. America, Exactly. I mean, how can we be talking about America first when we're actively doing things that will harm us? I mean, I think back even this decision about not mandating the flu vaccine for our forces. Do people forget what happened in 1918 and the big war, World War I, that happened concurrently? I mean, I think there was an estimate of 300, 400,000 troops that were out of the service because of flu. You know, that was a unique situation, a pandemic flu, but that could happen again.
Podcast Host / Narrator
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Chelsea Clinton
Jessica before we move on to our fact or Fiction segment where I'll throw some things out and you'll tell me whether they're fact or fiction or nuance. Feel free to add nuance. I am curious. We haven't talked about the cold and I think a lot of people also think most viruses are kind of just variations on the cold. I mean, we talked about how you mentioned someone with a prominent platform likely confusing measles and chickenpox. I do think a lot of people think, well, you know, aren't these just all inevitable? It's like the cold. What do you say if you hear something like that? Because I hear that totally.
Jessica Melati Rivera
I mean there are diseases that are inevitable. Norovirus, until we get a vaccine is inevitable. The amount of viruses that cause the cold, the amount of rhinoviruses that cause the cold are so, so many. And you're gonna get exposed to a lot of them. And unfortunately long term immunity is not one of the effects of it.
Chelsea Clinton
But are we trying called the common cold?
Jessica Melati Rivera
It's called the common cold. Reason? Yes. And can it cause significant harm? Absolutely. Can it cause complications like pneumonia, even hospitalization? And sure it absolutely can, depending on the person's body and their age. But again, getting an infectious disease is not an infectious disease strategy for public health. We don't want people to do that, which is why the pediatric vaccine schedule is what it is. We have determined based on mortality and morbidity risks, based on what are the worst outcomes population wise that we can reduce collectively if we take these vaccines. So many kids used to die of rotavirus before we had the rotavirus vaccine.
Chelsea Clinton
So many kids in a lot of the world still do.
Jessica Melati Rivera
So many kids all over the world still do because they don't have access to it. And it's not arbitrary. It is very methodical based on years of understanding population health. And the fact that we don't see that anymore is incredible. Polio used to disable and kill so many people.
Chelsea Clinton
Many people who I know we didn't even talk about polio. The number of people also who discount polio is. This is where I mind boggling to me, like, like this is within our family's lived experiences.
Jessica Melati Rivera
Like, exactly.
Chelsea Clinton
Like my mother really remembers. Like her mother didn't let her go to the pool. Yes, 100% until everybody got vaccinated for polio and Then it was, like, so exciting. They got to go swimming in the summer.
Jessica Melati Rivera
Yes.
Chelsea Clinton
At Hinkley Pool.
Jessica Melati Rivera
Yes. I. I think amnesia is going to be to our detriment in this case. It's the out of sight, out of mind mentality. Like, well, we don't see polio, so why do we need to vaccinate for it? Because we vaccinate for it is why we don't see it. And I do think that it's going to cause people to fall into the idea that it's just fine. I mean, there was an. I can't remember which official said this, but somebody said that polio coming back is the cost of our freedom. And I couldn't disagree more about how freedom.
Chelsea Clinton
I don't know what to say to that.
Jessica Melati Rivera
It really is unbelievable that somebody could say that polio is worth our freedom. Freedom for what? Like the iron lung? Like, is that what we're really talking about here? I mean, somebody asked me what the red line was for this, and I thought it was gonna be a kid dying from measles because we hadn't seen that in a day in two decades. And then two kids died. And then somebody asked me, like, what is it gonna be? And I actually.
Chelsea Clinton
And they're like, maybe whooping cough. Maybe like a kid dying of whooping cough.
Jessica Melati Rivera
We've seen that, too.
Chelsea Clinton
And we've seen that too.
Jessica Melati Rivera
And I actually think maybe it is the iron lung. Maybe it is that incredibly barbaric looking type of existence that you can explain
Chelsea Clinton
briefly what the iron lung is.
Jessica Melati Rivera
The iron lung is a device that was created so that it would help a person who is incapable of breathing on their own from getting oxygen to get oxygen.
Chelsea Clinton
And it's incredibly cumbersome.
Jessica Melati Rivera
Incredibly cumbersome. And it's not a way to live. It's because this disease can completely paralyze you and paralyze your ability to breathe independently. And that feels like torture. And so are we really gambling with a reality that there might be people who might have existences that are condemned to an iron lung? I just can't understand where the red line is anymore.
Chelsea Clinton
And we don't have to live that way.
Jessica Melati Rivera
We don't. It's entirely preventable.
Chelsea Clinton
And like, we being Americans collectively, like, we don't have to invite that specter into reality.
Jessica Melati Rivera
Which is why I think, like, bridge building is so important too, because I don't want people to just. I do see clear identity politics coming in and the confirmation bias of, like. Well, the people that I like, that I align with believe that Ivermectin is a panacea. That freedom is worth it to risk these diseases coming back. I want people to understand like you and I can be very politically unaligned and still believe that we have resources to not let our kids that we love the same suffer. And I want to get back there because it existed for a long, long time.
Chelsea Clinton
So many of the most prominent and passionate advocates for vaccines and vaccinations actually were often our first ladies.
Jessica Melati Rivera
Yes.
Chelsea Clinton
Including Mrs. Reagan. Right. And Mrs. Carter.
Jessica Melati Rivera
Mrs. Carter was a legend.
Chelsea Clinton
It's just this was not, it wasn't even bipartisan, it was fairly non political.
Jessica Melati Rivera
That's right.
Chelsea Clinton
All right, so our fact or fiction. I'm going to throw out some things and you're going to tell us whether they're fact or fiction or you want to add nuance.
Jessica Melati Rivera
All right.
Chelsea Clinton
I feel like we have to start with this one. Some vaccines actually can help prevent cancer.
Jessica Melati Rivera
Fact, Tell us more. We have two cancer preventing vaccines and I feel like again, this was a missed opportunity from a branding perspective that we weren't shouting it from the rooftop that HPV is a cancer preventing vaccine. It prevents several types of cancer for women and men.
Chelsea Clinton
And men. I think that was a real missed opportunity.
Jessica Melati Rivera
It was a real missed opportunity.
Chelsea Clinton
Not just for like adolescent girls, actually.
Jessica Melati Rivera
No, for whole adults. And they increased the age indication for it for that reason. And they also increased the specificity of the types of cancers. It wasn't just a cervical cancer vaccine. It was for oral pharyngeal head, neck and throat cancers, which is again, makes people squirm a bit when you think about how it's transmitted. And I like to make people feel comfortable with saying hands and mouths are great vectors for this virus. And so that's why it is a very, very important anti anti cancer vaccine. The other one is HBV hepatitis B vaccine, which is a virus infection that can lead to chronic illness, cirrhosis and even liver cancer. And that's why we vaccinate so early, because a infection with hepatitis B can lead to a lifetime of problems that is not treatable.
Chelsea Clinton
And so how do you feel about the recent recommendations around.
Jessica Melati Rivera
It's heinous and we've actually seen it in the data. We have seen a drop in parents adopting day one vaccination of hepatitis B because of a again attempt to rebrand it as an STI only or a virus that would be exclusively introduced to high risk behavior. And that's just simply not true.
Chelsea Clinton
If you eat a really good diet, you really can avoid getting infected with viruses.
Jessica Melati Rivera
False fiction, not true. This idea that you know the root cause is simply related to what you put in your body, that food is medicine, is just not true. You can eat the best, most balanced, most organic and clean diet. Which matters. Which matters. But it cannot prevent you from getting exposed to or affected by microbes and pathogens that are all around you. I mean, I feel like, isn't it Neil DeGrasse Tyson who tells you, talks about our ancestors were only eating organic food right. Prior to non organic food being available, and life expectancy prior to vaccines and clean water was 35 for many, many, many years. And it's because it doesn't just matter what you eat. It matters how you prevent very real threats like pathogens and vaccines and viruses.
Chelsea Clinton
It doesn't really matter who's on the acip.
Jessica Melati Rivera
Ooh, false fiction. What's the word? Fiction. It matters so much.
Chelsea Clinton
Tell us more, Jessica.
Jessica Melati Rivera
The acip, the Advisory Committee of Immunization Practices at cdc, is supposed to be an independent group of advisors that supports the CDC and how we make decisions about vaccines for the pediatric population and for the adult population as well. And they should be people with experience in virology, in vaccinology, in epidemiology, in clinical medicine. And when you don't have people with that type of expertise, you're going to have people who are not the right people to be making recommendations. These recommendations have very, very real impact on every single person's life because the recommendations tell insurance companies what to reimburse, what not to reimburse, what schedules should be allowed and what schedules should not be allowed. And so the people on that committee are very, very important.
Chelsea Clinton
Trust the science is good health messaging, terrible.
Jessica Melati Rivera
Hate it.
Chelsea Clinton
Tell us more.
Jessica Melati Rivera
I have tried to avoid that phrase. And you know, vaccines work constantly because they've become meaningless. And also, and I'm, I, I used
Chelsea Clinton
to say trust the science.
Jessica Melati Rivera
Yeah.
Chelsea Clinton
And I also now try to find other ways to talk about, I guess not the. But trust in science.
Jessica Melati Rivera
Yes, two of the three words, totally saying it's, who is the science? You know, what is the science? You know, with the, with the article there. Because I do think that it creates an infallibility and science is deeply fallible because science is an iterative process and humans are fallible. And so there can be revisions to it, there can be improvements to it, there can be corrections to it. And I just think that we need to get back into a conversation when we talk about trust. Trustworthiness to me is more important. How can the science be worthy of trust is the question and not just carte blanche as a mandate. Trust it.
Chelsea Clinton
And not all scientists are equally expert in all science.
Jessica Melati Rivera
We've seen lots of people with the credentials you would think that would make them trustworthy. One of them, most specifically about the Ivermectin conversation, has a active MD license and is selling Ivermectin Subscription based Ivermectin. Oh wait, there's that subscription. Oh yeah, I can get my muscle in America too. So it's really top quality Ivermectin straight to your door.
Chelsea Clinton
Okay, I'm sort of stuck on that for a moment.
Jessica Melati Rivera
I know, I know.
Chelsea Clinton
We should be worried about the hantavirus here in the United States.
Jessica Melati Rivera
Nuance. I don't think that public concern is necessary. I think that public health is watching it and managing it quite closely. But I can't overstate that the threat to the public is low and therefore I'd rather them divert their attention to the things that are high, which is the state of our public health in general and how we are unprepared for the next actual public health threat.
Chelsea Clinton
Jessica, thank you so much for your time today. Thank you for all that you're doing and just really grateful that we do have experts who are trying to help all of us make sense of the ongoing process that is science.
Jessica Melati Rivera
Thank you, Chelsea. I had a great time. Thank you.
Podcast Host / Narrator
You can follow Jessica at Jessica Melati Rivera on Instagram and check out her substack@makingsciencemakesense.substack.com it's really the perfect title for what she does.
Chelsea Clinton
Thanks for listening. Talk to you next week.
Podcast Host / Narrator
That can't be true. It's a production of Limonada Media and the Clinton Foundation. The show is produced by Katherine Barnes, mix and sound design by Johnny Vince Evans. Kristin Lepore is Senior Director of New Content and Jackie Danziger is VP of Narrative and Production. Maggie Kralshore is our Managing Director of Partnerships. Executive producers are Jessica Cordova Kramer, Stephanie Whittles, Wax and me, Chelsea Clinton. Special thanks to Erica Goodmanson, Sarah Horowitz, Francesca Ernst Kahn, Caroline Lewis, Sage Falter, Barry Lurie, Westerberg, Emily Young, and the entire team at the Clinton Foundation. You can help others find our show by leaving us a rating and writing a review. And if you can think of someone who might benefit from today's episode, please go ahead and share it with them. There's more of that can't be true with Lemonada. Premium subscribers get exclusive access to bonus content when you subscribe on Apple Podcasts you can also listen ad free on Amazon Music with your prime membership.
Guest: Jessica Malaty Rivera, Infectious Disease Epidemiologist
Release Date: May 14, 2026
In this episode, Dr. Chelsea Clinton sits with Jessica Malaty Rivera, an infectious disease epidemiologist and science communicator, to address growing anxiety surrounding the recent hantavirus outbreak. They delve into how pandemics shape our behavior, the differences between hantavirus and other viruses like COVID-19, the pitfalls of misinformation (including treatments and vaccine conspiracy theories), and why public trust and preparation are essential in public health. The conversation broadens to other urgent topics—measles outbreaks, vaccine hesitancy, the politicization of public health leadership, and how to parse fact from fiction in the current chaotic health landscape.
Timestamp: 01:45–05:13
“I hold a lot of empathy for the very real collective PTSD that people have from the pandemic … the pandemic is over. That acute time is over. … But I want to be so clear that we're not asking anybody to do any of that again because truly, truly, the risk to the public is low.” (03:01)
“You cannot even compare a disease or a virus like hantavirus to a coronavirus that spreads much more prolifically from person to person.” (03:33)
Timestamp: 05:13–09:46
“I'm personally very anti-cruise just for the norovirus effect of it all.” (06:17)
“There is not any reason to associate cruises now with hantavirus.” (07:41)
“Most … cases occur in … Arizona, New Mexico, Utah, Colorado … usually among … deer mouse.” (08:18)
Timestamp: 10:46–17:44
“Ivermectin … it does, but it doesn't. It's an anti-parasitic drug that's used for parasites. … The amount to have the effect in those petri dishes would actually hurt you.” (11:51, 12:06)
“Are you asking questions or are you correlating and making a causal claim about something … that had nothing to do with the vaccine itself?” (14:16)
“There's a protocol … that's very precise about what is required for isolation, what is required for quarantine, who is high risk, who is low risk. And it's being managed … in a really thoughtful way.” (15:13)
Timestamp: 17:44–20:14
“We need multilateral partnerships … our national security is directly connected to global health security.” (17:44)
Timestamp: 22:21–24:38
“I fear that people are gonna accuse us of crying wolf and perhaps being hyperbolic about something.” (23:33)
Timestamp: 24:38–29:03
“Measles is not benign … complications can be so severe. … 500 children would die a year in the U.S. [before the vaccine].” (25:20)
“Having someone who's not a licensed physician as the nation's doctor would have been bad.” (29:03)
Timestamp: 29:13–33:41
"Are they for the red team or the blue team? … We've lost the purple that existed with public health." (32:08)
On COVID and “PTSD”:
“Covid is not over. Covid is a persistent virus that still disables and harms people. But the pandemic is over. That acute time is over.” – Jessica Malaty Rivera (03:01)
On Hantavirus vs. COVID-19 Risk:
“Truly, the risk to the public is low. You cannot even compare a disease or a virus like hantavirus to a coronavirus.” – Jessica (03:33)
On Norovirus & Cruises:
“I'm personally very anti-cruise just for the norovirus effect of it all.” – Jessica (06:17)
On Ivermectin Myths:
“It does, but it doesn't. It's an anti-parasitic drug that's used for parasites. … The amount to have the effect … would actually hurt you.” – Jessica (11:51, 12:06)
On Science Messaging:
“Trust the science is good health messaging. Terrible. … Science is deeply fallible because science is an iterative process and humans are fallible.” – Jessica (43:44–44:06)
On Vaccine Amnesia:
“I think amnesia is going to be to our detriment in this case. … Like, we don't see polio, so why do we need to vaccinate for it? Because we vaccinate for it is why we don't see it.” – Jessica (37:05)
On Shared Public Health Goals:
“I want people to understand like you and I can be very politically unaligned and still believe that we have resources to not let our kids that we love the same suffer.” – Jessica (39:01)
Timestamp: 40:11–45:48
Chelsea puts Jessica on the spot with a series of rapid-fire statements:
| Segment | Start | End | |--------------------------------------|----------|----------| | Social Media Clip & Reactions | 01:45 | 05:13 | | Hantavirus Transmission & Cruises | 05:13 | 09:46 | | Misinformation & Treatment Myths | 10:46 | 17:44 | | Exit from WHO & Vaccine Technology | 17:44 | 20:14 | | Trauma's Impact on Readiness | 22:21 | 24:38 | | Measles/Vaccine Coverage Decline | 24:38 | 29:03 | | Politicization of Public Health | 29:13 | 33:41 | | Fact or Fiction Segment | 40:11 | 45:48 |
Chelsea and Jessica combine rigor with warmth—a style both authoritative and accessible. Jessica’s answers are empathetic, grounded in evidence, and patient with public fears. Chelsea is candid, occasionally self-deprecating, and deeply committed to public clarity and safety.
This episode will set your mind at ease about hantavirus—at least for now—while offering a crash course in how to wisely approach health news, avoid viral misinformation, and advocate for a public health system that serves everyone, regardless of political stripe. Highlights include practical advice, myth-busting with humor, sober warnings about systemic weaknesses, and an inspiring call to rebuild trust—one fact at a time.