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1
00:00:27,652 --> 00:00:29,492
[vacuum cleaner whirring]
2
00:00:32,198 --> 00:00:35,238
[reporter 1] Indianola School says
they will be closed tomorrow
3
00:00:35,326 --> 00:00:37,946
because about 20% of their students
are out with the flu.
4
00:00:38,038 --> 00:00:41,578
[reporter 2] Western Heights says they've
had so many student and teacher absences,
5
00:00:41,666 --> 00:00:43,586
canceling school was the best option.
6
00:00:43,668 --> 00:00:47,548
[reporter 3] ...schools in Braggs
right now are closed, 47 were out sick...
7
00:00:47,630 --> 00:00:50,760
[reporter 4] 145 students
called in sick on Monday.
8
00:00:50,842 --> 00:00:52,592
[reporter 5]
After an increase in reported absences,
9
00:00:52,677 --> 00:00:56,177
both Seymour and the Archer City ISD
will be closed tomorrow.
10
00:00:56,264 --> 00:00:58,894
A Muskogee school counselor is dead,
11
00:00:58,975 --> 00:01:01,135
making her one of the hundreds
of Oklahomans
12
00:01:01,227 --> 00:01:03,437
who have now fallen victim
to this year's flu virus.
13
00:01:17,994 --> 00:01:20,624
[Dr. Goracke] All right, so how long
have you been sick?
14
00:01:20,705 --> 00:01:22,165
-[woman] Just today.
-[Dr. Goracke] Just today.
15
00:01:22,248 --> 00:01:24,498
Did it kind of come on you
all of a sudden?
16
00:01:25,168 --> 00:01:27,458
[woman] I went to work this morning.
I was okay.
17
00:01:27,545 --> 00:01:29,205
-Like, my teeth was hurting.
-[Dr. Goracke] Mmm-hmm.
18
00:01:29,297 --> 00:01:32,547
Like, tender and I had a headache,
but nothing else.
19
00:01:32,634 --> 00:01:36,144
[Dr. Goracke] And did you feel body aches
and feel like you were getting a fever...
20
00:01:36,221 --> 00:01:37,811
-[woman] My skin feels like it's burning.
-Oh.
21
00:01:37,889 --> 00:01:40,229
-Eyes are hot?
-My eyes feel like they're burning.
22
00:01:40,308 --> 00:01:41,558
[Dr. Goracke] And then
what are her symptoms?
23
00:01:41,643 --> 00:01:43,693
[woman] She's got
a runny nose and a cough.
24
00:01:43,770 --> 00:01:46,110
[Dr. Goracke] And have you been exposed
to anybody that's had the flu?
25
00:01:46,189 --> 00:01:48,779
[woman] The county that we live in,
they just closed the school
26
00:01:48,858 --> 00:01:50,438
-because of flu.
-[Dr. Goracke] Did they?
27
00:01:50,527 --> 00:01:54,527
I think they get past 20%
and they don't send kids to school.
28
00:01:54,614 --> 00:01:57,834
It does help us stop the flu as well.
It stops the spread.
29
00:01:57,909 --> 00:02:00,409
[woman] When am I going to be able
to go back to work? Tomorrow?
30
00:02:00,495 --> 00:02:04,535
[Dr. Goracke] If you have a temperature
greater than 100.4,
31
00:02:04,624 --> 00:02:06,584
then you really need to be
out of the public.
32
00:02:08,128 --> 00:02:10,258
If those parents
that are in the workforce,
33
00:02:10,338 --> 00:02:13,878
their kids are at home,
they either have to find childcare
34
00:02:13,967 --> 00:02:17,297
so that they can go to work,
or they have to be off work.
35
00:02:17,387 --> 00:02:19,757
All right, it's just a light...
36
00:02:20,598 --> 00:02:23,428
Some of them may have sick days
and some of them may not.
37
00:02:23,518 --> 00:02:27,648
So it expands and we have parents
that are now out of work.
38
00:02:28,815 --> 00:02:32,065
Okay, I'll put together your paperwork
and we'll let you get out of here.
39
00:02:32,152 --> 00:02:34,862
It is a huge struggle,
it's a financial struggle,
40
00:02:34,946 --> 00:02:37,946
it's a mental struggle, physical struggle,
emotional struggle.
41
00:02:39,242 --> 00:02:40,832
[reporter] I know this is hard to believe,
42
00:02:40,910 --> 00:02:43,120
but 3,000 people across
the state of Oklahoma
43
00:02:43,204 --> 00:02:46,544
have gotten so sick, they've actually
had to go to the hospital.
44
00:02:47,625 --> 00:02:50,035
And there's still nine weeks left
in the flu season.
45
00:03:04,058 --> 00:03:05,808
[horns honking]
46
00:03:28,625 --> 00:03:30,665
[cell phone ringing]
47
00:03:32,212 --> 00:03:33,052
[Dr. Vijay] Hello?
48
00:03:34,255 --> 00:03:36,375
[in Hindi] Okay,
the one who was very serious,
49
00:03:36,466 --> 00:03:39,336
and asked me to prescribe the medicine?
50
00:03:39,427 --> 00:03:40,927
Is there some relief?
51
00:03:42,096 --> 00:03:43,506
So you are feeling much better?
52
00:03:43,598 --> 00:03:46,518
My wife is a doctor at Durlabhji as well.
53
00:03:47,685 --> 00:03:50,185
We have an agreement between us:
54
00:03:50,271 --> 00:03:53,441
when she's in the hospital,
I take care of the family.
55
00:03:53,524 --> 00:03:56,534
When I'm in the hospital,
she takes care of the family.
56
00:03:57,612 --> 00:04:00,622
She works only limited hours.
57
00:04:01,282 --> 00:04:04,372
She made this sacrifice for my sake.
58
00:04:04,452 --> 00:04:07,082
So one person could move ahead
while the other takes care of the family.
59
00:04:11,459 --> 00:04:15,879
There were financial difficulties
in paying for my education.
60
00:04:17,215 --> 00:04:21,505
I just had a few clothes
and I borrowed my text books.
61
00:04:23,846 --> 00:04:26,306
Then gradually, after completing my MD,
62
00:04:26,391 --> 00:04:27,601
my life straightened out.
63
00:04:29,519 --> 00:04:31,479
-Manish Ji, are you ready?
-Hmm.
64
00:04:32,230 --> 00:04:33,480
-Should I do your hair?
-Hmm.
65
00:04:35,024 --> 00:04:37,614
I have experienced poverty,
66
00:04:40,280 --> 00:04:42,870
and now, with God's grace, I have a lot.
67
00:04:47,120 --> 00:04:49,830
So I know the difficulties
faced by the poor.
68
00:04:49,914 --> 00:04:54,254
The poor are at the greatest risk
of the flu.
69
00:04:55,795 --> 00:04:59,585
A doctor alone cannot do
anything in tackling this flu.
70
00:04:59,674 --> 00:05:01,804
The government cannot tackle it alone.
71
00:05:01,884 --> 00:05:03,644
Neither can the public.
72
00:05:04,470 --> 00:05:08,270
It can be defeated
only if all three work together.
73
00:05:10,018 --> 00:05:13,728
[reporter 1 in English] Rajasthan accounts
for nearly 70% of the swine flu cases
74
00:05:13,813 --> 00:05:15,733
being reported from across the country.
75
00:05:16,733 --> 00:05:18,613
[Singh] This is the failure
of the health department
76
00:05:18,693 --> 00:05:21,033
under the health minister, Raghu Sharma.
77
00:05:21,738 --> 00:05:24,698
Rajasthan has lost 49 lives
due to swine flu.
78
00:05:30,663 --> 00:05:33,293
[Sharma in Hindi] Why is the percentage
of deaths increasing?
79
00:05:39,756 --> 00:05:41,716
People's health is our responsibility.
80
00:05:42,467 --> 00:05:44,387
This means we are shirking our duty.
81
00:05:46,429 --> 00:05:49,139
As soon as someone is found positive,
82
00:05:49,223 --> 00:05:52,063
then your department team
will visit them the next day.
83
00:05:53,144 --> 00:05:54,564
What are you busy doing?
84
00:05:54,645 --> 00:05:55,805
[man] I'm taking notes.
85
00:05:55,897 --> 00:05:57,227
He's the one who is taking notes.
86
00:05:58,858 --> 00:05:59,688
[indistinct]
87
00:05:59,776 --> 00:06:01,776
You should be doing this on your own.
88
00:06:01,861 --> 00:06:03,281
Make me the director, I will do it.
89
00:06:03,363 --> 00:06:05,323
You can come here and be a minister.
90
00:06:07,241 --> 00:06:11,001
If we don't take corrective measures,
then it is our fault, isn't it?
91
00:06:12,246 --> 00:06:15,996
Our attention is elsewhere,
92
00:06:16,084 --> 00:06:17,174
not on this.
93
00:06:18,461 --> 00:06:20,551
That is a sickness in our department.
94
00:06:25,051 --> 00:06:27,221
Have you prepared all the instructions?
95
00:06:27,804 --> 00:06:28,814
What are those?
96
00:06:28,888 --> 00:06:32,308
[man clears throat] Sir, first of all,
97
00:06:32,392 --> 00:06:35,692
there will be a daily monitoring
of house-to-house activities in the city.
98
00:06:35,770 --> 00:06:38,480
-[man continues indistinctly]
-You will do screenings?
99
00:06:39,649 --> 00:06:42,029
You should do continuous screenings.
100
00:06:42,110 --> 00:06:43,740
[man] We will monitor--
101
00:06:43,820 --> 00:06:47,530
Of course, you will be monitoring,
but complete screenings should carry on.
102
00:06:51,411 --> 00:06:53,831
[reporter in English] In an effort to curb
the spread, the Rajasthan health minister
103
00:06:53,913 --> 00:06:58,083
has now ordered
door-to-door screenings of patients.
104
00:06:58,167 --> 00:06:59,377
[indistinct chatter]
105
00:07:01,963 --> 00:07:03,343
[man 1 in Hindi] Yes, sir?
106
00:07:04,507 --> 00:07:06,837
[woman 1] This is
the swine flu control room.
107
00:07:08,803 --> 00:07:10,723
Now, tell me, how is your health?
108
00:07:11,556 --> 00:07:15,016
Madam, there are two patients,
109
00:07:15,101 --> 00:07:16,771
they are positive for swine flu.
110
00:07:18,521 --> 00:07:20,611
Can you tell me your address,
where are you from?
111
00:07:21,941 --> 00:07:25,531
Can you provide any landmark
near your location?
112
00:07:25,611 --> 00:07:27,991
[man 2] So we can confirm a visit
to your place?
113
00:07:28,072 --> 00:07:32,452
Ma'am, the two cases are positive
from the same house for swine flu.
114
00:07:34,120 --> 00:07:36,870
Let me know your ward number,
115
00:07:36,956 --> 00:07:40,076
and our survey team will contact you.
116
00:07:40,585 --> 00:07:44,585
Near the post office. Post office.
117
00:07:50,678 --> 00:07:52,808
[woman 1] The address
is near the post office.
118
00:07:58,561 --> 00:07:59,481
[knocking on door]
119
00:07:59,562 --> 00:08:02,482
[woman 2] Is anyone there?
Can you come out?
120
00:08:20,500 --> 00:08:24,880
[Carroll] The thing about controlling
a deadly virus...
121
00:08:25,630 --> 00:08:29,300
is you need to move from being
reactive to proactive.
122
00:08:31,260 --> 00:08:36,100
We know that viruses move from wildlife
into livestock into people.
123
00:08:37,391 --> 00:08:40,941
And so you don't wait for an outbreak
to infect humans,
124
00:08:41,020 --> 00:08:46,230
you find it and you fight it
before it ever infects a person.
125
00:08:55,868 --> 00:08:58,828
FAO is looking at what's happening
in animals,
126
00:08:58,913 --> 00:09:03,333
broadening our surveillance strategy
to look upstream.
127
00:09:04,168 --> 00:09:08,048
Usually, we would see
the clinical picture in animals
128
00:09:08,130 --> 00:09:10,880
before humans become infected.
129
00:09:11,634 --> 00:09:14,354
And it just bothers me when the report
130
00:09:14,428 --> 00:09:15,928
-first comes out of humans.
-[Carroll] Yeah.
131
00:09:16,013 --> 00:09:20,183
And not picking it up
two or three weeks earlier in livestock.
132
00:09:22,270 --> 00:09:26,820
We have a team that brings information
together from different sources,
133
00:09:26,899 --> 00:09:28,859
including our field teams.
134
00:09:31,654 --> 00:09:35,374
[man] I just received an email
from Russia.
135
00:09:35,449 --> 00:09:39,659
Basically, we asked
about this H5N6, remember?
136
00:09:39,745 --> 00:09:42,825
It seems to come from a gray gull in--
137
00:09:42,915 --> 00:09:47,085
So they actually went to check for a virus
and they couldn't find it?
138
00:09:47,169 --> 00:09:49,209
[man] Yes. It was a result
of active surveillance.
139
00:09:49,297 --> 00:09:51,717
-[woman] Okay.
-Which, it does matter
140
00:09:51,799 --> 00:09:54,549
because apparently the prevalence
was sufficiently high.
141
00:09:54,635 --> 00:09:55,505
Yeah.
142
00:09:55,595 --> 00:10:01,595
So we may, uh, see this virus next winter
143
00:10:01,684 --> 00:10:04,484
-being the main actor on the stage.
-[woman] Yeah, who knows?
144
00:10:08,065 --> 00:10:09,975
[indistinct chatter]
145
00:10:10,067 --> 00:10:13,197
But if we can go ahead
and, uh, get started...
146
00:10:14,697 --> 00:10:16,027
Paul, you have something?
147
00:10:16,574 --> 00:10:19,624
Uh, there is an interesting
detection of H5N6
148
00:10:19,702 --> 00:10:21,952
in the Saratov region
in the Russian Federation.
149
00:10:22,038 --> 00:10:25,118
And this is the first report
of this virus outside Asia.
150
00:10:26,208 --> 00:10:31,668
This is closely related to the viruses
that are circulating in China
151
00:10:31,756 --> 00:10:34,626
and caused several human infections,
152
00:10:34,717 --> 00:10:37,007
and some of them were fatal cases.
153
00:10:39,639 --> 00:10:44,729
[Lubroth] For us, it's quite important,
the triggers and the line of command
154
00:10:44,810 --> 00:10:48,480
within the veterinary system
or a veterinary service.
155
00:10:48,564 --> 00:10:52,494
Once we have that detection,
what happens next?
156
00:10:53,194 --> 00:10:57,664
How it links up to the medical services
and how we react to that detection.
157
00:10:57,740 --> 00:11:01,490
Closing down the markets,
ensuring that consumers are safe,
158
00:11:01,577 --> 00:11:04,997
that there is good communication
between the veterinary arm
159
00:11:05,081 --> 00:11:07,961
-and the public health arm at all times.
-[Carroll] Right.
160
00:11:08,042 --> 00:11:10,132
With the proper risk mitigation measures,
161
00:11:10,211 --> 00:11:15,221
there's no excuse for any outbreak
becoming more than an outbreak.
162
00:11:15,299 --> 00:11:19,259
But it all begins with timely
and effective surveillance.
163
00:11:35,820 --> 00:11:37,780
-[Carter] We're here with the band.
-[man] What's that?
164
00:11:37,863 --> 00:11:41,583
-[Carter laughs] We're here with the band.
-[man] Yeah, well, park right behind Brad.
165
00:11:41,659 --> 00:11:43,079
-[Carter] Behind him?
-[man] Yeah.
166
00:11:44,078 --> 00:11:44,948
[Carter] Okay.
167
00:11:47,540 --> 00:11:48,540
Gear it up.
168
00:11:52,044 --> 00:11:54,214
So much... all right.
169
00:12:05,307 --> 00:12:08,017
So is Paul gonna take two trips?
We'll do two trips?
170
00:12:08,102 --> 00:12:09,482
-One trip...
-One trip with him.
171
00:12:09,562 --> 00:12:11,562
...with the ranger on that trailer
172
00:12:11,647 --> 00:12:13,817
and then the four wheeler on the one
that's hooked up to Brad's truck.
173
00:12:13,899 --> 00:12:14,729
[Carter] Okay.
174
00:12:23,993 --> 00:12:29,043
When I'm in the field with hunters,
it's hard for people who don't understand
175
00:12:30,541 --> 00:12:32,211
to understand the full dynamics.
176
00:12:33,419 --> 00:12:34,669
You can't see it.
177
00:12:34,754 --> 00:12:37,764
The ducks aren't sneezing,
they're not coughing.
178
00:12:38,674 --> 00:12:40,224
But they have the flu.
179
00:12:43,220 --> 00:12:45,510
Wild birds are the ones
that are moving it.
180
00:12:45,598 --> 00:12:47,348
That's how the flu is getting moved.
181
00:13:04,658 --> 00:13:07,698
We're gonna catch these birds in this net.
There's rockets attached to it.
182
00:13:08,537 --> 00:13:11,287
Those rockets are gonna fire
when the birds are ready to be caught,
183
00:13:11,373 --> 00:13:12,793
when they're all balled up.
184
00:13:12,875 --> 00:13:14,375
The net's gonna go over the birds
185
00:13:14,460 --> 00:13:16,920
and groups of people are gonna go out
and take those birds out,
186
00:13:17,004 --> 00:13:18,804
we're gonna put them in keeping cages.
187
00:13:18,881 --> 00:13:20,591
I'm gonna swab them.
188
00:13:21,884 --> 00:13:25,354
And then those swab samples
will go back to the lab,
189
00:13:26,138 --> 00:13:29,558
to see what subtypes of influenza
come through here.
190
00:13:43,656 --> 00:13:46,866
Let's say there's a flu outbreak
at a chicken farm.
191
00:13:47,660 --> 00:13:49,620
The flu didn't start there.
192
00:13:49,703 --> 00:13:51,543
Maybe a hunter went out
and shot something,
193
00:13:51,622 --> 00:13:53,122
and then didn't clean his boots off,
194
00:13:53,207 --> 00:13:56,587
and went into the chicken house,
and, you know, spread all this flu.
195
00:13:57,795 --> 00:14:01,715
Wild birds are the movers of this virus.
That's what they do.
196
00:14:02,883 --> 00:14:04,303
[man] Be ready to go
when you hear the shot.
197
00:14:04,385 --> 00:14:06,675
Get down there as quick as you can.
Grab a crate, and start pulling birds.
198
00:14:07,513 --> 00:14:08,813
-[Carter] Now, we...
-Yeah.
199
00:14:08,889 --> 00:14:10,809
[Carter] Okay. Now, we just wait.
200
00:14:26,949 --> 00:14:28,619
[water dripping]
201
00:15:02,401 --> 00:15:04,531
[Dr. Kayali] My job is like
being a watchman.
202
00:15:16,749 --> 00:15:20,459
A lot of the scary viruses in recent years
have been linked to bats.
203
00:15:20,544 --> 00:15:21,754
-[man 1] Come over here.
-[man 2] Yeah, yeah.
204
00:15:21,837 --> 00:15:23,207
-[man 1] Okay?
-[man 2] Yeah, let's go.
205
00:15:24,548 --> 00:15:25,548
There they are.
206
00:15:25,633 --> 00:15:26,973
[Dr. Kayali] Ebola, for example.
207
00:15:27,051 --> 00:15:29,971
Coronaviruses, whether SARS or MERS.
208
00:15:30,054 --> 00:15:31,724
[bat screeching]
209
00:15:34,516 --> 00:15:36,056
[man in Lebanese] When they are in groups
you can catch them easily.
210
00:15:36,143 --> 00:15:36,983
You can't catch them one by one.
211
00:15:37,686 --> 00:15:38,686
[in English] Okay.
212
00:15:44,193 --> 00:15:45,033
Got it.
213
00:15:45,736 --> 00:15:46,566
Okay.
214
00:15:47,571 --> 00:15:52,281
[Dr. Kayali] And we now know that bats
can be a reservoir for the flu.
215
00:15:54,912 --> 00:15:57,252
My team and I believe we have discovered
216
00:15:57,331 --> 00:16:01,091
a new subtype of influenza
in fruit bats in Egypt.
217
00:16:02,836 --> 00:16:07,926
And I want to test these bats in Lebanon
to see if this virus is spreading.
218
00:16:12,554 --> 00:16:14,224
The young ones, they might bite.
219
00:16:17,017 --> 00:16:21,517
And you can see the teeth
are still clean and still sharp.
220
00:16:21,605 --> 00:16:22,725
Yeah, sharp and clean.
221
00:16:23,649 --> 00:16:24,569
Off you go.
222
00:16:26,860 --> 00:16:27,700
Next.
223
00:16:28,862 --> 00:16:33,412
The more we know about where viruses
come from, the better we are prepared.
224
00:16:33,993 --> 00:16:36,293
What we can do is study them
before they mutate,
225
00:16:36,370 --> 00:16:39,620
try to predict which route
they might take.
226
00:16:44,211 --> 00:16:47,511
So it's all about trying to break
the transmission cycle
227
00:16:47,589 --> 00:16:49,049
from animals to humans.
228
00:16:51,510 --> 00:16:53,010
[clucking]
229
00:16:59,768 --> 00:17:01,398
[Dr. Kayali] The most
vulnerable populations,
230
00:17:01,478 --> 00:17:03,898
or the populations
where a pandemic can start,
231
00:17:03,981 --> 00:17:05,861
are in caretakers of animals.
232
00:17:14,616 --> 00:17:16,826
[in Lebanese] We will take
a human blood sample.
233
00:17:16,910 --> 00:17:17,870
Human blood?
234
00:17:17,953 --> 00:17:20,913
[Dr. Kayali] Yeah, I need a worker
who works inside the farm.
235
00:17:20,998 --> 00:17:21,868
Okay.
236
00:17:21,957 --> 00:17:24,877
[Dr. Kayali] You and your shirt
in the street.
237
00:17:37,181 --> 00:17:38,721
[woman] Get well soon!
238
00:17:39,475 --> 00:17:42,595
You see how I was so soft with you?
239
00:17:42,686 --> 00:17:43,686
[man] Yeah, right.
240
00:17:48,525 --> 00:17:51,445
[Dr. Kayali] I'm really, really interested
in trying to catch that virus
241
00:17:51,528 --> 00:17:53,278
as it's causing the infection.
242
00:17:59,536 --> 00:18:03,496
Once we do that, we can look at
how transmissible it is.
243
00:18:03,999 --> 00:18:05,959
Can it infect other species?
244
00:18:06,460 --> 00:18:08,170
Does it have a pandemic potential?
245
00:18:10,756 --> 00:18:13,796
We will add the chicken and human samples
collected today
246
00:18:14,384 --> 00:18:17,434
to the bat samples and begin our testing.
247
00:18:17,513 --> 00:18:19,523
[clucking]
248
00:18:22,684 --> 00:18:24,524
[pigs grunting]
249
00:18:35,114 --> 00:18:36,414
-[Dr. Goracke] So, is this your...
-[girl] Mmm-hmm.
250
00:18:36,490 --> 00:18:37,910
[Dr. Goracke] What do you call it?
A pig or a sow?
251
00:18:37,991 --> 00:18:39,661
-[girl] A pig.
-[Dr. Goracke] You got a pig.
252
00:18:39,743 --> 00:18:42,003
-[girl] Her name is Chessie.
-Chessie? Okay.
253
00:18:43,038 --> 00:18:45,918
I don't think I've ever touched
a live pig before.
254
00:18:45,999 --> 00:18:48,539
Ooh, she's sweaty.
Or did you make her wet?
255
00:18:48,627 --> 00:18:51,297
Oh, yeah, we put water on her
before the big show.
256
00:18:51,380 --> 00:18:53,010
[Dr. Goracke] Oh! To make her shine?
257
00:18:54,883 --> 00:18:58,553
So, your mom told me that you did not
get the flu shot this year.
258
00:18:58,637 --> 00:19:00,467
Next year, you'll get the flu shot,
won't you?
259
00:19:01,223 --> 00:19:02,063
Probably.
260
00:19:02,141 --> 00:19:05,641
[Dr. Goracke] A little shot's not that big
of a deal compared to how sick you felt.
261
00:19:05,727 --> 00:19:09,147
And you got... Can you imagine
if you had the flu this week?
262
00:19:09,231 --> 00:19:10,861
-Oh, that'd be horrible.
-That'd be horrible.
263
00:19:10,941 --> 00:19:15,451
I wouldn't have got to show here.
I like showing pigs a lot.
264
00:19:16,196 --> 00:19:18,526
[announcer] All right, we're ready
to let them into the show ring here
265
00:19:18,615 --> 00:19:20,865
for our first class... the first reveals.
266
00:19:21,410 --> 00:19:25,500
[Dr. Goracke] Being a small-town doctor
is a unique position.
267
00:19:26,748 --> 00:19:27,828
[announcer speaking indistinctly]
268
00:19:27,916 --> 00:19:29,626
[woman] They're all nice enough to eat.
269
00:19:29,710 --> 00:19:31,670
Oh, yes, a little bit of bacon.
270
00:19:32,504 --> 00:19:37,264
Even if they haven't been my patient,
most people know, "She's the doctor."
271
00:19:38,093 --> 00:19:40,763
That opens up an opportunity
to be able to have
272
00:19:40,846 --> 00:19:45,766
a really interesting relationship
that I don't think a large town,
273
00:19:45,851 --> 00:19:48,401
or a city physician, really gets.
274
00:19:48,478 --> 00:19:50,358
[announcer continues indistinctly]
275
00:19:51,565 --> 00:19:53,565
[all cheering]
276
00:20:01,325 --> 00:20:02,735
[Dr. Goracke] Take a big, deep breath in.
277
00:20:02,826 --> 00:20:04,156
And then again.
278
00:20:07,456 --> 00:20:08,536
Just breathe normal.
279
00:20:11,501 --> 00:20:12,341
Good.
280
00:20:14,087 --> 00:20:17,927
Physicians focus outwardly on others
and what other people need.
281
00:20:18,008 --> 00:20:21,048
I'm gonna give you some antibiotics
in the IV tonight
282
00:20:21,136 --> 00:20:23,926
and then I'll give you a prescription
for some antibiotics
283
00:20:24,014 --> 00:20:25,684
to take for the next ten days.
284
00:20:25,766 --> 00:20:27,056
Do you have insurance?
285
00:20:27,809 --> 00:20:29,979
We are expected to be superhuman.
286
00:20:30,562 --> 00:20:35,362
We are expected to do the best that we can
for everyone that we come in contact with,
287
00:20:35,442 --> 00:20:38,112
with the kind of compassion
that they deserve
288
00:20:38,195 --> 00:20:41,945
and that's a calling
that I've been brought to,
289
00:20:42,032 --> 00:20:44,702
and I can do that, I can do my calling.
290
00:20:45,410 --> 00:20:47,200
If I can get the help that I need.
291
00:20:49,122 --> 00:20:51,122
I have a 72-hour shift
292
00:20:51,208 --> 00:20:54,838
and so it's important to me
that my husband is here with me at times.
293
00:20:54,920 --> 00:20:57,300
Because without Mike,
I couldn't do this work.
294
00:21:02,177 --> 00:21:03,177
Oh.
295
00:21:03,262 --> 00:21:04,392
You were out.
296
00:21:04,471 --> 00:21:06,011
Mmm-hmm. Sleeping good.
297
00:21:07,808 --> 00:21:10,018
-How are you?
-I'm here.
298
00:21:10,102 --> 00:21:12,022
-[Dr. Goracke chuckles softly]
-So.
299
00:21:12,104 --> 00:21:14,824
So, had two more cases?
300
00:21:15,399 --> 00:21:18,489
[Dr. Goracke] No, it was old cases
that just hadn't gotten over it.
301
00:21:18,568 --> 00:21:19,648
Oh, okay.
302
00:21:19,736 --> 00:21:21,316
-Yeah.
-Okay.
303
00:21:21,405 --> 00:21:22,235
[indistinct]
304
00:21:23,573 --> 00:21:27,743
[Mike] I'm wondering how long I was out.
I'm still feeling tired.
305
00:21:27,828 --> 00:21:29,868
-Half an hour to an hour?
-You're as tired as I was
306
00:21:29,955 --> 00:21:32,365
because you got disturbed
as much as I did last night,
307
00:21:32,457 --> 00:21:34,957
and then I got to sleep today
and you didn't.
308
00:21:35,043 --> 00:21:37,423
Yeah, I didn't get to sleep, so...
309
00:21:38,255 --> 00:21:39,965
Okay, well, let me go
take care of this patient.
310
00:21:40,048 --> 00:21:41,128
[Mike] All right, then.
311
00:21:42,718 --> 00:21:44,758
[Dr. Goracke] My first marriage
didn't do very well.
312
00:21:46,805 --> 00:21:51,225
And my divorce was particularly ugly.
313
00:21:55,022 --> 00:21:55,862
[Dr. Goracke] Hello.
314
00:21:56,648 --> 00:21:59,358
I was talking to your wife.
She's really worried about you.
315
00:21:59,443 --> 00:22:01,363
-[man] I've been trying to.
-[Dr. Goracke] Okay.
316
00:22:01,445 --> 00:22:05,195
The first year of medical school was
really, really difficult for me.
317
00:22:07,993 --> 00:22:12,413
My ex-husband was, uh...
sent to prison during that time.
318
00:22:14,791 --> 00:22:18,341
I came to school a couple times beat up.
319
00:22:20,339 --> 00:22:23,799
And my faith was shaken during that time.
320
00:22:24,676 --> 00:22:29,306
And then I met Mike
and he's a man of extreme faith.
321
00:22:33,060 --> 00:22:37,230
And what I learned throught that was
that every experience, good or bad,
322
00:22:37,314 --> 00:22:41,694
is building up in me,
like this wall of strength
323
00:22:41,777 --> 00:22:44,697
and that strength gets me through
all of the challenges
324
00:22:44,780 --> 00:22:46,820
that I'm confronted with, big and small.
325
00:22:48,033 --> 00:22:50,163
"James, a servant of God
and the Lord Jesus Christ
326
00:22:50,243 --> 00:22:53,043
to the 12 tribes
scattered among the nations.
327
00:22:53,121 --> 00:22:54,161
'Greetings.
328
00:22:54,247 --> 00:22:58,837
Consider it pure joy, my brothers,
whenever you face trials of many kinds,
329
00:22:58,919 --> 00:23:03,009
because you know that the testing
of your faith develops perseverance.
330
00:23:03,090 --> 00:23:07,640
Perseverance must finish its work
so that you may be mature and complete,
331
00:23:07,719 --> 00:23:09,099
not lacking in anything.
332
00:23:09,179 --> 00:23:12,219
But blessed is the man
who perseveres under trial.'"
333
00:23:52,472 --> 00:23:54,562
[birds chirping]
334
00:24:05,318 --> 00:24:07,318
[squawking]
335
00:24:09,406 --> 00:24:10,986
Three, two...
336
00:24:14,119 --> 00:24:15,449
[rockets fire]
337
00:24:34,264 --> 00:24:38,104
[Carter] We found that there are different
subtypes of virus in these ducks.
338
00:24:39,686 --> 00:24:41,646
These teal are long-distance migrants.
339
00:24:41,730 --> 00:24:44,980
They go from here and they'll go
all the way up to Saskatchewan,
340
00:24:45,901 --> 00:24:47,991
and then they'll come back again
in the fall,
341
00:24:48,069 --> 00:24:50,029
and then they'll go all the way down
to Argentina.
342
00:24:50,113 --> 00:24:51,663
So that's a huge migration.
343
00:24:51,740 --> 00:24:54,580
Along that flyway,
they're either picking something up,
344
00:24:54,659 --> 00:24:56,199
or they're dropping something off.
345
00:24:57,245 --> 00:24:59,455
-Whoa! Hello.
-Nice catch. [chuckles]
346
00:25:07,464 --> 00:25:10,224
[Carter] Doing these surveillance studies
helps us to understand trends
347
00:25:10,300 --> 00:25:12,470
that are going on with these birds.
348
00:25:12,552 --> 00:25:18,142
In case there's some kind of, let's say,
pandemic, or spillover or something,
349
00:25:18,225 --> 00:25:22,515
we at least have the information and data
to anticipate trends and we're ready.
350
00:25:22,604 --> 00:25:24,984
We're prepared
if there was a flu outbreak.
351
00:25:25,065 --> 00:25:27,065
[ducks squawking]
352
00:25:28,735 --> 00:25:30,235
[engine rumbling]
353
00:25:36,284 --> 00:25:39,004
[Carter] I thought I was gonna be
a teacher or a police officer,
354
00:25:39,079 --> 00:25:41,249
but the college atmosphere
was where I decided
355
00:25:41,331 --> 00:25:44,291
to go and start working
with students that way.
356
00:25:44,376 --> 00:25:50,086
And for the last 25 years now,
I've been in the sciences like this.
357
00:26:00,308 --> 00:26:03,138
Our big main goal is to see
what the prevalence of flu is
358
00:26:03,228 --> 00:26:07,228
in this area, at this time, right now,
with this population of ducks.
359
00:26:07,315 --> 00:26:09,475
You guys are gonna
hold the ducks like this.
360
00:26:10,068 --> 00:26:12,358
Keep them down by your chest, um...
361
00:26:12,445 --> 00:26:16,775
and we're gonna swab them
orally and cloacally.
362
00:26:16,866 --> 00:26:18,156
Put it in a media tube.
363
00:26:18,243 --> 00:26:20,873
They're gonna give you a number.
I'm gonna give...
364
00:26:20,954 --> 00:26:23,674
Put that number on the tube and then
you're gonna bring them over to Alindy.
365
00:26:23,748 --> 00:26:25,038
She's gonna bleed them.
366
00:26:25,125 --> 00:26:26,785
She's gonna bleed them
through the jugular,
367
00:26:26,876 --> 00:26:29,046
'cause we don't like to wing bleed,
'cause they're migrating.
368
00:26:29,129 --> 00:26:31,049
But remember the number
that Lizzy gives you,
369
00:26:31,131 --> 00:26:33,431
'cause that's the number
that you and I have to match,
370
00:26:33,508 --> 00:26:36,968
and Alindy and I have to match
to make sure we have the right sample.
371
00:26:37,721 --> 00:26:40,721
And then once that we find
if they have had flu,
372
00:26:40,807 --> 00:26:42,887
then we do a lot of serology back off
in the lab.
373
00:26:42,976 --> 00:26:44,136
Sound good?
374
00:26:44,227 --> 00:26:45,937
-Does anyone need this duck?
-[woman laughs]
375
00:26:46,021 --> 00:26:47,611
[Carter] Can I let it go?
'Cause I've been holding it.
376
00:26:47,689 --> 00:26:49,189
Okay. Sound good?
377
00:26:49,733 --> 00:26:52,493
-Do, like... Feel like a "break." [laughs]
-Let's go.
378
00:26:54,195 --> 00:26:56,485
[Carter] If they're busy at the table,
let it go.
379
00:26:56,573 --> 00:26:58,283
-Who needs a duck?
-[woman] We do.
380
00:26:58,366 --> 00:26:59,616
Six-six-six.
381
00:26:59,701 --> 00:27:00,661
Oh, come on.
382
00:27:00,744 --> 00:27:01,914
Sorry, Alindy.
383
00:27:03,079 --> 00:27:05,459
Okay, we're gonna try to do this for you.
Ready?
384
00:27:09,502 --> 00:27:11,172
[boy] That does not seem right.
385
00:27:12,422 --> 00:27:14,422
[chuckles] No, it isn't. Are you ready?
386
00:27:14,507 --> 00:27:16,007
This is gonna seem even worse.
387
00:27:16,551 --> 00:27:18,641
-Are you ready?
-[boy] Oh!
388
00:27:18,720 --> 00:27:22,770
[Carter] Oh, goodness.
I'm a terrible, horrible person, aren't I?
389
00:27:22,849 --> 00:27:25,599
[chuckles] You can let that one go.
Good job.
390
00:27:26,394 --> 00:27:27,734
Yeah, totally let it go.
391
00:27:28,396 --> 00:27:30,476
-Next. What's your number?
-[woman] Six-six-seven.
392
00:27:31,858 --> 00:27:32,938
[Carter] Are you 667?
393
00:27:33,485 --> 00:27:35,945
All right. So... I know.
It makes you all... That's it.
394
00:27:36,029 --> 00:27:36,909
So I'm gonna just help you,
395
00:27:36,988 --> 00:27:38,818
'cause you're gonna be holding
lots of ducks today, okay?
396
00:27:38,907 --> 00:27:41,527
Right there with those big pinkies.
Perfect.
397
00:27:41,618 --> 00:27:44,788
Some of my favorite parts is
the hunters who have killed them
398
00:27:44,871 --> 00:27:47,871
have never held them live,
399
00:27:47,957 --> 00:27:50,627
and then they hold them live
and there's, like, a new perspective.
400
00:27:50,710 --> 00:27:52,130
It doesn't mean
that they're not gonna hunt.
401
00:27:52,212 --> 00:27:54,422
Hunting... I love hunting, myself,
402
00:27:54,506 --> 00:27:58,426
but that perspective of having this,
like, live little creature is...
403
00:27:58,510 --> 00:27:59,760
They don't get that opportunity.
404
00:27:59,844 --> 00:28:01,684
They get the kill opportunity,
405
00:28:01,763 --> 00:28:04,683
but the live opportunity
is always my favorite part
406
00:28:04,766 --> 00:28:06,386
when they come out in the spring to do it.
407
00:28:14,192 --> 00:28:16,362
I have a role
where I can go out in the field,
408
00:28:16,444 --> 00:28:19,704
being part of the pulling of the birds
and the swabbing of the birds,
409
00:28:19,781 --> 00:28:23,121
and then taking those samples
and being able to process them,
410
00:28:23,201 --> 00:28:25,581
all the way to the end, to see the result.
411
00:28:27,789 --> 00:28:31,499
That one sample you bring back
and all the work that went into doing it,
412
00:28:31,584 --> 00:28:37,344
all the people involved in doing that,
that one sample is so important.
413
00:28:37,966 --> 00:28:40,836
This knowledge gives
the scientific community
414
00:28:40,927 --> 00:28:44,217
power to predict and prepare.
415
00:29:18,381 --> 00:29:20,471
[Carroll] As the human population grows,
416
00:29:20,550 --> 00:29:23,340
we see an increased appetite
for animal protein.
417
00:29:24,137 --> 00:29:29,137
And in response, we are raising livestock
at unprecedented levels.
418
00:29:30,769 --> 00:29:36,109
The problem with that is that the sheer
number of animals in a confined space
419
00:29:36,191 --> 00:29:42,661
elevates the risk for a virus
to spread and mutate at a rapid pace.
420
00:29:44,449 --> 00:29:47,829
While we can't predict where the next
influenza pandemic is gonna come from,
421
00:29:47,911 --> 00:29:52,331
there are certain places
that need particular attention.
422
00:29:52,415 --> 00:29:54,415
And China is one of those.
423
00:29:55,627 --> 00:29:58,337
It's the place
where we've seen the emergence
424
00:29:58,421 --> 00:30:02,181
of virtually
all of the deadly influenza viruses
425
00:30:02,258 --> 00:30:03,638
over the last half century.
426
00:30:04,719 --> 00:30:07,309
And it's right across the border
from Vietnam.
427
00:30:08,389 --> 00:30:12,389
And so we set up
across five different border markets
428
00:30:13,061 --> 00:30:15,401
during the influenza season,
429
00:30:15,480 --> 00:30:19,400
a routine monitoring of what in fact
was coming across.
430
00:30:21,402 --> 00:30:22,782
We know from recent history
431
00:30:22,862 --> 00:30:27,702
the consequences of poorly monitoring
the emergence and spread of bird flu.
432
00:30:29,536 --> 00:30:32,996
We at WHO believe that the world is now
433
00:30:33,081 --> 00:30:37,091
in the greatest possible danger
of a pandemic.
434
00:30:37,627 --> 00:30:41,967
[Carroll] In 2005, a new avian flu, H5N1,
435
00:30:42,048 --> 00:30:45,758
had spread out of China
and across Southeast Asia.
436
00:30:46,845 --> 00:30:49,345
The Vietnamese government decided that
437
00:30:49,430 --> 00:30:52,850
they could not, um, coexist with H5N1.
438
00:30:52,934 --> 00:30:56,944
They had to take draconian steps
to really bring it under control.
439
00:30:58,523 --> 00:31:01,483
Vietnam began culling
millions of chickens.
440
00:31:02,610 --> 00:31:04,700
The virus began to dramatically spread
441
00:31:04,779 --> 00:31:08,949
beyond Southeast Asia,
into Europe, and as far as Egypt.
442
00:31:10,910 --> 00:31:14,290
In September, 2005,
the World Health Organization
443
00:31:14,372 --> 00:31:17,332
estimated that avian influenza pandemic
444
00:31:17,417 --> 00:31:20,957
could kill up to
150 million people worldwide.
445
00:31:23,089 --> 00:31:26,089
The national government
essentially made a commitment
446
00:31:26,175 --> 00:31:32,135
to vaccinate virtually
every chicken and duck, um, in Vietnam
447
00:31:32,223 --> 00:31:35,483
to try and break the back
of the outbreaks.
448
00:31:36,394 --> 00:31:40,114
And within four months, they succeeded.
449
00:31:42,233 --> 00:31:45,493
Every epidemic is an opportunity to learn.
450
00:31:46,613 --> 00:31:48,493
We do this all the time.
451
00:31:48,573 --> 00:31:50,493
We are constantly monitoring,
452
00:31:50,575 --> 00:31:54,115
because you never know when something
is going to show up in an animal
453
00:31:54,203 --> 00:31:56,163
and then make the leap to humans.
454
00:31:59,208 --> 00:32:00,208
[Dr. Kayali] Karma?
455
00:32:04,589 --> 00:32:05,669
[in Egyptian] Where is she hiding?
456
00:32:06,382 --> 00:32:07,432
[exclaims] Little cat!
457
00:32:09,677 --> 00:32:10,717
Come and say hi.
458
00:32:10,803 --> 00:32:11,933
[Karma whines]
459
00:32:12,013 --> 00:32:13,893
Then let's sit outside in the garden.
460
00:32:16,059 --> 00:32:17,269
[grunts and exclaims]
461
00:32:19,187 --> 00:32:20,097
[speaks indistinctly]
462
00:32:27,028 --> 00:32:29,198
[Dr. Kayali singing]
463
00:32:30,657 --> 00:32:31,737
Welcome, little cat!
464
00:32:32,992 --> 00:32:34,582
[in English] This is pretty much home now.
465
00:32:35,495 --> 00:32:37,905
I've been here since 2008.
466
00:32:39,749 --> 00:32:43,999
My wife, Marwa,
we've been married for 16 years.
467
00:32:44,587 --> 00:32:46,257
She's, uh, from Egypt.
468
00:32:47,173 --> 00:32:49,763
I was born in Lebanon in 1975.
469
00:32:55,723 --> 00:32:59,893
That's the year that
the Lebanese Civil War started in Beirut.
470
00:33:01,562 --> 00:33:04,442
I was born in the city at its worst.
471
00:33:05,858 --> 00:33:11,738
And since then, it never really
bounced back and always had trouble.
472
00:33:14,450 --> 00:33:17,450
Lebanese people, we tend to migrate a lot,
473
00:33:17,537 --> 00:33:19,617
simply because there are no opportunities.
474
00:33:19,706 --> 00:33:22,456
So for me, I was lucky,
475
00:33:22,542 --> 00:33:26,462
because I had the chance to go
and get educated out in the West.
476
00:33:28,589 --> 00:33:30,009
The kids have been born here.
477
00:33:30,717 --> 00:33:34,927
Adam who is 14, and Karma,
who's gonna be turning five.
478
00:33:35,013 --> 00:33:37,143
[in Egyptian] What are you going to play
at the concert?
479
00:33:37,223 --> 00:33:38,473
[in English] "Back in Black."
480
00:33:39,517 --> 00:33:41,847
[in Egyptian] You didn't learn
any Arabic songs whatsoever?
481
00:33:51,070 --> 00:33:52,990
[in English] Where we are here,
482
00:33:53,072 --> 00:33:56,992
it's a little bit quieter
than the rest of Cairo.
483
00:34:00,288 --> 00:34:03,168
So, we get to enjoy a little bit of peace,
484
00:34:03,249 --> 00:34:05,789
but the hustle and bustle
is always accessible.
485
00:34:09,464 --> 00:34:10,594
Cairo's a big city.
486
00:34:11,382 --> 00:34:14,552
It's about 25 million people,
so it's quite large.
487
00:34:14,635 --> 00:34:15,845
Very, very extensive.
488
00:34:17,555 --> 00:34:22,555
My work focuses on avian flu
and Egypt is a hot spot for that.
489
00:34:23,394 --> 00:34:30,324
2005, 2006, the avian influenza virus
started moving out from China to Egypt.
490
00:34:30,985 --> 00:34:33,775
So we have been struggling
with it ever since.
491
00:34:33,863 --> 00:34:35,243
It comes back every year.
492
00:34:35,823 --> 00:34:39,543
And this is what motivates us
to continue our work in Egypt.
493
00:34:42,872 --> 00:34:44,212
Karma?
494
00:34:44,290 --> 00:34:46,960
My kids, they know in general what I do.
495
00:34:48,419 --> 00:34:53,759
But I tend not to bring work back home,
because I like to really dedicate
496
00:34:53,841 --> 00:34:56,551
most of my time when I'm at home
to the family.
497
00:34:58,429 --> 00:35:00,309
[Marwa] He's away a lot, actually.
498
00:35:00,389 --> 00:35:02,889
But, uh, we learn to cope with it.
499
00:35:03,935 --> 00:35:04,935
[in Egyptian] Shall I tickle you?
500
00:35:08,189 --> 00:35:11,109
[Marwa] It's tough on Karma
because she's a little girl
501
00:35:11,192 --> 00:35:14,032
and she asks a lot about him
when he travels.
502
00:35:15,154 --> 00:35:19,244
When she wakes up in the morning and asks,
"Where's Daddy?" she's always sad.
503
00:35:27,667 --> 00:35:31,247
[Dr. Kayali] I never spend more
than two to three weeks here in Cairo.
504
00:35:35,716 --> 00:35:37,636
I spend half of my time in Lebanon
505
00:35:37,718 --> 00:35:40,098
and then either the United States,
or somewhere in Europe,
506
00:35:40,179 --> 00:35:42,849
or somewhere in Africa,
depending on what's going on.
507
00:35:43,850 --> 00:35:46,810
It's hard,
but that's the nature of the career.
508
00:35:48,729 --> 00:35:51,649
These viruses are circulating
all the time.
509
00:35:53,234 --> 00:35:54,614
I'm trying to keep up.
510
00:36:13,754 --> 00:36:16,804
[Dr. Ahuja in Hindi] This morning,
through a call from the control room...
511
00:36:17,425 --> 00:36:20,135
I got to know about your two children
who are positive.
512
00:36:30,313 --> 00:36:32,903
What happened to the five-year-old child?
513
00:36:32,982 --> 00:36:34,822
[woman] Only cough and fever.
514
00:36:34,901 --> 00:36:37,741
-[Dr. Ahuja] Since when he is sick?
-Since January, he was sick.
515
00:36:39,697 --> 00:36:44,077
This medicine, Tamiflu,
is given to treat swine flu.
516
00:36:45,119 --> 00:36:47,499
You too, from today onwards
will start taking medicine with them.
517
00:36:48,873 --> 00:36:50,793
[woman] You know how swine flu spreads?
518
00:36:51,834 --> 00:36:54,004
When we're sneezing, coughing?
519
00:36:54,086 --> 00:36:56,956
Look on his face. Need to keep this clean.
520
00:36:58,174 --> 00:37:01,184
These are my children,
this much I will definitely do.
521
00:37:03,804 --> 00:37:06,184
[Dr. Ahuja] In the beginning,
it was not spreading so much,
522
00:37:06,265 --> 00:37:08,675
so the government did not pay
much attention.
523
00:37:08,768 --> 00:37:11,478
But now prevention care has increased.
524
00:37:11,562 --> 00:37:14,612
For that, we have
implemented this strategy.
525
00:37:15,816 --> 00:37:17,646
Which pregnant lady
were you talking about?
526
00:37:18,986 --> 00:37:20,776
-[woman 1] Nasira!
-Come up.
527
00:37:21,364 --> 00:37:22,744
[woman 1] We'll go down.
528
00:37:23,574 --> 00:37:25,374
-[woman 2] Let's go downstairs.
-[woman 1] Call her. What's her name?
529
00:37:27,286 --> 00:37:32,206
[Dr. Ahuja] This is a very
densely populated area. Many families.
530
00:37:32,291 --> 00:37:36,881
One germ can multiply into thousands
531
00:37:36,963 --> 00:37:41,263
and spread rapidly and continuously,
so the whole community is affected.
532
00:37:42,593 --> 00:37:44,803
When did you learn about the pregnancy?
533
00:37:46,055 --> 00:37:48,015
A couple of months ago.
534
00:37:49,350 --> 00:37:52,020
[woman] He is her husband, explain to him.
She is his second wife.
535
00:37:52,103 --> 00:37:54,613
[Dr. Ahuja] As you are staying with her,
536
00:37:54,689 --> 00:37:57,279
your two children
with your other wife are sick.
537
00:37:57,358 --> 00:38:00,028
Keep her away from those kids.
538
00:38:00,111 --> 00:38:01,491
Because... Yes.
539
00:38:01,570 --> 00:38:04,410
Because of their illness,
she might have to suffer.
540
00:38:04,490 --> 00:38:07,490
She'll be at a high risk and there may be
a threat to her and the child...
541
00:38:13,082 --> 00:38:15,462
We told them that a positive case
was reported here.
542
00:38:17,044 --> 00:38:21,804
So some were alarmed, some were concerned.
543
00:38:21,882 --> 00:38:22,882
[woman] What will happen to us?
544
00:38:22,967 --> 00:38:25,547
There is no problem, come out.
There is no problem.
545
00:38:26,137 --> 00:38:28,257
We are from the hospital.
546
00:38:28,347 --> 00:38:33,017
You have to take Tamiflu,
because you are close to a swine flu case.
547
00:38:34,562 --> 00:38:38,942
We send a team to conduct surveys
within a radius of one kilometer.
548
00:38:42,236 --> 00:38:43,946
[doctor] This is good work.
549
00:38:44,030 --> 00:38:46,200
It's a good step from the government.
550
00:38:46,282 --> 00:38:49,042
Even if we miss one case,
we still find 100 cases.
551
00:38:49,118 --> 00:38:51,078
And we stopped 500 from happening.
552
00:38:51,162 --> 00:38:53,542
[Dr. Ahuja] Is anyone sick in your house?
553
00:38:53,622 --> 00:38:55,582
Cough, cold, fever...
554
00:38:58,085 --> 00:39:01,205
[doctor] The problem is,
everyone should be vaccinated.
555
00:39:01,297 --> 00:39:03,007
[in English] But it is a costly vaccine.
556
00:39:03,591 --> 00:39:06,341
[in Hindi] And our population
is very high.
557
00:39:07,511 --> 00:39:11,391
It is hard for health care workers
to reach every corner.
558
00:39:12,266 --> 00:39:16,596
That's why in India, there is
higher activity of flu during epidemics.
559
00:39:29,992 --> 00:39:31,912
[Dr. Goracke] So, we just have three.
560
00:39:32,620 --> 00:39:35,460
These two are stable.
I've seen everybody today.
561
00:39:35,539 --> 00:39:38,419
She came in yesterday, had had the flu,
562
00:39:38,501 --> 00:39:41,381
got a little bit better
and then suddenly got really bad.
563
00:39:41,462 --> 00:39:44,222
Had a fever of over 103,
has bilateral pneumonia.
564
00:39:44,298 --> 00:39:45,878
So we may have to watch that a little bit.
565
00:39:45,966 --> 00:39:47,086
Okay, sounds good.
566
00:39:49,387 --> 00:39:50,507
[woman chuckles]
567
00:39:50,596 --> 00:39:51,806
Bye, Lizzie.
568
00:39:51,889 --> 00:39:53,929
Bye. See you later, Dr. Goracke.
569
00:39:56,185 --> 00:39:58,435
[Dr. Goracke] When I begin
my 72-hour shift,
570
00:39:58,521 --> 00:40:01,111
I'm kind of in this high-energy mode.
571
00:40:03,275 --> 00:40:06,485
[Dr. Goracke] About 12 to 15 hours
before the end of the shift,
572
00:40:06,570 --> 00:40:10,660
that's when I begin to feel
that fatigue sets in.
573
00:40:21,293 --> 00:40:23,843
Probably at least
three to four times a month,
574
00:40:23,921 --> 00:40:28,801
I think, "Ugh. I can't do this anymore.
I'm done. It's just too hard."
575
00:40:30,052 --> 00:40:32,222
And then I get some sleep
and I feel better.
576
00:40:33,055 --> 00:40:35,975
Or something really great happens,
or, you know...
577
00:40:38,185 --> 00:40:40,935
Something happens that changes my mind
and I do better.
578
00:40:54,076 --> 00:40:55,786
Father in Heaven, we thank you so much.
579
00:40:55,870 --> 00:40:59,620
Thank you for the time to be able to come
together in your presence with friends.
580
00:40:59,707 --> 00:41:01,667
Lord, thank you for this meal.
581
00:41:01,750 --> 00:41:04,630
We always wanna give you praise and glory.
In Christ Jesus' name. Amen.
582
00:41:04,712 --> 00:41:06,882
-[man] Great.
-Holly, I brought out your good napkins.
583
00:41:06,964 --> 00:41:08,344
Oh, good. Do you want...
584
00:41:08,424 --> 00:41:13,514
We love entertaining people at our home
and we have some incredibly great friends.
585
00:41:13,596 --> 00:41:14,596
Yeah.
586
00:41:15,764 --> 00:41:20,524
And one of the main focuses
of our private time
587
00:41:20,603 --> 00:41:22,153
has been prayer with our friends.
588
00:41:22,229 --> 00:41:23,979
All right, Lord, thank you so much.
589
00:41:24,064 --> 00:41:26,364
[all] Lord Heavenly Father,
we come before you tonight...
590
00:41:26,442 --> 00:41:27,652
[all continue praying]
591
00:41:29,653 --> 00:41:32,243
Just pray that you would
guide the doctors' hands
592
00:41:32,323 --> 00:41:35,083
and let them see everything,
uncover everything.
593
00:41:35,159 --> 00:41:37,619
[Mike] That you would keep them safe
as much as they travel...
594
00:41:37,703 --> 00:41:39,413
[Dr. Goracke] Lord, I thank you
for this prayer right now.
595
00:41:39,497 --> 00:41:41,207
[all continue indistinctly]
596
00:41:53,010 --> 00:41:53,970
Are we good?
597
00:41:55,554 --> 00:41:57,014
[all laughing]
598
00:41:57,097 --> 00:41:59,097
[Dr. Goracke]
When I dedicated my life to Jesus,
599
00:41:59,183 --> 00:42:02,853
I said, "I'm not going to be
like the world anymore.
600
00:42:02,937 --> 00:42:03,897
I'm gonna be like Jesus,"
601
00:42:03,979 --> 00:42:07,859
and Jesus was loving and he was kind
and he laid down his life for others.
602
00:42:09,151 --> 00:42:12,031
I have my own little place
in the community.
603
00:42:12,655 --> 00:42:15,155
But from my tiny little place,
it ripples outward
604
00:42:15,241 --> 00:42:19,291
and I know that there are hundreds,
maybe thousands of lives
605
00:42:19,370 --> 00:42:22,460
that are different
because they came in contact with me.
606
00:42:24,041 --> 00:42:28,381
And there's still a lot of time left
of this year's flu season,
607
00:42:28,462 --> 00:42:32,052
so I have to just be in prayer that God
has it in His hands
608
00:42:32,132 --> 00:42:36,302
and I can continue to do
what I'm supposed to do in His will.
609
00:42:36,387 --> 00:42:37,807
[indistinct chatter]
610
00:42:51,610 --> 00:42:52,780
[Dr. Kayali in English] Coffee.
611
00:42:53,862 --> 00:42:56,702
Coffee, coffee, coffee.
612
00:43:03,247 --> 00:43:04,997
I have a pretty full day, every day.
613
00:43:06,375 --> 00:43:09,665
[laughs] But coffee...
614
00:43:10,337 --> 00:43:11,957
Starts in the morning with coffee.
615
00:43:15,801 --> 00:43:19,851
I was born here
and it's still my favorite city,
616
00:43:19,930 --> 00:43:21,220
my favorite place to be.
617
00:43:22,808 --> 00:43:27,768
Every time I come back, it just brings
me back to my childhood, early days.
618
00:43:30,524 --> 00:43:35,404
So the samples that we have been
collecting over the last three days,
619
00:43:35,487 --> 00:43:37,777
we're gonna run
some molecular analyses on them
620
00:43:37,865 --> 00:43:40,525
and that will tell us
if we have the virus itself.
621
00:43:40,618 --> 00:43:42,488
Do we have influenza or not?
622
00:43:51,795 --> 00:43:54,165
All of my staff are graduate students.
623
00:43:54,256 --> 00:43:57,796
So as they're working on the project,
they're also learning.
624
00:43:58,510 --> 00:44:02,220
I did my PhD at the University of Iowa
in the United States.
625
00:44:02,890 --> 00:44:07,390
So for me, having graduate students
start developing their careers
626
00:44:07,478 --> 00:44:10,478
while they're working on a problem
that's relevant to their countries
627
00:44:10,564 --> 00:44:13,074
and doing it in their countries,
628
00:44:13,150 --> 00:44:15,030
it's incredibly important.
629
00:44:19,907 --> 00:44:20,817
[Moatasim in Egyptian] Science has
630
00:44:20,908 --> 00:44:23,288
always been my passion
since I was a child.
631
00:44:23,369 --> 00:44:26,709
I've always wanted to be like...
632
00:44:26,789 --> 00:44:29,669
Do you know how Einstein looked while
he was working, with his scruffy hair?
633
00:44:29,750 --> 00:44:32,590
I really liked that,
I wanted to be the same.
634
00:44:32,670 --> 00:44:35,590
Without the scruffy hair.
635
00:44:37,299 --> 00:44:42,639
Dr. Ghazi is my mentor and everything
I learned is coming from him.
636
00:44:42,721 --> 00:44:46,561
He doesn't approach science
in a conventional way.
637
00:44:46,642 --> 00:44:51,652
Actually, we're supposed to be
interested in what we do.
638
00:44:51,730 --> 00:44:53,070
To do something that we love.
639
00:44:58,987 --> 00:44:59,947
[Dr. Kayali] Chief!
640
00:45:00,781 --> 00:45:01,661
Let's take this.
641
00:45:01,740 --> 00:45:02,700
[Dr. Kayali in English]
What do we have here?
642
00:45:02,783 --> 00:45:06,203
-[Moatasim speaks indistinctly]
-It looks like we have some activity.
643
00:45:09,581 --> 00:45:11,421
So we do have a finding.
644
00:45:12,876 --> 00:45:16,546
We have to have a certain number
in order to call something positive.
645
00:45:16,630 --> 00:45:18,470
We use a cutoff point of 80.
646
00:45:19,758 --> 00:45:22,298
-So H was what again?
-[man] Human.
647
00:45:22,386 --> 00:45:24,846
-Where was his origin? Backyard?
-[man] Yeah.
648
00:45:26,306 --> 00:45:28,226
[Dr. Kayali] Thirty-two,
which we call the negative.
649
00:45:28,308 --> 00:45:33,268
Not high enough to call him positive,
so it's below the limit that we detect.
650
00:45:33,355 --> 00:45:37,525
Second human, another backyard.
He's at 64.
651
00:45:37,609 --> 00:45:40,029
We would still call that a negative.
652
00:45:40,112 --> 00:45:43,742
And the third human,
I think we sampled at the farm.
653
00:45:43,824 --> 00:45:45,954
That's another negative.
654
00:45:47,327 --> 00:45:49,287
For the bats, they're below 40.
655
00:45:49,830 --> 00:45:53,080
None of them make the cut,
so we're gonna call them negative.
656
00:45:53,667 --> 00:45:56,457
But then we have a chicken that's 256.
657
00:45:57,045 --> 00:46:01,125
So that's definitely a positive
for avian influenza H9N2.
658
00:46:02,509 --> 00:46:03,799
That was on the farm.
659
00:46:03,886 --> 00:46:06,216
On the farm, the virus
is what we call endemic,
660
00:46:06,305 --> 00:46:07,965
which means it's always around.
661
00:46:09,141 --> 00:46:10,731
Either the chickens were vaccinated,
662
00:46:10,809 --> 00:46:13,439
or during their growing period,
they had an infection.
663
00:46:14,271 --> 00:46:15,731
This is very, very expected.
664
00:46:16,398 --> 00:46:19,858
Nothing of concern,
but this is the nature of surveillance.
665
00:46:21,820 --> 00:46:25,320
Regardless, this is a good
learning experience for my students.
666
00:46:26,575 --> 00:46:29,745
We have some antibodies.
Why don't we have virus?
667
00:46:29,828 --> 00:46:31,958
[Moatasim] It might be
because of vaccination.
668
00:46:32,956 --> 00:46:34,206
[Dr. Kayali] Could be. One more.
669
00:46:34,291 --> 00:46:36,751
Distance. Is the distance between...
670
00:46:36,835 --> 00:46:38,585
[Dr. Kayali in Egyptian]
Distance between, all right.
671
00:46:38,670 --> 00:46:41,130
But it's not what I'm thinking of,
so one more.
672
00:46:41,215 --> 00:46:45,795
[in English] What do we know
about an infection or an activity of...
673
00:46:45,886 --> 00:46:46,886
[woman in Egyptian]
Anomalies or something?
674
00:46:46,970 --> 00:46:48,970
-The...
-Anomalies.
675
00:46:49,056 --> 00:46:50,056
The cold weather.
676
00:46:50,140 --> 00:46:51,350
[in English] Seasonality.
677
00:46:51,433 --> 00:46:53,733
We're a little bit out of
the influenza season,
678
00:46:53,811 --> 00:46:55,101
that's why we don't see it much.
679
00:46:55,187 --> 00:47:00,437
Um, influenza season picks up its activity
during the warmer months,
680
00:47:00,526 --> 00:47:04,906
so if April, May, then you...
We expect to see more.
681
00:47:04,988 --> 00:47:06,488
-[woman] Okay.
-[Dr. Kayali] Good job, everyone.
682
00:47:07,449 --> 00:47:08,279
Let's eat.
683
00:47:15,541 --> 00:47:17,131
[Moatasim] I'm going to be
the president of the table?
684
00:47:17,209 --> 00:47:18,379
[Dr. Kayali] Yeah.
685
00:47:18,961 --> 00:47:20,711
[indistinct chatter]
686
00:47:23,340 --> 00:47:25,380
Tomorrow, we need to return to Egypt.
687
00:47:26,176 --> 00:47:29,136
A new avian influenza has been detected.
688
00:47:29,805 --> 00:47:32,265
And it's essential
that we begin surveillance.
689
00:47:34,643 --> 00:47:37,733
We work under what we call
the "One Health" perspective,
690
00:47:37,813 --> 00:47:41,823
so we strongly believe that the health
of humans, of animals,
691
00:47:41,900 --> 00:47:43,990
of environments, of ecosystems,
692
00:47:44,069 --> 00:47:47,409
are all interconnected
and influenza is a great example.
693
00:47:49,032 --> 00:47:51,452
[Moatasim in Egyptian]
The bird migration patterns,
694
00:47:51,535 --> 00:47:55,245
as well as travel routes for
commercial airlines and people...
695
00:47:55,330 --> 00:48:01,250
So anything can affect any country and
any country can affect other countries.
696
00:48:02,921 --> 00:48:06,971
If something happens, the problem is that
it spreads rapidly between countries...
697
00:48:08,385 --> 00:48:10,295
before we're prepared.
698
00:48:20,188 --> 00:48:22,358
[Carroll] 2,000 years ago,
it's hard to imagine,
699
00:48:22,441 --> 00:48:24,821
but this was a robust, dynamic community.
700
00:48:26,320 --> 00:48:28,610
The Roman forum was the seat of power,
701
00:48:28,697 --> 00:48:31,367
both political and economic power,
702
00:48:31,450 --> 00:48:35,580
and never would they have imagined,
2,000 years later,
703
00:48:35,662 --> 00:48:38,292
we'd be standing here
looking over their ruins.
704
00:48:39,166 --> 00:48:43,876
The very idea that their civilization
wasn't a permanent civilization,
705
00:48:43,962 --> 00:48:46,172
just was something
they would never have grasped.
706
00:48:48,717 --> 00:48:51,967
Two thousand years later,
we're in exactly the same situation.
707
00:48:52,054 --> 00:48:55,064
We think the world we live in
is permanent.
708
00:48:56,975 --> 00:48:59,265
This is the eternal city
and if nothing else,
709
00:48:59,353 --> 00:49:02,403
the eternal city tells us
nothing is eternal, right?
710
00:49:02,481 --> 00:49:04,191
All things must pass.
711
00:49:05,150 --> 00:49:08,280
And to avoid the worst
consequences of change,
712
00:49:08,362 --> 00:49:12,742
we're going to have to change
the way we live on this planet.
713
00:49:13,575 --> 00:49:16,995
If we don't, then we are gonna pay
a severe price.
714
00:49:21,792 --> 00:49:23,792
[dramatic music playing]
57352
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