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These are the user uploaded subtitles that are being translated: 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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