Killing the Speckled Monster: How We Eradicated Smallpox

Daniel and Kelly appreciate that they've never had to worry about getting smallpox, and talk about the scientific and public health advancements that saved humanity from this ancient scourge.

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Episode Transcript

Speaker 1 (00:00):
Hello friends. First of all, a heads up. We're talking
about smallpox today and descriptions of the disease may be
upsetting for some listeners. It was pretty awful and we're
super lucky we don't have to deal with it anymore. Second,
I'm heading to the UK in August. The Royal Society
is sending me to the Edinburgh Book Festival. I'm going
to be doing events on August twelfth and the thirteenth,

(00:22):
and on August twelfth the Royal Society will announce the
shortlist for their twenty twenty five book Prize at the
end of the event i'm doing. If you're at the
book Festival, please come by and introduce yourself. I would
love to meet you. All Right on with the show.

(00:46):
No disease has ever been so instantly recognized or so
widely known and feared. Smallpox was hideous and unforgettable for me.
The memory of award full of smallpox victims thirty five
years ago in Dhaka, Bangladesh is still vividly etched in
my mind. Anxious, pleading, pock deformed faces, the ugly penetrating

(01:08):
odor of decaying flesh that hung over the ward, the
hands covered with pustules reaching out as people begged for help.
Neither water nor food offered comfort. Puss filled lesions covered
the insides of their mouth, making it painful for them
to even chew or swallow Flies were everywhere, thickly clustered
over eyes half closed by the pustules. More than half

(01:31):
the patients were dying, and there was no drug, no
treatment that we could give to help them. This was
a paragraph from D. A. Henderson's twenty nineteen book Smallpox,
The Death of a Disease. Smallpox is estimated to have
taken hundreds of millions of lives, and the story of
how humanity eradicated smallpox is the story of one of

(01:53):
our greatest victories. Coordinating across cultures and continents, we harnessed
science to spare future generations from this devastating scorge. Today,
we're going to talk about a project coordinated through the
World Health Organization and led by D. A. Henderson to
drive smallpox out of our bodies. However, smallpox remains in

(02:14):
our labs, and we'll talk about the risk that poses
for humanity. Welcome to Daniel and Kelly's Smallpox Free Universe.

Speaker 2 (02:35):
Hi, I'm Daniel, I'm a particle physicist. I've never had smallpox.
I did have chicken pox, and I've always wanted to say,
a pox on both your houses.

Speaker 1 (02:45):
I'm Kelly Waiter Smith. I study parasites and space. I
have also never had smallpox, thank goodness. I don't think
anyone has had smallpox since the nineteen eighties. And I
also lived in the era of chicken pox and had
that pox upon my house.

Speaker 2 (03:03):
Welcome to Talk some Pox, new podcast.

Speaker 1 (03:09):
I'm pretty glad I never had to see my kids
with chicken pox.

Speaker 2 (03:12):
Hmm, Yeah, I remember it being pretty miserable. Yeah, it's
like a few days home trying desperately not to scratch
all those itchy spots.

Speaker 1 (03:21):
Well, you know what was even worse. So Zach got
chicken pox, and when you're older, shingles is essentially chicken
pox waking up. Yeah, And right after our second child
was born, Zach got shingles on his back, and our
son wasn't vaccinated because he had just been born, and
I didn't want him to get chicken pox, and so
I had to stay upstairs with our newborn and didn't

(03:45):
let Zach up, and Zach stayed downstairs with our three
year old, who did not at all care that Zach
was suffering mightily, and so she would like smack him
on the back where he had his shingles spot, and
she'd be like, take me to the zoo, carry me around.
Then he was such a saint because he was miserable.
Shingles is the worst.

Speaker 2 (04:06):
Yeah, And shingles is also like maybe the most terrifying
name for a disease. Yeah, you know the other ones
like cow pox, smallpox, measles, whatever. It's sort of an
abstract thing, but shingles makes me feel like you're gradually
turning into a house or something. I don't know. The
visual that conjures up in my mind is terrible.

Speaker 1 (04:22):
Yeah, I think because I was reading about smallpox and
I saw a bunch of pictures of people with smallpox.
That is a worse image to me than a house.

Speaker 2 (04:31):
Yeah.

Speaker 1 (04:31):
I think I'd rather turn into a house than a
smallpox victim.

Speaker 2 (04:35):
Well, it's unfortunately an appropriate time to be talking about
smallpox and vaccinations and the science behind disease and pathogens
and infection. So we're dedicating today's episode to that topic.

Speaker 1 (04:47):
Yes we are. Yeah, it's a scary time. I just
got a message my daughter's starting a summer school, and
I got a message about measles being in the area
and how we all need to be alert to make
sure our kids don't bring measles to camp or I'm
home with measles from camp.

Speaker 2 (05:01):
Killers of the past are returning like zombies.

Speaker 1 (05:04):
Yes, but let's hope smallpox doesn't come back, which we
will return to at the end of the episode.

Speaker 2 (05:09):
All right, so you asked our listeners a question about smallpox.

Speaker 1 (05:13):
Yeah. So, while we are living in a moderately depressing
time in terms of measles making a comeback, at least
in the US, there is a lot to be excited
about that has happened in the past in terms of
disease control. And so I asked our listeners. D A.
Henderson led the effort to eradicate which deadly disease. And

(05:34):
I will tell you that DA Henderson is one of
my heroes, and I think everybody should know his name
because many of us probably owe our lives to the
fact that this man lived on this planet. So let's
see what our listeners had to say.

Speaker 3 (05:46):
Could it have been polio?

Speaker 2 (05:48):
We will be a gift.

Speaker 3 (05:49):
But to extrap a light from eradication, I have to
guess to these small books.

Speaker 4 (05:56):
Da Henderson worked tirelessly to help eradicate disco fever.

Speaker 2 (06:03):
I have no idea what disease da Henderson tried to eradicate.

Speaker 5 (06:10):
I don't recognize the name. But there's only two diseases
that have been eradicated, smallpox and renderpest. Might be one
of those, or it's something that he tried to eradicate
and did not succeed, in which case I have no idea.

Speaker 3 (06:23):
I do believe that we've only eradicated one actual disease
and the rest are just minimized but still happened. So
I'm going to guess at smallpox that I don't know.

Speaker 4 (06:35):
This person in their work just goes to show that
a lot of research and effort goes into saving lives
and making lives better without notoriety.

Speaker 2 (06:45):
I don't know what dia Henderson helped that with.

Speaker 3 (06:47):
Maybe polio or tuberculosis, but I don't know. I think
you you're the disease of using initials for first and
middle names.

Speaker 1 (06:57):
Good mix of answers here.

Speaker 2 (07:01):
What are da Henderson's first and middle names and why
does he go by initials?

Speaker 1 (07:05):
Well, let's look it up already, Like good start all right,
Donald Ainsley Henderson.

Speaker 2 (07:15):
That's not so bad. Why did we go by Da?

Speaker 1 (07:17):
I don't know someone whose last name is Wienersmith. It
sounds totally reasonable to me. I'm not sure what he's
so embarrassed about. He should be loud and proud. But
as I suspected, there actually weren't a lot of people
who immediately were like DA Henderson helped eradicate smallpox. I
know that name, yeah, you know, it's as important a
name to me as Lincoln or something like that. But

(07:38):
this man probably saved many, many, many lives. Smallpox was
a horrible scourge on humanity for like thousands of years,
and he played a huge role in eradicating it. So
how much do you know about smallpox, Daniel?

Speaker 2 (07:52):
I know that it sounds terrible, okay, and that I
don't have to worry about it, for which I'm grateful
to people whose research is actually practical unlike mine.

Speaker 1 (08:01):
And I would like to point out how amazing it
is that smallpox is not at the forefront of like
anyone's mind in our generation. You know, I was born
in eighty two, which is two years after the declaration
that smallpox was eradicated, and so I don't think much
about this, but if you were born in the eighteen hundreds,
for example, there was a good chance that you would

(08:22):
lose someone in your family to smallpox.

Speaker 2 (08:24):
I think it has interestingly a different cultural impact than polio.
Polio we sort of know more about, and we've heard
maybe more about the vaccination and the success there. And
I wonder if it's because polio didn't kill all of
its victims, it left them paralyzed. And so there are
people around today like Mitch McConnell who suffered from polio
as a kid and like can talk about it, whereas smallpox'

(08:47):
victims are like, you know dead.

Speaker 1 (08:49):
Well, polio still is around, right, Polio is coming back
you Yeah, smallpox is gone.

Speaker 2 (08:55):
Yeah.

Speaker 1 (08:55):
No one has had smallpox for what forty plus years
now or something, which is incredible wood knock on wood.
But but I mean people who did have it, it
was horrible. So there's Yeah, smallpox is caused by a virus,
and there's two main versions. There's Variola major and veryola minor.
The major one is majorly awful. It kills something like

(09:17):
thirty percent of the people who get infected. Oh wow, Yeah,
it was really common in asia, and then there's variola minor.
The death rate is lower, it's about one to two percent,
which still, like, you know, if my kid got infected
by smallpox, I wouldn't like those odds. That's petrifying.

Speaker 2 (09:31):
Nobody wants to roll that die.

Speaker 1 (09:33):
Yeah, no, absolutely not. And it was miserable. So you
mentioned that polio leaves a lot of people debilitated for
the rest of their lives. Smallpox creates you know, sort
of like chicken pox, but much worse, pos all over
your body. Often they scar and they'd leave sort of
pits in your skin that you'd have for the rest
of your life. And if the smallpox ended up getting
into your eyes, you would also go blind. And so

(09:56):
smallpox was a leading cause of blindness, and so it
would also leave a life of people debilitated if it
didn't happen to kill them.

Speaker 2 (10:03):
Right, And how does it actually work? Like what is
the virus doing?

Speaker 1 (10:06):
Well? So, typically the way you get infected by the
viruses you breathe it in. So like if somebody talks
in some of their like saliva, it gets aerosolized and
then you breathe it in. A couple days later, you
start showing symptoms. The symptoms include puss filled lesions that
cover your entire body, including inside of your mouth. Oh
and yes, and these lesions start, you know, like weeping puss,

(10:30):
and that puss is contagious, and it becomes almost impossible
to drink water, to breathe, and I think your you know,
your immune system probably just gets overwhelmed. To be honest,
I'm not one hundred percent sure what it is that's
killing someone, but you just end up covered in these
horribly painful lesions. And we didn't have a treatment, so
if you got it, you just had to work your

(10:51):
way through it. There wasn't like a medicine for it.

Speaker 2 (10:53):
So no antivirals, no treatment even for the symptoms.

Speaker 1 (10:56):
Uh no, wow, No, I mean so like there's a
quote for the opening from da Henderson where he was
describing seeing this in a hospital in Bangladesh and they
were just all of these people suffering, they couldn't drink water,
and he was lamenting that there was just nothing we
could do for them once they got infected. But for
a while, we actually did have some pretty good ways

(11:18):
of preventing people from getting infected. So smallpox is one
of our early stories about figuring out ways to vaccinate people,
which is kind of amazing. Initially we did this thing
called vari elation. And so the idea here is that
there's some strains of smallpox that are more lethal than others.
And so if somebody in your family comes down with

(11:39):
a mild case of smallpox, you like managed to hit
that incredible jackpot where they got smallpox, but not the
really bad one. Ye, you would take the puss from
one of their lesions and you would use a needle
to like inject it under your own skin.

Speaker 2 (11:53):
Oh my god.

Speaker 1 (11:54):
Couple things. So, One, you're getting a less virulent strain,
and if you breathe that in, it's worse for you
than if you get it through your skin. I don't
think we totally understand why that is the case.

Speaker 2 (12:06):
But the big picture strategy here is get infected by
the lesser one, which will protect you against the worse one.

Speaker 1 (12:12):
Yes, exactly, but you know, you'd still often get covered
in those pocks and you'd be you know, scarred for
the rest of your life, but you had a better
chance of surviving. But a problem with this method is
you were still infected by smallpox, and you were more mobile,
you could move around more because you had a less
bad case.

Speaker 2 (12:30):
Oh so you're spreading it exactly, Yes.

Speaker 1 (12:32):
So you're breathing it out. And there's some stories about
people like sending vary related individuals into war zones to
try to like get the other side infected by smallpox.
Oh gosh, I know, absolutely horrible, like early examples of biowarfare.

Speaker 2 (12:46):
How far back in history is this, Like have people
been infected by smallpox for all of human history? Or
is it a recent thing?

Speaker 1 (12:52):
Yeah, so we don't know exactly when it first popped up.
We think that it was first infecting rodents, and what
probably happened is there were a couple instances where it
jumped from rodents to humans and then it probably fizzled
out and didn't go from human to human. But one
of those times when smallpox jumped from a rodent to
a human, it also had the ability to go from
human to human after that.

Speaker 2 (13:13):
Are we blaming this on rodents with good data or
we just bigoted against rats because I'm pro rat.

Speaker 1 (13:18):
We have established that you and I are both pro rat.
I've been looking into adopting a rat, but it would
have to live in my office, and then it might
mess up our audio, So I think I might not
adopt a rat.

Speaker 2 (13:28):
I think the listeners would like hearing a few stups
from a rat now, and then I think they might.

Speaker 1 (13:33):
They might have could play in my lap while we're
having these conversations.

Speaker 2 (13:36):
We'll see we can interpret it sounds as whether it's
agreeing with you or disagreeing with you. It'd be fun.
I vote yes.

Speaker 4 (13:42):
I vote rat include citations, Kelly, workshop that joke a
bit more, Kelly, calm down, rat it to me.

Speaker 1 (13:52):
I'll get to it.

Speaker 2 (13:53):
I think we're envisioning the rats like those grumpy guys
on the Muppets, you know, sitting in the theater.

Speaker 1 (13:58):
I love those two those But anyway, back on track,
So are.

Speaker 2 (14:02):
The rats really to blame here or are they just
escapegoat or escape rat?

Speaker 1 (14:05):
Yeah, we can't be one hundred percent sure, but there's
pretty good evidence that smallpox is similar to viruses that
you find in rats, So there's a good chance that
it jumped.

Speaker 2 (14:13):
So why didn't we call it rat pox? Because the
other one we call it cowpox or chicken pox, right,
so why do we call it rat pox?

Speaker 1 (14:19):
I believe that those are also not very well named poxes.
I think that we encounter cow pox when it's in cows,
but I think that that also is often in rats,
And so I think these viruses are often in rats,
but then it jumps into other organisms that we interact
with more regularly, and then we name it after that.

Speaker 2 (14:38):
So rats are to blame for rat pox and cowpox
and chicken pox.

Speaker 1 (14:42):
I no, I'm not going on the record for all
of those. I'm sure there's some variability, but I think
I remember reading that cow pox also is often in rats.
But you know, that's not relevant to us. What's relevant
is that when we're milking the cows, we see the pustules.

Speaker 2 (14:55):
All right, so we think it came from rats. But
how long ago are we talking about? What's the earliest
record forward evidence of smallpox?

Speaker 1 (15:01):
I don't know exactly when the earliest recorded evidence is.
I did come across in eleven fifty seven BC. Ramsey's
the fifth in ancient Egypt, appears to have died from smallpox.
You can see the like pox in his mummy.

Speaker 2 (15:14):
Wow.

Speaker 1 (15:14):
So it's been around for a while. And you know,
we were talking about variolation, which is when you like
pass less virulent strains. We have evidence that that started
in India sometime around one thousand BC, and about two
thousand years later it was introduced into China. And so
we've been as a species dealing with this thing for
thousands of years. But this very clever species that we

(15:37):
are managed to eradicate it in the nineteen eighties. So
that's pretty amazing.

Speaker 2 (15:41):
Actually, it is amazing when you live in a turning
point in human history, right where you have like thousands
of years where we live one way and then we've
done something to change fundamentally to human experience. That's incredible
to live in those moments.

Speaker 1 (15:52):
Right, Yes, Yeah, I mean like when my daughter was born,
I had very high anxiety post part of anxiety, and
so almost every day I would think to myself, I
am so lucky that I don't have to worry about
smallpox on top of everything else, Like, there's no way
my daughter's getting smallpox. How lucky am I? But yeah, no,
this is a fundamental difference in what parents and people

(16:14):
need to worry about.

Speaker 2 (16:15):
I'm like an anxious person also and a worrier as
a parent, but I've never worried about smallpox. I've worried
about cars, I've worried about lightning. I've worried about coyotes.
I've worried about all sorts of crazy stuff, but never
a small fox. That's amazing. Where did that even come
from in your mind?

Speaker 1 (16:30):
When my daughter was born, I had trouble sleeping at night,
and Da Henderson's story about eradicating smallpox. Where a bunch
of these facts today come from was what I read
in the middle of the night when I couldn't fall asleep.

Speaker 2 (16:42):
And maybe not a great idea from middle of the
night reading I'm a new parent.

Speaker 1 (16:46):
No, I made a lot of bad choices with my
reading materials back then. But that was the same year
where we found in one of the labs in the
United States old vials of smallpox that somebody had not
destroyed like they were supposed to. They had forgotten them,
and they were in a closet somewhere. And if that
had gotten out, yea, we would have like And so anyway,

(17:07):
I was thinking, oh my gosh, do we still have
like vaccine stockpiles somewhere? What would happen if smallpox came out?
But anyway, we're going to get back to that at
the end. So getting back to solutions.

Speaker 2 (17:17):
So for thousands of years we've been suffering with smallpox.
We had this variolation strategy to minimize the impact of smallpox.
When did things change? When did humanity like step up
our approach to this.

Speaker 1 (17:29):
Well, so the variolation technique was great. It brought death
rates from like thirty percent to one percent, but it
was still a risky procedure. You know, there was still
some chance that you were going to end up killing
your kid when you variolate to them. So in seventeen
ninety six, Jenner makes this amazing observation, which is that
women who work with cows who like milk cows, they'll

(17:51):
get these like pustules on their hands. So the cows
get cow pox, which is a closely related but different
virus causing these poxes. The women who are milking the cows,
you know, become very close to the puss that's produced
by these pustuls, and they end up getting cow pox
on their hands. But it's not a big deal. But
that virus is closely related enough to smallpox that getting

(18:15):
those pustuls on your hands was correlated with not getting
smallpox throughout the course of your life. And so this
had become sort of anecdotal, and then someone started taking
it seriously and they were like, hold on, what if
we just start purposefully infecting people with the puss from
these you know, these poxes on cows and see if
we can use that to protect people from smallpox.

Speaker 2 (18:38):
Let's go from correlation to causation.

Speaker 1 (18:40):
Yeah, that's right. And so they started like purposefully infecting
people with puss from these like boils on the cows.
And the people who got this method of vaccination and
it was called vaccination because vodka is a word for cow.

Speaker 2 (18:55):
Oh my gosh, isn't that where vaccine comes from? From vodka?
I had no idea.

Speaker 1 (19:01):
Yeah, so cool, so cool.

Speaker 2 (19:03):
We should call it vakapox.

Speaker 1 (19:06):
It rolls off the tongue a little bit.

Speaker 2 (19:07):
Better better than cow box.

Speaker 1 (19:09):
But I mean, this was like about one hundred years
before the germ theory of disease, and there was just
this like correlation that someone picked up on and they
were like, let's try it, and many lives were saved.
But it also wasn't a perfect method, do you.

Speaker 2 (19:22):
Know what they were thinking? Like, they didn't have the
germ theory, but they obviously were being kind of scientific
about it, right, They're looking for evidence finding, correlations making, hypotheses,
testing these things. Did they have an idea for why
it would work?

Speaker 1 (19:34):
Yeah, So I can't say that I have read widely
what people were thinking at that time, but I would
guess that the thought process wants something like you only
get smallpox once in your life, Like if somebody lives
through smallpox, they're not going to get it again. And
we knew that, and they probably noticed that, like, look,
this other person is getting some sort of pustial POxy
related thing and then they don't get smallpox. And I

(19:57):
don't know why that is, but let's lean into it, like,
you know, assumed it was some kind of immunity.

Speaker 2 (20:02):
And that might sound sort of like ad hawk to people,
But don't forget that there's lots of modern medicine that
we rely on because it's effective, but still don't fully
understand how it works. Like Katrina was telling me the
other day, we don't understand the molecular basis for like
tile and all, wow, why exactly that works? Well? All right,
but we have a lot of data that it does,
so we feel safe.

Speaker 1 (20:23):
And we talked a couple episodes ago about how we
don't really understand how general anesthesia works at a like
molecular level, but you know, you make these steps forward
and you kind of try to figure out why they
worked after the fact. But if it works, you know,
you keep moving forward.

Speaker 2 (20:37):
And this is a really important point for public health,
right because in fundamental science, we can like you know,
twitter around for years wondering about what's the nature of
space and time and try to figure it out and
take a decade or whatever. But public health, like you
have to make decisions. You got to say, like what
are we doing, are we doing this, we're doing that?
Are we recommending this to kids? And were recommending that?

(20:57):
And so the scientific debates can and should still canntinue,
but you also have to make policy decisions even without
perfect information. So it's like super.

Speaker 1 (21:05):
Challenging, Oh my gosh. And in the next segment we're
going to get into more detail about how difficult it was.
You know, when you decide that you need to vaccinate
like most of the world to try to eradicate smallpox,
what do you do about the people who say, I
don't want to take the vaccine. Yeah, yeah, it's complicated.
And so this vaccinating using cowpox worked great, but there
were some problems. You know, cows aren't always producing lesions

(21:27):
at the time when you want to vaccinate people. Sometimes
cows get puss filled lesions caused by other stuff, and
so instead of actually vaccinating somebody, you've just injected some
bacteria into their body and so not perfect. And then
often what would happen is that you would use the
lesion from the cow to infect the first person, and

(21:47):
then that person would get a lesion on their arm,
and then you would transfer it from one person to another.
So there's stories about kids with lesions on their arms
getting sent across the sea to like move that vaccine
from person to person to like bring the vaccine to America,
because it was easier to do that than to do
it with a cow.

Speaker 2 (22:06):
Children are smaller than cows, that's true. It's easier to
shift than I found. Yeah, it's a smaller box required.

Speaker 1 (22:11):
Right, Some of them cooperate better than cows. Two not
all of them, but at least they're smaller, so you know,
you can push them around. But sometimes they would also
transmit tuberculosis, and not necessarily for the children, but if
you were doing this with adults, sometimes you'd transmit syphilis
from person to person. So also not a perfect method.

Speaker 2 (22:31):
All right, so we moved past just suffering through smallpox
and pasted variolation to minimize the impact into early forms
of vaccination. Let's take a break, and when we come back,
we'll hear more about the modern approaches to vaccination and
the role played by D. A. Henderson and keeping Kelly
up at night. All Right, we're back, and we're hearing

(23:11):
about humanity's struggle and victory against smallpox, the macroscopic beings
finally winning out over the microscopic It's amazing that we
can eradicate smallpox, but not rats, right, Rats just seem
like they're going to be here forever.

Speaker 1 (23:24):
Yeah, No, they absolutely are. I would not center your
hopes high for eradicating rats. There's a lot of kinds
of rats. It's complicated.

Speaker 2 (23:32):
Yeah. Yeah, And I like rats anyway, So I'm not
saying we should. I'm just saying it's amazing how we
can actually squash out an entire form of life because
we decided it's too dangerous.

Speaker 1 (23:43):
Yeah. So, I mean, we were successful at squashing smallpox,
but we've tried. I mean, the amount of money that
has gone into trying to squash malaria has been intense,
but we have not succeeded. And we were trying at
the same time to eradicate malaria as we were trying
to eradicate smallpox. But one of the quote unquote nice
things about smallpox is that it just infects people, and

(24:04):
so that makes it a little bit easier to eradicate.
And we were able to create a vaccine that was effective,
whereas attempts to eradicate malaria using vaccines haven't been as successful.
And I'm queuing up an episode with an expert on
why it's so hard to make vaccines for parasites. But
we got lucky that smallpox was easy to control with
the vaccine and only impacted people, so we didn't have

(24:27):
to also control something like mosquitoes.

Speaker 2 (24:29):
All right, So then tell us about how we started
to make more rapid progress against smallpox.

Speaker 1 (24:34):
Yeah, So this method of using cows to help vaccinate
people and then vaccinating arm to arm was difficult and laborious,
and it was hard to do mass vaccination. But then
we figured out ways to dry the vaccine and then
rehydrate it so that you could essentially have a farm
with loads of cows. You could collect a bunch of pus.

(24:55):
You could dry it out and then it would be
stable for longer periods of time, and then you could
rehydrate it wherever you decided that you needed it.

Speaker 2 (25:03):
But we're still using essentially cowpus as a vaccine for smallpox,
that's right, Yeah, And you said that started in the
late seventeen hundreds. How long did.

Speaker 1 (25:11):
That go on for till we eradicated smallpox? As much
as possible, We were using cowpox to vaccinate people instead
of smallpox because it was just safer.

Speaker 2 (25:20):
So early part of last century, early nineteen hundreds, were
still using cowpus to fight smallpox.

Speaker 1 (25:25):
So when I was reading about this in the nineteen fifties,
they were talking about how they learned how to freeze
dry the viruses for the vaccine, and they were still
using cows, and they thought it was cow pox that
they were using, but then when they genotyped it later on,
it looked like they were using vaccinia, which is another
closely related virus, and so maybe that virus got into cows,

(25:48):
but we were using stuff collected from cows, is the point,
because it was just less likely to kill people. But
it was still a problem for immunocompromise people. There were
still some people who had very bad reactions and some
who passed away from using this vaccine.

Speaker 2 (26:03):
So we started out not knowing at all how it worked.
And then we developed germ theory while we were still
doing this, and then we kept using it even after
we had a deeper understanding of like the microbiology of
what's going on here. That's fascinating.

Speaker 1 (26:16):
Yeah, I mean, we kept using it, but we got better,
and you know, we ended up with better techniques, and
at some point, like during the World Wars, we had
created essentially this like vaccine gun where somebody would come
by and it was like hydraulically operated and it would
like inject the vaccine and then you could get the
next person in and now you could do a thousand
people in an hour, and that really sped things up.
But the method that ended up being used to eradicate

(26:39):
smallpox was much easier. So they created this cheap, very
short needle that was bifurcated, so it's like a fork
with only two times, and what you do is you
would stick it into vaccine that had been freezed, dried,
and then rehydrated, and surface tension would hold the water
with the virus particles between the times.

Speaker 2 (26:59):
Like a fork. We're talking a fork basically.

Speaker 1 (27:01):
Like a fork. Yeah, and then they'd stab you in
the arm a bunch of times and it didn't hurt
that much because it didn't need to like go too
far in, but they would like get it under your
skin by doing that over and over and over again.
But they could do it really fast, and then when
they were done, they'd put it in another container and
at night they would sterilize those containers and you could
use the needles over and over and over again. And

(27:21):
they were cheap. They didn't require a lot of training.
You could literally train someone by giving them an orange
and being like practice stabbing this orange, and then they'd
be good.

Speaker 2 (27:32):
So then when you're sitting down to get stabbed, and
you asked your nurse have you done this before? And
she says, oh, I vaccinated lots of oranges, mangoes, soap apples,
I'm super experienced. Yeah, that's right.

Speaker 1 (27:41):
Any fruit you can think of I have stabbed.

Speaker 2 (27:45):
Thank you to all the oranges who suffered so the
humans could survive. Really, that's taking it for the team. Yeah,
So this is really a step forward, not in terms
of like virology or microbiology, but in engineering, right, this
is just like, how do we get this vaccine rapidly
to a lot of people?

Speaker 1 (28:01):
I mean yes and no. So like that jet injector
we were talking about, that was an amazing step forward
at the time, but it still broke a lot and
you needed to bring replacement equipment with you. And when
you're going to really remote places, if you ran out
of replacement equipment, you'd be in a lot of trouble.
Where's these bifurcated needles? This was a very simple solution.
It was about five dollars for a thousand of them.
They could be reused one hundred times. You could sterilize

(28:23):
them in boiling water. It becomes much easier. And so
sometimes it's not about like the most complicated engineering solution,
it's just finding the thing that is cheap and efficient,
and in this case, it was a bifurcated needle.

Speaker 2 (28:37):
But I think that is the best engineering solution, right,
not like over engineered, but just like, how can we
use our manufacturing process and deal with the reality situation
to solve this problem efficiently, effectively and cheaply. I think
that's great engineering.

Speaker 1 (28:49):
Yeah, yeah, amazing, and they even like would shorten the
needle to get the cost down so that they could,
you know, use less metal for each one. Okay, so
that is how we made and delivered the vaccine that
eventually eradicated smallpox.

Speaker 2 (29:02):
And so we're still again using the cow sourced one, right, Yeah,
that's surprising me. I thought this whole story was gonna
be like and then we figured out how to actually
build a vaccine again smallpox by like crippling it or
one of the typical vaccination strategies. But you're saying we
used one disease against another the whole time.

Speaker 1 (29:19):
Yeah, it's incredible.

Speaker 2 (29:20):
That's amazing.

Speaker 1 (29:21):
What that is? Amazing?

Speaker 2 (29:23):
Yeah, all right, so tell us about the campaign to
eradicate smallpox.

Speaker 1 (29:26):
Amazingly, it kind of starts with the Soviet Union. So
during the Cold War, the Soviet Union kind of like
backed away from the international community, and after Stalin died,
thank goodness, Stalin died. Wish he had died sooner, but
he didn't.

Speaker 2 (29:38):
So anyway, speaking ill of the dead, is that what
you're doing?

Speaker 1 (29:42):
He just decided, like millions of people, Yes, I am so. Anyway,
in nineteen fifty nine, the Soviet Union is like stepping
back into the World Health Assembly and trying to get
involved in the international community again. And they propose, hey,
let's eradicate smallpox and we we will volunteer to donate
freeze dried doses of vaccines, literally millions of them, and

(30:06):
this is their way of kind of like getting good
with the international community and the international community. I think
the idea at the time was, you know, we probably
can't actually eradicate smallpox. There have been some efforts to
eradicate other diseases that had kind of fallen flat on
their face. People weren't super optimistic this was going to work,
but they were sort of humoring the Soviets because they
were happy that they were back. And so while this

(30:28):
proposal was accepted, not a lot of momentum happened. Not
a lot of people were dedicated to the project. There
wasn't a lot of money dedicated, but it was clear
that the Soviets were on board. So around the mid
nineteen sixties, USAID, which I'll note we tanked, got doged. Yes, right,
so USAID got doged. Doesn't exist anymore, which I think

(30:52):
is devastating. But anyway, so they teamed up with the
Center for Disease Control, or the CDC in the US,
and they started trying to eliminate smallpox and measles from
twenty countries in West Africa. So they were starting to
get the ball rolling and momentum is starting to build,
and the World Health Organization, with the US's input, passes

(31:12):
this proposal that Okay, we're going to take eradicating smallpox seriously.
And there was a bit of contention here, so there
was enough members of the community thinking that this was
actually impossible that when it kind of got pushed by
the US DA, Henderson got put in charge almost as punishment.
So the guy in charge of the World Health Organization

(31:32):
thought this was going to fail, and because the Americans
had pushed it, he wanted an American leading it so
that when it failed, the blame would fall on the Americans.

Speaker 2 (31:42):
Wow, the politics, the politicist. So but tell us who
is Dea Henderson. Now he's appeared in our story. But
what's he been doing this whole time?

Speaker 1 (31:50):
Yeah, so he's been studying public health. He was working
at the CDC on that project where they were trying
to eradicate smallpox and measles. And it turns out he's
it's just really great at organizing stuff. He's a really
great administrator, and he is really good at like cutting
through the bullsh and just getting stuff done. And he

(32:13):
sort of gets a really good reputation for being a
person who makes things happen.

Speaker 2 (32:17):
And it's fascinating that this is basically the obstacle, right, Like,
at this point, we have the technology, We even have
the engineering to manufacture these things so they're simple and
cheap and robust. He's just a question of like getting
all these things to all the arms in the world. Right,
it's really just a paperwork and organization.

Speaker 1 (32:34):
Yeah, it's paperwork and organization, but it's also like the
cleverness to think through the right system. So initially the
thought was, you know what if we can vaccinate eighty
percent of the people in the countries where you're still
getting smallpox, right, we'll get what's called herd immunity. And
the idea is that there's enough people who are resistant
to the disease that it will run out of people

(32:56):
can infect and it'll fizzle out. But it turned out
eighty percent just wasn't high enough. There were still there
were enough people being born, especially in places like India,
where population density is really high, that this herd immunity
at eighty percent wasn't doing the.

Speaker 2 (33:09):
Trick walking me through the thinking here. So even if
you have twenty percent of the population that still is
susceptible to smallpox, they're like surrounded by a buffer of
people who are immune, and so the disease just like
fizzles out because it can't jump into another host. How
do you calculate that eighty percent number? Doesn't it depend
on like density and interactions and all sorts of stuff.

Speaker 1 (33:29):
Everything you said is correct. Oh yeah, they started off
thinking eighty percent was going to be enough, and then
when they actually started observing things out there, they would
hit eighty percent, and the disease still had plenty of
people to infect, plenty of new babies being born, and
it could still it's so contagious that that twenty percent
that were left, ye, were enough to keep that disease going.

Speaker 2 (33:51):
Because if I had to calculate this, like eighty percent
seems like, I don't know, it's a reasonable figure, But
if I had to estimate it, I would have guessed
like ninety nine points something. Yeah, because as it is
an infectious disease, right, and it came from one origin, right,
so in principle, one person with it still out there
could infect new.

Speaker 1 (34:07):
People absolutely, and so that ended up being the reality
on the ground was that eighty percent was not enough,
and there was some discussion about, well, maybe if we
kick it up to ninety percent, and so, you know,
part of it I think is well, what number do
we think mathematically will work, and then another part of
it is well, what realistically could we accomplish. And another
problem they were experiencing was like, so you know, the

(34:28):
Soviets were donating a lot of vaccine, but a lot
of the vaccine they were donating was low quality and
wasn't working, and so that was also causing them some problems.
And what they ended up deciding was that, like, look
for this disease in particular, hitting some percentage is not
going to work. So what they did was they vaccinate
as many people as they could, and then they would
do contact tracing, so essentially they would wait to hear

(34:51):
if someone got infected, and when they got the message
that there was an infected person in some city, some village,
some herding community, they would go out there. They would
lock down that person, they would figure out everybody that
person had interacted with, and then who those people.

Speaker 2 (35:08):
They would kill them and they would kill them.

Speaker 1 (35:10):
No, and no, they.

Speaker 2 (35:12):
Would send them to a farm where they can run
and jump all day long.

Speaker 1 (35:15):
No, no, it was much nicer than they would offer
them free vaccines.

Speaker 2 (35:20):
Oh okay, yes, but they've already been infected, right.

Speaker 1 (35:22):
Well maybe yes, maybe no. And so you know, just
because you have encountered somebody doesn't necessarily mean you got infected.
And then also to try to make sure, like if
those people did get infected, you want to make sure
that they don't pass it to other people. And so
you not only vaccinate the first group of people who
you think contacted the initial infected person you know of,
you also vaccinate all of the contacts of those people.

(35:46):
And in this way you make the most use of
your vaccine, and you like take the oxygen out of
the fire that could have started there.

Speaker 2 (35:54):
So you're pouring water on all the embers just to
make sure they don't spread uncontrolled.

Speaker 1 (35:58):
Yes, exactly. And one of the things that we lucked
out with is you know, like with a disease like syphilis,
there's also a sort of moral judgment that gets passed
on the person who gets infected smallpox didn't have that
kind of moral judgment, and so people were more likely
to come forward if they had a case, they would
be less likely to hide it. And in some cases
and in some countries, to try to really encourage people

(36:20):
to come forward or to encourage people to rat out
other people, we would offer monetary rewards.

Speaker 2 (36:26):
Listen to you using the word rat in a negative way.
Oh maybe, I mean language, This is where it comes from, Kelly.
You're propagating anti rat bigotry.

Speaker 1 (36:35):
Thank you so much for pointing that out. I will
work on doing a better job.

Speaker 2 (36:39):
You need to be in a rat ally.

Speaker 1 (36:40):
I mean really, I think of myself as a rat
ally as long as they're not in my chicken coop.
I didn't like them there anyway.

Speaker 2 (36:49):
But this is a good point where we need to
know where the outbreaks are and we can only know
that if people report. So it's important that people are
not embarrassed.

Speaker 1 (36:56):
Yeah, yeah, that's right. It's important that people aren't embarrassed.
And the other thing that I think what's important to
learn here is they learned over the course of the
work that they were doing, and they adjusted the way
that they were working. You know, so when you're doing science,
so often you start off with one plan and then
when the rubber hits the road, you need to be like,
this isn't working. What can we do that's better? And

(37:18):
so they adjusted and man, this is an amazing story
of people adjusting to so many different conditions.

Speaker 2 (37:25):
For example.

Speaker 1 (37:26):
For example, so when the World Health Organization decided that
they were going to really try to eradicate this disease,
it was still pretty common in about thirty one different
countries and there were a lot of complicated things happening
in those countries. So, for example, they had wiped out
smallpox in Bangladesh and then partition happened and the war
broke out between Pakistan and Bangladesh. And when that happened,

(37:48):
Bangladeshis crossed the border into India en mass where they
picked up smallpox again refugee camps, yes, And then India
went in and kicked out the Pakistanis and the Bangladeshis
went back home and they brought smallpox with them.

Speaker 2 (38:05):
Oh boy.

Speaker 1 (38:05):
So the World Health Organization was in there and they
were trying to keep people from getting smallpox and trying
to contain it as it moved back into a country,
but there were a number of different cases where civil
wars or wars of one sort or another would break out,
and there were people who were trying to eradicate smallpox
who would sort of die through this process. But they were,
you know, doing the best they could to figure out,

(38:25):
like how do you vaccinate people when you have all
of these refugees moving from one place to another, and
how do you track things? But amazingly they did it.
And then there were a couple cases where, you know,
we talked about how there's not really a stigma around smallpox,
there was a stigma around being a nation that still
had smallpox in an era where it was being eradicated.

(38:46):
So there was a setback. In nineteen seventy one, Iran
got a case of smallpox, but they didn't want anybody
to know because they wanted to commemorate the two thy,
five hundredth anniversary of the Persian Empire. So the Iranian
government wanted to have this big celebration. But you don't
want people from all over the world descending on your
country if you have smallpox. Yeah, and so they were

(39:09):
trying to eradicate it with a mass vaccine campaign sort
of kept on the down low, but their stocks were
of poor quality and it wasn't working. So the World
Health Organization eventually got involved. They brought their better freeze
dried vaccine and they managed to wipe it out. But
there were all of these cases of like things came up,
and you know, I can just imagine that if I

(39:29):
was at the World Health Organization at smallpox broke out,
and it was because some countries rulers were like trying
to make sure I didn't find out about it. Man,
at some point you got to be like, how are
we ever going to do this? Like this is never
going to happen. I quit, amazing, But Dea Henderson never quit.
He just kept going and it's amazing.

Speaker 2 (39:47):
And what was he like as a bureaucrat? Was he
like a rule follower? Was he like a tyrant?

Speaker 1 (39:53):
He was not a rule follower. If you read the
book that he wrote about eradicating smallpox, it is mostly
a story about how he was told to do one
thing and he did another.

Speaker 2 (40:04):
And that's how you get stuff done, folks.

Speaker 1 (40:06):
Well that's how he got this done. And you know,
each different nations would have different bureaucracies that you had
to understand or route around. So, for example, there were
instances where he had to send mail through an intermediary
and he wouldn't get a response back on a timescale
that was useful for trying to attack an outbreak. And
so even though he was supposed to send the mail

(40:27):
through an intermediary, he started sending the mail to the
intermediary at the same time as he sent it directly
to the other person. And he knew he wasn't supposed
to do that, but there were all sorts of cases
where he was like, look, if I don't break this rule,
we are not eradicating small box. So I'm doing it.
And so yeah, he was he was a bit of
a character.

Speaker 2 (40:48):
Well, sometimes you got to break a few constitutional eggs
to make me Onlet right, and so let's take a break,
and when we come back, we'll hear about the last
gasps of smallpox, eradicating it finally and string humans from
that suffering. All right, we're back, and we're hearing about

(41:23):
the story of smallpox, humanity's victory over the microbe. So
we're near the end of this. Tell us what were
the last battles in eradicating smallpox?

Speaker 1 (41:33):
So towards the end India still had about sixty percent
of the remaining cases. There's a lot of people in India.
That density and the fact that this country is huge
made it really hard to eradicate. And as we mentioned,
there was that conflict happening with Pakistan and Bangladesh. There
were people crossing borders. It was getting really hard to
get this stuff under control. Additionally, there was an issue

(41:54):
because there was a small community who had a religious
leader that was refusing the vaccine and was refusing the
vaccine for the rest of the community as well. So
we talked earlier about like, you know, what, what do
you do in this case? Like so, at this point,
almost all the countries in the world had smallpox eliminated.
They were closing in on being able to eradicate this

(42:15):
disease which has killed millions of people millions of people
in our history for thousands of years yea for thousands
of years. And so the question is do you respect
this religious leader's desire to not get the vaccine when
it has been documented that smallpox cases are popping up
in this community and are then spreading to surrounding regions.
And so this is not something that will burn out

(42:37):
on its own this has been causing problems that are spreading.
And what they end up deciding they need to do
is they essentially pin the religious leader down and vaccinate
him wow, against his will. And once he's vaccinated, he
says something to the effect of, all right, well I
guess that was God's will. Everybody else should ge vaccinated
to that's a good handle, yeah, I guess, and so

(43:02):
but yeah, so there were some very difficult ethical questions.
I think in general, what they would try to do
is they would in every country where they started a
program for eradication, they would try to find local medical
people and get them on board and have talked to
them about how the vaccine worked and help them talk
to the community so that people could have their questions answered.

(43:23):
And this could be done in the most like ethical,
not like pushy way possible. But at the end there,
I don't think there were a lot of cases where
people were pinned down and vaccinated, but at the end
there they were like, look, we are closing all the loops.

Speaker 2 (43:37):
Yeah. Well, it's a fascinating question and a real puzzle
for policymakers, right how to deal with these things and
their arguments for it on both sides. Right, it's clearly
a balance between like public good and individual freedom. Yeah right,
It's not clear where to draw that line, and it's
different in every case. And I'm a philosopher or an ethicist.
You know, imagine somebody is like walking around shooting guns

(43:59):
out them directions in public areas. You'd be like, yeah,
that's not allowed. That's clearly over the line. You could
make the argument that, you know, walking around spreading a
disease is similar to that, And so I'm not making
that argument. I don't want to be authoritarian about lockdowns whatever.
I know this is a really touchy subject. Yeah, I
just want to highlight that there's never an easy answer
here for public health officials.

Speaker 1 (44:19):
You know, so many times during COVID I would hear
people complaining about how things were being managed, and my
response every time was, I am so glad I'm not
in charge right now. Like me too, I would hate
to make these decisions because you know, lives are on
the line. Every decision that you make has a downside
no matter what you do, and even if you do nothing,

(44:40):
then you're sort of still on the hook for a
bunch of deaths.

Speaker 2 (44:43):
And the scientific understanding is evolving, right, Like, we don't
understand how is this spread, what works, what doesn't work.
And as we were saying earlier, you need clear policies, right,
you can't always convey like, hey, everybody, go read these papers.
Let's discuss. You know, somebody's going to make a decision
like do we close schools or not. Yeah, those are
hard decisions to make, and science informs them. But in
the end it's a political decision. Right, how do you

(45:05):
balance this versus that this risk versus that risk. Science
doesn't make the decisions, it just informs them. And sometimes
science is wrong, right, It's never fully settled and it's
always in flux. So yeah, wow, it's hard to be
a public health official.

Speaker 1 (45:19):
Oh my gosh. Yeah, so hard and so important that
we are spending this time when there isn't a major
pandemic killing a bunch of people, that we try to
spend that time helping the public to understand science and
trying to build trust. Yeah, that we then get to
benefit from, you know, when something like that happens. But anyway,
so tell us.

Speaker 2 (45:39):
About the victory. Right, So people worked in India. They
pinned down this religious leader to stamp out those last
embers was that the end of smallpox.

Speaker 1 (45:46):
I believe the last case in nineteen seventy five was
a homeless person on a railway platform that they found
and they treated and quarantined and it didn't get passed.
And then Ethiopia was the last country to have smallpox.
That a little complicated because there were a lot of
nomadic herders, so it was hard to get in touch with,
you know, each herd to make sure there hadn't been

(46:07):
any cases of smallpox. So we had a period where
no smallpox cases were reported. We thought we had eradicated it.
We waited for an additional two years where people were
hired to like go around the world looking for cases
and like go into communities trying to find it. And
after two years of looking hard for smallpox and not
finding it, we declared in nineteen eighty that smallpox had

(46:31):
been eradicated. Amazing, yay. But this wouldn't be an episode
run by Kelly if there wasn't something scary at the end.
So one of the difficult things about smallpox is that
it looks like chicken pox and monkey pox, and so
when you're trying to figure out if you've eradicated it
or not. If a pox case pops up, you want

(46:54):
to send a sample of that virus to a lab
to confirm, Hey, this is definitely chicken pox, for example,
smallpox popping back up again. And so during this eradication procedure,
it was regularly the case that samples of the pox
were sent to labs in the Soviet Union and the
United States, and they split the case load because it

(47:15):
was a lot of work verifying you know, what virus
was which. But at the end of this process, a
lab in the United States and a lab in the
Soviet Union had lots of different virus samples in their freezers.

Speaker 2 (47:29):
Oh I see.

Speaker 1 (47:30):
So at the end of this process, the virus had
been eradicated in the wild and had been eradicated in
human bodies, but it was still existing in labs.

Speaker 2 (47:40):
And Kelly at three in the morning as a new mom,
where you worried about this escaping from labs and affecting
your children.

Speaker 1 (47:46):
Not initially, but as I said, in twenty fourteen, they
found some smallpox vials that were in a lab in
the US that were just in some stinking closet where
somebody had forgotten them there. And at this point we
probably don't have immunity anymore, none of us, and so
if it got out, it could spread quickly, and it
does get out of labs sometimes it does.

Speaker 2 (48:08):
Are there documented cases of that?

Speaker 1 (48:10):
Yeah, So in nineteen seventy eight there was a woman
who was working in a lab above a UK lab
that studied smallpox, and smallpox must have gotten into the
ventilation system and ended up in her lab and she
got smallpox and died, And so we know that sometimes
it does get out. And I think after that the

(48:30):
UK was like, you know what, we'll just destroy all
of our stores. But the scientific community has decided to
not get rid of all of our samples. And there's
a complicated reason why. So in nineteen seventy two, a
bunch of countries agreed, look, we're not going to try
to make biological weapons anymore. And so nations were supposed
to stop doing that kind of research, but the Soviet

(48:53):
Union kept doing it, and in particular, they kept doing
research on how you could weaponize smallpox. And there's some
reason to believe that they thought the US was doing
it too, and so they had to do it to
keep up. But the US wasn't doing it or at
least if the US was doing it, that has not
become public. And so the Soviet Union continued to do it.
And so around the time when there was discussions about like, okay,

(49:16):
all the labs that still have smallpox, we should destroy it,
this news came out that the Soviet Union had been
using it for biological weapons. And now the US didn't
want to eradicate THEIRS, because what if a biological weapon
made from smallpox does get released? If you have smallpox
in your lab, then you've got a starting point for

(49:36):
doing research to figure out how you can, you know,
maybe make more vaccines or how you can address this.
And so it ended up being determined that the US
didn't want to eradicate theirs, and then the Soviet Union
didn't want to eradicate THEIRS. And then when the Soviet
Union fell apart, scientists who had access to the vaccines
ended up all over the place, and there was some

(49:58):
concern that, you know, a lot of the scientists during
the fall of the Soviet Union didn't have enough money
to feed their families. So are they selling it to
you know, nations that might like to have smallpox to
make their own biological weapons. And so it is still
the case that we have these samples in our freezers
and hopefully they never get out a lot of I mean,

(50:19):
they're under many layers of security, but they're kept for
a variety of reasons. The bio warfare stuff we talked about. Also,
you know, maybe if monkey pocks jumps to humans in
a way where it's even more transmissible than it has
been in the past, maybe understanding smallpox could help us
with that. And so there's a bunch of different science
related reasons that we've come up with. But the point
is smallpox still exists on this planet, and that keeps

(50:42):
Kelly up at night.

Speaker 2 (50:46):
So why don't we just keep vaccinating people? Like, yeah,
we eradicated it, but it sure would be nice to
be immune. What's the cost of vaccination?

Speaker 1 (50:53):
Yeah, so difficult is with vaccination is another reason why
some people argue that we need to keep smallpox around.
So the current vaccine that we have using that cowpox
is dangerous for people who are immunocompromised. So, for example,
people with HIV AIDS could die if they got this vaccine.
And so there are folks who argue, like, look, we

(51:14):
need to keep smallpox around because we might be able
to as you mentioned earlier in the show, maybe we
could genetically modify smallpox so that we could create a
vaccine that makes people immune to smallpox without killing people
who are immunocompromised. And so, because we don't have a
perfect vaccine, maybe you want to keep smallpox around in

(51:35):
case you need to do more vaccine research in the future.
To more clearly address your question, you asked, why don't
we just vaccinate everybody? So one you'd have to always
vaccinate everybody for a disease that isn't in circulation right now.
That would be incredibly expensive. And this vaccine is not
without risks, And so if you vaccinated everybody, there would
be a subset of the population who would die from

(51:56):
this vaccine every year, which seems unnecessary at a time
when this disease is not spreading in the United States
or in the world.

Speaker 2 (52:04):
Yeah, yeah, so there really are risks there, and you
don't just want to vaccinate people, yeah.

Speaker 1 (52:09):
Just for the heck of it. Although, man, in twenty fourteen,
if you had told me I could vaccinate my daughter
for smallpox, I might have. I might have gone for
it because I was a little crazy in the middle
of the night. I was talking to a friend who's
in the military, and I think he said that he
did get vaccinated for smallpox. And so I think there
are some people working in some government job where if

(52:30):
you are not immunal compromised, you might still get the
vaccine on the off chance that you would be the
kind of person who would encounter a bio weapon on
the front line. But this conversation I had was like
over a decade ago, So maybe we don't do that anymore.

Speaker 2 (52:42):
All right, Well, it's amazing what humanity can do when
they come together and get organized and decide that we
all have the same goal and we're going to make
the sacrifices and used the resources necessary to achieve that goal.
It's incredible.

Speaker 1 (52:55):
It is incredible. And so you know, when I was
rereading da Henderson's book, and I also reread School by
Jonathan Tucker, And while I was rereading these stories.

Speaker 2 (53:03):
I love your pronunciation of that word scurge.

Speaker 1 (53:06):
How do you say it?

Speaker 2 (53:07):
Scourge?

Speaker 1 (53:08):
Scourge? Oh? No, is it like three up prions where
I'm saying it wrong?

Speaker 2 (53:13):
No one of us is all right.

Speaker 1 (53:15):
Well, okay, sounds good. But so, while I was reading
those stories, you know, I was, I was getting pretty depressed.
So I was uplifted by the fact that our species
came together and cooperated across nations to eradicate this disease
that had killed millions of us for thousands of years.
But on the other hand, us AID is not around anymore,

(53:35):
and the World Health Organization the United States has pulled
out of that. And I don't want to pretend that
the World Health Organization is without problems, because da Henderson
complains about the bureaucracy and that organization over and over
and over again. But he was still able to coordinate
this effort that brought all the nations of the world
together and brought all of our resources together, and the

(53:58):
strength of this organization and with this particular person in charge,
was able to eradicate this disease. And you know, I'm
worried that we, you know, instead of fixing institutions that
have problems in the United States, we're just pulling out
of them. And I worry that the next time we
need to coordinate, we are going to be in a
less good position to do that. And so anyway, I was,

(54:19):
on the one hand, very proud of our species for
eradicating smallpox and a bit scared for our ability to
do something like that again in the future.

Speaker 2 (54:27):
Well, as scientists, the best we can do is to
help people understand how this works, what's going on, what
do we know, what do we not know, what are
the risks, what are the benefits? And we hope that
that helps people be informed when they make their decisions,
policy makers and individuals.

Speaker 1 (54:42):
Yep, yep. But to end on a high note, you know,
I do think it's worth sitting and thinking how lucky
we are that most of us don't have to worry
about tuberculosis or smallpox. We can be vaccinated for measles
and for polio. There's so many things that would have
occupied so much time and worry for parents or you know, anyone,
for people living in the past that you know, we

(55:04):
we can forget about today. So many people have never
thought about smallpox more than five seconds. And what a
blessing isn't the word I'm looking for. What's the word
I'm looking for? What a luxury that is?

Speaker 2 (55:15):
What a what a mitzvah that is?

Speaker 1 (55:19):
What a mitzvah that is? And so anyway, we are
very lucky to live in the time we live in.

Speaker 2 (55:24):
Yeah. And also it's a testament to what humans can accomplish. Right.
We have changed the nature of life on Earth. We've
removed a big source of suffering and misery. Yeah, and
that tells me that we can do more, We can
improve lives. Science really does help us improve the quality
of our life.

Speaker 1 (55:40):
Yay science, Yay science. Let's end on that.

Speaker 2 (55:43):
So thank you Toda Anderson for coordinating that massive international
project to improve all of our lives, and thank you
all for joining us on this historical tour of a
human victory.

Speaker 1 (55:59):
Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio. We
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