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March 10, 2020 27 mins

How does the coronavirus affect travel? We're still in the early days of the COVID-19 epidemic, and many of us are asking ourselves the same questions: Is it safe to travel now? Will it be safe in the future? Am I staying home forever? These are issues best answered with rational thought and critical analysis, not fear and panic. So we turned to Dr. Jennifer Haythe of Columbia University Medical Center for expert advice. In this episode, she explains how viruses travel and offers tips for staying safe and healthy — right now and always — when traveling. Find links to the resources mentioned in this episode, along with Dr. Jenn’s go-to, must-have travel kit, in the show notes at

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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:07):
I think you're getting a lot of hysterical, panicked people,
and it's it's inappropriate to believe anything you read on
the internet. I think that if this had unfolded in
a different way in the media, people might not feel
so panicked. Right now, Welcome to A Way to Go,
a production of I Heart Radio and Fathom. I'm jeral
and Gerba and I'm Pavio Rosatti. We're recording this podcast

in early March, when the new outbreak of coronavirus, the
COVID nineteen variation, is wreaking havoc and spreading quickly. According
to the World Health Organization yesterday, more than cases have
been recorded, resulting in more than three thousand deaths, twelve
of those in the United States, though frankly, these statistics
will probably be outdated by the time we finished recording
this episode. Sixty seven countries have been hit. The disease

is still in its early days, we're already seeing massive
impact worldwide. Stock markets are reeling. Global supply chains have
been disrupted. Businesses are telling employees to work from home.
The week's long carnival festival in Venice was canceled last month.
The Louver Museum is closed as our schools throughout Italy temporarily.
These are precautionary measures and they're prudent, but they're also alarming.

Travelers are afraid and they're canceling trips. The consequences will
be severe. The European Commissioner for Internal Markets estimates the
financial toll in the tourism industry in Europe alone will
amount to one point one billion per month. And people,
regular people, smart people, confuse people are panic buying supplies,
canned goods, hand sanitizers, face masks, toilet paper. Garlyn and

I spend our days on the front lines of the
travel industry, of leisure travel, which, let's be clear, is
the very definition of non essential travel. And for weeks
we've been having the same conversation with everyone. Our friends,
are concierge, clients, are colleagues, even among ourselves. Is it
safe to travel? Will it be safe to travel in
the future? Will I be staying home forever? It's an
important question best answered with rational thought and critical analysis,

not fearmongering and panic, which is a lot of what's
been going on now. This can be challenging given the
fact that things are changing super fast and that many
of those so called objective sources are given conflicting guidance.
No wonder we're confused. No wonder we're stocking up on
toilet paper and chickpeas. It feels like a way to
exercise control in a world that feels very much out

of control. We decided it was time to look for
calm answers from an expert. Our guest today is Dr
Jennifer Hayth, a cardiologist at Columbia University Medical Center. Dr
jenn lives in New York City with her family and
is an avid traveler, both within the Northeast and recently
to Africa with the women's health organization Every Mother Counts.
She spends a significant amount of time working in the
cardiac I see you with critically ill patients and is

familiar with the care of people with critical illness and
infectious disease. Thank you so much for being here, Thank
you for having me, Dr jen Let's start at the beginning.
Coronavirus isn't new. We've been living with variations on this
for years. We've known them as SARS, mrs H one
N one, swine flute. They're all coronaviruses, Is that right?
So coronaviruses are a family of viruses, and Stars and

mers were both coronaviruses. We also have a number of
coronaviruses that affect people day to day. I mean we
test for coronavirus on our respiratory panel all the time.
It's just can cause a regular common flu H one
and one was part of the swine flu or influenza family,
which is a different family of viruses. So what's different
about this one? COVID nineteen. So COVID nineteen is different

in that it seems to cause more severe illness in
a certain group of patients. So for the flu, for instance,
can cause severe illness in many people, but you know,
overall we see mild to moderate illness in regular patients
across the country and throughout the world. People can also
be vaccinated against influenza. Coronavirus or COVID nineteen does not
have a vaccine, and so it seems to be that

it attaches itself to a receptor in the lungs and
can cause more severe respiratory illness, particularly in people over
the age of seventy, people with prior cardiovascular disease. Underlying
pulmonary disease or immunocompromised patients. So we're hearing it's like
epidemic and pandemic. Are we there yet? You know, these
are terms that people are throwing around, and you know,

it's hard to know for sure where we stand. Look,
this is a virus that's clearly very contagious. It seems
to spread quite rapidly, and we're seeing it pop up
now pretty much on every country across the world. So
you know, in my opinion, I would probably call that
a pandemic. I guess the question is will it have
sustained community spread within you know, certain countries. And we're
just at you know, starting to see the beginning of this.

In China, we saw this big upward curve and it's
sort of a peak happening now, where in fact, they're
reporting a decline in cases in China, whereas in this country,
and if you look across the world, the curve is
just starting to take off. So we're really in that
phase where we're going to start to see this sort
of exponential growth period and then it's going to flatten out.
How do viruses travel? So it's a great I mean,

I wish we all knew the perfect answer to this.
You know, all viruses are slightly different. So some viruses
are respiratory pathogens, meaning that they virus particles are found
in the um sputum and in the nasal congestion or
in the respiratory cough you know, air that comes out
of someone's lungs. So in in those instances, if the

if the particles are aerosol ized and you then breathe
in the air of someone who has recently coughed or sneezed,
or you touched the surface within a relatively short period
of time of someone who's coughed or sneezed on that surface,
you could get it. There are some viruses that are
passed through the g I track, so we'll you know,
we see a lot of viruses where people get diarrhea
and vomiting. You know, those viruses are passed more through

fecal oral transmission. So if you're taking care of someone
who's been vomiting or had diarrhea, you could then ingest
through your mouth or through your nose into your oral
cavity and the virus can then enter your body that way.
So for instance, ebola was a virus that you know
was really transmitted more through the g I track, people
had to really be involved in the care of those
patients intimately in order to contract the virus, whereas you know,

Ours and Mirrors was more of a respiratory pathway, and
this coronavirus appears to be predominantly through a respiratory pathway.
We've all seen the pictures. So it starts with one
person and then another person crosses the country, and then
it goes here, and then it goes there. Right, people
are terrified to fly. This is going to sound stupid,
but is it because air is everywhere and we don't
really see the things floating around us, that makes it

so much more communicable. Yeah, I mean, I think it's
it's really clear to us that viruses are communicated when
people are close together. Obviously, if you cough, you know,
on the street and nobody's around, it's unlikely that those
particles are going to infect anyone, especially you know, someone
walks by a few moments later, those particles have gone
and dissipated into the air. So it's not like all
the air is infected with virus particles. But if you

you know, if you're in a school, if you're congregating
for a conference, if you're sitting in a movie theater,
if you're in an area with a lot of people,
at a certain percentage of those people have the virus
coughing and sneezing, you can then inhale the particles yourself.
So what you really need to have is some degree
of close contact in the viruses. We've seen it in COVID.
You know, it seems to be that that's how it's spread,
which is why you know, influenza is so much more

common during the school year. People you know, are I mean,
obviously there's some thought that it becomes less stable as
it gets warmer, but for the most part, you know,
when we see people in large groups together, summer camps,
places like that, where there's an outbreak, it's because people
are in closed quarters. Is that why traveling poses a
little bit of a risk, Because people are in a
metal tube together breathing the same air for six hours,

eight hours, fourteen hours at a time. Right, So when
you're traveling, there's a lot of places where you're in
closed quarters with people. So you you know, maybe you
took a bus or a taxi with a taxi driver
going to the airport, that person is transporting a lot
of other people, right, So that's person who's a high
risk person potential for spreading illness. Then you're sitting in
an airport next to a million other people in the

waiting area. All of those people, some of them may
be infected. Then you get on a plane, like you're saying,
and you're in very close quarters with you know, there's
some air recirculation and an airplane, but it's close quarters.
That being said, we're not seeing a outbreak of coronavirus
nineteen or COVID nineteen in flight attendants or pilots. So
you know, you have to keep these things in perspective
that we don't understand exactly how transmission always occurs, but

it seems that the most likely way that this is
being transmitted is, you know what, we just describe people
breathing in particles, touching particles, then touching their mouth or
their eyes, and then passing it onto their loved one,
who then goes to another event, and so and so
on and so on and so on. One of the
misconceptions about travel is that your stand and I didn't
know this until I started doing research for this episode.

We think it's canned air in fact, airplanes are constantly
filtering the air, so the air on the plane is
being filtered and clean continuously and constantly. I was fascinated
to learn that. Yeah, no, that is actually fascinating. And
so while we are concerned about air travel right now,
you know, there haven't been strict restrictions set by the
CDC or the w h O about getting on a plane.

They don't want you to travel to places necessarily that
are you know, restricted travel because of outbreaks, but the
planes themselves haven't been a huge source, whereas, for instance,
a cruise ship where people are in closed quarters a
lot have become a you know, this sort of den
of epidemic. Yet when we were talking about the travel warnings,
the one consist of travel warning is please don't get

on a cruise if you're going to be anywhere in Asia.
And as we're taping this episode, there's a cruise ship
off the coast of San Francisco that is has thousands
of passengers on it and they're helicoptering in tests before
they're going to let the ship doc and let people
go home. But that's a good thing to keep in
mind as well when you're talking about perspective, because cruise
ships are known to be places where this kind of
thing happens. The neurovirus, I mean, effects every This is

one of the reasons I don't really ever want to
get on a cruise ship. Just sounds like a thing
there geral And you're not alone. I think a lot
of people feel that way about cruise ships, especially the
large ones. And you know, you just never know what
you could set. Am I wrong or do a lot

of these diseases start in animals, No, you're not wrong.
I mean there's a lot of thought that bats and
you know, certain animal species. The pangulin has been one
of the animals that's been questioned about whether it was
the source of coronavirus. So, these these viruses exist in
animals and then there's some mutation that happens that allows
the virus to be able to then spread in humans.
So how does it go from bat to human? Well,

it depends. I mean, if you're handling bats, if you're
eating bats, if you are are ingesting animals that are
infected with a virus, or if you're cooking with those products.
That's also can bite you in your sleep, right, isn't that? Yeah?
So bats can you know, bite you, but people can
are eating bats, So anytime that you ingest an animal
that might be infected, it's a potential risk. This was

also seen with you know, mad cow disease, so people
were eating animal products that had been exposed to a
certain protein virus and then contracted it through ingestion of
the of the meat itself. Another thing that's been to
remember about transmission pabia is that we hear these cases
that a breakout in urshell or you know, somewhere in
the United States, and then because the index case presents

of the hospital with illness, they then test all of
the family and contacts around that individual. That doesn't mean
that that individual was necessarily the source of infection. That
individual could have been infected by someone else in their
community and then just presented with more severe disease. So
I think we need to be very careful about assigning
a sense of blame to sick individuals here. First of all,

I think that there's going to be a lot more
sick people. We should take that off off the table
and just remember that that person also became infected somehow
from another person who became infected. So there's no real
person who needs to blame for infecting other people. Yeah,
I'm really glad that you said that, because there's so
much fear and fear based decision making that's happening, and
it can have a devastating effect on on society, on culture. Yeah,

I mean I think it's leading to a lot of
like racism and phobia. Correct Gerlyn at a Chinese restaurant
last night that was empty. Yeah, I mean, that's just
it's ridiculous. There's no you have no bigger chance of
getting coronavirus or COVID nineteen as you're having dim sum correct.
So how scared should we be of COVID nineteen. It's
really an evolving situation. There's different ways to think about it.

I think it's tricky. I am of the belief that
similar to H one on one, which by the way,
infected forty five to sixty million Americans, and there's been
at least twelve thousand, five hundred or so deaths attributed
to age one on one in this country from the
two thousand nine outbreak, and hundreds thousands more across the world,
and that actually influenza virus swine flu affected young people

in a pretty significant way, and there was a particularly
pregnant women. So in this case, we're seeing you know,
older people, affected, people with underlying medical problems and disease
states infectious disease. So on the one hand, it's worrisome,
it's traveling quickly, it seems to be very contagious, and
we worry about those populations in particular being very vulnerable.
On the other hand, I really believe that if we

could test everyone right now and we saw how many
people are actually walking around with this illness or have
a cold and don't realize that that's what they have,
the death rate would be much lower. And I've said
before that I think we should look to South Korea
as an example of what the mortality rate. Maybe they've
done a huge amount of testing, they have drive through
testing at this point, way more testing than we've done,

and their mortality rate is like about at half a percent.
So if you are a young, healthy person with travel
plans and you're taking the precautions, really the thing that
you would be worried about is that you might be quarantined. Yeah,
I mean, look that people have their own levels of
risk mitigation, right what you're comfortable doing, So some people
may always say, I'm never going to a remote location

because I'm too scared that if I hadn't had appendicitis
and I was stuck in the middle of nowhere, I
wouldn't be able to get out. And then there are
people who travel all over the world and don't care
about any of those things, and if something happens to them,
they're fine with it. In this case, it's you know,
in some ways, it's similar, would you go on a
trip if there was a risk of getting the flu
while you were there? I think that you probably would. Um,
But you know, there's so much worry right now that

I think that people are nervous, and I understand that,
and I think you have to decide on your own
what if I got this virus when I was not
at home, how would I feel about having this virus
in a country that wasn't my own country? Do I
think that I would get an appropriate level of health care?
And then, like you just pointed out, Jerelyn, what what
happens if you then do have the virus or the
country you've gone to has a lot of cases crop

up and they want to quarantine you in that country.
So these are things you have to be prepared to
deal with and if that's okay with you, then you
can travel. This is a very personal issue for me
because I've been invited to go to Brazil and then
to South Africa and May, and I really want to
go to both places. I'm still taking a weight and

see attitude because I feel like there's still a little
time before I have to pull the trigger. But I'm
not uh calamitous person. I miss Pollyanna. Everything is always
going to be fine. All the time. You tell me
I'm going to be quarantined, I'm like, oh good, I'll
catch up on my email. But I'm still nervous about this,
and I feel like it's partly because I'm maybe reading

too many new stories, but also partly because it just
feels incredibly unknowable. I can sit here and say I
won't mind being quarantined in Brazil, but I don't really
know what that means. Maybe you don't want to do
something that feels irresponsible or that would be perceived as irresponsible.
I completely agree with you, Pavia. I mean, I think
that you're going to have to take it day by day.
I think it's reasonable to be nervous. I think everybody

feels nervous right now. I think that as more information
comes out to people who test positive who may not
be eighty and above with chronic pulmonary disease or heart disease,
and it's like, Okay, I know a lot of people
who have had this, and they've all kind of just
had the flu. And as the months go on, if
that's how it seems to appear, I think you'll feel
more comfortable. But again it's a personal decision. You have

to be ready to face the consequences. I do think
that waiting is appropriate and being cautious so that you know,
as time goes on, Okay, I'm ready to face this now,
or it seems more likely that I would get quarantined
or not. So you would pause before booking these plane tickets.
I would pause before going to places that don't have
great medical care and medical facilities, so that you're prepared

for when you go there. So Dr Jensen's we can't
have you on speed dial. What are the sources that
you are checking for reliable information that the rest of
us can be following also, So I think it's really
important to look to the CDC, look to your city,
and state health departments, look to the w h O.
I mean, those are the most reliable sources of information
at this point. Outside of that, I think you're getting

a lot of hysterical, panicked people, and it's it's inappropriate
to believe anything you read on the internet. I mean really,
I mean some of the things we've seen on the
internet about what happened in China, and we have no
way of verifying whether that's true or not, and yet
people are were panicked about it. So, you know, I
think that if this had unfolded in a different way
in the media, people might not feel so panicked right now. Um,

I think that that helped propagate a lot of misinformation.
So we need to really, you know, button down, be
very serious us about you know, what we do and
don't know. Go to your health department, ask your pediatrician,
ask your your physician, you know, call the emergency room
if you're concerned and you want to be tested or
you think you might need to be tested, but you know,
don't just search random things on the internet. What are

the things I should be worried about? I mean, what
should I be feeling to know if now is the
time to call my doctor? First of all, if you've
had any travel to an affected area and you develop symptoms,
that would be a red flag. But at this point,
I think we're at the stage where we know that
people are contracting the disease who haven't had any you know,
international travel. If you develop a high fever, a cough, always,
any shortness of breath, you know, if you feel short

of breath or having a medical emergency, you need to
go to the emergency room. But if you have a
fever and aches and pains and you feel pretty much
like you have the flu, but you're worried about it
that you have COVID, call your primary care doctor and
say this is how I'm feeling. What should I do?
What's the next step. They're probably going to tell you
to stay home, take some tile, and I'll drink soup
until you feel better. If your symptoms get worse and
you're really concerned, you can say I'm more concerned. I

think I should be tested. Dr Jennis, do you do
contract the coronavirus? Are you good to go? Or is
it possible that you can get it again? So there

have been some reports that there are patients who have
contracted coronavirus been discharged from the hospital, for instance, in China,
and then tested positive again later. This is not something
that's been well established by the CDC or the w
h OH. We don't really think that this is a
pattern at this time. Again, this is a changing moving target.
We're getting more and more information every day. So I

like to think of it a little bit like genetics. Right, So,
before we knew how to genotype the human body, we
didn't know where any any genes were, what anything was.
And as more people are getting tested and people do
twenty three and me, we're getting all this genetic information.
It's not like that genetic information didn't exist before. It
was there, we just didn't have it. And the same
thing is going to happen with COVID. More information will

come in about the strains and recurrence rates, and it's
just that we need to actually have that body of
information to tap into, and we're not there yet. Let's
talk about the best practices for travelers. What would you
say are the things that we should do to protect
ourselves and protect the people around us. First of all,
you always have I mean, hand washing is crucial. You
have to wash your hands all the time, more times

than you even want to wash your hands. You just
gotta keep washing your hands and using hand sanitizer. It's
clearly instinctive to you, because I in the twenty minutes
that you've been sitting across from us, you reach for
the pure l twice. Yes, exactly. It's funny. I was
thinking they're going to look back on this time and
say that the hospital acquired infections drop dramatically in the
period between you know, February and July of two thousand

twenty because there was so much extra caution around handgen
as well as I have two little kids and my
daughter's in a school with four hundred four year olds.
I mean, just think about how gross that is, and
all of a sudden it's super squeaky clean, and I'm
thinking this is probably how it should be all the time.
I agree with you, I agree with you, And what

now that you're mentioning kids. One thing that is sort
of a gift about this disease is it doesn't seem
to affect children much. It seems to be really sparing kids,
which I think is a big relief for so many people.
But isn't that also because kids are surrounded to your point,
earlier about disease spreads and were in large groups of people.
Kids are constantly coming home from school with running noses.
I mean, kindergarten is a hotbed of Snot right, it's

just so they're immune. Is it that their immune systems
are stronger. So we actually don't have a total understanding
of white kids aren't getting this. I think that the
running assumptions are one that maybe there's something about this
virus that the receptors that are needed for it to
attach and the long haven't been fully formed or developed
yet in children, and other possibilities that children get a

lot of coronavirus is throughout their childhood and youth, they're
exposed constantly to other coronaviruses and so they have some
kind of an immune response prepared for that. Whereas as
you get older and you age and you tend to
get coronavirus is less as a day to day virus
that your immunity wanes and older people are at higher risk. So,
in addition to handwashing, what are just general best practices

for travelers to keep themselves safe and healthy. First and foremost,
you need to make sure that if you're someone who
takes medication. You need to be prepared with at least
sixty days supply, depending on how long you're going to
go away for. So assume that if your trip is
two weeks long, instead of bringing two weeks of medication,
I would bring forty five days or sixty days of medication,
knowing that you may potentially get quarantined. And always take

your medications on your travel on your carry on bag.
You don't want to be, you know, separated from your
medications for any travel purposes COVID regardless, you want to
have your medications with you, so you should never check medication.
The other thing to do is if you're someone again
who has chronic underlying medical conditions, which is you know,
people who are most at risk for contracting this in
a severe way, is to know where the hospitals are

where you're going. You know, what are the best facilities
to go to. Does your doctor know a doctor where
you're going? You know, this could be true in the
United States, and you know overseas travel. You know, people
like to wipe down their seats in their in their plans.
That's fine. I think that's a good idea. I don't
know that that's going to necessarily prevent you from getting it,
but if by all means, you know, wipe your seat down,
try to minimize the alcohol intake. Obviously, don't do drugs

things that could make you more prone or your immune
system more weak. So you know, try not to be
having way too much wine, you know, having too much fun,
staying up, like, get good night's sleep, you know, be
really well rested, typical things we would want to promote
for good immunity. Dr Jen, do you have any good
tips and practices that you follow for just generally staying
healthy when you're traveling? So I definitely do well. First

of all, I do try to get a good night's
sleep when I'm on trips and not stay up really
really late and feel very overtired. Another thing I do
is I always bring sanitizing wipe, So if I'm going
to if we go to a public place or we
go to you know, you know, a museum, I always
wipe my hands before and after. I often even go
when I go to the bathroom in those places, I
always wash my hands and you know, hand sanitize afterwards.

Do you wipe down the tables. Let's say you go
to a museum and you're eating at the cafe, do
you wipe down the table first? If the table looks
dirty to me? I would wipe it down. If it
didn't look dirty or it looked like it had been cleaned,
I would not have normally done that in this era.
I probably would. And are you carrying specific lights al
disinfectants or the cotton nail baby wipe types of things?
Are those good enough? Baby wipes tend to be very

very mild. I would use something that has more of
a like a disinfectant and it or chlorox component to it.
In my travel overseas, I always bring with me some
extra medications. So some of the things that I like
to bring with me are you know, a general antibiotic
that can be used to treat things like a urinary
tract infection or a gastro intestinal infection. I'll usually bring

some flucanosol in case someone develops a fungal infection or
you know, some kind of g I fungal infection. I
will always bring with me tail and all advil um
i'd be profin. I'll often bring eye drops in case
somebody develops, you know, pink eye. And my family, I
have a whole medication prep bag that I take with
me that I have, you know, my doc to prescribe

to me so that I have it ready to go
in case of emergencies. Is this something that we can
do because fluconazol, what was the drug that you mentioned?
I tend to bring separate floxus in fluconazol. So these
are things though that regular travelers need to go to
doctors and they need to get these things beforehand. Exactly
you would have to get your doctor to prescribe it
for you. I mean there are some things that you
can get over the counter. You could certainly get, you know,

ben and drill Thailand, I'll advil, you know, things that
you would need that you don't want to have to
go out and get if you were not feeling great
or you know. Benadryl I think is a great drug. Diphenhydramine,
you know, if you're tolerant of it and you're not allergic.
It's always helpful first of all, for you know, if
you develop a rash, if you're having trouble sleeping, you
can take one at bedtime. It's it's helpful for people
who are having a cough to help suppress the cough

at night. It's really I want to add this to
a show notes just your kit and your whole traveling.
The travel kid is a good one. Another important thing
to bring is some emmodium. If anybody develops diarrhea then
and they have to get on a plane and they
can't not get on a plane, it's good to have
some emmodium. I mean, basically, should create a travel pack
where you're prepared for the basic major things that could
happen to you, and then you know you have it

ready to go in case of an emergency. So, Dr Jen,
the final takeaway for travelers, the takeaway is this is
a serious virus. We don't have enough information to make
very good decisions at this point. I would say a
wait and see attitude as best. You have to remember
risk mitigation, what you're comfortable with, what you're not comfortable with.
It's your decision. Ultimately, nobody can totally assure you that

everything will be fine, but that's true of everything in
this world. Thank you for a clear, concise, rational, non
fearmongering answers. Dr Jen, You're welcome. Thank you so much
for having me. It was really great to have you here.
We'll have links to everything Dr Jen mentioned in the
show notes, But for those of you who are curious now,
you can go to CDC dot gov for current, up

to date information about this virus. Also w h O
dot I n T for the World Health Organization. We'll
also have a link to Dr Jenn's Instagram account at
dr Jen Haith. That's at d r j E n
n h A y t h E and that's our show.
Thanks for listening. If you like what you heard, please subscribe,
and you know, leave us a five star review. Oh

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being a tourist. I'm Jarlyne Gerba and I'm Pavio Rosatti
and We'd like to thank our producer, editor and mixer
Marcy to Pena and our executive producer Christopher Hastiotis. For
more podcasts from I Heart Radio, visit the I Heart
Radio app, Apple Podcasts, or wherever you listen to your

favorite shows. The mat Sch funded to be Bud
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