November 17, 2021 • 19 mins
A woman in Argentina known as the “Esperanza patient” has become only the second documented person whose own immune system possibly cured her of HIV. She is what’s known as a so-called elite controller of HIV. This happens in an estimated 1 in 200 people and their immune systems are able to suppress the virus from replicating to very low levels without using antiretroviral treatments. While still unknown how this occurs, it does provide hope for the 38 million people living with the virus. Benjamin Ryan, contributor to NBCNews.com, joins us for what to know about the “Esperanza patient.”
Next, where have all the public bathrooms gone? Going through the pandemic and seeing the closures of bars, restaurants and other public spaces, it laid bare how very few places there are for a person to relieve themselves. It was a trend that was definitely happening before the pandemic with many places being closed or just neglected which also gave public restrooms bad reputations. According to a “Public Toilet Index,” the U.S. only has eight toilets per 100,000 people overall. Elizabeth Yuko, contributor to Bloomberg CityLab, joins us for what to know about the lack of public bathrooms.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
It's Wednesday, November. I'm Oscar Ramiors in Los Angeles and
this is the daily dive. A woman in Argentina, known
as the Esperanza patient, has become only the second documented
person whose own immune system cured her of HIV. She
is what's known as a soul called elite controller of HIV.
(00:22):
This happens in an estimated one and two people and
their immune systems are able to suppress the virus from
replicating to very low levels without using anti retroviral treatment.
While still unknown how this occurs, it does provide hope
for the thirty eight million people living with the virus.
Benjamin Ryan, contributor to NBC news dot Com, joins us
(00:43):
for what to know about the Esperanza patient. Next, we'll
have all the public bathrooms gone. Going through the pandemic
and seeing the closures of bars, restaurants in other public spaces,
it laid bare how very few places there are for
a person to relieve themselves. It was a trend that
was definitely happening before the pandemic would many places being
closed or just neglected, which also gave public restrooms bad reputations.
(01:05):
According to a public toilet index, the US only has
eight toilets for one thousand people overall. Elizabeth Yuko, contributor
to Bloomberg City Lab, joins us for what to know
about the lack of public bathrooms. It's news without the noise.
Let's dive in so effectively. They found that her immune system,
through some means that they don't know exactly, had basically
(01:29):
killed off any last virus that could have repopulated the
virus within her body. Joining us now is Benjamin Ryan,
contributor to NBC news dot com. Thanks for joining us, Benjamin,
thanks for having me. Let's talk about an interesting story,
the Esperanza patient. This is a woman who lives in
Argentina who has become only the second documented person whose
(01:50):
own immune system may have cured her of HIV. There's
been a couple of other swirling cases, two that involves
stem cells another person who you know their own uh
immune systems saved them as well. But this is the
latest one that we're learning about. So Benjamin start us off.
Tell us about the Esperanza patient and what's going on
with her. This is a woman, as he said, she's
(02:13):
about thirties years old and she lives in Argentina. She
has a daughter that she had last year, and she's
pregnant with a second child now. Her first child was
born HIV negative. She was diagnosed in two thousand thirteen,
and there was some irregularities in the way that her
HIV test came back, So it just seems that she
wasn't developing antibodies to all the different components of the virus,
(02:33):
the different viral antigens, So that was sort of a
red flag to practitioners in Argentina. And gradually she got
connected with a researcher down there who got connected with
another one who's a specialist in this type of research
at the Reagun Institute in Boston, which is affiliated with
Harvard and m I T. And these researchers used very
sophisticated technology to come over one billion of hersels and
(02:56):
then included five hundred million cells from a placenta after
she gave birth. In fact, that was a kind of
an amazing turn of events that she had given birth
and so they were able to get a bunch of
her own tissue and they were unable to find what's
called any replication competent virus, and what that means is
that any virus that was lies into the DNA of
the cells that would be able to produce viable new
(03:19):
copies of HIV. So effectively, they found that her immune system,
through some means that they don't know exactly, had basically
killed off any last virus that could have repopulated the
virus within her body. One of the things about the
Esperanza patient, and you know she's going she wants some
anonimity with all of this, right, that's why they're calling
(03:41):
her that. But there's these group of people that are
so called elite controllers of HIV and estimated one people.
And this is kind of where some of this hope
lies in, right to figure out how these people are
able to suppress the virus, right. And I don't want
to say people should have hoped that for HAPs they're
one in ten million people or one in twenty million
(04:02):
people whose body just happens to be able to do
this magnificent sheet of beating HIV on its own. But
where the hope is is the notion that researchers can
try to figure out what happened in some way harnessed it,
are replicated through some sort of therapeutic means. And as
you said, so the Esperants a patient as well as
another woman by the name of Lauren Willenberg who's the
(04:23):
sixty seven year old list in San Francisco. They both
are members of the class of elite controllers. And these
are people whose immune systems, through some means that they
don't quite very well understand just yet, are able to
control viral replication without the need for antiterator viral treatment.
It's possible they have some sort of very aggressive killer
T cell response to HIV infection that just isn't something
(04:45):
that we see in other people. So this is something
that researchers have been setting for many years to try
to better understand. And so Lauren Willenberg and the esperants
A patient in both cases it seems that their T
cell response was so strong that it was able, as
they said, to basically kill off any replication competent virus
that's hidden in these cells. I mentioned that there were
(05:06):
a couple of other cases of men who research said
they were able to stop the HIV in them as well.
That was kind of a different case than when we
heard about them already. There was an American and then
one from London, but they had cancer, very specific cancer.
They received stem cell transplants, and that's kind of how
they got over. But those are some other interesting aspects
(05:28):
to it too, because it's not they can't. They were
able to functionally cure them, but they say that's not
really a cure for the most amount of people. They
had an extradulating case with cancer. The stem cell transplant
is pretty strenuous on the person, and that's not really
a course of treatment for a lot of people. What
happened in those cases it was two men, as you said,
each had cancer. They had a kind of blood cancer,
(05:50):
lymphoma or leukemia in each case, which was treatable through
a stem cell transplant. What happens that a stem cell transplant,
It's essentially you're given somebody else's commune system. First, they
have to ablaze or kill off your own immune system,
which is a very devastating toxic process, and then they
give you someone else's stem cells, which repopulate your body,
hopefully with immune cells from the other person. Now, there's
(06:11):
a small percentage of people from European descent who have
a natural immunity to HIV. Their immune cells lack what's
called a certain coreceptor, onto which HIV detaches in order
to begin the process of affecting a cell. So if
your immune system lacks these coreceptors, HIV basically can't get
in the door. It sort of lacks the knob to
(06:32):
turn the door to get into those cells. And that's
what happened in these cases with these two men. The
first case was written up in the New England Durnal
Medicine in two thousand nine the guy named Timothy ray Brown,
and the second case was announced in two thousand nineteen. Again,
as you said, a man in London, and I just
spoke with a researcher of that case study in the
past few days and he was able to tell me
(06:53):
that whereas before he thought the man was probably cured
of HIV, in this case, now he thinks he was
almost definitely cured. And the reason why they have to
be very cautious, it's because you just never know after
a certain amount of time if HIV might come rowing back.
And the reason that is when HIV infects a person,
it establishes what they call the viral reservoir. Now they're
all the sort of active immune cells, little effect that
(07:14):
are going around and doing active things. And then there
are what are called long live them cells, or long
live memory cells, and those are cells that are not
replicating new copies of the virus, but yet are still infected.
And because they're not actually working through the machinery of
making new virus, the antiretroviral therapy can't see the virus
in those cells and can't go after them because it
(07:36):
only works with the virus is being replicated, and so
that's why it can hide for long periods of time
in these reservoir cells. And then if you were to
go off your at to richer virals after a time,
they would sort of come back to life and start
repopulating the body with new virus. And that's why it's
so difficult to get a handle on HIV. You can
sit dorian for so long and be suppressed well enough,
(07:56):
and then pop back up and you you you're another
article talking about kind of the road ahead for an
HIV curev cure research. They call it cure research, but
people are very hesitant to use that word because of
what you just spoke to. It can pop up. So
tell me a little bit more broadly about some of
these other ways of trying to cure HIV. There's multiple
(08:18):
fronts that they're doing. You know, there's gene therapy, something
called kick and kill, something called block and Block, and
then other vaccines that their hope that can work on this. Right,
So there's so much that's going on the genetic field
these days, with Christopher cast nine in particular, which is
essentially kind of scissors that can sniff and edit in
different gene sequences. So you know, ideally you'd have some
(08:40):
sort of therapy that you could inject into somebody and
it would go in and would find all the HIV
in the cells and sniff it out. That's a lot
of user said than done, of course, So essentially they're
trying to find ways that are less toxic and more
scalable of recapitulating what we've seen in the American man
and the London patient as he's called. But you know
that would not require an actual stem cell transfer. It
(09:00):
and key therapy and that kind of thing, which you
know would not be ethical to give to people if
they were already facing a fatal blood cancer. So that's
one avenue, and so kick and kill is essentially trying
to use some sort of agents that would wake up
all of those resting cells that aren't replicating new copies
of virus so that then some other therapy that's the
kick part and some other therapy with the kill part
(09:21):
would come in and build the cells that are infected.
There's been a lot of failures in that realm of
research over the years. It's been pretty discouraging. A similar,
somewhat opposite way of doing it would be blocked and
Loft was essentially trying to figure out where those cells
are that are harboring Latin copies of the virus and
then just keeps them from ever waking up again. And
so in a way that seems to be what some
(09:43):
lead controllers have done. What they found in research is
that it seems that their immune system has preferentially killed
off cells in which the virus is capal of replicating,
and what's left over is virus that send spliced into
the cellulo DNA and kind of a remote dead zone
that's too far away from the levers that start up
replication to be able to have any potential effect on
(10:05):
the body and to be able to a few out
new copies of the virus. And then again there's other
ways of sort of hopefully prompting the immune system to
kind of do a better job going after the virus.
That would be something along wise of a therapeutic vaccine.
People often look at HIV cure as a binary factor,
either you're or not. I like to give people more
hope to say that, Like, we're talking about decades of research.
(10:26):
Potentially here before there's some scalable cure if you will
ever be developed. But in the meantime, what can happen
to the researchers find more and more ways to make
living with HIV even more innocuous. Indirectrical viorrol therapy is
very effective. It can mean you can lead practically a
normal lifespan. But even then you have HIV that is
well treated by antiretrovirals, they're still at higher risk of
(10:48):
a lot of negative health outcome, they think because of
the chronic inflammatory state to which HIV gives rise. So
if you can find ways of shrinking the viral reservoir
and of tamping down that kind of information that you
get even when you are well treated with h IVY,
that's the kind of stuff that hopefully HIV research will
discover along the way and so essentially make HIV a
more and more innocuous state. Benjamin Ryan contributor to NBC
(11:11):
news dot Com. Thank you very much for joining us.
Thank the lout take care. Much after prohibition and after
a lot of these public restrooms or comfort stations were built,
they realized, oh, everybody's using them, which is what we wanted.
(11:35):
But also what we want more is nicer things for ourselves.
Joining us now is Elizabeth Yuko, contributor to Bloomberg City Lab.
Thanks for joining us, Elizabeth, Thanks for having me. I
wanted to talk about public bathrooms. We've seen them, their
presence really decline in the United States. I mean, I'd
be hard pressed to even name one off the top
(11:57):
of my head and say, oh, there's one right here.
Kind of thing. One of the things that happened throughout
the pandemic as restaurants and bars and even retail spots
closed down, everybody kind of noticed there was far less
opportunities and places to go. And it's, you know, really
kind of a problem throughout the country right that. We
see the effects of it. You know, we're homeless, people
(12:18):
urinate on the street, things like that. You know, people
have difficulties. We heard stories about Uber and Amazon drivers
having to go in bottles because there was nowhere to
go throughout the pandemic. It's an issue that the country
has this lack of public bathrooms. So Elizabeth, you looked
into it, tell us a little bit more about what
we're seeing. I mean, as you mentioned, there has been
a noticeable lack of public restrooms for years now, but
(12:40):
the pandemic really put a spotlight on that in terms
of human and dignity, and you know, having unhoused individuals
having to go and buckets with kitty litter, or as
you mentioned, the drivers having to urinate and bottles, and
I think there was this notion that because everyone was
at home, or a lot of people were at home
(13:00):
during the pandemic, that the existence of public restrooms didn't
really matter. But what that's not accounting for, aside from
essential workers and frontline workers and everybody else who is
keeping us moving during the time, it didn't account for
the fact that a lot of what we considered to
be public restrooms are actually located, as you mentioned, in
(13:22):
private commercial establishments, so bars, hotels, department stores, restaurants that
type of thaying, coffee shops as a huge one, fast
food restaurants, so places that people normally count on to
use the restroom were not available. And one time in
particular that this was very evident was summer when there
(13:44):
were the widespread protests against the murder of George Floyd
and thousands of people were flooding into major cities and
had nowhere to go to the restroom. So you had
public irination complaints up in major cities. You had businesses
were closed but posted on social media, Hey if you
need a restroom, were open. Just the public service. Plus
(14:07):
you know the fact that we've been told to wash
our hands, I mean our entire lives. But that was such,
especially at the beginning, such a major component of COVID prevention,
that when you're out and about and realize you don't
have the opportunities to wash your hands with open water,
you notice that they're missing. Definitely, Yeah, it's a public
health issue at that point. There's an interesting thing. There's
(14:30):
a thing called the public toilet Index, and in auguste
we got some numbers. So in the United States we
only have eight toilets for one thousand people overall. And uh,
the article you mentioned, it's tied with Botswana. Iceland leads
these rankings with fifty six for one thousand residents. So
very very few numbers for the amount of people that
(14:51):
we have in the States, and so the question is
how did we end up with so few opportunities and
locations to go? And you did kind of a dive
into the history of how things started, and you mentioned that,
you know, the department stores and how there was a
very few true public restrooms throughout the country. Yeah. Absolutely,
And it was interesting but also disheartening to see the
(15:13):
parallels between what was going on a hundred plus years
ago and the conversations were still having and challenges were
still having today. And one of them, yeah, as you mentioned,
was the shift from thinking that the government should be
responsible for probviding facilities like public restrooms to more of
(15:34):
a consumer model of privacy, which is a term that
Peter Baldwin, an historian at the University of Connecticut, coined.
And Yeah, in that case, there were the wealthier upper
class women who initially had campaigned for public restrooms and
either were part of the progressive movement in general or
(15:56):
part of the temperance movement, and they saw public restrooms
as a way to decrease alcohol usage and men, particularly
because if a man was in public and yeah, exactly,
and he needed to use the restroom, it was the
bar or the alley, and when he was in the bar, mus,
we'll go to shot in a beer. So that was
(16:18):
kind of part of their campaign. But after Prohibition and
after a lot of these public restrooms or comfort stations
were built, they realized, oh, everybody's using them, which is
what we wanted. But also what we want more is
nicer things for ourselves. So that's when hotels and theaters
(16:41):
and department stores became known restroom locations. And even though
they were technically open to the public, there were ways
around that policy, like the bargain basements and department stores.
So the hope in that case was that the less
(17:01):
wealthy customers would go straight to the bargain basement and
use the toilet down there and shop their deals and
not disturb the wealthier customers upstairs. So that was kind
of the beginning of the end of public restrooms. It
wasn't that linear, because there were spikes in the construction
of public restrooms during the nineteen thirties during the New
(17:24):
Deal projects like the Works Progress Administration in the c
c C. And those were primarily public toilets built in
rural areas or parks, and then in the nineteen fifties,
once the highway system started getting going and created, there
were the highway rest stops. But that really was one
(17:45):
of the last major implementations of public restrooms, And so
since then you've seen a lot of closing and not
really any opening. Where are we now because you didn't
mention a couple of examples, I think the Portland's lou
was one of them. And there are some cities that
are adding these types of facilities in their localities there, Yes, definitely.
(18:10):
I spoke with Stephen Soifer from the American Restroom Association
as I was writing this article and kind of asked
him what are your top picks for cities that are
are making progress in this area? And Portland was far
and away the how did the pack for this? Yes,
they have the portlandou which they designed specifically for Portland,
(18:33):
but is being used in cities across the country like Denver,
San Antonio, Texas, Cincinnati, Ohio, and probably in other places.
Seemed to come and these are self contained kind of
toilet pods that are designed so they're difficult to vandalize
(18:53):
and easy to clean. And yeah, so those or versions
of those might be the wave of public restumes of
the future, because you know, instead of building an entire
dedicated structure like a comfort station, you just have this
pre prefab toilet that you you know, stick there and
(19:14):
people can use. Elizabeth Yuko, contributor to Bloomberg City Lab.
Thank you very much for joining us. You're welcome. Thank you.
That's it for today. Join us on social media at
Daily Deve pod, on book, Twitter, and Instagram. Leave us
(19:35):
a comment, give us a rating, and tell us the
stories that you're interested in. Follow us on I Heart Radio,
or subscribe wherever you get your podcast. This episode of
The Daily Divers produced by Victor Wright and engineered by
Tony Sorrentino. I'm Oscar Ramirez and this was your Daily
Die
It's Wednesday, November. I'm Oscar Ramiors in Los Angeles and
this is the daily dive. A woman in Argentina, known
as the Esperanza patient, has become only the second documented
person whose own immune system cured her of HIV. She
is what's known as a soul called elite controller of HIV.
(00:22):
This happens in an estimated one and two people and
their immune systems are able to suppress the virus from
replicating to very low levels without using anti retroviral treatment.
While still unknown how this occurs, it does provide hope
for the thirty eight million people living with the virus.
Benjamin Ryan, contributor to NBC news dot Com, joins us
(00:43):
for what to know about the Esperanza patient. Next, we'll
have all the public bathrooms gone. Going through the pandemic
and seeing the closures of bars, restaurants in other public spaces,
it laid bare how very few places there are for
a person to relieve themselves. It was a trend that
was definitely happening before the pandemic would many places being
closed or just neglected, which also gave public restrooms bad reputations.
(01:05):
According to a public toilet index, the US only has
eight toilets for one thousand people overall. Elizabeth Yuko, contributor
to Bloomberg City Lab, joins us for what to know
about the lack of public bathrooms. It's news without the noise.
Let's dive in so effectively. They found that her immune system,
through some means that they don't know exactly, had basically
(01:29):
killed off any last virus that could have repopulated the
virus within her body. Joining us now is Benjamin Ryan,
contributor to NBC news dot com. Thanks for joining us, Benjamin,
thanks for having me. Let's talk about an interesting story,
the Esperanza patient. This is a woman who lives in
Argentina who has become only the second documented person whose
(01:50):
own immune system may have cured her of HIV. There's
been a couple of other swirling cases, two that involves
stem cells another person who you know their own uh
immune systems saved them as well. But this is the
latest one that we're learning about. So Benjamin start us off.
Tell us about the Esperanza patient and what's going on
with her. This is a woman, as he said, she's
(02:13):
about thirties years old and she lives in Argentina. She
has a daughter that she had last year, and she's
pregnant with a second child now. Her first child was
born HIV negative. She was diagnosed in two thousand thirteen,
and there was some irregularities in the way that her
HIV test came back, So it just seems that she
wasn't developing antibodies to all the different components of the virus,
(02:33):
the different viral antigens, So that was sort of a
red flag to practitioners in Argentina. And gradually she got
connected with a researcher down there who got connected with
another one who's a specialist in this type of research
at the Reagun Institute in Boston, which is affiliated with
Harvard and m I T. And these researchers used very
sophisticated technology to come over one billion of hersels and
(02:56):
then included five hundred million cells from a placenta after
she gave birth. In fact, that was a kind of
an amazing turn of events that she had given birth
and so they were able to get a bunch of
her own tissue and they were unable to find what's
called any replication competent virus, and what that means is
that any virus that was lies into the DNA of
the cells that would be able to produce viable new
(03:19):
copies of HIV. So effectively, they found that her immune system,
through some means that they don't know exactly, had basically
killed off any last virus that could have repopulated the
virus within her body. One of the things about the
Esperanza patient, and you know she's going she wants some
anonimity with all of this, right, that's why they're calling
(03:41):
her that. But there's these group of people that are
so called elite controllers of HIV and estimated one people.
And this is kind of where some of this hope
lies in, right to figure out how these people are
able to suppress the virus, right. And I don't want
to say people should have hoped that for HAPs they're
one in ten million people or one in twenty million
(04:02):
people whose body just happens to be able to do
this magnificent sheet of beating HIV on its own. But
where the hope is is the notion that researchers can
try to figure out what happened in some way harnessed it,
are replicated through some sort of therapeutic means. And as
you said, so the Esperants a patient as well as
another woman by the name of Lauren Willenberg who's the
(04:23):
sixty seven year old list in San Francisco. They both
are members of the class of elite controllers. And these
are people whose immune systems, through some means that they
don't quite very well understand just yet, are able to
control viral replication without the need for antiterator viral treatment.
It's possible they have some sort of very aggressive killer
T cell response to HIV infection that just isn't something
(04:45):
that we see in other people. So this is something
that researchers have been setting for many years to try
to better understand. And so Lauren Willenberg and the esperants
A patient in both cases it seems that their T
cell response was so strong that it was able, as
they said, to basically kill off any replication competent virus
that's hidden in these cells. I mentioned that there were
(05:06):
a couple of other cases of men who research said
they were able to stop the HIV in them as well.
That was kind of a different case than when we
heard about them already. There was an American and then
one from London, but they had cancer, very specific cancer.
They received stem cell transplants, and that's kind of how
they got over. But those are some other interesting aspects
(05:28):
to it too, because it's not they can't. They were
able to functionally cure them, but they say that's not
really a cure for the most amount of people. They
had an extradulating case with cancer. The stem cell transplant
is pretty strenuous on the person, and that's not really
a course of treatment for a lot of people. What
happened in those cases it was two men, as you said,
each had cancer. They had a kind of blood cancer,
(05:50):
lymphoma or leukemia in each case, which was treatable through
a stem cell transplant. What happens that a stem cell transplant,
It's essentially you're given somebody else's commune system. First, they
have to ablaze or kill off your own immune system,
which is a very devastating toxic process, and then they
give you someone else's stem cells, which repopulate your body,
hopefully with immune cells from the other person. Now, there's
(06:11):
a small percentage of people from European descent who have
a natural immunity to HIV. Their immune cells lack what's
called a certain coreceptor, onto which HIV detaches in order
to begin the process of affecting a cell. So if
your immune system lacks these coreceptors, HIV basically can't get
in the door. It sort of lacks the knob to
(06:32):
turn the door to get into those cells. And that's
what happened in these cases with these two men. The
first case was written up in the New England Durnal
Medicine in two thousand nine the guy named Timothy ray Brown,
and the second case was announced in two thousand nineteen. Again,
as you said, a man in London, and I just
spoke with a researcher of that case study in the
past few days and he was able to tell me
(06:53):
that whereas before he thought the man was probably cured
of HIV, in this case, now he thinks he was
almost definitely cured. And the reason why they have to
be very cautious, it's because you just never know after
a certain amount of time if HIV might come rowing back.
And the reason that is when HIV infects a person,
it establishes what they call the viral reservoir. Now they're
all the sort of active immune cells, little effect that
(07:14):
are going around and doing active things. And then there
are what are called long live them cells, or long
live memory cells, and those are cells that are not
replicating new copies of the virus, but yet are still infected.
And because they're not actually working through the machinery of
making new virus, the antiretroviral therapy can't see the virus
in those cells and can't go after them because it
(07:36):
only works with the virus is being replicated, and so
that's why it can hide for long periods of time
in these reservoir cells. And then if you were to
go off your at to richer virals after a time,
they would sort of come back to life and start
repopulating the body with new virus. And that's why it's
so difficult to get a handle on HIV. You can
sit dorian for so long and be suppressed well enough,
(07:56):
and then pop back up and you you you're another
article talking about kind of the road ahead for an
HIV curev cure research. They call it cure research, but
people are very hesitant to use that word because of
what you just spoke to. It can pop up. So
tell me a little bit more broadly about some of
these other ways of trying to cure HIV. There's multiple
(08:18):
fronts that they're doing. You know, there's gene therapy, something
called kick and kill, something called block and Block, and
then other vaccines that their hope that can work on this. Right,
So there's so much that's going on the genetic field
these days, with Christopher cast nine in particular, which is
essentially kind of scissors that can sniff and edit in
different gene sequences. So you know, ideally you'd have some
(08:40):
sort of therapy that you could inject into somebody and
it would go in and would find all the HIV
in the cells and sniff it out. That's a lot
of user said than done, of course, So essentially they're
trying to find ways that are less toxic and more
scalable of recapitulating what we've seen in the American man
and the London patient as he's called. But you know
that would not require an actual stem cell transfer. It
(09:00):
and key therapy and that kind of thing, which you
know would not be ethical to give to people if
they were already facing a fatal blood cancer. So that's
one avenue, and so kick and kill is essentially trying
to use some sort of agents that would wake up
all of those resting cells that aren't replicating new copies
of virus so that then some other therapy that's the
kick part and some other therapy with the kill part
(09:21):
would come in and build the cells that are infected.
There's been a lot of failures in that realm of
research over the years. It's been pretty discouraging. A similar,
somewhat opposite way of doing it would be blocked and
Loft was essentially trying to figure out where those cells
are that are harboring Latin copies of the virus and
then just keeps them from ever waking up again. And
so in a way that seems to be what some
(09:43):
lead controllers have done. What they found in research is
that it seems that their immune system has preferentially killed
off cells in which the virus is capal of replicating,
and what's left over is virus that send spliced into
the cellulo DNA and kind of a remote dead zone
that's too far away from the levers that start up
replication to be able to have any potential effect on
(10:05):
the body and to be able to a few out
new copies of the virus. And then again there's other
ways of sort of hopefully prompting the immune system to
kind of do a better job going after the virus.
That would be something along wise of a therapeutic vaccine.
People often look at HIV cure as a binary factor,
either you're or not. I like to give people more
hope to say that, Like, we're talking about decades of research.
(10:26):
Potentially here before there's some scalable cure if you will
ever be developed. But in the meantime, what can happen
to the researchers find more and more ways to make
living with HIV even more innocuous. Indirectrical viorrol therapy is
very effective. It can mean you can lead practically a
normal lifespan. But even then you have HIV that is
well treated by antiretrovirals, they're still at higher risk of
(10:48):
a lot of negative health outcome, they think because of
the chronic inflammatory state to which HIV gives rise. So
if you can find ways of shrinking the viral reservoir
and of tamping down that kind of information that you
get even when you are well treated with h IVY,
that's the kind of stuff that hopefully HIV research will
discover along the way and so essentially make HIV a
more and more innocuous state. Benjamin Ryan contributor to NBC
(11:11):
news dot Com. Thank you very much for joining us.
Thank the lout take care. Much after prohibition and after
a lot of these public restrooms or comfort stations were built,
they realized, oh, everybody's using them, which is what we wanted.
(11:35):
But also what we want more is nicer things for ourselves.
Joining us now is Elizabeth Yuko, contributor to Bloomberg City Lab.
Thanks for joining us, Elizabeth, Thanks for having me. I
wanted to talk about public bathrooms. We've seen them, their
presence really decline in the United States. I mean, I'd
be hard pressed to even name one off the top
(11:57):
of my head and say, oh, there's one right here.
Kind of thing. One of the things that happened throughout
the pandemic as restaurants and bars and even retail spots
closed down, everybody kind of noticed there was far less
opportunities and places to go. And it's, you know, really
kind of a problem throughout the country right that. We
see the effects of it. You know, we're homeless, people
(12:18):
urinate on the street, things like that. You know, people
have difficulties. We heard stories about Uber and Amazon drivers
having to go in bottles because there was nowhere to
go throughout the pandemic. It's an issue that the country
has this lack of public bathrooms. So Elizabeth, you looked
into it, tell us a little bit more about what
we're seeing. I mean, as you mentioned, there has been
a noticeable lack of public restrooms for years now, but
(12:40):
the pandemic really put a spotlight on that in terms
of human and dignity, and you know, having unhoused individuals
having to go and buckets with kitty litter, or as
you mentioned, the drivers having to urinate and bottles, and
I think there was this notion that because everyone was
at home, or a lot of people were at home
(13:00):
during the pandemic, that the existence of public restrooms didn't
really matter. But what that's not accounting for, aside from
essential workers and frontline workers and everybody else who is
keeping us moving during the time, it didn't account for
the fact that a lot of what we considered to
be public restrooms are actually located, as you mentioned, in
(13:22):
private commercial establishments, so bars, hotels, department stores, restaurants that
type of thaying, coffee shops as a huge one, fast
food restaurants, so places that people normally count on to
use the restroom were not available. And one time in
particular that this was very evident was summer when there
(13:44):
were the widespread protests against the murder of George Floyd
and thousands of people were flooding into major cities and
had nowhere to go to the restroom. So you had
public irination complaints up in major cities. You had businesses
were closed but posted on social media, Hey if you
need a restroom, were open. Just the public service. Plus
(14:07):
you know the fact that we've been told to wash
our hands, I mean our entire lives. But that was such,
especially at the beginning, such a major component of COVID prevention,
that when you're out and about and realize you don't
have the opportunities to wash your hands with open water,
you notice that they're missing. Definitely, Yeah, it's a public
health issue at that point. There's an interesting thing. There's
(14:30):
a thing called the public toilet Index, and in auguste
we got some numbers. So in the United States we
only have eight toilets for one thousand people overall. And uh,
the article you mentioned, it's tied with Botswana. Iceland leads
these rankings with fifty six for one thousand residents. So
very very few numbers for the amount of people that
(14:51):
we have in the States, and so the question is
how did we end up with so few opportunities and
locations to go? And you did kind of a dive
into the history of how things started, and you mentioned that,
you know, the department stores and how there was a
very few true public restrooms throughout the country. Yeah. Absolutely,
And it was interesting but also disheartening to see the
(15:13):
parallels between what was going on a hundred plus years
ago and the conversations were still having and challenges were
still having today. And one of them, yeah, as you mentioned,
was the shift from thinking that the government should be
responsible for probviding facilities like public restrooms to more of
(15:34):
a consumer model of privacy, which is a term that
Peter Baldwin, an historian at the University of Connecticut, coined.
And Yeah, in that case, there were the wealthier upper
class women who initially had campaigned for public restrooms and
either were part of the progressive movement in general or
(15:56):
part of the temperance movement, and they saw public restrooms
as a way to decrease alcohol usage and men, particularly
because if a man was in public and yeah, exactly,
and he needed to use the restroom, it was the
bar or the alley, and when he was in the bar, mus,
we'll go to shot in a beer. So that was
(16:18):
kind of part of their campaign. But after Prohibition and
after a lot of these public restrooms or comfort stations
were built, they realized, oh, everybody's using them, which is
what we wanted. But also what we want more is
nicer things for ourselves. So that's when hotels and theaters
(16:41):
and department stores became known restroom locations. And even though
they were technically open to the public, there were ways
around that policy, like the bargain basements and department stores.
So the hope in that case was that the less
(17:01):
wealthy customers would go straight to the bargain basement and
use the toilet down there and shop their deals and
not disturb the wealthier customers upstairs. So that was kind
of the beginning of the end of public restrooms. It
wasn't that linear, because there were spikes in the construction
of public restrooms during the nineteen thirties during the New
(17:24):
Deal projects like the Works Progress Administration in the c
c C. And those were primarily public toilets built in
rural areas or parks, and then in the nineteen fifties,
once the highway system started getting going and created, there
were the highway rest stops. But that really was one
(17:45):
of the last major implementations of public restrooms, And so
since then you've seen a lot of closing and not
really any opening. Where are we now because you didn't
mention a couple of examples, I think the Portland's lou
was one of them. And there are some cities that
are adding these types of facilities in their localities there, Yes, definitely.
(18:10):
I spoke with Stephen Soifer from the American Restroom Association
as I was writing this article and kind of asked
him what are your top picks for cities that are
are making progress in this area? And Portland was far
and away the how did the pack for this? Yes,
they have the portlandou which they designed specifically for Portland,
(18:33):
but is being used in cities across the country like Denver,
San Antonio, Texas, Cincinnati, Ohio, and probably in other places.
Seemed to come and these are self contained kind of
toilet pods that are designed so they're difficult to vandalize
(18:53):
and easy to clean. And yeah, so those or versions
of those might be the wave of public restumes of
the future, because you know, instead of building an entire
dedicated structure like a comfort station, you just have this
pre prefab toilet that you you know, stick there and
(19:14):
people can use. Elizabeth Yuko, contributor to Bloomberg City Lab.
Thank you very much for joining us. You're welcome. Thank you.
That's it for today. Join us on social media at
Daily Deve pod, on book, Twitter, and Instagram. Leave us
(19:35):
a comment, give us a rating, and tell us the
stories that you're interested in. Follow us on I Heart Radio,
or subscribe wherever you get your podcast. This episode of
The Daily Divers produced by Victor Wright and engineered by
Tony Sorrentino. I'm Oscar Ramirez and this was your Daily
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