February 21, 2025 • 18 mins
Colds and respiratory illnesses are to be expected, but are we getting sick more often than we used to? And are there more viruses going around these days? Dr. Keith Armitage, infectious disease specialist at University Hospitals, sheds light on the newest infectious disease data and why some people are more susceptible to getting sick.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
You know what's going to happen.
Every winter season comes this acceptancethat somebody we know
is going to get a coldand somebody we know is going to get
something even worse,some type of respiratory virus.
But you know what?
I've noticed latelythat there's an onset of cold season,
then launching a spread of somethingeven nastier
than a raw nose and hacking cough.
(00:22):
It's really weird and it's confusing,and it has me talking a lot about it
with people I know. For me personally,I lost my voice.
One daughter got a fever, the otherjust coughed nonstop for three weeks.
My husband, who is never spared,did not get sick.
It's really bizarre
and it made me wonder, werewe are sick with something different?
(00:43):
Yeah.
Macie, two months ago
we did a podcast on the immune system,and we talked then about how everyone
in our families were sick.
And unfortunately on my side,not much has improved.
Family’s still sick.
Every friend they know has a kidthat's sick or they're sick.
And so it just seems to comeand go in and out.
And you know what
it got me thinking
is, is what we experiencedover the last few years with the pandemic,
isolation and work from homemade us more susceptible to getting sick?
(01:06):
I'm wondering the exact same thing.
Hi, I'm Macie Jepson.
And, I’m Matt Eaves.And this is the science of health.
A recent Bloomberg analysis found that 44countries and territories
that reported a resurgence in oneor more infectious diseases,
that's at least ten timesworse than pre-COVID baseline.
(01:28):
Here to shed some light onthat is Doctor Keith Armitage,
co-chair of the Department of Medicine,and the Doctor Robert A.
Salata chair in Infectious Diseasesat University Hospitals, Cleveland.
Doctor Armitage, welcome. Hi, guys.
I'm always curiouswhen I talk to physicians
why they get into their specialty.
How did how did you find yourself in aninfectious disease as your area of focus?
(01:49):
I have two answers to that.
You know, when I was in medical schooland especially when I came to UH to train,
there's a lot of really strong role modelsand people I looked up
to were infectious disease doctors,you know,
the kind of seem like medical detectives,you know, Doctor House.
It was interesting, I reflected.
And sometimes my father's a biologistand very much a scientist.
My mother is a historianwho never met someone she didn't like.
(02:11):
And so infectious diseaseskind of is the combination
of human existence, human healthand the natural scientific world.
And the interaction betweenthe natural world and human health,
you know, take a little bitfrom each parent. So.
All right, Doctor Armitage, let's startwith what's going on here at the US.
12 million people with the flu.
17 states are at a high or very highlevels of respiratory illness.
(02:33):
How does this compare to previous years?
And are we sicker now than, say,five years ago or even ten years ago?
So every year in North America,there's a 6
to 8 week period where we seepeak influenza activity.
And we're in that right nowin Northeast Ohio.
Some years are worse than otherssome years the strains the virus
circulate are stronger.
The match between the vaccine inthe circulating viruses isn’t as strong.
(02:56):
There probably is some impactfrom the pandemic, the period of time
when we were socially distancingpeople weren't getting exposed to viruses,
so there's probably some increasedsusceptibility in general.
Another leftover effect from the pandemicis that fewer
people are getting vaccinated.
You know,I mean, the numbers are, I think, 43%.
(03:17):
This is a like I think as of December,
43% of Americans got vaccinated.
Last year, 37% this year.
That has to have an effect, right?It does.
I think it has a modest effecton transmission,
has a huge effecton the vulnerable population and there's
unequivocal data that the vaccine preventshospitalizations and deaths.
(03:41):
There's unequivocal datathat the vaccine prevents time off work.
You know, for people otherwise healthy.
So, doctor, you mentioned earlierthat the pandemic did have some effect
on our immunity just from the timethat we were away from people.
But let's talk about Covid itselfand getting it
and what that did to our bodies.
You know, kind of like pneumonia,then you're more susceptible to pneumonia.
(04:04):
With Covid, are you more susceptibleto respiratory illnesses?
I mean, are we weaker?
Is it leading to more illness?
Yeah, that's a great question.
And there are individuals who we see
who had bad Covid pneumonia,whose lungs were damaged,
and they'll put them at riskfor respiratory
infectious pneumoniafor the rest of their life.
(04:26):
Thankfully, that's not that many people.
So I think the average personwho who got Covid
wasn't sick enough to be in the hospitaldidn't have a severe case,
but there's probably no long term effectthat makes him more susceptible.
The period of time when people were not
getting exposed toviruses did have a big impact.
So every year, influenza circulatesin North America.
(04:48):
Other viruses circulate in North America.
We get exposed to them every year,and through our lifetime
we build up immunityand we're much less likely to get sick.
You know, naturally, that'srelated to year after year of exposure
and reexposureand having our immune system stimulated.
And we had a little gap in that.
One of the most
fascinating sort of pieces of dataabout the pandemic was influenza.
(05:11):
You know, influenza occurs in the winter.
You know, the worldwide pandemic startedsort of January, February, March.
Well, that summer in Australia,they had no influenza
because they were masking and socialdistancing.
Stunning and profound.
And then the same thing happenedin North America.
So there clearly was a period of timewhen we were masking and social distancing
that we weren'tgetting exposed to viruses,
(05:32):
and it probably left usa little more susceptible.
Particularly in kids, I thinkthe first year of kind of normal behavior,
not social distancing,not masking in kids, we saw a lot more RSV
because kids had gone a yearand a half, two years
without being exposedto RSV, for instance.
When do they catch up?
Is it taking longer for themto build up these immunities
(05:53):
but eventually they're going to be justas strong as they would have otherwise?
I don't think the average case of Covidis impacting our immune systems long term.
I think the kids that kind of had
a little, little gap in exposure,they should catch up over time.
One more thing.
These modern teststhat detect the RNA or DNA of viruses,
you know, weren't around 10or 15 years ago in frontline settings.
(06:15):
So some things are increasedbecause we're seeing them.
So we're seeing a lot more RSV in adultsyou know, respiratory and other virus.
But we're probably detecting casesand making a diagnosis
that we weren't years ago.
And that's probably truefor other viruses.
So some of it is modern diagnostictechniques have allowed us to identify
which virus we're getting.
But maybe it feels like a bit morebecause we're saying you had RSV,
(06:36):
you had adenovirus,you had, you know, metapneumovirus virus,
you had parainfluenza because these testsfor them are so common now.
So are we not seeing a big increase inan amount of viruses like you're saying?
Maybe it's more of, well,we're just we're able to detect it more
so than people are associating that with,well, because now we know what it is.
This must be going around more.
I think that's part of it.
I think because it's it's in the news
(06:57):
more you say,oh, we're detecting these viruses.
And before,you know, we were getting colds and flu
and we didn't think about as muchbecause we can't identify what it is.
Some years are are worse for virusA, some years are worse of virus B.
There's a bacteria called mycoplasmapneumonia.
So mycoplasma pneumonia sortof the classic cause of walking pneumonia.
(07:18):
Big surge in cases this year in September,October, November.
Now is pneumonia contagious?
I keep hearing mixed things on this.
The classic cause of pneumonia.
We don't really think of themas contagious.
You know, these are bacteria.
They're in the environment,
although, you know, kids carry itand then give it to their parents
and grandparentsand they end up carrying it.
(07:38):
And then some get pneumonia.
So not contagious.
But there is kind of spreadin populations.
Shifting back to to vaccines and maybe,you know, going off topic a little bit,
I hear people in my inner circle say oftenafter they get a vaccine, they get sick.
And I'm pretty certainthere's some bias going on there.
But in fact, recentlya friend's mother got a shingles vaccine
and then immediatelyafter it got that shingles and Macie,
(08:00):
I think you had even said after a fluvaccine, you know, you'd gotten the flu.
I sure did. Butcan you get sick from getting a vaccine?
So there are some vaccines that we callreactogenic.
Muscle aches and fever for a day.
The shingles vaccine is actually knownto be reactogenic
especially the secondone of the modern shingles vaccine.
A lot of people,you know, have a fever for a day.
(08:22):
There are some vaccinesthat almost never do that.
But, the flu vaccinedoes not give you the flu.
The shinglesvaccine does not give you the shingles.
And if you think about, say,the flu vaccine,
when 60 or 80 millionpeople are getting a flu vaccine,
some of them are going torandomly get sick
the next day,whether they got the vaccine or not.
Vaccines don't give you the infection,but some vaccines,
what we call reactogenic,where people feel sick for a day.
(08:44):
And when you get the vaccine,is that weakening your immune system?
Is that is it opening a window,so to speak?
No. Really the opposite. Vaccinesstimulate your immune system.
In general, vaccinesgive you a stronger immune system.
There's no vaccine that is zero risk.
You look at the net benefit for societyand the vaccine wins.
But there's this,
you know, these rare side effectsthat can occur with some vaccines
(09:05):
related to the immune system.
Another conversation
that always seems to happen, along withI just got the shot, now I'm sick.
Somebody is always sick these daysand everybody talks about it.
Where were you exposed?What do you think it is?
How did you get it?Your symptoms are different than mine?
What do you think that is?
We were all dealing with somethinga little bit different.
Are theremore variants out there right now
(09:25):
or are we just talking about it more?
I think we're talking about it more.
I think we're more focused on it and we're
more focused on getting the diagnosisbecause we have the diagnostic techniques.
There's clearly seasonal variationand annual variation.
And we talked abouthow influenza is stronger
and more widespreadsome years than others.
You know, this fall we had this mycoplasmathat a lot of people experience
(09:45):
that and didn't get diagnosed, you know,and so there's
there's annual variation, butI don't think that we're more susceptible.
Is there a benefit to getting sick fromthe real virus versus getting a vaccine?
You know, in general, natural infectionprobably gives you better
and long lasting infection.
There's some
there's some exceptions where the vaccinemay be better than natural infection
(10:07):
but is risky in some cases.
And so that's why the vaccines aregenerally safer than natural infection.
Well, and also costly.
Like for the flu, you could be out of workfor 4 or 5 days, right?
Again, influenza -Full-blown influenza is high
fever, muscle aches, headacheand a nonproductive cough.
Most adult Americanshave had that at least once in their life.
It is not good.
(10:27):
You feel really sick.
And again,most of us don't, especially when we're,
you know, out of our 20s or 30s,we don't get full blown influenza
because we have some immunity frombeing exposed to flu strains every year.
We hopefully have immunityfrom the vaccines.
But when you get the full blown influenza,it is like getting run over by a truck.
It's bad.
And then those who have never hadit will likely say, you know, I'm
(10:48):
just going to take my chances.
I mean, I don't think this conversationis going to change anybody's
stanceon whether or not to get a vaccination.
Either they're going to do itor they're going to say, I'm
I'm not afraid of the consequences,and I'm going to take my chances.
And I'm wondering, are healthy peopledying of respiratory illness?
You know, with influenza,
the people who die of influenzaand the typical seasonal influenza
(11:12):
are people who have some underlying
frailty, lung disease,heart disease or other chronic conditions.
There's clearly people who do diefrom those illnesses, and there's clear
data that vaccine preventsthat in a big population.
Whether an individual person wouldor wouldn’t
have gotten sick, it's harder to tell.
It was pretty clear with Covid,
you know, we'd see people
who would end up on a ventilator and dyingof Covid, and the data was pretty strong
(11:34):
had they've been vaccinated,they wouldn’t have.
I know it's a controversial topic,but that's that's the truth,
that’sthe science. You know, that’s the fact.
And again,I know there's lots of controversies
around vaccines and that's notwhat we're here to talk about. But
in general, vaccines have a net benefitin terms of preventing fatal illness.
It's really more specific subgroups.
That's why Covid is so unique.
And of course, now there's a there'sa concern about a novel influenza strain.
(11:57):
And if you think back,I think it was 2008, 2009, we had a novel
H1n1 strain, and that's the year we didsee young adults dying of influenza.
We saw young adults in their 30sand 40s on a ventilator from influenza.
And that'sbecause it was such a novel strain.
They didn't have any kindof a library of immune responses.
That's sort of the public health concern.
(12:18):
Covid kind of caught people by surprisein terms of it being Covid,
but there's always been a public healthconcern about a novel virus
that we have no immunity toand that's what happened with Covid.
Absolutely.
I mean, I rememberwhen you were walking us through this
and you said, you have to understandthis is novel.
Yeah.
And I'd never even heard that,to be honest with you.
But I think we're all intimately aware ofof what that means now.
(12:40):
Well there's a lot of focus now
on the flu in chickens and cows,this new strain of avian flu.
And the big worryamong experts in this area in general,
was that there would be a strain of fluthat was both aggressive in human beings
and easily transmissible
from human to human, and that was whatkept people up at night before Covid.
And that still kind of
keeps you up at nightthat we'd have a strain of influenza,
(13:02):
that both can infecthumans make us very sick,
to which we have no immunity,and then is highly transmissible among us.
And so far it hasn't happened.
And what's happening,I think there's been 6
or 7 cases of peoplegetting this, this new avian flu.
There's just no transmissionbetween people to speak of.
So it's currentlynot a public health threat,
but the wrong mutation,the wrong change in the virus and then,
(13:22):
you know...Onepandemic in my career is enough,
you know,hopefully we won’t have another pandemic.
But that does worry people.
Is there an easy way to answerwhy something can pass
from, say, a chicken to a human,but not a human to human?
Or is it getting into the molecular...?
Yeah, that's a great question,and probably something
that I'm not an expert in,but it's very clear that yes, throughout
(13:43):
human history there are influenzastrains in birds and other animals.
So I'm old enough to rememberthe big swine flu epidemic.
And maybe this is in the 1970s.
Gerald Ford was presidentand a soldier at Fort Dix in New Jersey.
I think it's where it is.
Died of what they thought was swine flu.
And there was a sudden concern that thiswas going to spread from human to human.
(14:04):
And it turned out it didn't.
And then that vaccine caused controversyand led to people being vaccine hesitant.
But why these flu strains?
You know, the great fluepidemic of 1918 was a novel strain.
It was highly transmissible.
The genetic components of these viruses,why they do
or don't require the genetic abilityto be so transmissible,
is not an area that I've done a deep divein, except it's the issue.
(14:29):
And I think when people went backand looked at using modern molecular
techniques, modern science of the 1918strain, they did probably identify
some genesthat made it highly transmissible.
What did
we learn from this novel virus, Covid-19?
As a medical community
that you feel is going to betterprepare us for a future pandemic?
(14:50):
We certainly learnedthat if the resources are there,
sort of modern medicine, can producevaccines and medicines at warp speed.
So so we do have these new incredibletechnologies.
These mRNA vaccines in sort of April,
May of 2020,which does seem like a lifetime ago.
(15:11):
They started working on the Covid vaccine.
And I knowI had highly respected colleagues
that said no waythis would be ready in this calendar year.
And it was.
I think we have learnedwe have the the capacity and the science
to produce highly effective vaccinesin a pretty short time period.
And one reasonI think people were a little less worried
about influenza is we have the technologynow to produce influenza vaccines,
(15:34):
and if there's a novel influenza strain,we can make a vaccine quickly.
I am curious to knowwhat does keep you up at night.
You kind of touched on that in general,but what are you worried about right now?
Yeah,I mean, I, a lot of things I worry about,
but in terms of like public health
and pandemics and viruses,another a novel virus that emerged from
(15:58):
maybe the, you know, wild animalsthat passed into human beings.
It's important to continue to investin public health and monitor, you know,
I mean,
I got a text from, a dear, dear friend
today that a nurse in Kampala,Uganda, dated Ebola.
So there's been a little minioutbreak in eastern Africa,
(16:19):
and now it's in the major city of Kampala,which is a big booming
capital city with,you know, a lot of people
that now, you know,so that's something to keep an eye on.
And, you know, we are never goingto not have any of these threats.
The key is to is to pay attentionand use science and expertise to respond.
I think based on what we wentthrough with Ebola a few years ago,
(16:40):
what we went through withSARS-Covid, the new Covid-19.
We should continue to investin public health and, you know, expertise
apolitical.
There's nothingpolitical at all about science,
nothing political at allabout public health.
But monitoring what's going on
so we can respondappropriately is critical.
I feel like we've reacheda place of extremes in our society.
(17:00):
On one side, it's like challengingscience is seen as anti-science.
And then on the other side, people
blindly acceptingor unwilling to accept revised findings.
So as a clinician and a scientist,where do you see or where do you draw
the line between healthy discussionand where it becomes unproductive?
It's kind of a cliche, but the key is whatwe call evidence-based medicine.
You know,scientists are incredibly independent
(17:23):
and critical of each other,looking at data and analyzing papers.
And then what comes outin terms of recommendations usually goes
through a lot of discourseand and discussion.
And it does evolve.
There's nothing in scienceor medicine is infallible.
What is your last wordto people who are listening today?
(17:43):
My last word would be that we'realways going to have seasonal viruses.
Every year is different, you know, payattention to what's going on.
There are some viruses have a treatment.
So influenza, you know,has a medication, it’s pretty effective.
You know, it's not for everybody.
It's not for people who are mildly ill.
Certainly
high risk people should should thinkabout getting a medicine for influenza.
(18:04):
People who are really symptomatic forfor a day or so.
You know, kind of having some knowledge
about when to think, doI need a medicine or not?
You know, thinking when,when to call a doctor, persistent
high grade fever, shortness of breath,you know, chest pain.
Maybe it's just not a simple cold or flu.
Some of my advice.
Doctor Keith Armitage, University
Hospitals Cleveland,thank you for joining us.
(18:25):
Thanks for having me.
Rememberyou can find and subscribe to this podcast
wherever you get your podcastsor go to University
Hospitals or the Science of Health,depending on where you subscribe.
And for more health news, advicefrom our medical experts,
and the Science of Health podcast,go to UHhospitals.org.
You know what's going to happen.
Every winter season comes this acceptancethat somebody we know
is going to get a coldand somebody we know is going to get
something even worse,some type of respiratory virus.
But you know what?
I've noticed latelythat there's an onset of cold season,
then launching a spread of somethingeven nastier
than a raw nose and hacking cough.
(00:22):
It's really weird and it's confusing,and it has me talking a lot about it
with people I know. For me personally,I lost my voice.
One daughter got a fever, the otherjust coughed nonstop for three weeks.
My husband, who is never spared,did not get sick.
It's really bizarre
and it made me wonder, werewe are sick with something different?
(00:43):
Yeah.
Macie, two months ago
we did a podcast on the immune system,and we talked then about how everyone
in our families were sick.
And unfortunately on my side,not much has improved.
Family’s still sick.
Every friend they know has a kidthat's sick or they're sick.
And so it just seems to comeand go in and out.
And you know what
it got me thinking
is, is what we experiencedover the last few years with the pandemic,
isolation and work from homemade us more susceptible to getting sick?
(01:06):
I'm wondering the exact same thing.
Hi, I'm Macie Jepson.
And, I’m Matt Eaves.And this is the science of health.
A recent Bloomberg analysis found that 44countries and territories
that reported a resurgence in oneor more infectious diseases,
that's at least ten timesworse than pre-COVID baseline.
(01:28):
Here to shed some light onthat is Doctor Keith Armitage,
co-chair of the Department of Medicine,and the Doctor Robert A.
Salata chair in Infectious Diseasesat University Hospitals, Cleveland.
Doctor Armitage, welcome. Hi, guys.
I'm always curiouswhen I talk to physicians
why they get into their specialty.
How did how did you find yourself in aninfectious disease as your area of focus?
(01:49):
I have two answers to that.
You know, when I was in medical schooland especially when I came to UH to train,
there's a lot of really strong role modelsand people I looked up
to were infectious disease doctors,you know,
the kind of seem like medical detectives,you know, Doctor House.
It was interesting, I reflected.
And sometimes my father's a biologistand very much a scientist.
My mother is a historianwho never met someone she didn't like.
(02:11):
And so infectious diseaseskind of is the combination
of human existence, human healthand the natural scientific world.
And the interaction betweenthe natural world and human health,
you know, take a little bitfrom each parent. So.
All right, Doctor Armitage, let's startwith what's going on here at the US.
12 million people with the flu.
17 states are at a high or very highlevels of respiratory illness.
(02:33):
How does this compare to previous years?
And are we sicker now than, say,five years ago or even ten years ago?
So every year in North America,there's a 6
to 8 week period where we seepeak influenza activity.
And we're in that right nowin Northeast Ohio.
Some years are worse than otherssome years the strains the virus
circulate are stronger.
The match between the vaccine inthe circulating viruses isn’t as strong.
(02:56):
There probably is some impactfrom the pandemic, the period of time
when we were socially distancingpeople weren't getting exposed to viruses,
so there's probably some increasedsusceptibility in general.
Another leftover effect from the pandemicis that fewer
people are getting vaccinated.
You know,I mean, the numbers are, I think, 43%.
(03:17):
This is a like I think as of December,
43% of Americans got vaccinated.
Last year, 37% this year.
That has to have an effect, right?It does.
I think it has a modest effecton transmission,
has a huge effecton the vulnerable population and there's
unequivocal data that the vaccine preventshospitalizations and deaths.
(03:41):
There's unequivocal datathat the vaccine prevents time off work.
You know, for people otherwise healthy.
So, doctor, you mentioned earlierthat the pandemic did have some effect
on our immunity just from the timethat we were away from people.
But let's talk about Covid itselfand getting it
and what that did to our bodies.
You know, kind of like pneumonia,then you're more susceptible to pneumonia.
(04:04):
With Covid, are you more susceptibleto respiratory illnesses?
I mean, are we weaker?
Is it leading to more illness?
Yeah, that's a great question.
And there are individuals who we see
who had bad Covid pneumonia,whose lungs were damaged,
and they'll put them at riskfor respiratory
infectious pneumoniafor the rest of their life.
(04:26):
Thankfully, that's not that many people.
So I think the average personwho who got Covid
wasn't sick enough to be in the hospitaldidn't have a severe case,
but there's probably no long term effectthat makes him more susceptible.
The period of time when people were not
getting exposed toviruses did have a big impact.
So every year, influenza circulatesin North America.
(04:48):
Other viruses circulate in North America.
We get exposed to them every year,and through our lifetime
we build up immunityand we're much less likely to get sick.
You know, naturally, that'srelated to year after year of exposure
and reexposureand having our immune system stimulated.
And we had a little gap in that.
One of the most
fascinating sort of pieces of dataabout the pandemic was influenza.
(05:11):
You know, influenza occurs in the winter.
You know, the worldwide pandemic startedsort of January, February, March.
Well, that summer in Australia,they had no influenza
because they were masking and socialdistancing.
Stunning and profound.
And then the same thing happenedin North America.
So there clearly was a period of timewhen we were masking and social distancing
that we weren'tgetting exposed to viruses,
(05:32):
and it probably left usa little more susceptible.
Particularly in kids, I thinkthe first year of kind of normal behavior,
not social distancing,not masking in kids, we saw a lot more RSV
because kids had gone a yearand a half, two years
without being exposedto RSV, for instance.
When do they catch up?
Is it taking longer for themto build up these immunities
(05:53):
but eventually they're going to be justas strong as they would have otherwise?
I don't think the average case of Covidis impacting our immune systems long term.
I think the kids that kind of had
a little, little gap in exposure,they should catch up over time.
One more thing.
These modern teststhat detect the RNA or DNA of viruses,
you know, weren't around 10or 15 years ago in frontline settings.
(06:15):
So some things are increasedbecause we're seeing them.
So we're seeing a lot more RSV in adultsyou know, respiratory and other virus.
But we're probably detecting casesand making a diagnosis
that we weren't years ago.
And that's probably truefor other viruses.
So some of it is modern diagnostictechniques have allowed us to identify
which virus we're getting.
But maybe it feels like a bit morebecause we're saying you had RSV,
(06:36):
you had adenovirus,you had, you know, metapneumovirus virus,
you had parainfluenza because these testsfor them are so common now.
So are we not seeing a big increase inan amount of viruses like you're saying?
Maybe it's more of, well,we're just we're able to detect it more
so than people are associating that with,well, because now we know what it is.
This must be going around more.
I think that's part of it.
I think because it's it's in the news
(06:57):
more you say,oh, we're detecting these viruses.
And before,you know, we were getting colds and flu
and we didn't think about as muchbecause we can't identify what it is.
Some years are are worse for virusA, some years are worse of virus B.
There's a bacteria called mycoplasmapneumonia.
So mycoplasma pneumonia sortof the classic cause of walking pneumonia.
(07:18):
Big surge in cases this year in September,October, November.
Now is pneumonia contagious?
I keep hearing mixed things on this.
The classic cause of pneumonia.
We don't really think of themas contagious.
You know, these are bacteria.
They're in the environment,
although, you know, kids carry itand then give it to their parents
and grandparentsand they end up carrying it.
(07:38):
And then some get pneumonia.
So not contagious.
But there is kind of spreadin populations.
Shifting back to to vaccines and maybe,you know, going off topic a little bit,
I hear people in my inner circle say oftenafter they get a vaccine, they get sick.
And I'm pretty certainthere's some bias going on there.
But in fact, recentlya friend's mother got a shingles vaccine
and then immediatelyafter it got that shingles and Macie,
(08:00):
I think you had even said after a fluvaccine, you know, you'd gotten the flu.
I sure did. Butcan you get sick from getting a vaccine?
So there are some vaccines that we callreactogenic.
Muscle aches and fever for a day.
The shingles vaccine is actually knownto be reactogenic
especially the secondone of the modern shingles vaccine.
A lot of people,you know, have a fever for a day.
(08:22):
There are some vaccinesthat almost never do that.
But, the flu vaccinedoes not give you the flu.
The shinglesvaccine does not give you the shingles.
And if you think about, say,the flu vaccine,
when 60 or 80 millionpeople are getting a flu vaccine,
some of them are going torandomly get sick
the next day,whether they got the vaccine or not.
Vaccines don't give you the infection,but some vaccines,
what we call reactogenic,where people feel sick for a day.
(08:44):
And when you get the vaccine,is that weakening your immune system?
Is that is it opening a window,so to speak?
No. Really the opposite. Vaccinesstimulate your immune system.
In general, vaccinesgive you a stronger immune system.
There's no vaccine that is zero risk.
You look at the net benefit for societyand the vaccine wins.
But there's this,
you know, these rare side effectsthat can occur with some vaccines
(09:05):
related to the immune system.
Another conversation
that always seems to happen, along withI just got the shot, now I'm sick.
Somebody is always sick these daysand everybody talks about it.
Where were you exposed?What do you think it is?
How did you get it?Your symptoms are different than mine?
What do you think that is?
We were all dealing with somethinga little bit different.
Are theremore variants out there right now
(09:25):
or are we just talking about it more?
I think we're talking about it more.
I think we're more focused on it and we're
more focused on getting the diagnosisbecause we have the diagnostic techniques.
There's clearly seasonal variationand annual variation.
And we talked abouthow influenza is stronger
and more widespreadsome years than others.
You know, this fall we had this mycoplasmathat a lot of people experience
(09:45):
that and didn't get diagnosed, you know,and so there's
there's annual variation, butI don't think that we're more susceptible.
Is there a benefit to getting sick fromthe real virus versus getting a vaccine?
You know, in general, natural infectionprobably gives you better
and long lasting infection.
There's some
there's some exceptions where the vaccinemay be better than natural infection
(10:07):
but is risky in some cases.
And so that's why the vaccines aregenerally safer than natural infection.
Well, and also costly.
Like for the flu, you could be out of workfor 4 or 5 days, right?
Again, influenza -Full-blown influenza is high
fever, muscle aches, headacheand a nonproductive cough.
Most adult Americanshave had that at least once in their life.
It is not good.
(10:27):
You feel really sick.
And again,most of us don't, especially when we're,
you know, out of our 20s or 30s,we don't get full blown influenza
because we have some immunity frombeing exposed to flu strains every year.
We hopefully have immunityfrom the vaccines.
But when you get the full blown influenza,it is like getting run over by a truck.
It's bad.
And then those who have never hadit will likely say, you know, I'm
(10:48):
just going to take my chances.
I mean, I don't think this conversationis going to change anybody's
stanceon whether or not to get a vaccination.
Either they're going to do itor they're going to say, I'm
I'm not afraid of the consequences,and I'm going to take my chances.
And I'm wondering, are healthy peopledying of respiratory illness?
You know, with influenza,
the people who die of influenzaand the typical seasonal influenza
(11:12):
are people who have some underlying
frailty, lung disease,heart disease or other chronic conditions.
There's clearly people who do diefrom those illnesses, and there's clear
data that vaccine preventsthat in a big population.
Whether an individual person wouldor wouldn’t
have gotten sick, it's harder to tell.
It was pretty clear with Covid,
you know, we'd see people
who would end up on a ventilator and dyingof Covid, and the data was pretty strong
(11:34):
had they've been vaccinated,they wouldn’t have.
I know it's a controversial topic,but that's that's the truth,
that’sthe science. You know, that’s the fact.
And again,I know there's lots of controversies
around vaccines and that's notwhat we're here to talk about. But
in general, vaccines have a net benefitin terms of preventing fatal illness.
It's really more specific subgroups.
That's why Covid is so unique.
And of course, now there's a there'sa concern about a novel influenza strain.
(11:57):
And if you think back,I think it was 2008, 2009, we had a novel
H1n1 strain, and that's the year we didsee young adults dying of influenza.
We saw young adults in their 30sand 40s on a ventilator from influenza.
And that'sbecause it was such a novel strain.
They didn't have any kindof a library of immune responses.
That's sort of the public health concern.
(12:18):
Covid kind of caught people by surprisein terms of it being Covid,
but there's always been a public healthconcern about a novel virus
that we have no immunity toand that's what happened with Covid.
Absolutely.
I mean, I rememberwhen you were walking us through this
and you said, you have to understandthis is novel.
Yeah.
And I'd never even heard that,to be honest with you.
But I think we're all intimately aware ofof what that means now.
(12:40):
Well there's a lot of focus now
on the flu in chickens and cows,this new strain of avian flu.
And the big worryamong experts in this area in general,
was that there would be a strain of fluthat was both aggressive in human beings
and easily transmissible
from human to human, and that was whatkept people up at night before Covid.
And that still kind of
keeps you up at nightthat we'd have a strain of influenza,
(13:02):
that both can infecthumans make us very sick,
to which we have no immunity,and then is highly transmissible among us.
And so far it hasn't happened.
And what's happening,I think there's been 6
or 7 cases of peoplegetting this, this new avian flu.
There's just no transmissionbetween people to speak of.
So it's currentlynot a public health threat,
but the wrong mutation,the wrong change in the virus and then,
(13:22):
you know...Onepandemic in my career is enough,
you know,hopefully we won’t have another pandemic.
But that does worry people.
Is there an easy way to answerwhy something can pass
from, say, a chicken to a human,but not a human to human?
Or is it getting into the molecular...?
Yeah, that's a great question,and probably something
that I'm not an expert in,but it's very clear that yes, throughout
(13:43):
human history there are influenzastrains in birds and other animals.
So I'm old enough to rememberthe big swine flu epidemic.
And maybe this is in the 1970s.
Gerald Ford was presidentand a soldier at Fort Dix in New Jersey.
I think it's where it is.
Died of what they thought was swine flu.
And there was a sudden concern that thiswas going to spread from human to human.
(14:04):
And it turned out it didn't.
And then that vaccine caused controversyand led to people being vaccine hesitant.
But why these flu strains?
You know, the great fluepidemic of 1918 was a novel strain.
It was highly transmissible.
The genetic components of these viruses,why they do
or don't require the genetic abilityto be so transmissible,
is not an area that I've done a deep divein, except it's the issue.
(14:29):
And I think when people went backand looked at using modern molecular
techniques, modern science of the 1918strain, they did probably identify
some genesthat made it highly transmissible.
What did
we learn from this novel virus, Covid-19?
As a medical community
that you feel is going to betterprepare us for a future pandemic?
(14:50):
We certainly learnedthat if the resources are there,
sort of modern medicine, can producevaccines and medicines at warp speed.
So so we do have these new incredibletechnologies.
These mRNA vaccines in sort of April,
May of 2020,which does seem like a lifetime ago.
(15:11):
They started working on the Covid vaccine.
And I knowI had highly respected colleagues
that said no waythis would be ready in this calendar year.
And it was.
I think we have learnedwe have the the capacity and the science
to produce highly effective vaccinesin a pretty short time period.
And one reasonI think people were a little less worried
about influenza is we have the technologynow to produce influenza vaccines,
(15:34):
and if there's a novel influenza strain,we can make a vaccine quickly.
I am curious to knowwhat does keep you up at night.
You kind of touched on that in general,but what are you worried about right now?
Yeah,I mean, I, a lot of things I worry about,
but in terms of like public health
and pandemics and viruses,another a novel virus that emerged from
(15:58):
maybe the, you know, wild animalsthat passed into human beings.
It's important to continue to investin public health and monitor, you know,
I mean,
I got a text from, a dear, dear friend
today that a nurse in Kampala,Uganda, dated Ebola.
So there's been a little minioutbreak in eastern Africa,
(16:19):
and now it's in the major city of Kampala,which is a big booming
capital city with,you know, a lot of people
that now, you know,so that's something to keep an eye on.
And, you know, we are never goingto not have any of these threats.
The key is to is to pay attentionand use science and expertise to respond.
I think based on what we wentthrough with Ebola a few years ago,
(16:40):
what we went through withSARS-Covid, the new Covid-19.
We should continue to investin public health and, you know, expertise
apolitical.
There's nothingpolitical at all about science,
nothing political at allabout public health.
But monitoring what's going on
so we can respondappropriately is critical.
I feel like we've reacheda place of extremes in our society.
(17:00):
On one side, it's like challengingscience is seen as anti-science.
And then on the other side, people
blindly acceptingor unwilling to accept revised findings.
So as a clinician and a scientist,where do you see or where do you draw
the line between healthy discussionand where it becomes unproductive?
It's kind of a cliche, but the key is whatwe call evidence-based medicine.
You know,scientists are incredibly independent
(17:23):
and critical of each other,looking at data and analyzing papers.
And then what comes outin terms of recommendations usually goes
through a lot of discourseand and discussion.
And it does evolve.
There's nothing in scienceor medicine is infallible.
What is your last wordto people who are listening today?
(17:43):
My last word would be that we'realways going to have seasonal viruses.
Every year is different, you know, payattention to what's going on.
There are some viruses have a treatment.
So influenza, you know,has a medication, it’s pretty effective.
You know, it's not for everybody.
It's not for people who are mildly ill.
Certainly
high risk people should should thinkabout getting a medicine for influenza.
(18:04):
People who are really symptomatic forfor a day or so.
You know, kind of having some knowledge
about when to think, doI need a medicine or not?
You know, thinking when,when to call a doctor, persistent
high grade fever, shortness of breath,you know, chest pain.
Maybe it's just not a simple cold or flu.
Some of my advice.
Doctor Keith Armitage, University
Hospitals Cleveland,thank you for joining us.
(18:25):
Thanks for having me.
Rememberyou can find and subscribe to this podcast
wherever you get your podcastsor go to University
Hospitals or the Science of Health,depending on where you subscribe.
And for more health news, advicefrom our medical experts,
and the Science of Health podcast,go to UHhospitals.org.
Popular Podcasts
True Crime Tonight
If you eat, sleep, and breathe true crime, TRUE CRIME TONIGHT is serving up your nightly fix. Five nights a week, KT STUDIOS & iHEART RADIO invite listeners to pull up a seat for an unfiltered look at the biggest cases making headlines, celebrity scandals, and the trials everyone is watching. With a mix of expert analysis, hot takes, and listener call-ins, TRUE CRIME TONIGHT goes beyond the headlines to uncover the twists, turns, and unanswered questions that keep us all obsessed—because, at TRUE CRIME TONIGHT, there’s a seat for everyone. Whether breaking down crime scene forensics, scrutinizing serial killers, or debating the most binge-worthy true crime docs, True Crime Tonight is the fresh, fast-paced, and slightly addictive home for true crime lovers.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.
The Clay Travis and Buck Sexton Show
The Clay Travis and Buck Sexton Show. Clay Travis and Buck Sexton tackle the biggest stories in news, politics and current events with intelligence and humor. From the border crisis, to the madness of cancel culture and far-left missteps, Clay and Buck guide listeners through the latest headlines and hot topics with fun and entertaining conversations and opinions.