Transcript: The Rise of Zoonotic Diseases | Mar 24, 2020

A caption on screen reads "@spaikin, @theagenda." Steve sits in a room with white walls, a low slanted ceiling and several framed pictures on the walls including one of George Drew and one of Walter Kronkite. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a blue shirt and a checked red tie.

A caption on screen reads "The rise of zoonotic diseases. @spaikin, @theagenda."

Steve says FROM EBOLA TO COVID-19, ZOONOTIC DISEASES - THOSE WHICH CROSS FROM ANIMAL TO HUMANS - ARE INCREASING IN FREQUENCY. WHY IS THAT? AND WHAT CAN BE DONE TO STOP THEIR SPREAD? WITH US VIA SKYPE FROM TORONTO TO EXPLAIN: Dr. SAMIRA MUBAREKA, MICROBIOLOGIST AND INFECTIOUS DISEASES PHYSICIAN AT SUNNYBROOK HEALTH SCIENCES CENTRE, PART OF THE TEAM WHICH RECENTLY ISOLATED WHAT IS TECHNICALLY CALLED SARS-COV-2, THE AGENT CAUSING THE COVID-19 OUTBREAK.

Samira is in her forties, with short brown hair. She's wearing glasses and a purple poncho.

Steve continues DR. MUBAREKA, IT'S GREAT TO HAVE YOU ON TVO TONIGHT. YOU ARE HUNKERED DOWN, I GUESS, IN THE BUNKER AT SUNNYBROOK HEALTH SCIENCES. HOW ARE YOU DOING?

Samira says WELL, WE ARE INDEED HUNKERED DOWN, READY FOR ACTION.

Steve says LET'S START WITH JUST SOME ZOONOSIS 101. I SUSPECT THIS IS A TERM PEOPLE HAVEN'T HEARD BEFORE. WHAT ARE SO-CALLED ZOONOTIC DISEASES?

The caption changes to "Samira Mubareka. Sunnybrook Health Sciences Centre."

Samira says SO, ZOONOTIC DISEASES ARE ESSENTIALLY DISEASES THAT ARE CAUSED BY TRANSMISSIBLE AGENTS, THOSE ARE VIRUSES, BACTERIA, PARASITES, LESS FREQUENTLY FUNGI, AND WHAT MAKES THEM DIFFERENT FROM THE ONES THAT WE'RE USED TO TALKING ABOUT IN TERMS OF HUMAN PATHOGENS IS THAT THEY CAN GET PASSED ON FROM ONE SPECIES TO ANOTHER. AND IN GENERAL, EVEN THOUGH THAT CAN REALLY INCLUDE ANY SPECIES, WE TEND TO THINK OF THEM IN TERMS OF TRANSMISSION BETWEEN ANIMALS AND HUMANS OR THE OTHER WAY AROUND.

Steve says WHAT ARE THE MOST COME ZOONOTIC DISEASES?

Samira says WELL, TO BE HONEST, PROBABLY THE MOST COMMON, SOMETHING THAT WE UNDERAPPRECIATE, ARE PROBABLY THE BACTERIA THAT CARRY ANTIBIOTIC RESISTANCE GENE DETERMINANT. THOSE ARE PROBABLY THE ONES THAT ORIGINATED IN A WAY FROM A ZOONOTIC SETTING AND SPILLED OVER INTO HUMANS AND THAT WE'VE BEEN DEALING WITH MORE DECADES. BUT I THINK THE CONTEXT NOW IS QUITE DIFFERENT AND WE'RE DEALING MORE WITH... SO THESE ARE LESS COMMON BUT INCREDIBLY IMPACTFUL VIRAL ZOONOSES. SO, OF COURSE, THERE'S COVID-19, CAUSED BY SARS CORONAVIRUS 2 AS BEING A PRIME EXAMPLE RIGHT NOW. BUT OTHER RECENT EXAMPLES INCLUDE ZIKA, EBOLA, WEST NILE, AVIAN INFLUENZA. THERE ARE QUITE A FEW OF THEM. SOME DO SPILL OVER FROM ANIMALS TO HUMANS AND SOME OF THEM DO THAT DIRECTLY OR THEY CAN DO IT THROUGH A VECTOR LIKE A MOSQUITO OR A TICK. SO, AGAIN, ZIKA, WEST NILE BEING EXAMPLES OF THAT.

Steve says AND WOULD THE ANIMAL, HIM OR HERSELF, HAVE TO BE SICK IN ORDER FOR THAT VIRUS TO PASS OVER TO A HUMAN AND INFECT THE HUMAN?

Samira says NO, NOT NECESSARILY. SO WE THINK ABOUT RESERVOIRS. RESERVOIRS ARE... THEY CAN BE HOSTS. THE ENVIRONMENT CAN ALSO BE A RESERVOIR. BUT WHEN WE'RE THINKING ABOUT THEM, WE'RE MAINLY THINKING ABOUT ANIMAL RESERVOIRS. THEY DON'T HAVE TO EXHIBIT SIGNS OF ILLNESS IN ORDER TO BE A RESERVOIR AND BE CAPABLE OF TRANSMITTING THE VIRUS FROM THE RESERVOIR HOST TO A HUMAN OR ANOTHER SPECIES.

Steve says NOW, YOU MENTIONED THAT THE PATHOGENS CAN PASS BETWEEN SPECIES, THROUGH TICKS OR MOSQUITO BITES OR WHATEVER, THOSE KINDS OF THINGS. ARE THERE OTHER WAYS THAT IT TRANSMITS AS WELL?

Samira says WELL, DIRECT CONTACT IS ONE POSSIBLY. SO MAYBE, IF I GIVE AN EXAMPLE PEOPLE ARE MORE FAMILIAR WITH WHEN YOU THINK ABOUT RABIES. THAT'S AN EXAMPLE OF A ZOONOSIS THAT TRANSMITS FROM A DIRECT HOST, THAT COULD BE A DOG, FOX, RACCOONS, A BAT, ET CETERA, AND IS TRANSMITTED TO HUMAN OR ANOTHER SPECIES OF MAMMAL THROUGH DIRECT CONTACT.

Steve says DOES IT EVER GO THE OTHER WAY, FROM HUMANS TO ANIMALS?

Samira says WELL, THAT'S MUCH LESS WELL-STUDIED BUT THERE HAVE BEEN SOME EXAMPLES THAT HAVE BEEN RELATIVELY WELL DESCRIBED. IF YOU RECALL IN 2009, THERE WAS AN INFLUENZA VIRUS PANDEMIC. AND EVEN THOUGH THAT ORIGINATED IN ANIMAL RESERVOIRS, SO A COMBINATION OF BIRD AND SWINE INFLUENCE VIRUSES SORT OF RESORTING AND SPILLING OVER FROM SWINE TO HUMANS, A LOT OF SWINE DISEASE, PARTICULARLY IN CANADA AND IN THE U.S., WAS PROBABLY MORE THE RESULT OF INFECTIONS FROM HUMANS BACK TO SWINE. SO IT CAN GO THE OTHER WAY. IT'S SOMETHING WE CALL REVERSE ZOONOSES.

Steve says THE REASON I ASK IS I'VE HAD A BUNCH OF EMAILS OVER THE LAST FEW DAYS FROM PEOPLE ASKING, YOU KNOW, CAN MY DOG, MY PET DOG, MY PET CAT, CAN THEY GET COVID-19, FOR EXAMPLE? WHAT'S THE ANSWER TO THAT?

Samira says WELL, WE DON'T KNOW THE ANSWER TO THAT, UNFORTUNATELY, YET. I KNOW THERE HAVE BEEN REPORTS ABOUT THE POSSIBILITY, BUT THEY'RE NOT CONVINCING YET AND ESSENTIALLY WHAT WE WOULD NEED TO DO IS A COMPREHENSIVE STUDY TO LOOK AT INDIVIDUALS WHO ARE INFECTED AND WHETHER OR NOT IT DOES GET PASSED ON TO THE ANIMAL. WE DON'T HAVE A CLEAR ANSWER AT THIS STAGE.

Steve says ONE OF THE THINGS I HAVE HEARD, AND I THINK I WAS ON THE AMERICAN VETERINARY ASSOCIATION SITE THE OTHER DAY LOOKING INTO THIS, IS BECAUSE THIS PARTICULAR PATHOGEN LIKES FLAT SURFACES LIKE TABLETOPS OR DOOR HANDLES OR ELEVATOR BUTTONS, THAT KIND OF THING, THAT A PET'S FUR WOULD ALMOST CERTAINLY MAKE IT A POOR CANDIDATE TO TRANSMIT THE VIRUS. DOES THAT MAKE SENSE?

Samira says WELL, THAT HASN'T... SO STUDYING PETS AS A FOMITE HASN'T BEEN DONE YET. THERE HAS BEEN A STUDY LOOKING AT HOW LONG THE VIRUS SURVIVES ON SURFACES, AND NON-POROUS SURFACES, HARD PLASTICS, METAL, THAT KIND OF THING, IT DOES TEND TO SURVIVE LONGER ON COMPARED TO SOMETHING LIKE CARDBOARD AND CERTAINLY A PET'S FUR WOULD BE MORE... CONSIDERED GENERALLY MORE POROUS. BUT THAT REALLY HASN'T BEEN STUDIED, AT LEAST TO THE BEST OF MY KNOWLEDGE, TO DETERMINE WHETHER OR NOT PETS CAN SERVE AS A POTENTIAL, WHAT WE CALL FOMITE OR A SURFACE YOU CAN TOUCH AND ACQUIRE THE VIRUS FROM.

Steve says DR. MUBAREKA, TAKE US RIGHT BACK TO DECEMBER, TO THE VERY BEGINNING OF THIS WHOLE THING. TAKE US BACK TO WUHAN, CHINA, AND TELL US HOW DID THE PATHOGEN, WHICH CAUSES COVID-19, MAKE THE ORIGINAL JUMP FROM ANIMALS TO HUMANS?

Samira says SO THERE ARE A NUMBER OF DIFFERENT POSSIBILITIES. ONE THING THAT WE DO KNOW IS THAT THERE ARE CERTAIN CONDITIONS THAT HAVE TO BE MET FOR THAT SPILLOVER TO HAPPEN. SO REALLY TO BREACH THE SPECIES' BOUNDARY, AS WE WOULD SAY, IS FIRST OF ALL YOU WOULD NEED TO HAVE AN INFECTED RESERVOIR, AND IT WOULD NEED TO BE IN CONTACT SOMEHOW WITH THIS INFECTED RESERVOIR. SO THERE'S AN EPIDEMIOLOGICAL ASPECT TO THIS. YOU ACTUALLY NEED TO HAVE THE PROXIMITY. AND THE OTHER VERY, VERY IMPORTANT ASPECT IS MUCH MORE MOLECULAR. THE BIOLOGICAL CIRCUMSTANCES HAVE TO PERMIT SPILLOVER. SO WE PROBABLY HAVE COME IN CONTACT WITH ANIMAL PATHOGENS ALL THE TIME AND WE DON'T GET INFECTED FROM THEM BECAUSE WE'RE NOT WHAT YOU WOULD CALL COMPETENT HOSTS. EITHER WE DON'T HAVE THE RIGHT RIGHT RECEPTORS OR THE ROUTE OF TRANSMISSION. IN THIS CASE WE BELIEVE THE VIRUS HAS THE RIGHT CONDITIONS OR I GUESS VIRAL DETERMINANTS TO BE ABLE TO ENTER HUMAN CELLS. MORE SPECIFICALLY WHAT THAT MEANS IS THERE ARE RECEPTORS ON THE SURFACE OF OUR CELLS THAT THE VIRUS HAS TO BIND TO. AND THAT BINDING HAS TO BE PRETTY SPECIFIC TO DO THAT. THERE MUST HAVE BEEN AN ADAPTATION AT SOME POINT. IT ISN'T CLEAR IF THE ADAPTATION HAPPENED IN THE POTENTIAL RESERVOIR, WHICH MAY BE BATS, WE DON'T KNOW WHETHER THERE WAS A HOST AT THIS STAGE, THERE MAY HAVE BEEN TRANSMISSION FROM ONE HUMAN TO ANOTHER AND ADAPTED. THE TWO POSSIBILITIES ARE BEING CONSIDERED.

Steve says SURE. BUT IF IT DID GO FROM BATS TO HUMANS, HOW WOULD THAT TRANSMISSION HAVE TAKEN PLACE?

Samira says SO THERE WOULD HAVE HAD... ASSUMING IT WAS DIRECTLY FROM BATS TO HUMANS, THEN THAT REALLY WOULD HAVE HAD TO HAVE BEEN THROUGH DIRECT CONTACT, OR THROUGH AEROSOLS THAT WERE GENERATED BY THE BATS. AND THIS IS WHERE, YOU KNOW, IT'S REALLY IMPORTANT TO UNDERSCORE THAT, YOU KNOW, THE BATS ARE NOT THE PROBLEM. I WOULD EVEN SAY THE VIRUS IS NOT THE PROBLEM. IT'S REALLY BEEN OUR BEHAVIOUR AS HUMANS THAT'S BEEN THE ISSUE. WE'VE MANAGED TO PRETTY MUCH ENCROACH ON EVERY CORNER OF THE PLANET AND INTO THE NATURAL WORLD WHERE NORMALLY WE WOULD NOT BE COMING INTO CONTACT WITH SOME OF THESE VIRUSES, AND THE MORE OFTEN WE DO THAT, THE MORE WE DISRUPT HABITAT AND BECOME... COME INTO CLOSE CONTACT OR PROXIMITY TO THESE VIRUSES, THE MORE LIKELY WE ARE TO SELECT FOR SOME MUTATIONS THAT WOULD BENEFIT THE VIRUS IN TERMS OF REPLICATING IN A HUMAN. SO WE HAVE TO ACKNOWLEDGE OUR ROLE IN THIS... IN THIS PANDEMIC.

Steve says WELL, THAT'S INTERESTING. SO IN YOUR VIEW IT'S NOT ALL THAT IMPORTANT THAT WE FIND OUT WHICH ANIMAL IN PARTICULAR WE MAY HAVE CAUGHT THIS FROM ORIGINALLY, IT'S OUR OWN BLOODY BEHAVIOUR THAT WE'VE REALLY GOT TO FIX HERE; IS THAT IT?

Samira says WELL, IT'S BOTH. AS LONG AS WE DON'T KNOW WHERE IT CAME FROM, IT CAN ALWAYS RE-EMERGE. AND OBVIOUSLY IF WE KNOW WHERE IT CAME FROM, THEN THAT HELPS US MODIFY OUR BEHAVIOUR AND THE MANNER WHICH WOULD ACTUALLY MITIGATE ANOTHER SPILLOVER EVENT. SO CONTINUING TO DO SURVEILLANCE IS REALLY IMPORTANT. SO THERE ARE OTHER EXAMPLES SUCH AS WITH AVIAN INFLUENZA VIRUS, THAT THAT'S DONE INCREDIBLY WELL, IN A VERY SUSTAINED AND THOROUGH MANNER. IT'S BEEN DONE LESS WELL FOR SOME OTHER VIRAL ZOONOSES, AND I THINK WE'VE LEARNED A LESSON HERE. WE HAVE TO RE-THINK THE WAY WE INTERACT WITH THE NATURAL WORLD BECAUSE IT'S NOT JUST ABOUT DOING SURVEILLANCE AND AVOIDING SPECIFIC SITUATIONS, IT'S UNDERSTANDING THE IMPORTANCE OF PRESERVING BIODIVERSITY AND NOT ENCROACHING ON THE HABITATS THAT WOULD DIMINISH THAT BIODIVERSITY AND PUT US AT HIGHER RISK AS WELL AS THE ANIMALS AT HIGHER RISK.

Steve says YOU MADE A LIST OF SOME OF THE ZOONOTIC DISEASES WE'VE BEEN FACING OVER THE PAST COUPLE OF DECADES, SARS, MERS, H1N1, EBOLA... IT'S A PRETTY GOOD LIST AND NOW THERE'S COVID-19 AS WELL. ARE WE AT THIS PARTICULAR POINT IN OUR HISTORY FACING MORE ZOONOTIC DISEASES THAN AT OTHER POINTS IN HUMAN HISTORY?

Samira says I THINK THERE ARE A COUPLE OF POSSIBILITIES. MOST LIKELY. AND AGAIN PARTLY DUE TO HUMAN BEHAVIOUR BEYOND WHAT I'VE ALREADY MENTIONED. SO IN SOME CASES, GLOBAL TRAVEL HAS REALLY ACCELERATED THE SPREAD OF THESE VIRUSES. IT'S POSSIBLE THAT IN THE PAST THERE WERE JUST AS MANY SPILLOVER EVENTS. I THINK PROBABLY MORE SO NOW. LET'S JUST SAY FOR THE SAKE OF ARGUMENT THERE WERE AS MANY. THEY WOULD BE MORE CONTAINED BECAUSE THERE WOULD BE LESS GLOBAL AND MASS TRANSIT THAT REALLY ENABLES THE RAPID SPREAD OF THESE VIRUSES. THE OTHER THING I THINK THAT'S CONTRIBUTING ALSO IN SOME RESPECTS IS CLIMATE CHANGE. SO IN THE SENSE THAT THE VECTOR... THAT REFERS MORE TO THE VECTOR BORNE DISEASES, THE ONES THAT ARE TRANSMITTED BY TICKS AND MOSQUITOES... WE'RE CHANGING THE GEOGRAPHIC SPREAD OR RANGE OF THESE VECTORS THROUGH CLIMATE CHANGE. SO THAT ALSO ENABLES THE SPREAD OF THESE ZOONOTIC DISEASES. I THINK LASTLY WE'RE ALSO PERHAPS BETTER AT DOING SOME OF THE SURVEILLANCE AND THE DIAGNOSTICS SO WE UNDERSTAND WHAT WE'RE DEALING WITH. SO IT'S A COMBINATION OF BETTER DIAGNOSTICS AND IDENTIFICATION, BUT PROBABLY MORE LIKELY A GREATER CONTRIBUTION FROM OUR OWN... OR BY OUR OWN BEHAVIOUR.

Steve says I SHOULD FOLLOW UP ON THAT CLIMATE CHANGE ANGLE BECAUSE FRANKLY, THAT'S AN ANGLE TO THIS COVID-19 STORY THAT I HAVE NOT HEARD BEFORE. CAN YOU JUST EMBELLISH A LITTLE BIT MORE ON WHAT PARTICULARLY RELATED TO CLIMATE CHANGE MIGHT BE A FACTOR HERE?

Samira says WELL, I THINK CLIMATE CHANGE IS MORE LIKELY TO AFFECT MORE THE VECTOR BORNE ZOONOTIC DISEASES. SO THE ONES THAT ARE TRANSMITTED BY TICKS AND MOSQUITOES, FOR EXAMPLE. SO THAT IS BECAUSE CLIMATE CHANGE AFFECTS THE POPULATION OF THESE VECTORS AND THAT ALLOWS THEM TO EXPAND THEIR RANGE. NOW, IN TERMS OF COVID-19, THERE IS NO VECTOR. THIS IS NOT... IT'S ACQUIRED CURRENTLY BY HUMAN-TO-HUMAN TRANSMISSION. SO THERE WOULD BE LESS OF AN IMPACT ON CLIMATE CHANGE WITH RESPECT TO COVID-19, IN TERMS OF ITS TRANSMISSION, BUT IT WOULD HAVE MUCH MORE OF AN IMPACT IN TERMS OF THE TRANSMISSION AND I GUESS SPREAD OF THE RANGE OF OTHER ZOONOTIC DISEASES LIKE WEST NILE AND ALL THE ONES THAT ARE TRANSMITTED THROUGH MOSQUITOES AND TICKS.

Steve says HMM. NOW, THE TYPICAL FLU, INFLUENZA, THAT WE GET OUR FLU SHOTS OR THAT WE'RE SUPPOSED TO GET OUR FLU SHOTS FOR JUST BEFORE THE WINTER SEASON COMES IN, IS THAT INFLUENZA VIRUS A ZOONOTIC DISEASE?

Samira says SO, AT THE OUTSET, WHEN IT FIRST EMERGED, AND INFLUENZA VIRUS, MOST OF THEM STARTED AS A PANDEMIC, AT THAT POINT THERE WOULD HAVE BEEN SPILLOVER FROM AN ANIMAL HOST, SWINE, POSSIBLY BIRDS, THE COMBINATION OF THOSE TWO TYPES OF VIRUSES. BUT THEN THE SUSTAINED SPREAD BECOMES HUMAN TO HUMAN. FOR EXAMPLE, EVERY SEASON IT'S NOT THAT THERE'S A PARTICULAR ZOONOTIC EVENT THAT TRIGGERS THE SEASON, IT'S JUST KIND OF MAKING ITS WAY AROUND THE GLOBE FROM THE NORTHERN HEMISPHERE TO THE SOUTHERN HEMISPHERE AND BACK UP AND ROUND AND ROUND AGAIN JUST SOLELY THROUGH HUMAN-TO-HUMAN TRANSMISSION. WHEN WE SEE THE ZOONOTIC COMPONENT IS WHEN THERE'S A NEW PANDEMIC. SO WHAT THAT MEANS IS THAT IT'S A NEW INFLUENZA VIRUS THAT NONE OF US ARE IMMUNE TO THAT SPILLED OVER, GENERALLY SPEAKING FROM AN AVIAN OR BIRD RESERVOIR, PLUS OR MINUS ANOTHER INTERMEDIATE HOST INTO HUMANS. THAT IS WHEN YOU GET A PANDEMIC. AND THEN SUBSEQUENT SPREAD DOES BECOME... COME FROM ONE PERSON TO ANOTHER. SO IF YOU THINK ABOUT, FOR EXAMPLE, HIGHLY PATHOGENIC AVIAN INFLUENZA VIRUS, IT HAS NOT BECOME A PANDEMIC VIRUS. IT HAS WHAT WE CALL PANDEMIC POTENTIAL, BECAUSE WE'D BE AT RISKS. WE DON'T HAVE VACCINES OR ANTIBIOTICS TO THAT VIRUS. BUT SO FAR, KNOCKING ON WOOD, THAT TRANSMISSION HAS REALLY BEEN LIMITED FROM BIRDS TO HUMANS, AND WE'VE NOT SEEN SUSTAINED SPREAD OF THAT VIRUS, KNOCKING ON WOOD AGAIN.

Steve says KNOCKING ON WOOD, YES.

Samira says YES. SO THAT PARTICULAR INFLUENZA VIRUS DOES REMAIN A ZOONOTIC VIRUS IN THE SENSE THAT THE HUMANS WHO DO GET INFECTED BY HIGHLY PATHOGENIC AVIAN INFLUENZA VIRUS GET INFECTED FROM BIRDS, NOT FROM OTHER HUMANS. BUT THE SEASONAL INFLUENZA VIRUS... AT ONE POINT IT WAS A ZOONOTIC SPILLOVER. IT BREACHED A SPECIES BOUNDARY. BUT CURRENTLY WOULD BE CONSIDERED A HUMAN PATHOGEN.

Steve says WE'VE GOT JUST A COUPLE OF MINUTES LEFT HERE AND I WANT TO TOUCH ON ONE LAST THING. YOU MENTIONED BEFORE WE ACTUALLY STARTED OUR CONVERSATION OFFICIALLY THAT YOU HAD BEEN SORT OF HUNKERED DOWN IN THE BUNKER AT SUNNYBROOK HEALTH SCIENCES FOR A COUPLE OF MONTHS, WHICH SUGGESTS TO ME THAT NOT ONLY ARE YOU DILIGENT AT DOING YOUR JOB, BUT THAT... BUT THAT THERE'S A LOT ABOUT THIS THAT PROBABLY KEEPS YOU UP AT NIGHT. WHAT DO YOU WORRY ABOUT AT A MOMENT LIKE THIS?

Samira says WHAT DO I NOT WORRY ABOUT IN A MOMENT LIKE THIS? OBVIOUSLY THE RESPONSE IS TOP OF MIND FOR EVERYONE AND I HAVE TO ADMIT THAT YOUR REQUEST TO TALK ABOUT ZOONOSES WAS QUITE NICE BECAUSE IT GIVES US A BIT OF PAUSE TO THINK BACK ABOUT HOW DID THIS ALL EVEN BEGIN? BUT REALLY WHAT'S KEEPING US ALL UP AT NIGHT IS HOW ARE WE GOING TO DEAL WITH THE SITUATION AS IT UNFOLDS. YOU KNOW, WE WERE SPEAKING A LITTLE BIT EARLIER, WE HAVE LEARNED SO MUCH ABOUT HOW TO MANAGE THESE THINGS THROUGH... AFTER SARS AND, YOU KNOW, WE'VE HAD LUCKILY NO CASES OF EBOLA HERE IN CANADA. BUT WE'VE BEEN PREPARING FOR THEM. SO A LOT OF THAT PREPARATION WAS ABLE TO BE PIVOTED OVER TO COVID-19. AND ALSO THERE'S A LOT OF PREPARATION THAT'S UNDERWAY EVERY YEAR FOR SEASONAL INFLUENZA VIRUS AND THAT BURDEN IS NOT GOING AWAY EITHER. SO, AGAIN, A LOT OF THE PROTOCOLS, THE ISOLATION, ET CETERA, IT'S JUST THE SCALE NOW. SO I THINK... I MEAN, THERE'S STILL A LOT TO BE ANSWERED. WE DON'T HAVE... THINGS ARE CHANGING. I EVEN HESITATE TO MAKE ANY KIND OF RECOMMENDATIONS OR SUGGESTIONS BECAUSE, YOU KNOW, IN AN HOUR OR SO, IT MIGHT POTENTIALLY CHANGE. BUT... BUT THE ISSUE IS THAT WE ARE... WE NEED TO BE PREPARED FOR THE SCALE OF WHAT'S TO COME. AND THERE IS... WE DON'T REALLY KNOW EXACTLY WHAT THAT SCALE WILL BE. WE CAN LOOK AT OTHER JURISDICTIONS TO GIVE US AN IDEA. OF COURSE, CANADA HAS ITS OWN UNIQUE CONTEXT, SO WE CAN'T... WE CAN'T PREDICT WITH 100 PERCENT PRECISION. BUT WE NEED TO MAKE SURE NOW, IN A WAY, BECAUSE OF THE WAY THIS HAS ROLLED OUT GLOBALLY, WE'VE HAD SOME TIME TO SEE WHAT'S HAPPENING IN OTHER JURISDICTIONS AND TO MAKE SOME PREPARATIONS. BUT THE DOWNSIDE OF IT IS, MANY OF THE RESOURCES THAT WE WOULD NEED, BECAUSE THERE'S BEEN SUCH WIDESPREAD DISEASE, HAVE BEEN USED AND NOW WE NEED TO FIND SUPPLIES TO REINFORCE OUR RESPONSE.

Steve says INDEED. DR. MUBAREKA, IT'S REALLY GOOD OF YOU TO JOIN US ON TVO TONIGHT AND HELP EXPLAIN SO MUCH OF THESE DIFFICULT TIMES IN WHICH WE LIVE. THANKS SO MUCH AND GOOD LUCK BACK IN THE BUNKER.

Samira says THANK YOU VERY MUCH. APPRECIATE IT.

Watch: The Rise of Zoonotic Diseases