All language subtitles for Pandemic.How.to.Prevent.an.Outbreak.S01E05.Prayers.Might.Work.1080p.NF.WEB-DL.DDP5.1.x264-Wuhan

♪ Your Grace is sufficient
To cover my past ♪

♪ Your love is more than enough
More than enough ♪

♪ Your love is more than enough
More than enough ♪

♪ Your love is more than enough
More than enough ♪

♪ For me ♪

Thank you for your grace.

Thank you for your forgiveness.

Hallelujah, Hallelujah, Hallelujah.

The one thing
about medicine and faith that is unique

is that when you meet someone
who is on their darkest day,

they're in their worst health.

Most people in that situation
are pretty much open to faith.

They're open to prayer.

So I think that medicine creates
kind of a different environment for faith.

I will rejoice.

I often attribute the fact
that I'm still standing to God,

because why am I not just shaking

and not able to be successful
in anything I do

based on the trauma
that we went through as a family?

I have two children, my son, Jay,
and my daughter, Shaylee.

They live up in Oklahoma City
and visit about once a month.

My divorce was not easy on my children,

particularly since I was in medical school
at that time.

First year of medical school,
you would have been 14.

I purposefully would pick.

I have a test to study for tomorrow,
my daughter has a game.

But there were times when I had to say,
"I have to study or I'm gonna fail,

and then this whole thing will be
for nothing, so..."

I don't look back and think,

"I wish you would've
spent more time with us."

'Cause you were able to balance, you know,

school and work and family time
really well.

- That's something that I really aspire to.
- Thank you..

- I don't feel that way.
- You don't...

- You feel like I just left you?
- You should tell the truth, Shay.

Not "left," you obviously were doing
something that is fruitful now,

but, yeah, I wish
that we had more time with you.

Yeah.

I did kinda feel like I was Jay's mom
at some points.

I would make food for us
and hang out with us

and I would pretend to be his teacher.

Yeah, home school.

I guess we didn't realize
at the beginning how hard

and how much time it was gonna take, so...

Becoming a doctor
and being a doctor

has definitely come with sacrifices.

My daughter doesn't believe in God.

Had I known that the result
of me becoming a physician

was going to result in her
not having faith,

then to me that decision is easy,

and in a heartbeat, I would have dropped
my pursuit of my career.

I started questioning when I was 11,
so it's been a long time.

And then kind of just went in and out
of it and then just don't believe, so...

And you're at peace with that?

- Mmm-hmm. Yeah.
- Yeah.

I'm not.

- Right.
- 'Cause I'm going to hell.

- Well...
- Is...

But I don't...
I'm not trying to convert anybody, like,

"No, there is no God, Mom.
Stop believing what you believe."

But I also want the same,
you know, respect.

Yeah,
but I'm your mother.

Yeah.

Knowing that Shaylee
doesn't believe like me

doesn't make me love her less.

In fact, it makes me more
compassionate for her,

like, I want her to have what I have.

- Do you have everything?
- Mmm-hmm.

As a parent, at some point, you say,

"Okay, I've trained, I've given, I hope,"

and then, ultimately, they're another
person that makes their own choices.

In medicine, it is a sacrifice.
It just is.

We sacrifice all kinds of things
to be doctors.

The time will
come when we'll harvest what's for Jesus.

What's the preacher trying to say?

The preacher is saying this...

Get hold of your bread.

Get hold of your bread.

- Throw it into the sea.
- Throw it into the sea.

After sometime, you will see,

that loaf will return to you.

And that loaf will return to you.

Amen.

I read from my Bible
in the Book of Hosea,

my people get misled,
because of lacking knowledge.

Yesterday, I got news

about one of our brothers,

who had his in-law,

who died from Ebola in Butembo.

I know there are others
who take it lightly.

Others don't know that Ebola is real,
but Ebola is real.

And we need to be guided
and trained about it.

We serve with these brothers,

to fight these diseases like Ebola.

I will invite them one by one to speak.

I came here this morning
to this house of the Lord

because I am also a Christian.

We came here to talk about Ebola.

If we mobilize together, we can avoid
bringing this disease to Goma.

It's a disease that has
unfortunately killed over 600 people

since the epidemic started in North Kivu.

It's a disease that has made
families here disappear.

I would like to know
where it comes from.

Let us ask.

Unfortunately, Ebola was discovered
in Congo and Sudan.

Unfortunately,
some consider us their enemy.

According to them,
we brought the disease into the community.

Maybe they see a kind of invasion
coming from others

to implement the Ebola response.

So the starting point is that we have
to initiate community dialogue.

You have to convince them to trust you.

What are the quarantine measures

for people who come
from contaminated places?

We do not recommend quarantine for Ebola.

When we impose quarantine,
people hide and flee.

When someone touches
a positive person and flees,

that person will die, but before they die,

they will contaminate other people.

With this kind of outbreak,

we can count on science,

we can count on medicine,
but we cannot count on human behavior.

We cannot predict how people will react.

If the community
collaborates, Ebola will be over.

And in order to realize that, we need you.

Help yourselves and your families.

We're counting on you.

The wind is helping.

Ado, grab the pot and remove the lid.

Ghazi travels a lot,

and since he's Lebanese,
he doesn't have a lot of friends in Egypt.

The people coming today
are his co-workers.

- Did Neama finish?
- Ibrahim, Give me that plate to fill it.

How about some salad, Yousef?

So you cook a blend
of Egyptian and Lebanese food, right?

Yes, that's right.

The food is very good.

My co-workers
in Egypt, we're like family.

We've known each other
for more than ten years now.

We have a shared common goal,
which is to save lives

and one of our recent tests shows signs

that there is a potential influenza case
back here in Cairo.

What happened
with Ahmed with the H5N2?

There's a strong outbreak
in Gharbiya.

- Of what?
- In Gharbiya.

They don't know,
but the situation is very bad.

- In poultry?
- In poultry.

It's full of farms there.

Can't we get samples from there?

No, we have them.

In our surveillance,
the positivity is very high.

Positive in what?

H5 and H9.

We're talking about almost 20%.

20%? This is too high!

- What happened, Mukhtar?
- I don't know.

Go get some water from the cooler.

In 2005, we had
the first detection of the first bird flu

as it's commonly called...

The avian influenza virus.

It started moving out from China

and going elsewhere in the world
through wild bird migration.

Soon after that, the virus started
crossing from the migratory birds

to domestic poultry.

Infected birds
have been culled.

The virus has shown up
in almost half of Egypt's 26 provinces.

Workers in the Egyptian
health ministry's central lab

are checking throat swabs from people
who may have been exposed.

And very soon after,
we started getting human infections.

Since the disease was so new to us,

there were no protocols in place
to fight it.

It was never really controlled,
and if you look at the data,

Egypt had the most human infections
with H5N1.

So Egypt became what is known as
a hot spot.

The H5N1 outbreak in Egypt
was a game changer for surveillance.

It's our job to make sure
it doesn't happen again.

Did we determine
a sequence from the sample yet or not?

We're at the end of flu season.
Why is our surveillance so high?

There's something happening.

The main purpose of this trip
is to administer the vaccine to pigs

and over the course of a few months,
determine the most effective dose.

Here. I just have
a way that I want to do it.

I think this'll work, we basically...

We know Centivax works in pigs.

Getting it to work in fewer shots
will be a big deal.

But getting it to work in just one shot
will be a massive success.

We have seven groups of pigs.

One group is a negative control
that receives salt water.

One group is a positive control
that contains a seasonal vaccine

that pigs would normally receive.

It's 58. 58.

58. Just put it in.

Five groups are getting
different doses of Centivax.

- Good? Okay.
- Yeah.

This group of pigs holds
the biggest promise for us.

Let's proceed.
I'll go start this thing up at the lab.

We inject them with a flu virus
that we've created in the lab

that is inactive and won't make them sick,

but their immune systems will respond
to it just like it is the flu.

I make that...

I will help you, right?

While we're anticipating the results
of this test,

we're still nervous
about our funding going forward.

We expected to hear back
from the Gates Foundation this month

so that we can move on
to human clinical trials.

We haven't heard anything
so we're certainly getting anxious.

Whether or not we get that money,

right now, we need
to focus on this project.

- Good morning.
- Good morning.

Can I see a doctor, please?

Are you experiencing any fever, rash?

Yeah, I'm having a fever,
some abdominal pain,

and I've just been vomiting, slight cough.

Okay.

I'm gonna need you to put these gloves on,

place the mask over your face
and the plastic in your pocket.

Have you traveled outside of the country
within the last 30 days?

Yeah, three days ago, I went to
the Democratic Republic of Congo.

- Okay. Melinda?
- Yes.

Please come.

I have a patient who's traveled to DRC.

- Sent to us?
- Yeah.

- Give him the sheet. Perfect.
- Okay.

Also, could you step out
between the double doors there

and place this sheet around you?

Everything's okay?

Yeah, we're just gonna ask you to wait
between the doors, okay?

- I'll come talk to you in a minute.
- Thank you.

Okay? My gown and my mask.

Attention all staff, attention all staff.

Code E. Attention all staff, Code E.

We are in an environment
where we're surrounded by these outbreaks,

and it's imperative that we maintain
readiness for all these types of diseases

that are gonna come knocking at our doors.

So what we're practicing today
is on Ebola virus disease.

We are in currently the second-biggest
outbreak of Ebola virus disease

in the Democratic Republic of the Congo.

This is... This is real life.

So what's going on is we're just gonna ask
you to stay a few feet apart, okay?

At least six feet.
So it's just safety precautions for you

and for everyone around you, okay?

Just to make sure everything is okay.

We're gonna go around the building.

There'll be some nurses
and doctors in there.

They're gonna be wearing
some big old plastic suits

that might look a little scary.

Don't be scared.

Attention please, Code E.
All the nurses, please come inside.

To the isolation areas... we have to be
ready for the team to arrive.

Donning team is getting prepared.

Once the donning team's prepared,
we'll say, "Ready to proceed."

We can say, "Prepared now."

So what we'll do
is per the protocol,

we'll just leave the bridge open.

If you need anything from us,

we've got the team here
and we'll get you the resources.

Thumbs up. We're ready.

Donning team is prepared
to receive the patient.

Shift over into the room?

Nice deep breaths.

Excellent.

So with these symptoms and your travel
makes you very high risk.

The worry is that you may have
contracted Ebola virus.

We're going to try to stop any kind
of epidemic from starting.

As such, the safest way of doing this
is to transfer you in a special unit

that will be coming here
wearing protective gear,

and transport you to Bellevue.

We're gonna dress out in...

all the normal PPE
for Ebola transports, okay?

All right.

If you guys are comfortable
and ready to accept the patient,

I'll let Coney Island know and the patient
will be out momentarily.

They're coming out.

These types of cases
require a very large response.

Let's pull you across.

This is really one patient.

If it was a pandemic flu,

you would most likely have
a much higher patient care count

and you would need more hands on deck.

- All right.
- You're in good hands.

The funds that we use
for maintaining readiness

will stop by 2020
if funding is not reissued.

We may have to cut some of the programs
and activities that we do

if we don't have that money.

And if we can't keep up with this training
and maintaining readiness in general,

then we're risking more lives.

All right,
so it doesn't seem to be an infection.

The one thing that I can't do
that I think you need is an ultrasound.

Like, if you were to have a blood clot
in your leg,

the test of choice is that ultrasound.

Is there any way
I could stay here?

Probably not but I can talk to...

And the reason is
that we don't do dialysis.

- Right.
- So if we got...

If you were here for more than two days,
you're gonna need dialysis.

- We...
- Well, let's get to the end

- of what we're doing, okay?
- Okay.

Let's just figure out what's going on.

I love my patients.

So it's really hard to sometimes
not have all the resources that they need.

You need a hug? Aww.

- Morning, good morning.
- Morning.

I've never ran
a hospital before.

When I interviewed with the board,
the hospital wasn't in good shape.

Knew it was going to be a challenge.

We had a physician, Dr. Lensman,
who was here for a long time.

His saying was,

"All I've got is an EKG machine,
a stethoscope and a Bible."

Hi, this is Richard from the hospital.
How are you?

Good. Is Mr. Simmons available? Thank you.

We had $2.2 million in debt

and we did not have the money
to service that debt.

Mr. Simmons, Richard from the hospital.
How are you?

We'd been receiving a one-cent sales tax
from this county,

but this sales tax is due to expire
this year.

And that money went to support
the operations of the hospital.

Would it be out of line for me to ask
for a public service announcement

to remind the teachers
and the now-professional staff to go vote?

And so there was a concerted effort
to mount a county-wide vote

to extend or renew the sales tax.

Eleven hospitals in Oklahoma
have closed in the last two years.

That is a trend nationally,
that rural hospitals are closing.

The doors are shut at
the Paul's Valley Regional Medical Centre.

A Norman hospital is closing down,
giving employees almost no notice.

In the wake of a state-wide
healthcare budget crisis,

another hospital closes its doors.

The pace of the closures
has only escalated in recent years

and the National Rural Health Association

says more than 280 hospitals,
with 700,000 patient visits,

are at risk of shutting down.

Debbie, Richard, how are you doing today?

2015, Jefferson County
was the most unhealthy county

in the state of Oklahoma.

So if the hospital were to close,
there'd be a huge impact.

I was just calling to remind you
to get out there and vote.

Hopefully, it all turns out positive.

Violence and mistrust

are seriously hampering efforts
to contain this outbreak.

Ebola treatment centers like this one
are often attacked by militia groups

and people are either too scared
or too suspicious to seek medical help.

The longer this outbreak rages on,

the higher the risk
of it spreading globally.

This weekend was marked

by an acceleration of incidents
related to community reluctance,

with unfortunate violence.

Most of my colleagues,
including myself, we are quite determined.

We want to stop this virus.

Concerning the operational zone,

we observed 11 incidents,

but this time, including violence.

Just yesterday, a team was ambushed.

Two vehicles were battered with rocks.

So long as we don't control
the big hotspots,

we cannot regain control of other zones
that were previously under control.

We continue to find cases.
Yesterday, we found seven cases.

We have to adjust our leadership
in terms of Butembo.

So I will go to Butembo
and take over coordination there.

While my team are taking
a lot of risks in a dangerous place,

I have to be there with them.

If our situation worsens,
it could be the case

that we totally have to move out.

Oui, hello?

But it would be
really the last option.

Because moving out means leaving Ebola.

The only objective
is to save the population from Ebola.

At the end of the day,

we have an absolute
ethical and moral imperative

to make sure that we do that.

And inevitably, that requires people
going to areas that are not safe.

It's like a soldier...

where you can lose your friends...

but you have to move towards the victory.

And we have no option...

but moving toward this victory.

- Those are the big ones.
- Yeah.

This is one of our
most important experiments yet

because it will determine
whether our vaccine can be delivered

in fewer doses to pigs.

We know how easily
things can get messed up,

especially if we're doing it
in multiple languages

and it's loud and the pigs
are kind of grunting and crying.

There's a thousand ways

that we could achieve a negative result
or a poor result...

and it's nerve-wracking.

That's why we have
this methodical way

where either Diego
or Juan will hold the pig,

or both of them,

and then Corina will wipe the dirt
off the ear tag

and she will read it,
verbally say the number,

and then I will read it
and then I will say the number.

Sixty-nine. Sixty-nine.

And we'll look in each other's eyes

and make sure that we both
said the same number.

And then usually I'll go tell Jake,
"Hey, it's number 52,"

and he'll say, "52?"
And I say, "Yes, 52."

Then he goes and grabs number 52,

I look at it and I read "52,"

I take the cap off
and I hand it to Corina.

For all 35 pigs.

Seventy-one.

- And we're done.
- Done.

That was awesome.

Whoo!

You can go and hang out
with the piggies a little bit now.

- Oh, yeah?
- Yeah.

We just injected all
these pigs with our new round of Centivax.

I'm very confident we're gonna see
some improvement.

I think the question is,
are we gonna see total improvement

in fewer doses?

And I think
that's what we have to wait and see.

So, our work here
in Guatemala is basically over...

and we are going to fly back
to San Francisco.

So, the next step is we wait.

I will be back here in three weeks.

We will begin
pulling blood out of the animals,

sending it back to the lab,
and beginning to determine

how their bodies are responding
to the vaccine.

We might get lucky and see
the kind of response that we need

after one shot.

And if we achieve this in pigs,

it will be a huge step towards our goal
of a post-pathogen humanity.

Every now and then,
we get surprised by the nature

of a new bug or a new virus in our region.

- That positive control?
- Positive control.

Where are the two samples?

And now we have confirmed

the presence of an avian influenza virus
here in Cairo.

Is that the first time
you'll try it on this?

Yes.

We don't know
how severe it is, how pathogenic it can be

and so we're really interested

in trying to understand
as much as possible about it.

Can we tell
if these came from one farm or not?

Yes, I was just telling Hisham
to check on this.

All right.

The outcome could be
a novel virus that we do not know about

in the animal population.

And so we do not know
how severe it would be

in the human population.

To me, it becomes a little bit personal
when it's in your own backyard.

What do you
want to eat, Besah?

Do you want falafel? No?

Try it, you'll like it.

A city like Cairo,

with a big population,
with this close and intimate interaction

between its people means that the virus
is going to be spreading rapidly.

What worries me about my family

is when these viruses
are out in the community...

and my family
would be part of that community.

Another influenza pandemic.

If you ask any influenza scientist,
they tell you it's coming.

We don't know which virus
is going to cause it.

We don't know when it's gonna happen.

So the only thing we can do
is just keep an eye on things.

You have to do your surveillance,
you have to be prepared,

and you have to do the science.

Jefferson County will soon decide

whether they wanna continue a 1% sales tax

that goes toward
the Jefferson County Hospital.

A few years ago, the hospital
in Jefferson County nearly closed

after going around $2.2 million in debt.

This is coming up for a vote
when five rural hospitals in Oklahoma

had to close their doors

due to financial problems
over the past nine years.

- That's for you.
- There you go.

- Thank you.
- Y'all want a sticker?

Today, this county
is having a vote to extend the tax

that supports this hospital.

In my mind, if it doesn't pass,

everything would
completely just fall apart.

Of course,
nobody likes to pay taxes.

When the initial straw poll was taken,
there was 151 were "yes,"

41 were "undecided"
and nine were "no."

We have limited resources,
but you have to invest in this facility.

We provide health care services
within the county and the communities.

I took an oath.

And the oath was to protect and serve
the people of Jefferson County.

The average person in Jefferson County
is probably making about $18,000 a year.

We're an agricultural community.
There's not a lot of money in that.

The sales tax is what drives everything
for this community...

and it's just not enough.

Everything's divvied up
according to necessity and need.

Every department struggles.
Every area of county government is trying.

It is a challenge. It's...

There are days that you wonder
and say, "How are we gonna make it?"

The average person in our community,

they don't understand that there's times

that I pay out of my pocket
for fuel in our vehicles.

They just know that when they call,
we come.

A vote was presented to continue

paying on a debt we had
for our county hospital.

It's a good thing
that we're supporting our hospital

and taking care of it, but we also need...

We need fire service,
we need ambulance service,

we need law enforcement.

We even need my dog, Joe,
to help with our mission.

There's so many avenues
that finances can help

in a rural community that...
What takes priority?

And that's quite a challenge.

These votes are very important.

They affect more than people realize.

How are you doing, Robert?

I know we've been dealing
with medical stuff with you.

Your blood pressure's been high.

Our problem is, as you know,

- I'm only budgeted so much money.
- Yeah.

We don't have a way
to get you the medication you need.

Yeah.

Robert, I don't want you
to have the issues you're having,

but also, my hands are tied
on how I can help you.

- Yeah.
- Anything you wanna tell me or...

talk to me about?

- No, I just need to get that medication.
- I know you do.

- And I don't have the money to do it.
- I know.

I wish that the state would give us
something to take care of you guys better.

Didn't mean to get you upset, bubba.

He has no plan.
He has no insurance. He has nothing.

But we have $38 in our medical account.

And it's not easy.

Okay, did we figure anything out
on Grant's appointment?

Yes, we did.

Talked to Dr. Goracke. They're just gonna
call in his prescriptions

until we can...
They can get him on some emergency aid.

- Okay, thank you.
- Yes, sir.

Bye.

We need a hospital.

This is Dr. Goracke.

If you start taking things away
from a rural community like this,

before long it dries up and blows away.

With that being said,

we're maxed out on our tax base,
but it's still not enough,

and that is hard,
because there's nothing else to pull from.

It's an issue that needs to be addressed
state-wide,

and I'm hoping that we see some changes.

- Sheriff, how are you?
- How are you doing? Doing well.

Thank you.

Richard.

Yes, sir.

The final tally was...

664 to 45.

- Okay.
- 93.65% to...

- 6.35% no.
- Okay.

There you go.
You can hang that on your wall.

All right. Thank you.

- Right. Y'all have a good evening.
- All right. See you later.

It shows that it was
a 664 and 45.

664 "for" and 45 "nay."

Basically, if you round up,
a 94% approval.

So that's pretty good.

In fact, that's really good.

Yeah, it's very humbling, actually.

This vote shows
that our county supports our hospital.

In terms of our hospital,

I just don't see it operating
for very long

without the support of its people.

We still face
so many difficulties here, but...

this small win is still a victory
to celebrate for our community.

I had two new calls
this morning, one with an Atlas guy.

They're interested
in six projects with us.

- They're all...
- Six?

- Six projects.
- All right. Cool.

And the Gates Foundation
is probably going to email.

I don't know.

I've been checking regularly
and I have not received it yet.

If you do receive it...

- I won't read it.
- ...don't open it.

Yeah, I'm not gonna open it.
I'll let everybody know.

We'll get together
and we'll read it together.

'Cause I could use some buddies
if the answer's like...

- "No"?
- Yeah. If the answer's "no,"

- then I could use a tequila shot.
- Yeah.

And we have extra champagne
if the answer's "yes,"

- so we're prepared for all eventualities.
- That's true...

But, yeah,
we'll read it together.

So, while we are waiting
for the results of the Gates grant,

the show must go on,

so we're meeting with other companies,

looking for potential areas
of collaboration.

Our technology relies on the ability
to see lots of versions.

So what we did is we took a snapshot
of evolutionary history.

We used hyper-geometric triangulation,
which is just a fancy way of saying,

"Find one flu and then find one
that's the most distant,

then another most distant from those two,
then from those three, until..."

If we get the grant tomorrow

and if those experiments
went well this year,

then you could
probably go off the shelf by 2025

or earlier to receive this vaccine.

We have two different TC rooms.
Over on this side,

it's just big decks of PCR machines,
'cause we use lots of PCR...

The Gates grant is for $1.95 million.

That's enough for two years of research

and an additional set of scientists
that are gonna come join our team.

So what we're looking at here
is the data that we generated...

actually just yesterday.

So, it took about two months
of testing every day

on these live flu viruses
to finally narrow it down

and optimize all the conditions exactly
to get it just right.

I had an email come in

we should take a look at
in a little bit.

- Okay.
- Yeah.

- Well, thanks a lot for coming out.
- Thank you.

Very nice to meet you.

- Thank you for coming.
- Thank you.

- Thanks.
- And let's be in touch about that.

- All right, excellent.
- Okay.

- Take care.
- Safe travels.