Episode 2: How To Prevent A Plague

May 8, 2020

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Welcome to Interesting If True, the podcast that promises not to lie to you… on purpose… unless it’s funny…

I’m your host this week, Aaron, and with me are our panel.

I’m Steve, and did you know that for its sheer ability to calm the soul, it only takes about 7 cute otter videos to equal one beer, and otter videos are acceptable at work.

I’m Shea and this week I learned that before you go out into public, ask yourself: Is it worth it? Can I work it? Can I put my thing down, flip it, and reverse it?

I’m Jenn and I learned this week that May 7th, when the patron cut of this episode drops, was the date Herman W. Mudgett was hanged in 1896 for crimes against humanity…and hospitality. You may know Herman better as the notorious American serial killer HH Holmes.

The news from the field of medicine and health care is all the rage right now, but we don’t wanna talk about Coronavirus. So I’m bringing a timely story from last year on the anniversary of a medical breakthrough.

Aaron’s got a story on medicine too.

Editors Note: When I say ‘DARPA’ at the start of the story, I definitely don’t mean ‘DARPA’, I meant the Bhopal Disaster. 🙄 Because I’m bad with acronyms.

Jenn’s Pox Upon Your House

Today I have a story about EDUCATIONAL HISTORY (ree…ree…ree…ree)!!

It’s not particularly weird, but it’s time appropriate, both in an anniversary sense and it’s more current event-y than it ever should be.

Traveling back in time to May 14, 1796, in rural England, we see the incredibly influential scientist, Dr. Edward Jenner, introducing his most celebrated invention. And now since we live in the most backward of timelines it has become his most controversial. What was this history-altering, millions of lives saving, now somehow debated event? That was the day Dr. Jenner put into use his newly developed smallpox vaccine. Yep, in case you weren’t already aware Dr. Edward Jenner was the father of the innovation of medical vaccinations.

Please see his May pin-up for Sultry Georgian Era Scientists Monthly, complete with the accessory of cow illustration. (Cowpox features into the story, hold on.)

Full disclosure: despite being considered the father of immunology, he was not the first to suggest that exposure to lighter doses of the same or similar illnesses would confer at least some form of immunity. I’ll cover that soon.

Anyway, that’s right(!), I’m gonna talk about the history of vaccinations and exactly what they did for the progress of human society (spoiler alert: a lot more people survived).

Episode 2: How To Prevent A Plague 1

First, we need to learn a bit about the disease that was the first to be inoculated against: the now naturally eradicated smallpox. I say now naturally eradicated bc first off that how’re awesome vaccinations are and secondly (and scarily) it’s considered an excellent potential bioterror weapon. (Just an FYI: in late 1975, Rahima Banu, a three-year-old girl from Bangladesh, was the last known person in the world to have naturally acquired smallpox, per the CDC. She did survive and an intensive vaccination campaign around her home prevented any others from becoming infected.)

Smallpox was a devastating disease for pretty much all of the known human history. It’s believed to have appeared sometime around 10,000 BC as humans in NE Africa were beginning the first agricultural communities. From ncbi.gov (US National Library of Medicine National Institute of Health): The earliest evidence of skin lesions resembling those of smallpox is found on faces of mummies from the time of the 18th and 20th Egyptian Dynasties (1570–1085 bc). The mummified head of the Egyptian pharaoh Ramses V (died 1156 bc) bears evidence of the disease. At the same time, smallpox has been reported in ancient Asian cultures: smallpox was described as early as 1122 bc in China and is mentioned in ancient Sanskrit texts of India.

As humans began to develop trade routes, unsurprisingly, more than goods and services were shared. Smallpox was introduced to Europe sometime between the fifth and seventh centuries and was frequently epidemic during the Middle Ages as if they needed more things to die from. And then of course as the New World was discovered we had a few smallpox highlights: the 16th Century – European colonization and the African slave trade import smallpox into the Caribbean and Central and South America while for the 17th Century – European colonization imports smallpox into North America (oh, and lest we forget our Aussie friends, Great Britain brought it to the Oz land in the 18th century).

Fun fact, the term ‘small pockes’ (pocke meaning sac) was first used in England at the end of the 15th century to distinguish the disease from syphilis, which was then known as the great pockes.

We’ve probably all heard how the Native Americans were decimated by the introduction of European diseases. Smallpox was introduced by the Spanish and Portuguese conquistadors to Southern and Central America. The disease decimated the local population and was instrumental in the fall of the empires of the Aztecs and the Incas. Similarly, on the eastern coast of North America, the disease was introduced by the early settlers and led to a decline in the native population. The devastating effects of smallpox also gave rise to one of the first examples of biological warfare. Again from ncbi.com: During the French-Indian War (1754–1767), Sir Jeffrey Amherst, the commander of the British forces in North America, suggested the deliberate use of smallpox to diminish the American Indian population hostile to the British(he was the flaming asshole who initiated the ‘gifts’ of smallpox infected blankets). Another factor contributing to smallpox in the Americas was the slave trade because many slaves came from regions in Africa where smallpox was endemic.

To put that information into perspective, smallpox in the Old World killed about 30% of those afflicted (while blinding and disfiguring many others), but when brought to lands that have never been exposed the fatality rate was closer to 90%.

Starting around the last thousand years or so, it began to be understood that those who had survived smallpox didn’t develop it again, so they often became the de facto caregivers.

Interesting side note, the “caregiving” wasn’t so much. This fake-care involved herbal remedies, bloodletting, and exposing them to red objects. One prominent 17th-century English doctor realized that those who could afford care actually seemed to be dying at a higher rate than those who couldn’t. Yet that didn’t stop him from telling a smallpox-infected pupil to leave the windows open, to draw the bedsheets no higher than his waist, and to drink profuse quantities of beer. Helpful! Episode 2: How To Prevent A Plague 2

This rudimentary understanding of the disease led to what became known as variolation, a very early form of inoculation (warning, this gets a little gross). Variolation involved taking pus or powdered scabs from patients with a mild case of the disease and inserting them into the skin or nose of susceptible, healthy people. Ideally, the healthy people would suffer only a slight infection this way and, in so doing, would develop immunity to future outbreaks. Some people did die, but at a much lower rate than those who contracted smallpox naturally. Practiced first in Asia and Africa, variolation spread to the Ottoman Empire around 1670 and then to the rest of Europe within a few decades. Its first proponent in the present-day United States was Cotton Mather, a Puritan minister best known for vigorously supporting the Salem witch trials (more proof a broken clock is right twice a day). Benjamin Franklin, who lost a son to smallpox, was another early American supporter.

But this minor…band-aid of healthcare did little to staunch the destructive flow of smallpox’s havoc. In the 18th century in Europe, 400,000 people died annually of smallpox, and one-third of the survivors went blind. The ‘speckled monster’ as it was colloquially referred to, struck suddenly and viciously. The case-fatality rate varied from 20% to 60% and left most survivors with disfiguring scars. The case-fatality rate in infants was even higher, approaching 80% in London and 98% in Berlin during the late 1800s.

But now, around the turn of the 18th century, Dr. Edward Jenner swaggers onto the scientific stage. He was quite the science-y Renaissance man: he studied geology and carried out experiments on human blood. In 1784, after seeing public demonstrations of hot air and hydrogen balloons he Jenner built and twice launched his own hydrogen balloon. It flew 12 miles (yay?). He also spent time studying the cuckoo bird and was the first to publish a paper noting how the cuckoos are giant, lazy assholes who lay eggs in other birds nest to be raised mostly at the expense of the lives of the foster parent-birds own chicks. (Interestingly, while this paper was accepted in many naturalist circles, it was also widely ridiculed. For more than a century, antivax dum-dums used the supposed defects of the cuckoo study to cast doubt on Jenner’s other work.)

Anyway, moving on to his most influential discovery, Jenner used the rural legend/rumor/wives tale that milkmaids never developed smallpox because most all were exposed to cowpox (a closely related but much milder virus).

In 1796 he found a young dairymaid, Sarah Nelms, who had fresh cowpox lesions on her hands and arms and, using matter from Nelms’ lesions, he inoculated an 8-year-old boy, James Phipps on May 14th of that year. Subsequently, the boy developed mild fever and discomfort in the shoulder/armpit area… Nine days after the procedure he felt cold and had lost his appetite, but on the next day, he was much better. In July 1796, Jenner inoculated the boy again, this time with matter from a fresh smallpox lesion. No disease developed, and Jenner concluded that protection was complete.

Of course, it wasn’t quite so simple and advances were necessary, but his original version of vaccination was extremely successful. Within 18 months of the first inoculation, 12,000 persons in England had been vaccinated and the number of smallpox deaths dropped by two-thirds. U.S. President Thomas Jefferson wrote to Jenner in 1806,

“Future generations will know by history only that the loathsome smallpox existed and by you has been extirpated.”

Not in any way to excuse the entire disgusting rape and slavery aspect of TJ, but it must have been nice to have had such a brilliant and eloquent president.

Because the vaccine originally had to be transferred from arm to arm, its use spread slowly. It was also much less effective in tropical countries, where the heat caused it to quickly deteriorate. Nonetheless, one country after another managed to rid itself of the disease. The last reported U.S. case came in 1949. Spurred by two new technological advances—a heat-stable, freeze-dried vaccine, and the bifurcated needle—the World Health Organization then launched a global immunization campaign in 1967 with the goal of wiping out smallpox once and for all. That year, there were 10 million to 15 million cases of smallpox and 2 million deaths, according to WHO estimates. Yet just a decade later, the number was down to ZERO.

So happy birthday to vaccines and I’m very sorry we have fucked up the progress you created like the stupid troglodytes we are.

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Merchants of False Hope

Normally this story would be exclusive to subscribers at Patreon.com/iit, but we wanted to release the first few shows to everyone to give you an idea of what you can get for as little as a dollar a show.

I was watching Chopped the other day, as I am wont to do, and while the contestants described their intentions for the 10 grand, one stuck out. Chef ICan’tRemember has a daughter with cerebral palsy – which fucking sucks for sure – and her plan for the money was another in what it seemed had been a long line of stem cell therapies. This time she was to travel internationally as the services she sought are illegal in the U.S.

Now, obviously, I’m going to get into the cellular bits, but before I do, the aforementioned story prompted my looking into this and while the “therapies” discussed are almost entirely pseudoscience I think we can forgive Chef McGee for latching onto anything that promises help. That kind of desperation is entirely understandable… and, unfortunately, it’s also easily exploitable…

On to the legal parts.

The San Francisco Chronicle published an article called “Merchants of hope,” apparently misunderstanding what “Merchants”, “hope”, and maybe even “of” means…

So there’s this surgeon, Dr. Berman, who got rich inflating boobies and tucking faces, he even invented a newer form of breast implants he regards as his own “person Sistine Chapel”. Yeah. Although, according to the article following his work they are safer, and better, and bouncier… ok, maybe I added the last one.

Anyway, now he sells stem cells by the seashore now. The expensive kind too, one session can range from 2 to 20 grand, often with multiple treatments recommended! Apparently, in doing so he’s become the nearly universal focal point of stem cell… let’s call it treatments. Of course, the current scientific consensus is that there is “little or no scientific proof that they work,” but hey, when you’ve got a bucket of stem cells, every nail is Christopher Reeve’s I guess…

So this guy has built the largest chain of stem cell clinics in the country, second only to McD-NA with locations in 33 states, including 38 clinics in California alone offering services purporting to cure everything from age-related knee pain to MS. Because why not.

Then the big bad FDA sent him a “pics or GTFO” notice. That’s a legal term!

See, the FDA has this thing it likes to see in medical interventions called results. And because of this egregious need to conform to reality, they “targeted” – SF’s terminology, not mine – the clinics. Then again credit where credit is due, “renegade” clinics as SF describes them “operate with little legitimacy and oversight” on the wooing edge of legitimate science.

Stem cells are undifferentiated cells. Which is to say, very simplistically, they can become cells similar to whatever they are surrounded by. Theoretically allowing therapies to regenerate hearts, brains, bones, skin, etc, perhaps providing cures for injury, or as we saw in Jupiter Ascending, curing people of the aging process.. and Mila Kunis of the serious part of her career.

The options for stem cell therapy really is limited only by the imagination… and reality.

Mostly reality.

But realities pesky persistence hasn’t slowed people’s interest in stem cells. For example, Cali voters approved some $3 billion to stem cell research in 2004. To be clear, stem cells do present incredible opportunities for research and medical advancement. But the former takes too long, so let’s pick back up with the latter!

Tapping into popularity and popular misconceptions consumer stem cell clinics have a seemingly endless supply of fanatical clients willing to slather the umbilical-ambrosia on themselves and their loved ones. Of course, none of those cells are FDA approved, nor are they backed by laboratory science, animal studies, or rigorous human testing. In fact, the stem cells offered by clinics are mostly autologous (au·tol·o·gous) adult stem cells — meaning they come from a patient’s own body making them cheaper to harvest and less controversial to work with — while lab settings seem to prefer umbilical or fetal tissue. So… you know… apples vs. crabby nap-time apples.

So, the misconception, embryonic stem cells along with laboratory-generated induced-pluripotent stem cells, can turn into every other kind of cell and regenerate themselves endlessly. Adult stem cells can turn only into certain types of cells and will eventually stop replicating.

So people in desperate need of the kind of medical help we just don’t have available yet instead turn to the “merchants of hope” … an odd name for people selling not what they purport to be selling, and therefore really not providing “hope” so much as the hope for hope.

Stem cell clinics have no registry, no licensing authority at any level, and no real oversight – even communal or in-industry best standards. It’s the cellular wild west out there whatever glop sticks to the wall… or your spine is good enough. That said, these clinics are thriving – in 2008 you couldn’t find one online even, referral only, in 2016 a cursory Google returned some 570 locations offering all the services. These results are available in a paper published in the journal Cell Stem Cell, by the department of redundancy department. Current estimates are around 700 active clinics in America having treated some 20,000 people with experimental, unproven, bio-hackery horseshit…

So what’s a person to do?

Well, if you’re not Richie Rich you might take to Chopped or as many times many more people have done, crowdsource that shit. Sites like GoFundMe are flooded with heart-wrenching stories of chronic illnesses, diseases, and good old fashion pleas for any help staving off old age or the reaper for just a little longer…

Remember that 3 billion in Cali? It funded this thing called the California Institute of Regenerative Medicine (Cali prop 71, 2004) to fund and really dig into stem cell research. Since then CIRM officials have raised more concerns than hopes. With cases of consumer stem cells blinding people, causing spontaneous tumor growth, and hopefully not in the case of our Chef, overseas services have been known to just straight up kill people.

“Some of these places, they’re very much just focused on the profit. Some of them are just rebels. But some of them, do they genuinely believe in stem cell magic?” said Knoepfler, a professor of cell biology and human anatomy at UC Davis. Whatever motivates them, it hardly matters, he continues, “patients need to approach all of them with skepticism. I get it. It’s hard to be patient. I understand if you’re miserable, if you’re partially paralyzed or have debilitating arthritis or you’ve had COPD for 20 years and you’re looking for a game-changer. But if something sounds too good to be true, it probably is.”

For-profit centers claim all manner of things from stem cells ability to rebuild rods and cones in your eyes (that’s the bit that blinds you), to rebuilding nerves damaged by Multiple Sclerosis (the bit that can become tumors), even improve or repair the immune system and genetic disorders (the bit that kills you). Of course, all these claims, if there is any evidence for them, is entirely based on studies of cells in Petri dishes. Evidence of human benefit is almost always anecdotal and, per experts in actual stem cell research, years if not decades away.

To critics, Berman said he’s tired of hearing that “We’re a bunch of quacks and scallywags … we’re charlatans and taking advantage of people. “That’s ridiculous,” he said. “Why would I be doing this unless it was incredibly successful?”

Well, one answer springs to mind – 20k per session, multiple sessions, and new Dr.’s in your network pay licensing, membership, and recurring operational fees, never mind the 30k stem cell machine they’re required to buy called the “Time Machine” because of stem cells reported ability to literally make you younger like an episode of fucking Futurama.

“The idea that it’s this magic cure is greatly exaggerated,” David Spiegel, a Stanford psychiatrist said. “At the moment, most of it in clinical practice is snake oil. … I don’t have much of a sense of humor about these practitioners and companies that are fleecing people on false hope.”

Though all of these treatment centers have increasingly moved out of the country, to Mexico or the Cayman Islands. Remember the network of doctors I mentioned? Well, they kept a database of patients so they could track people’s recoveries – which, they say, amounts to some 80% of clients. The FDA seized that list and has followed up on its own. They found a very different result and… well the U.S. Marshal’s raided offices last year so… yeah. Turns out some stem cell offices have been blending client’s stem cells with stashes of the smallpox vaccine because they claimed to be able to cure cancer, which they can’t, but there have been a few shit studies that suggest smallpox vaccines help cancer-fighting drugs so… fuck it, why not?

Obviously there are risks, especially to people with compromised immune systems. Some folks got sick, one person was hospitalized after a brain injection.

So… is any of it real?

Well, recently a Japanese doctor won a Nobel Prize for some progress. Surgical experiments have been done at Stanford, but all the people conducting those studies… you know, the ones who know what they’re talking about… all say that it’s too early to tell and that they need more, like way more, time.

In the meantime, the FDA is coming down on Stem Cell clinics, but they’re still everywhere, presenting burgeoning science as miraculous woo, and abso-fucking-lutely wracking in the cash doing it.

Outro

I’m Aaron, Thanks to all our listeners, supporters, and my co-hosts. We’d like to extend an extra thank you to this week’s new patrons! Find out more about the show, social links, and contact information at InterestingIfTrue.com.

Music for this episode, Retro, was created by Wayne Jones and was used with permission.

The opinions, views, and nonsense expressed in this show are those of the hosts only and do not represent any other people, organizations, or lifeforms. All rights reserved, Interesting If True 2020.

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