This podcast is for information purposes only and should not be considered professional medical advice.

We do not need one hundred perfect activists.

We need a million imperfect ones.

This is very exciting to get some hot disaster gus.

Yeah, healthcare is so expensive.

Har he needs his own podcast doctor in order to stay healthy.

I'm hurry, Condibolu.

I'm doctor pre Uncle Wally, and this is health Stuff.

Hi everyone, Welcome to Health Stuff.

I'm so excited for you to hear the conversation today with an old friend of mine, doctor Neil Vora.

I actually went to college with him.

He's now the senior advisor for one Health at Conservation International and a former CDC Epidemic Intelligence officer.

He's also a badass.

He's responded to major Ebola outbreaks around the World's led New York City's COVID nineteen contact tracing program.

This was back when COVID just started, and he now heads the Preventing Pandemics at the Source Coalition.

He also teaches at Columbia, serves on several global health boards, and writes for outlets like The New York Times in Nature.

I'm really excited to introduce him to you.

We hope you enjoy the conversation.

Super super excited for today's guests, doctor Neil Vora.

Just for our listeners here, I actually have known Neil since college and I was I think I was a freshman when you were a senior.

And full disclosure, Neil, I was like afraid to talk to you when I was an undergrad because I thought you were the coolest person like around and you had already met Jane Goodall by the age of thirteen.

And recently you have been named Time one hundred's most influential rising Star, which is I'm not surprised, like very consistent with your brand, like you make like Dosa Keith's most interesting man in the world look like a square honestly.

So thank you so much for coming on the show and talking to us about just all the really really cool things you've worked on in the past and are going to work on.

Wow, what a kind of introduction.

And I have to say, like your memory is amazing that you recall that I met Jane Goodall when I was thirteen, Like that's incredible, and yeah, I had such a you know, it was a pleasure for me.

To work with you back in undergrad.

I think.

I was like, you're maybe a teaching assistant type thing for a chemistry class or something.

Yeah, I mean I was just an undergrad with an anxiety and an IBS problem, and like I just I just remember you had your stuff together.

You were like, yeah, I'm going to study infectious diseases.

I want to like battle ebola.

And I was like, okay, well I have a nut allergy and an EPI pen So no, you were so cool, and it's been so awesome just to see you continue that trajectory with all the amazing projects you've been working on.

Well again, thank you, and then right back at you.

Because you are pioneering your own way.

I'm really excited to be to hurry as well.

So this is gonna be a good conversation.

Yeah.

May I just also add rarely do I meet another person whose hair I'm envious of, because I'm very partial to my hair and I feel like I have some damn good hair.

But I look at your hair and I'm like, man, oh man, I'm in second place to the listeners at home can't see this, but it's glorious.

It's a glorious main it's good.

It's evolving over the last like six months.

Every two months, I'm changing it up, so I think I might stick with this for a while.

Kid Man, it's good.

Thank you.

It's rare that you get to meet a superhero U, and so getting to meet you is the closest thing I probably will get to that.

Because you're a medical doctor, an epideviiologist, a conservationist.

You have been called a disease hunter for investigating infectious disease outbreaks around the world.

I just want to know, just how did you get here?

Well, thank you for that kind compliment.

I'm not sure it's true.

You know that I get to follow my passions.

I have been so fortunate in my life to have these opportunities.

When I was a kid, I knew I wanted to do public health as a future career.

My dad, who's from India, originally had smallpox when he was a child.

That's a disease that kills over thirty percent of people that it infects.

He had it when he was less than five, and he still has the legacy of smallpox to this day in the form of scars on his face.

And so when I was growing up, you know, I could see the impact that it had on his own life, and it inspired me to pursue a career in public health.

He made me believe that one day I could join the Centers for Disease Control and Prevention the CDC and be like those people in the sixties and seventies that eradicated smallpox.

That's a gift that keeps on giving.

None of us have to worry about smallpox.

But the other thing that I've always loved are reptiles, and that since undergrad, as pre uncle might remember, I wanted to combine health and conservation, so I did med school.

Had a little bit of an existential crisis.

Did I make the right choice?

Because I would look for guidance on how to combine these careers and I wouldn't get a lot of direction.

I ended up joining the CDC and had one of the most amazing experiences of my life.

It was such a privilege to get to do that work.

I was chasing infectious diseases around the world.

But I found that we weren't in the public health sector talking enough about protecting nature to improve our health.

And that's why I left the CEC and how I work at a nonprofit for the.

Listeners that maybe might be new to this.

They might not have an understanding of the impact of nature on our health.

Can you help us make the connection between why does deforestation matter for our health?

Why is this important?

You know?

For me that all came into focus during a year off that I took from medical school.

I was in Uganda doing ATIV and malaria research, trying to figure out my own future directions.

But before I even came across that life changing paper for me personally, I have to give a shout out to two movies that actually had a very big impact on me.

So when I was fourteen, I saw the movie Outbreak that was released in the mid nineties, and I was like, I want to be like Renee Russo Cuba getting jor Dustin Hoffmann and one day where that has mass.

But you'll remember in that movie there's this monkey that was running around that they're trying to catch before it like leads to more what are known as zoonautic infections, right, so infections caused by pathogens that jump from animals into people.

Then another movie that I watched, probably when I was maybe a junior or a senior in college, is twenty eight Days Later.

Yeah, and I love horror movies.

You know that movie is all about again this like fictitious virus, the rage virus that jumps over from animals into people and then causes the zombie apocalypse.

But again, you know, these movies captured my imagination.

They they helped me start understanding how what we are doing to nature and animals in particular is actually leading to more outbreaks that affects us.

And then I read that paper in two thousand and eight published in the journal Nature, and it was like an epiphany for me.

I suddenly understood how infectious diseases are increasingly emerging around the world.

Most are caused by viruses and other pathogens that jump from animals into people.

And it's because of what we're doing cutting down rainforests, putting people in closer proximity to wildlife as well as our domestic animals.

We're stressing wildlife out.

So just like humans, when we're stressed, we're more likely to get sick.

The singles for wildlife, when they lose their habitats, they're more likely to express infections and infect us.

We're sticking animals in these awful conditions in industrial forms where there's genetically homogeneous chicken populations, for example, that don't have a lot of immunity.

They're not robust and resistant to infections.

We are trading wildlife around the world.

Then, you know, it really worries me that we are going to see more and more pandemics in the coming decades and unless we make a major change in how we interact with nature.

Your organization One Health, you have a three pronged approach to dealing with this.

You talk with the intersection of human, animal, environmental health.

Can you talk about the importance these things have in creating and preventing infectious disease.

Yeah, you know.

So.

I work for this organization called Conservation International.

It's a nonprofit that was started maybe thirty forty years ago, and our mission is to protect nature for people.

Now, the old model of conservation is that people used to get separated from the areas being protected, which is a fundamentally flawed approach because people are a part of.

Nature, not apart from nature.

And so the way we do conservation is to put communities at the center of all of our work.

And so the way I see it is, when done right, conservation is public health.

Any intervention to protect nature is actually improving our own health.

And this gets back to the fact that we need nature to survive.

There is no future for humanity without nature.

But if you look at the past fifty years, around almost seventy five percent of wild animal populations have declined.

Something like that.

If you look at the mass of all mammals that occupy the planet today, ninety six percent are humans and our livestock like cows and pigs, and only four percent are wild animals, wild mammals, And so we've caused this massive decline and what's known as biodiversity, the variety of life on this planet.

And to me, that's just so scary.

There is no future for our species if we live on a planet without biodiversity.

Everything we get for our survival comes from nature.

We're talking about water, air, the supplies that allow us to live in cities and villages and on, and so we need to start taking care of our planet to secure a better future.

I'll just say one more thing.

You know, we have had massive gains in human progress over the last fifty to one hundred years thanks to our extraction of resources from nature, such as fossil fuels, thanks to development of new technologies.

Again, made possible by resources as well as our ability to convert natural landscapes into other forms of lands such as farms, and so because of that, we've seen human well being go up, but at the same time, the well being of nature has been declining.

But now we've arrived at this tipping point where we have things like climate change and this mass extinction and pandemics which are happening because of what we've done to nature.

So we need to correct that imbalance.

So let's kind of double click a little bit and slow down on what because you're hitting on some like really really big collective oriented themes.

And one of the questions that I have for you, given all that you know, is what can a singular, average person do who may not have corporate ties, who is just like a regular person.

Because when a regular person hears all this, there's almost a sense of like, well, this seems really a lot bigger than me.

What can I do?

So what sort of advice do you have for listeners or people just listening going about their lives, like how can they make changes in the right direction?

I love this question because I've been in that place myself before four and a half years ago, when I made the move to Conservation International.

I felt so much anxiety about what is happening to the planet and that I am not contributing to the solutions.

I just felt like I was part of the problem.

I felt a lot of anger at my own self for not doing more.

So it's almost paralyzing.

And then I had this amazing opportunity in early twenty twenty one to move over to this nonprofit and it was nine and day for me.

Suddenly I was surrounded by people who are committed to protecting nature for their lives.

Right, They've made that their their life's purpose, and I see those solutions all around me.

Right, there are so many incredible things happening every day, so many people who go unrecognize, but who are committed to planting trees or doing whatever they can.

Now, I'm not saying that everyone needs to you know, if you care about nature, that you need to drop your you know, whatever you're doing and find a job full time and conservation or you know, become you know, among you know and renownced like the material world.

But there is something that each of us can do.

One of my favorite climate activists, Clover Hogan, has this quote where she says, we do not need a hundred perfect activists, We need a million imperfect ones.

And I really love that because none of us are perfect.

We don't we should not be holding ourselves to this unattainable stand Rather, each of us can choose to do something that's within our grasp and do it really well and have impact in that area and then inspire others to take action in their own way.

Right, So, you don't need to have this massive change in your life or you know, renounce everything that you have right now in your life.

You just really need to find where it is that you can have an impact in your own life and just start doing that.

So, identify what it is that you care about, identify what your strengths are, and then move forward on that.

Maybe it's about reducing uses of certain materials in your work, or maybe it's about eating less meat in your diet.

Again, we don't have to be perfect, but just choose an area and start making progress.

What does success look like to you?

And do you feel like success is possible?

One of my favorite authors, Ianna Elizabeth Johnson, has this book What If I Get It Right?

And so your question reminds me of that wonderful book, and I do believe a better world is possible.

Right.

We're not in you, I hope here right now.

We will never be in utopia.

There's always room to do better and continually improve.

But I see so much progress.

Right if you compare how people are doing today compared to how we were fifty years ago.

Right, so many more people are living above the poverty line around the world.

That is incredible progress.

That gives me hope.

I see so much action in terms of the private sector, governments around the world taking action to reduce carbon emissions.

A few years ago, out of the Convention on Biological Diversity, which is the UN arm that deals with protecting biodiversity, over one hundred and ninety countries signed on to this Global Biodiversity Framework to protect thirty percent of land and oceans by twenty thirty.

Right, these are all incredible landmark achievements.

Of course, we need to move beyond talk, but I believe in a continual improvement process.

Right.

So I don't know if there is a clear definition of success for me, other than I firmly believe that we need an awakening.

We need to and I say this as a scientist and someone who's currency of work are data in facts.

But that alone is not enough to inspire action.

Right, we have decades upon decades of data that the climate is changing, yet we do not have sufficient action to date.

But what I think is really critical are you know the people like YouTube who have like this fun approach to gathering information and like using comedy to inspire people.

People who are artists, writers, actors, right, all types of people to inspire us to think of a better future that I think is possible.

Again, if you think back to the nineteen forties and you lived in in Europe when when the Nazis were taking over, right, this seemed like the world was about to end, but people rose up to the challenge and change the world.

And I think that a better future is possible.

More to come on health stuff.

So I mean, it's very interesting because you've been studying pandemics like way before COVID, and I feel like the world, let's say the United States, like didn't really think about pandemics until it actually affected our lives and now we're all pandemic aware.

But I am so curious when COVID happened, were you like already over it before it even started because of the work that you do.

Or were you just as sort of frazzled as the rest of us, or was it more like, oh yeah, like I told you so, guys, what was your experience of COVID given your background?

Yeah, you know, my partner often says that I can be this is before COVID, right like, and she would say that I'm a party proper.

We were like in twenty nineteen at this campfire.

We met the random people around this campfire, right like, they were at the same hotel as us, and we just started talking.

Then I go on and say, look, we are at this really difficult point in history where there's the convergence of five existential threats climate change, loss of bio diversity, artificial intelligence, nuclear war, the war on truth.

Right Like, I just like rattled off these things, and.

I'm like they were like, man, we're just at a rave.

Dude, Yeah exactly.

And then the next year the pandemic struck.

Right.

And the reason I'm emphasizing this is because many people in the public health space have been saying for decades it's not a question of if a pandemic is going to occur, it's a matter of when And if you look at the last one hundred and seven years, right, since nineteen eighteen, there have been six viral pandemics at least depending on how you count it, you could even say there's more.

But there's been four flu pandemics, there's been an HIV pandemic, and then there's COVID.

In total these it killed over ninety million PEO.

So pandemics claim a lot of wise and because of what we are doing to nature, we are going to see the pace of pandemics increasing several fold in the coming decades.

So I think it's very likely in the next ten years we will see another pandemic, and I think it could be far worse than COVID.

Right, seven million plus people died from COVID.

It was awful, but in many ways we dodged a bullet, right, because there are even more deadly pathogens out there, such as some of the novel influenza viruses.

And on top of that, we are worse off today in certain ways than we were back in twenty nineteen because there's been a collapse of public health infrastructures all over the world.

There's less trust in public agencies in general.

Beyond health institutions and healthcare workers are tired.

Many of my closest friends are emergency room and infectious disease doctors who were working in New York City hospitals back in and I just when I hear what they went through, it breaks my heart.

It was so hard, and that was the experience for healthcare workers all around the world, and so I'm very concerned about this.

In twenty twenty, Mayror Bill de Blasio in New York City tapped me to lead the city's COVID contact tracing program.

It was the hardest thing I've ever done professionally.

You know, I've been to Western Central Africa for the two biggest e Bowl outbreaks ever.

I was in Haiti after the twenty ten earthquake.

You know, I've seen awful, awful things, but nothing like the response in New York City.

And that's heartbreaking, right, Like the number of people that died, suffered so much, the isolation, right beyond just the debts, but we all know this, right, people just felt socially isolated.

Yeah, so it worries me.

What did you learn from leading the contact tracing program in New York?

Like, were there lessons learned from that.

Yeah.

I mean the lessons I learned was I guess, like, on a personal level, surround yourself with good people.

I had the most amazing team.

It wouldn't have been possible without this team I had.

Like, these are people who already were so impacted by the pandemic, but they stood up in the face of all that adversity, worked the craziest hours, and they did this because they believe in public service.

And I just am so grateful to them.

I think that mission matters right when you people are inspired by mission, And so often I think we lose sight in the modern world of like purpose because we've become so disconnected from each other.

But when we start connecting again personally, I think it can reinspire us to work towards a better world.

Now.

In terms of like the public health lessons that I learned, it's just a lot of what we already knew before the pandemic, which is that we have to invest in public health infrastructure.

Public health services are a public utility.

As late David Lee used to say that it's a public utility that goes unrecognized when public health is working well because you're not having outbreaks of diarrheal disease from your water supply that you're getting through your city pipes, or because you're not dealing with, you know, outbreaks of respiratory pathogens.

You don't even know that public health is there working in the background.

It's only when things go wrong that then you know, people become aware, but then they get angry.

We're asking more and more of government, but expecting government to do provide those services with less and less resources.

So I think it's a tough situation, but I hope that we can start reinvesting in our public health institutions like the CDC.

It is so I mean, speaking of the CDC, there's been so many changes, so many cutbacks.

If you could, let's say you got the call and you know, they were like, okay, Neil, you run the CDC, what would be kind of the top maybe one or two things that you would want to have in place, like PRONTO.

Data and surveillance are the backbones of public health work, and so we need to be investing in our public health surveillance systems that we can get good data on which we can base decisions.

Right, some of the major killers in the country are not necessarily the ones that we can make movies out of.

Right, So, even though I'm an infectious disease public health expert, you know, a lot of the public health work needs to happen on chronic diseases like cardiovascular disease, you know, bring you know all about like access to better foods, and there are food deserts around the country and around the world.

So I think there's a lot of basic public health work that needs to get done.

But what concerns me is that we don't again talk about that connection to nature, which is the focus of my work now.

A lot of the bad things that we're already seeing and that we're going to increasingly see in the coming decades are a result of our broken relationship with nature.

So for me, we have to start correcting that imbalance, protecting what's left of nature so that we can actually secure our own future.

I mentioned before, we're losing biodiversity at this astonishing pace.

We are in the midst of the sixth mass extinction.

Right The last one before this was around sixty five million years ago when the dinosaurs disappeared after an asteroid collided with our planet.

But this sixth one, right now, this is the only one that's because of a single species, and that's us humans.

We are destroying landscapes, we are causing climate change, and as a result, all these animals, all these plants, fungi, these species are disappearing.

And you know, beyond the obvious ways that this impacts our health, like for example, you know, providing clean water to whole cities or giving us clean air.

Beyond those obvious examples, as this web of life unravels, there are so many surprising ways that it begins to impact our health.

I'll give you an example.

This researcher, I think it was last year he published this incredible work.

There's this fungal infection spreading in bats in North America.

Came from somewhere, probably in the Eastern hemisphere, but this fungal infection was introduced.

Over a million bats have died across the US and Canada.

Now that might not sound like a big deal, but what this researcher showed is that as bats have declined, farmers have had to use more and more pesticides because bats off any insects, and as pasticide uses increase, there is a correlation to increased infant mortality.

Right, So basically, the loss of these bats is leading to infants dying.

Now, I have to be very caveat this by saying, we don't know for sure that the loss of bats is causing those infint debts, but there is this strong correlation and there's other examples of this.

Right, So we need to start protecting what's left on this planet because if at the end of the day, all we have left our humans cows, pigs, and chickens, that's going to lead to a lot of bad things.

We need that biodiversity for our own resilience.

I mean related question like what policies should nations put in to play enact in order to reach these goals?

You know.

So there's that Convention on Biological Diversity out of the United Nations that I mentioned, right, So there are nations committed to protecting thirty percent of their lands and marine ecosystems by twenty thirty.

The problem is, you know, despite this commitment, there has not been the resources to necessarily follow up on that, and so we need more resources getting invested in this area.

The challenge is that, you know, when we talk about protecting nature, quite often the money, the profit incentive is not necessarily there.

Right now, an acre of forest is worth more chopped down than it is worthstanding, and we have to reassess our incentive structures.

So I just want to take a minute to pause a little bit because you're naming huge, huge topics and it's palpable, Like I can feel it in my body when you talk about it, just the passion you know, you're it's almost like you're speaking on behalf of mother nature, Like I'm the representative for this and it's a lot.

It seems like it's a lot to receive, it's a lot to carry, especially like in your body.

And so I'm so curious Neil, about how do you keep yourself regulated on a day to day basis when you know all of this stuff, you have, all of these concerns, you're naming these really really big issues.

It's a lot to digest.

What do you do to keep yourself not like crying in a ball several hours a day or maybe maybe you do do that, Maybe that is what you do.

Like I'd love to understand, like what is your self care practice to do work on this level?

Yeah, it's tough, right, like when you're constantly dealing with you know, the possibility of you know, the next species dying out.

It's hard.

I remember, and I think it was twenty twenty two a report came out that said one in five reptiles are threatened with extinction or something like that, and reptiles are like my, my, my thing.

And I just remember crying when I when I heard about that.

But I would say that there's four things that keep me going.

Number one, personal relationships, particularly to my partner who's meeting her was the best thing to ever happen to me.

I'm so lucky I have her in my life.

I have an amazing family, right, so, an amazing family and friends, and so personal relationships.

Number Two is Brazilian jiu jitsu.

I like going at it.

Yeah, yeah, you know, which has been a really interesting experience for me.

If any one is following like the Ultimate fighting damage that maybe not.

But like next year, President Trump is talking about having a UFC match on like the grounds of the White House.

I love UFC.

I'm not sure I'm necessarily a big fan of doing UFC at the White House, but Brazilian jiu jitsu is key to mixed martial arts, which is what UFC is all about.

And for me when I go train, I started training around maybe six years ago.

I stumbled upon this, but it's just been life changing because when I am training for that hour hour and a half that I'm at the gym, like I don't think about anything else.

It's my way to disconnect and it just puts me in a state of flow.

Then I can come back to my work with charge.

But the other really cool thing is I used to live in New York City and I used to train in New York City.

Last year I moved to upstate New York.

And you know, when I trained in the city, I was training with a lot of people who were left leaning liberal like me.

But now upstate here in the Hudson Valley where I train at, there's a lot of people who are on the op as the end of the political spectrum.

And you know, when we're at this gym, though we are all together, we are finding community.

We trust each other, right like in jiu jitsu, you're literally trying to rip each other's arms and legs off, and so you know, there's so much trust that comes with that.

And for me, it's a beautiful thing that in this neutral third space of this martial arts gym.

We're able to come together and find community, and that actually gives me hope.

I think we need to start reconnecting more.

Item number three is spirituality.

When you do conservation and you're thinking about nature, you're necessarily thinking about things bigger than you, and you see the interconnectedness of all life, and so it's just it's been humbling.

You know.

I recognize my insignificance in the grand scheme of the universe, but I'm also so grateful that I'm on this planet, that I have this brief moment of time to pursue my purpose.

I feel so grateful for that every day.

And the fourth thing I'll just mention is horror.

I love vampires and zombies and things like that.

And you know, a lot of when you think about horror and like scary stories, a lot of this has inspired those stories by things we do not understand in the world.

So back in the seventeen hundreds, all that people were talking about in Europe was vampires.

They were so scared of vampires.

And this was before the germ theory of disease was really popularized, and so you had common diseases like rabies and tuberculosis that didn't have an explanation, and vampires was one way that people tried to understand and comprehend those types of public health threats.

And you know, in the current age, what we're grappling with is climate change and like, you know, a world that's rapidly changing, you know, not just from climate change, but from other factors as well.

And that's why I think we've seen a rise in you know, zombie movies and shows in recent years.

But it provides this sandbox through which I can explore some of my worst fears and it helps me deal with the reality that were now living in.

I'm really curious as to because you were involved in fighting the to ebola outbreaks in Central and West Africa, how do you do work like that and not constantly fear your own like your own death because it's such a there's so many workers who are exposed to ebola and died from it pretty quickly.

Like knowing that even with hazmat suits and the rest of it, like there is this high risk, Like how do you put that aside to do the work you need to do?

You know, honestly, as a CDC employee, when you get deployed to deal with an outbreak.

You actually tend to know what you're dealing with by the time you get there, so you know what precautions to take.

The people who I think are at more risk and the real heroes are those frontline healthcare workers who are seeing people often without a lot of resources, and then they have to manage these people with unknown illnesses and then they can themselves get sick.

So we saw in Ebola outbreak after Ebola outbreak, healthcare workers are at such high risk.

I remember when I was in like the Congo.

This is in twenty nineteen.

I was in the Congo for the second biggest e bullet outbreak ever, and we were visiting this this hospital and there was these surgical masks that were strung up along the side of the building of a hospital because they were being washed and reused in the middle.

Of an a Bola outbreak.

And I was like so struck by that.

So I took pictures and when I came back, I used them in presentations saying like this is how dire the circumstances are.

Or when I was in Liberia, you know, in.

The biggest e bullet outbreak ever, overnight the community care center affiliated with the community hospital I was working out of.

They just ran out of gloves overnight.

Right, how do you take care of your bullet patients without gloves?

My god, it was appalling, but you know, you fast forward to spring of twenty twenty, COVID is now happening.

I'm in New York City.

My closest friend from residency calls me one day because she's working out of a New York City hospital and she has to, you know, be working in the emergency room to deal with COVID patients.

And the hospital was running out of N ninety five respirators and masks, and she was asking me whether I had any spare respirators that she could borrow.

And I still had a stack of N ninety fives from my prior Ebola deployment that I could then give to her.

But underscores infectious diseases are equalizers.

It does not matter where you are in the world.

Right when an emergency happens, it'll strain any system after a certain point, including a resource rich place like the United States.

So how do I stay safe?

I mean, you use science and you make educated decisions.

I think generally, you know, again, the work is generally pretty safe, but of course there's there's a risk every time I you know, I even crossed the street in New York City just walking to go to a restaurant.

Right, you can get hit by a car.

So you just you make decisions in life and you just have to try to be smart about them.

We'll be back with more health stuff after this break.

There's so many things that I want to like double click on.

Firstly, can we just go back to the jiu jitsu?

So, like, are you so what I'm imagining is like, okay, we get liberals and conservatives and we just get them to wrestle with each other, and like this, this is this the solution to our country right now, Like let's just get on the mat and like get it all out.

I mean, this is just amazing how much camaraderie is built in that setting, right, Like you have people who are just there to pursue this.

I mean some people are trying to go pro but most of us are there, like and you know, we're just there at the end of the day or on the morning before work or after work.

To get a little blow off, a little steam.

Yeah, you're just there to like work through your stuff.

Yeah right, yeah, exactly.

But it's just like jiu jitsu in particular, Like you said, it's kind of like wrestling.

It's a grappling based art, and it's pretty great in that, Like you're on these masks, especially with my hair is like a mop and the math's literally after a session like have puddles of sweat, and you know, sometimes you're below someone in there like a real sweater and they're just dripping sweat into your eyes and your face and your nose and mouth, and I'm just like closing my eyes and trying to not get that in my orifices.

But it builds this camaraderie.

And I right, I'm not sure jiu jitsus for everyone.

You know, it's something, you know.

The point, though, is that we need to refine these third spaces schools, places of faith, libraries, right and in a lot of ways, these neutral third spaces have been eliminated, and we are then losing our connection to other people and our ability to see each other's humanity.

I think we certainly need to start thinking outside of the box and getting really creative about solutions towards working through our differences and maybe it is time to bring in the absurd and the magical.

Maybe that is the answer.

We just need to wrestle it out and sweat on each other and get our pharaoams mixed up, and we may not agree with each other, but at least we can hold each other in humanity.

Or we could watch the fun TV.

Yeah.

Speaking of which, so did you watch Last of Us?

Because that, to me is like the latest sort of like disaster film invoking climate change and like mold, which you know, I definitely have experienced treating people who have gotten mold sickness and whatnot.

So I mean, have you checked out the show, and if so, like, what are your thoughts on that?

Yeah?

I even had an op ed in the New York Times about the Last of Us.

It's definitely something that Look, it's a fantastic show.

I will say that it's more of a show about relationships than it is about horror, but I didn't think it does that very well.

And I do love how they open up with this amazing TV interview the scientists and talking about changing climate.

You know, let's take a step back and talk about fungal infections, right, and preamplely you've treated them before.

Fungal infections can be really tough to treat because fungal cells can be very similar to human cells, and so then the medicines used to treat those infections can be very toxic to our own bodies.

But like, if you have an invasive fungal infection, it can be tough to treat.

But if you look at fungal diseases in other organisms, right, we have things like tritomycosis that has caused extinction of entire species of amphibians.

Right, you have things like we talked about white nose syndrome before that's caused a depth of over a million bats across the United States and Canada.

Right, Fungal infections can be so pervasive because if they're environmentally spread, they're just releasing their spores in the air.

We're always we're constantly breathing in these spores, and if the fungus is capable of infecting us, then it can lead to bad things.

Now, the thing that the List of Us show does really well is it makes this point that as climate is changing, as the world is getting on average warmer and warmer, it's creating an evolutionary pressure where fungi are basically being selected for those that can live at higher temperatures.

But many of the fungal species right now that are already around the world are ones that live at temperatures They thrive at temperatures lower than the human body temperature.

So if we are selecting for fungal species that can live at warmer and warmer temperatures, we might be seeing more and more fungal outbreaks in the future.

And there's already one cannibal species that at least one of the leading theories for how it evolved is because of climate change, and this causes devastating infections in people.

But like, what else is there out there that where we currently don't recognize as a human pathogen, that in the coming decades will be considered a human pathogen because of climate change?

This is very exciting to get some hot disaster gus.

Yeah, this is.

What I've been waiting for exactly.

It's worrisome right, Like, and again, you're the spores are all around us, so how do you protect yourself in that setting?

So what we need to be doing right investing more in prevention, you know, to your earlier question, what would I do if I had more control of public health.

Decision, if you were the king of the CDC, what would you do?

Yeah, we need to be investing in prevention, right We need to go upstream, take care of nature, you know, start keeping forest protected, start fighting climate change more aggressively than we are right now.

We are going to blow past our climate goals because we're not taking enough action right now.

You know the other thing that that resonates with me with what you're saying as a physician, it sort of also makes me acutely aware of how much I need to continuously be on top of the data to stay on top of this, because you're essentially talking about emerging diseases of climate change, you know, novel diseases as a result of the changing environment.

As a physician, like I can't just rely on like the stuff they taught me in med school and residency.

I need to be up to date right now and tomorrow and the next day.

And so you know, it's it's also a call to action to any healthcare professionals who are listening that it's in your best incentive to stay on top of this and don't be like a year behind because a year from now we could be in a very different situation like covid.

It happened overnight.

Yeah, I think you're absolutely right.

You know, the medical world is changing very fast, particularly from infectious diseases.

If you look at just like the last fifteen years, we've had ebola, zeica.

You know, massive measles operate, COVID, mpox, avian flu is on the horizon, right like, these things are popping up.

Who would have thought that a mosquito born virus like the Zica virus would cause birth defects.

You know, before two thousand and seven, there had only ever been less than twenty reports cases of zica in humans, right, it was considered a very minor infection.

Two thousand and seven, the first ever recognized outbreak of Zica happened.

I was in this island in the Pacific Ocean called yap On that during that outbreak, over seventy percent of the entire population is estimated to have become infected.

Over seventy percent.

Wow.

And even then, in this setting of an outbreak like that, the birth defects of zica were not recognized.

So not until twenty and sixteen, when Zica made its way to the Western hemisphere when it started spreading at these massive epidemic levels that people started to recognize that.

But it gets back to what you were saying, Prianca will always be astute clinicians that recognize that, hey, what I'm seeing in front of me in this patient is a little bit weird, and let me work with the health department, let me work with the CDC to do additional testing to find out what's going on here.

And that's why I've let you know so much respect for clinicians who do this work.

It is so hard to do this work.

You're working such long hours, there's so much to learn.

There's so much pressure on our doctors and nurses and physician assistance and beyond to do all this work to take good care of patients.

And on top of that, there's always this personal risk.

We're living in the pandemic scene right where pandemics are just a part of the world we now live in because of what we've done to the world, and there's a risk adherent to that for those clinicians doing that work.

You talked about the influence of like outbreak in your childhood and how that made you want to do the work that you do.

How accurate.

Are those films.

I think they do a great job.

You know, this is what I mean Like horror and these thrillers.

They take a particular aspect of reality and maybe the you know, they fictionalize it, they dramatize it, make it interesting.

They're rooted in some level of reality of evidence.

But then they take leeways right again to make it entertaining.

But I think that actually has a really important role because as again we've seen with Ebola, zeka ebola just in the last ten to fifteen years, when these real outbreaks happen, they defy conventional clinical and public health wisdom.

We have to have humility, those of us who are scientists and you know, doctors or whatever, epidemiologists, we have to have humility.

And that's what I think Horror gets right.

They're taking these fears to their worst extreme.

But I would say that COVID in many ways was a nightmare.

You know, whether or not you believe in the COVID vaccine, it was a nightmare because we were isolated and people were dying and whatever else.

So I think that these fictitious depictions of infectious diseases are very important, even for an expert like me for me to like imagine what is going on and how things are getting worse or what directions the world can go in.

So yeah, they take you know.

I don't think zombies are real, but with that being said, I think, like again, there's validity to those films.

We live in a time of just so much false information, and especially coming from the White House and various agencies.

How do people find their way to the truth when you're getting all this false information.

That's one of my greatest concerns.

And I you know, of all the existential threats out there, from the mass extinction to pandemics, to the risk of nuclear war and artificial intelligence, to me, the one that worries me the most is misinformation and disinformation because we have, for example, decades upon decades of evidence that the climate is changing.

But there's also been a very concerted campaign, in part by fossil fuel companies and others with vested interests that have spread all this misinformation such that people are still debating, including in the United States, whether climate change is real or whether humans are the cause of it.

Right like now, it's shifted in people are saying that climate change is real, but humans aren't the cause of it is what some people are saying.

The reality is that we know that the climate is changing and that's because of human activities, particularly the combustion of fossil fuels.

And we're seeing this on the public outside with anti vaccine rhetoric.

It's all the same thing, right, And so ultimately science has been a victim of its own success.

We have longer lifespans than ever before on average in recent years, fewer children are dying under five, There's more access to energy, food, right, we live better lives.

None of us would want to give this up.

This has been made possible by science and technological developments, and yet you have entities that are purposely spreading misinformation and disinformation to undermine progress.

And so it really worries me.

A life spreads faster than the truth, you know, in the age of social media gets harder and harder, and then you have deep fakes where fake videos are being created.

So it's just it's very complex, and I think we need to combat that miss and disinformation with accurate information.

But this gets back to what I was saying before.

You know, we need to not just have scientists, the communicators and ambassadors for science.

We need to be teaming up in creative ways.

And Pranco, you were saying I think something like this before as well.

But we need to be teaming up in creative ways across different expertise, right, and getting information out there, and I guess meeting people where they're at, right, Like, we all prefer to receive information in different ways, So let's make sure that information gets packaged in different ways and delivered effectively.

Yeah, and a little jiu jitsu doesn't hurt either while you're at.

Actually like, oh look, I'll give you an example though.

One of the people in my gym, you know, one of the really experienced people who can just kick my butt.

But like you know, early on when I first met him and he would like find out that I'm a doctor, and then we started to build trust.

You know, he asked me like, what is your view on the COVID vaccine because he had never received it before.

And then after we had built that trust, he said, you know, now that you're saying it, I guess it makes sense, right, And so is that personal connection, that trust that had been built.

I think in a lot of ways, our healthcare institutions and our public health in structure in the United States has failed the population of this country.

And you know, healthcare premiums are about to go up, and we're going to continue to fail people.

And to me, that's heartbreaking.

So people have lost trust in the institutions that can help them.

Yeah, I mean healthcare is so expensive.

Har he needs his own podcast doctor in order to like stay healthy.

Yeah, this has nothing to do with the podcast.

I'm being paid with health advice.

So Neil, thank you so much for your time today and just really truly educating us about so much that's going on.

And what I'm also taking is that like you're you're still hopeful, like you you don't like we're not screwed, right, like you tell tell me we're not screwed.

Right, Well, we aren't screwed.

There's solutions all around us.

And like I'm living proof that action is the best antidote to despair.

I've never been more hopeful for the world, you know, even to spy, like so many things that I'm used to that this country is used to suddenly falling apart.

The future is right the as MLK would say, the moral arc of the universe is long, but it bends towards justice, but it's up to us to make it bend in that way.

And so let's all do something that we can to create a better.

World, Doctor Neil Vora, everyone, thank you so much.

Yes, oh, thank you all so much.

It's been a pleasure to be here.

Yeah, that was great.

Health Stuff is a production of iHeart Podcasts.

The show is hosted by me Harico Debolu and doctor Prianco Wally.

Producers are Rebecca Eisenberg, Jenna Kagel, Christina Loranger, Maya Howard, and Katrina Norville.

Our researcher is Maria Tremarki and our intern is Katia Obeldea Yala.

To send us a question, you can email us a voicemail at health Stuff podcast at gmail dot com.

Thank you for listening.