The Symbiotic Podcast

Changing the Game in Epidemiology: Nita Bharti

March 07, 2022 The Huck Institutes of the Life Sciences Season 3 Episode 2
The Symbiotic Podcast
Changing the Game in Epidemiology: Nita Bharti
Show Notes Transcript

Nita Bharti is an expert on the interplay of population movement and disease and a pioneer in the use of unorthodox data sources to better inform public health decisions. In this livestreamed conversation, she shares her open-minded, intellectually curious approach to epidemiology on multiple continents, working with people, animals, and spillover events between the two.

Relevant Links

Featured Guest

  • Nita Bharti
    Huck Early Career Professor; Assistant Professor of Biology

Cole Hons: Greetings fellow homo sapiens, and welcome to The Symbiotic Podcast live in the studio for our third season. This is our second live stream. It's all completely live. We're out here without a net on the high rope talking to some of our favorite scientists at Penn State who are taking risks and changing the game. I'm going to introduce our guests today in just a moment, but before I do, I just want to let you know that if you want to participate today, you can just join the chat. Just put your name in or stay anonymous if you wish. Right there next to this streaming window, you can see a place to pop your name in. Hit accept and you'll be able to put in your questions. There's a little button that will come up allowing you to ask questions. Also to vote for other people's questions. And at the end of our 45 minutes here, we'll be asking those questions live to our guest, Dr. Nita Bharti, who's with us today, our buddy, Hey, Nita.

Nita Bharti: Hey, Cole. Thanks for inviting me.

Cole: Thank you for coming out here. And I know you're so, so busy. We managed to pull you out of this. We're putting the phones aside. We're talking in real life in the same spot with our masks on safely. I wore my pink mask just for you.

Nita: I love it. I was going to say, I love the pink mask.

Cole: Thank you. Well, I know you like our unicorn and he's got a pink horn, so I thought I'd try and pink it up a little bit for you. So thank you so much for coming out. It's great to see you again. This is your second time on The Symbiotic Podcast.

Nita: Yeah, it is. I think our first time was sort of like the first week that the news was breaking about COVID.

Cole: That's exactly right. I think it was February 2nd if I'm not mistaken.

Nita: We weren't calling it COVID yet.

Cole: No, no. It wasn't even called a pandemic. It was called an outbreak. The first death had just happened in Hong Kong. There were no deaths in the US and already people were starting to freak out. Some healthcare workers, I remember, in Hong Kong. I kind of went back and looked at that a little. We talked about a lot of things, though, that have played out. I mean, we talked about vaccine hesitancy right out of the gate. We talked about some ugly, racist, horrible, xenophobic things and a lot of those things have played out two years later. It's like being in a different world. I'm hoping we're getting to the tail end of this thing. What do you think about that?

Nita: So I would say a couple things. The-

Cole: And I'll ask you to just turn that mic towards you just... There. Perfect. Thank you. It should stay. That's great.

Nita: All right. So I'll say that a couple of things that we had talked about during that early podcast were really just recognizing patterns that happen over and over again with disease outbreaks and spillover events, and then eventually pandemics. So that pattern recognition, it's kind of sad that we see these same behavioral emergences with really every time they could be avoided. Like the vaccine hesitancy, which has been around as long as vaccines have been around. And the racism and the xenophobia, which happens every time we see geographical spread of an infectious agent.

Nita: Coming back to your other question, I don't really think that this is over. We're seeing new news about variants and other emerging variants, and I think this will continue to be something that we have to worry about.

Cole: Try and fix this for you. Sorry. Keith was sitting in here. There. I think we [crosstalk 00:03:41].

Nita: Oh, that's perfect. Yeah. I don't think this is over by a long shot. I don't think that it's going to be over as long as we keep pretending that it's over. I think a lot of the backing off and the behavioral interventions that we keep doing, so talking about lifting mass restrictions and reducing distancing guidelines and things, I think those are all pretty good ways to make sure we're not going to be done with this.

Cole: I mean, we're here really to talk more about your research in general and some of the ways that you've been pushing the envelope and trying new things. But I just had to bring that up considering the last time we talked. And I know that there's such a range of how people react and have reacted and continue to react. And there's so much just exhaustion around the pandemic that so many people just feel. I hear people say like, "I'm done with this," because we all feel like we want to just be done. But before we get into to your research in particular, I'd like to touch on this word "endemic" because that's a word that we hear a lot. That this virus is going to become an endemic part, just kind of floating around almost like the seasonal flu eventually. Could you speak to that for just a minute? Your thoughts on that?

Nita: So I think a lot of epidemiologists feel like the word "endemic" is sort of going the way of the phrase "herd immunity", where it was just misunderstood and used incorrectly for a long time. So the word endemic doesn't mean that it's not a problem anymore. The word endemic really means that there's a pretty consistent level of either incidents or prevalence of a pathogen in an area over a certain amount of time and you can define what that time is. So if we talk about flu, your example of seasonal flu, we see increases and decreases seasonally. But for the most part over the course of a year, year to year, we see a pretty predictable number of cases. And then there's the years where we don't and we can talk about that in a minute. But for the most part we say that that's endemic because yeah, we see these seasonal fluctuations, but we also kind of know what the annual level of cases is going to be for influenza.

Nita: That's basically all it means. It doesn't mean that it's not a problem. We could say, okay, we're at a place where we've decided that COVID is endemic. And that means that we are okay with the level of morbidity and mortality that we're seeing on a really predictable and regular basis. We're okay with saying that's how many cases and deaths we're going to have caused by COVID every month or every year or whatever, in the US or in the world, whatever we decide. And so we could make that decision. We could. I think it would be a huge misstep because we are experiencing a very high level of excess deaths and cases still, but that's really what it means. It doesn't mean it's not a problem. It means it's something that we have to worry about a lot.

Cole: Yeah. Something it makes me think about is deaths in cars. Like so many traffic accidents a year and you just sort of... It's not that we become numb to it, but as you say, there's a level of acceptance of this is just how things are and we go on and we go back to that phrase we've heard so much over the last two years, when does it go "back to normal?"

Nita: I mean, I think there's something really interesting there about that analogy, right Cole? So we have so many things in place to reduce traffic deaths and to minimize the number of accidents. Seat belts, airbags are getting better all the time. Crumple zones on cars are improving. We have constant improvement about that because we sort of feel like traffic deaths are avoidable and should not happen. And then I would also say with the flu we have a huge amount of infrastructure in place to sound alarms when we get beyond a certain level of either early cases or mortality in alarming age ranges. There are ways that we manage those things so that they're either constantly trying to be reduced or that we really have pretty strict thresholds about what's acceptable and what's not. And so to say that we're going to get to a place where COVID is endemic with what we're seeing now, we could make that decision, but it would be pretty callous.

Cole: Well, we could spend this entire time just focusing in on COVID and we're going to speak a little bit about some of the things that we did early in the pandemic when we were answering questions from the public. You and Beth and our team was helping. We'll touch on that in a little bit, but I don't want to go too deep. We'll get lost in it-

Nita: We will.

Cole: ... and we'll be out of time before you know it. So I do want to do make sure I'm staying on point with this season. This third season of the podcast we're really focusing on risk takers and game changers, and you've made our list because we see you as somebody who is changing up the game in epidemiology in a way. And with conversations that you and I have had, I don't see you as a person who's necessarily breaking rules or throwing the baby out with the bath water or like a total revolutionary.

Cole: But we've talked about this. You're adding a new dimension, and I see you as more pushing the boundaries of the way epidemiology is done in some fresh new ways. So before we talk about the science, I want to ask about you. I asked David Hughes, our first guest for this season last week, and he shared about his teenage years and getting kicked out of high school. And he's doing pretty good for somebody who got kicked out of high school. But what about you, Nita? Were you a boundary pusher growing up as a girl? And what's your background and how would you describe yourself personality-wise?

Nita: I don't think I was really a boundary pusher. I didn't love school. I didn't get kicked out of school, but I didn't love school. I think that my, sometimes I call it a superpower and sometimes I just say that it's my unique perspective. I grew up in an immigrant family, so my parents immigrated to the US in the '70s and me and my brother were born here. And so when you're born and you're raised in an immigrant family, you're always noticing what's different. What's different about your family and the other kids at school. What's different about the way you do things, even little things. And when you're little, you're usually trying to make those assessments constantly so you can assimilate and fit in. And then when you age out of that you sort of realize there's huge benefits to seeing things in different ways. And there's really, really massive improvements to be made if you don't assume that everything is, always has been, and should be the way that everyone's doing it.

Cole: Yeah. So not just taking everything as the only way, this is the way, and it's the only way because right there in your house, you're experiencing a different perspective every day. That's really interesting. I also have noticed, and this is from following you on Twitter because sometimes we'll go back and forth and promote each other and we're always trying to promote your career because it's just fabulous to watch and be a part of that, but I would call you a critic. That's one thing I would say. You are a very critical person, I've noticed. And it seems that you're not satisfied with the status quo, I've noticed. You know what I mean? Do you think that impacts the way you approach science, too, having a critical mind? Which is of course essential. It's essential to have the critical faculties in full play to approach science.

Nita: I think I might need maybe a little more clarity on what you're referring to. I do have a very critical scientific mind obviously, but that's not what you're talking about.

Cole: Well, just like if there's a software that's terrible, you know what I mean? And maybe that's just your Twitter. Maybe Twitter's where you go to vent and get that out.

Nita: No, I do think that, yeah, I mean there are inefficiencies built into the ways that we do things. I think everyone has those inefficiencies, but yeah. I mean, what's Twitter for? That's where we air our grievances. I don't know.

Cole: For many, I believe it is. But do you think that ties into the immigrant side of things? Seeing things from another perspective helps you to have more of a critical eye of what's not maybe working in the mainstream or what's accepted as normal and right and just fine in the mainstream?

Nita: So I don't know if that's necessarily related to being from an immigrant family. I do think that probably has something to do with being a woman of color and a little bit of an outsider in science or feeling like a little bit of an outsider in science. Of course I belong here, but there's not a lot of people who look like me in this field and in this profession. So, I think that makes me more aware of things that aren't working.

Cole: Right on. Thanks for sharing that. Do you have any ideas of what we might be able to do to improve that? I know that's a huge topic. Again, we could spend an entire podcast on that easily. And I don't know. It's a lot to ask you just off the cuff, but do you have any ideas of things you think that the community could do better? Academia?

Nita: I mean, I think that one of the things that's been holding back improving diversity in academia is again, kind of doing things the way that we've been doing. And for a long time science and really most professions throughout the US were we're white men. And so there's networks that exist that are in place to sort of promote that, promote those connections. And I think we will rely on those networks a little more than we should, because we're not recognizing the value of other networks that integrate a lot more diversity, or that are centered on different cultures or different races. So, I think those things are difficult.

Nita: I also think, without being a total pessimist, I think we're stuck on a little bit of a hamster wheel. So I say this a lot. Common's phrase, "Why do I need ID to get ID? If I had ID, I wouldn't need ID." I think we're sort of in this loop where you need diversity to get diversity. It's hard to attract diversity with a panel of all white men because it's not easy to see yourself at that institution. So I think there's a little bit of that happening. Schools have had success with cluster hires, so hiring a bunch of or a number of new tenure line faculty that maybe don't fit the current demographics. And I think that that can be successful if it's managed correctly and supported financially.

Cole: Financial support always comes into play.

Nita: I mean, it comes back to that all the time, right?

Cole: Yes. Absolutely. Well, I know our time with you is limited and I do really want to show this video because we've been working really hard, and I hope you're going to like it because you haven't even really seen it yet.

Nita: I'm dying to see it.

Cole: So I'm going to ask Dan to cue up the video and then we'll have a discussion specifically about your research. So if you're ready, Dan, we're going to cue that up for the people. This is a sneak peek. It'll be lightly edited a little bit more before it's released. This is from our new Life From All Angles video series.

Narrator: This traffic camera sits atop of pole at the intersection of Atherton Street and College Avenue in State College, Pennsylvania. It records grainy, low-quality video used to monitor traffic flow. 700 kilometers above that camera, a 600 million satellite moves at over seven and a half kilometers per second. It captures high resolution images used by governments, private companies, and scientists. For one team at Penn State, both the humble traffic camera and the cutting-edge satellite represent an opportunity. Each can play a role in more effectively responding to future outbreaks of disease.

Nita: So when we're thinking about disease ecology, we're really concerned with three interlinked factors. The host, the pathogen, and the environment. And they all control what's going to happen with interactions and movement and disease transmission.

Narrator: Nita Bharti is an assistant professor of biology, and a member of Penn State's Center for Infectious Disease Dynamics.

Nita: And what we find is that the interactions between the human and the environment can often drive the interactions between the human and the pathogen. And if we miss that, then we miss a really important part of the system.

Narrator: In some of her earliest work, Bharti used satellite imagery to track seasonal population shifts in the African country of Niger. Driven by the Sahel's seasonal wet/dry cycles, many of the nation's laborers are semi-transient. The population of cities like Niamey, the national capital, swell when people move there to find work in the dry season. When the rains return, workers leave to cultivate their crops. Similarly, the number of people coming down with measles, a highly infectious disease, spikes on the same cycle. Cases flowed during times when people crowd into urban areas and drop back down when people return to the countryside.

Nita: So highly mobile populations or migrant populations are more vulnerable to vaccine preventable diseases than largely sedentary populations. Some of that is due to the fact that a lot of our disease response strategies are built around assumptions of sedentary populations.

Narrator: To better track seasonal population movement, Bharti and her team used nighttime satellite imagery to demonstrate predicted density fluctuations. This enabled more accurate, targeted interventions with the measles vaccine. Bharti's research group has also used satellite imagery to examine disease ecology. Using thermal satellite and on the ground monitoring, Bharti's team and collaborators in New South Wales showed that the Eastern Australia mega fires of 2019 and 2020 burned more than a third of the habitat used by gray headed flying foxes.

Nita: So we're working on Hendra virus, and Hendra virus is a virus that spills over from fruit bats called flying foxes to horses, and then to a number of other species, including humans. Fruit beds that are infected with Hendra virus seem to be fine. It's just the spillovers that are a problem. Those spillovers seem to be a factor related to loss of habitat, and encroachment of a human system on the wildlife system.

Narrator: And as for those traffic cameras, Bharti's lab used data from them along with anonymized mobile phone location data to track compliance with lockdown measures from March to August 2020. The team found that as restrictions were eased, increased traffic was a clear predictor of increases in COVID cases. Non-intrusive surveillance methods such as these could help public officials predict and allocate limited medical supplies during future outbreaks.

Cole: That was really fun to work on. Neato. We're so excited to be able to share these stories of all this cool stuff going on at Penn State. And blow us away. You're all over the planet. You're in Africa, you're in Australia. You're right here in Centre County. It's local. It's global. And when we talked about doing this thing, the video in this live stream, we were trying to figure out what ties all this together. And for us, the thing we noticed is this use of digital data streams in a new way. And I know it's not just you, it's your team as well. And we're The Symbiotic Podcast. We always talk about that team and the different disciplines coming together. So could you tell us a little bit about how you came to use the satellite data that was considered junk data, for example, or the traffic cameras in Centre County and working with your team on that? Could you tell us a bit about that?

Nita: Yeah. So we could go way back. The exploration of satellite data to better understand human infectious diseases, that started maybe almost 15 years ago. So I started that work when I was a grad student and it was the first time that anybody had done anything like that. And luckily, I didn't quite know that because I might have been deterred if I had thought that it wasn't a normal thing to do. But I also, luckily, was in a position where I had a lot of freedom to fail. So I had a very supportive advisor and he was kind of just very trusting with me to go off on these weird tangents and directions. And so that's how that work started.

Nita: And then it just grew. We basically were trying to understand why the dynamics of something we understand as well as measles looked so different in places where it continued to persist. And we've talked about this before, but basically it goes back to the assumptions that we were making about populations didn't match up with those populations where measles was still persisting. And so all of the dynamics that we had expected to see for measles and other infectious diseases just didn't hold true. So, this kind of goes back to backing up and really reexamining your assumptions.

Cole: Yeah. Take a look from another perspective like you spoke about earlier.

Nita: Yeah. So that's kind of where that came from. The traffic camera data is a fantastic story. So Brian Lambert is a programmer in my lab and I didn't even know about these traffic cameras. We were doing this work in Centre County. We were talking about how to get sort of eyes on movement and eyes on how people would be moving around. And we had looked at some satellite imagery, but it wasn't really ideal for what we were trying to do. And Brian said that he knows that there's these traffic cameras and that PENNDOT maintains them. And they just stream live video from-

Cole: Almost all the time. Some of them are always, so 24/7.

Nita: I mean, it's 24/7, yeah. And so they're streaming live video of roads and highways and intersections and just scattered throughout the county, and that they're publicly available. So you could go look at them right now and anybody could. And so he basically developed a way to grab a still image every 20 seconds from each of these cameras and use slightly modified off-the-shelf object recognition packages in Python to count the cars and the pedestrians in each image every 20 seconds.

Cole: Wild, yeah.

Nita: And so it turns out that the reason that he knew about these traffic cameras is because when he needs to leave the house on football Saturdays, he likes to be able to see if he's going to be able to get to the grocery store easily.

Cole: Yeah. Living in this town, I understand that's really important.

Nita: So seven days a year this is super handy.

Cole: Yeah, that's right.

Nita: Which is, I got to say, probably the best life hack I've ever heard.

Cole: That's great.

Nita: And so he brought this idea to the table and we loved it and he really kind of took it from an idea to a product. He's really the brains behind that operation.

Cole: That's fantastic. I love that story. Well, let's also talk about the cell phones, because I don't know if our viewers all caught that in the video, but you also use, let's see if I can say this right, anonymized, right? Anonymous cell phone data, which freaks out a lot of people, the idea that we're being tracked everywhere. If you've seen the Snowden movie or you look at Facebook and all the data that's bought and sold about all of us, a lot of people get very concerned. They have a lot of issues with this idea of our data versus privacy. And I know that you've gone pretty deep into that subject. Could you tell us a little bit about that? How do you do that responsibly?

Nita: So I think the first thing is that yes, your data that you generate and that you should own, you don't own. It is out there. It can be bought and sold and it often is. Phone companies are held to, I mean, reasonably high standards about what they're allowed to share, but what they have and what they can use is theirs. What they share, like with people who are doing research like us, is some small fraction of the total number of phones or visit counts or mobility traces, whatever it would be. Some fraction of the network that they share that is completely anonymized and with which you can't track or trace a single phone. You can see population level movements or population level behaviors and activities and changes, but you really don't see anything that's identifiable and that's critical. We don't actually want to know what everybody's doing. And if we need to know that level of detail to understand infectious diseases, then we're no longer looking at patterns.

Cole: Yes. So with that in mind, you explained a bit in the video of the big three of epidemiology, about people and the environment and the pathogens and how they all interact. What do these digital data streams give us that we didn't have before?

Nita: That's a great question. Why do we need these? How have we been fine for so long without them? In a way they give us a lot more information on the host, in this case, humans. They give us a lot more information because it's at larger scales. It's a slightly different type of information than you might get from a conversation or an interview, but it's from a lot more people. So there's that aspect of it. And then you're also able to see what these sort of larger scale interactions, what the environment look like. And in this case, the environment can really be anything.

Nita: One of the really nice examples from Centre County is that we can easily see when home football games are happening in the cell phone data. So I don't know whether you went to the game or not. I don't know what individual people did, but I can see that a lot of people... A huge increase in visits to Beaver Stadium happened on seven Saturdays. Well, eight, because we also see the Blue-White game. Eight Saturdays a year. So we're able to see how people are interacting with the events around them, with their environment, and a little bit with each other.

Cole: And how do you take that kind of data and put it back into your epidemiological forecast?

Nita: Yeah. What is it? Why do we care people are at Beaver Stadium? What does that tell us? So really what we're able to do, what's really useful about a lot of these sort of passive surveillance kind of strategies, including satellites and phones and traffic cameras, is that we can look at relative amounts of movement. And that really gives us a proxy for contacts and interactions. And the reason that's important is because contacts and interactions are what drives transmissions, so me transmitting an infectious pathogen to you. But transmission events are not observable. We cannot see those. What we can see are proxies for contacts or interactions or movements. So if you're out and you're moving and you're interacting with one person, then another person, and then another person, that's a string of interactions or contacts. So that's a baseline for where we can set some knowledge about risk of transmission.

Cole: That's it, that word risk. And you and I have talked about this before as we were talking about risk-taking scientists and good risk versus bad risk and how much risk is acceptable. That seems to be at the crux of so many arguments and discussions and battles, even throughout this pandemic of what's acceptable. Is this riskier than that? And what's the right intervention? And it sure gets dicey when you add layers of sort of politics and ideologies and belief systems into the matrix. I mean, that seems to me to be the hardest piece of all. We can look at who's moving around, but what those individuals are doing, the choices they're making, what they believe, what they choose to do, where their value system is, how much risk they're willing to take personally for themselves, how much they care about the risk to others, that's really tough to manage, right?

Nita: So in a lot of ways, I would say managing that is one thing, but understanding that is really kind of where we have to start.

Cole: How would you start to try to understand? I mean, I'm not asking you to solve it for the world, but what the heck? We have all this information and we still, like you said earlier, just that hamster wheel. How do we get off the hamster wheel?

Nita: I mean, I think there's a lot of things that have been done that have been helpful. A lot of things that remain to be done that could be helpful. But really the biggest one is understanding where people are coming from. So we have, we all do, I do this, too. We have a sort of knee-jerk reaction to people who are doing things that we think are too risky or that we think are unsafe or uninformed. And oftentimes when we drill into it they are operating on different information. And whether it's accurate or not is a different story, but they don't feel uninformed. And so understanding where people are coming from and what they're afraid of. So sometimes people are just afraid of things that we are not afraid of and so that makes us feel that they're acting irresponsibly or in an uninformed way.

Nita: And it's really just that we haven't addressed their fears or maybe they have a very different risk level, a risk threshold. A lot of people who are really very, very afraid of this pandemic and kind of unable to function, they have a very different risk threshold. And that may be because they're more vulnerable. So a lot of times when we're talking about what's okay to do, what society should move towards, what restrictions to lift, we're kind of thinking about maybe the healthiest people in society. We're not necessarily thinking about the most vulnerable. And really our obligation is to protect those first and foremost, and we just sort of keep missing that.

Cole: Well, I know you have a great passion for informing the public because you worked with us, with our team here at Huck to put out... We did 63 Ask CIDD videos, CIDD being the Center for Infectious Disease Dynamics, of which you are a member, along with your colleague, Beth McGraw and our team here. We were answering questions from the public that they would submit. Made 63 of those videos. And while I have you here and we're doing this livestream, we need to share this with you audience out there. Of all those 63 videos that we made to answer questions, to try and give the best information we were able to offer to the public, of all those 63 videos, the top two... It's always very interesting to me that the top two most shared and viewed videos on our YouTube page.

Cole: It was kind of surprising because I would've thought they would've been flip flopped. The top two videos were, can you get COVID? Can it be transmitted sexually, through sexual activity? And how does alcohol kill the virus? And I don't know if it's the Penn State community or what it says about it, because a lot of these folks were at Penn State, but it turns out the number one video was the alcohol video, not the transmitted during sex video, which had about twice as many views for some reason. But I bring it up because, you know where I'm going with this, at about 3:00 one night, somebody decided to randomly email the Huck website, which I'm the primary. It'll hit me and my team first. And we got an email from the Netherlands from a DJ by the name of Jerry Guild-Brandson who goes by the name of Techneck.

Cole: And I'm going to ask Dan. I asked him to put this in here because these are one of the moments that life can be pretty grim, particularly in the middle of a pandemic with people dying all around you. And you do all this work and sometimes it's very frustrating because sometimes it doesn't even seem to be catching. But Jerry Guild-Brandson, Techneck, from the Netherlands was so inspired by your video about how alcohol can kill the virus that he decided to do something a little special. Dan, can you play this? We'll play this for the people.

[upbeat, techno music begins]

Nita: In addition to soap and water, alcohol is a recommended cleaning agent to destroy the coronavirus, by destroying the lipid or fatty bilayer that holds it together.

Kill the virus.

Kill the virus.

Kill the virus.

Kill the virus.

Kill the virus.

Kill the virus.

Destroy. Destroy. Destroy. Destroy the coronavirus.

You shouldn't try to use alcohol ... You shouldn't try to use alcohol ... You shouldn't try to use alcohol ...

You shouldn't try to use alcohol that is meant for human consumption to kill the virus.

You shouldn't try to use alcohol that is meant for human consumption to kill the virus.

Kill the virus.

And 60 to 80% alcohol cleaners are also highly effective.

[music ends]

Cole: So needless to say, people, we were not ever expecting some DJ from the Netherlands to pick up one of our Ask CIDD videos and take it into the clubs. But Techneck just appeared and it just shows you the power of passion and you just never know in this crazy, mixed up, globalized world where your content might end up. So all you scientists out there, if you want to get into the clubs, Nita's pioneering the way for you. Anything's possible.

Cole: So it really was remarkable to make all those videos, in all seriousness. It was nice for me to be involved because people would come up on the street and just say, "Oh, thank you for doing those videos." People had questions. They still have questions. I sense that as we've got the vaccines now and we're boosted and people feel safer than they did at the time that we were just cranking those out every day, but as you said earlier, I don't think we're out of the woods yet.

Cole: Wait. What's going on over there, guys? I'm sorry. Somebody's-

Off-camera Producer: Can we help you?

Cole: Hello?

Batty: How's it going?

Cole: It's going all right. Who are you?

Batty: I have a battygram.

Cole: A battygram?

Batty: Yeah. The bats have been loving you and loving your work. They're sending all their bat-love your way.

Nita: Thank you, Battygram.

Batty: You're welcome.

Cole: Thanks, Batty.

Nita: Wow. Should I actually open this right now?

Cole: Why don't you just open it up. Yeah. What is that?

Nita: It's all very unexpected, people. But I'm going to need to know where you got that bat costume.

Cole: Well we couldn't help loving on the bats when you sent us the pictures for the video of all those bats in Australia. What did they send you there?

Nita: "Dear Nita, we just wanted to thank you for all the hard work you've been to on behalf of people, bats, and the entire natural world. You're the best, like flying grey-headed foxes of Eastern Australia." And there's a little drawing. I don't know if we can get that.

Cole: Wow. That's really special.

Nita: It's really cute. This is adorable.

Cole: Well, obviously you have friends in the bat world.

Nita: Friends everywhere, man. This is adorable.

Cole: That's terrific.

Nita: And there's a diagram here too. I don't know if you guys can see that. Fantastic.

Cole: You got friends in the Netherlands. You got friends in the bat world in Australia. That's going to be a pretty nice segue, actually. We talked about Penn State's ongoing diversity challenges. Like every other university we're trying to meet those challenges. But I'm taking hope when I see some of the new plushie mascots that are available at Penn State. And I don't know if you noticed with David Hughes. We're going to be doing a little research of our own, Nita. For every audience that we see from every one of our guests, we're going to ask which of the alternative plushies people like, because you don't just have to go with the Penn State Nittany Lion anymore. Dan, do you want to show people the nice little feature that we have put together for our plushies? If you'll let me know when that's running. Like I say, you don't have to stick with just the Nittany Lion, who, by the way, to the alcohol point, sometimes I think the regular Nittany Lion plushie maybe needs to be in a 12-step program. Possibly. Possibly.

Nita: Does he drink a lot?

Cole: I don't know. It wouldn't surprise me, but I would support him in getting the support. But maybe he's getting support.

Nita: He does a lot of pushups. I know that. So he's got a gym membership probably.

Cole: Yeah. Not the guy who's in the costume. I just mean this plushie in particular, that particular mascot.

Nita: I think does a lot of pushups.

Cole: Yeah, he definitely does. But it's nice that he is in a larger, broader community now. So we're going to ask people to vote. You can vote for your favorite alternative plushie. We've got a pink unicorn.

Nita: So wait, so when you say that-

Cole: Yeah. Go ahead. Yes.

Nita: When you say you can vote for your favorite alternative plushie, are you telling them that they can't vote for the lion?

Cole: No. No. The lion is not involved. No.

Nita: So they can only vote for anybody but the lion.

Cole: Anybody but the lion. But I mean-

Nita: I just want to understand the rules.

Cole: It's just to see if people are given an alternative to the usual, where are people on this? Do people like the unicorn? Do people like the little bear, the little baby bear? That's like the little baby indoctrination bear to get your infant to be a Penn Stater right out the gate.

Nita: Is that a beanie?

Cole: It is a beanie. He's got a beanie butt. And then there's the gnome, kind of the wizened old gnome. That's been very popular. And we also have a llama. There's also a Penn State llama, which surprised me. It surprised me that Penn State could kind of open up like this to new ideas. So what we're doing is we're asking everybody out there, you can vote right now, the unicorn, the gnome, the llama, or the bear. And then based on where those votes go, we'll be able to see at the end of the year for each one of our scientists which audience tracks with which plushie. And we'll let you know how that all pans out at the end of the season. Do you have a favorite?

Nita: So I know that I have previously said that I like the unicorn. But I've been sitting here and there's these really adorable llamas behind you. So I feel like I'm a little primed for the llama right now. I don't know if that's subliminal messaging on your part, but I'm kind of leaning towards the llama today.

Cole: I like the llama too. That's the only one with the name. I believe it's Lisa Llama is the name of that.

Nita: That's good to know.

Cole: All the others, we may have to name them in future episodes. So it's 12:45 and I just realized that we didn't get to, oh my goodness, the questions. Can we hang for just the top question that's voted? Because I did promise the audience. Like I say, it's live so anything can happen.

Nita: Sure. Yeah.

Cole: We haven't crashed and burned yet.

Nita: I could storm out if I don't like the question. We don't even know.

Cole: You could just storm right out. That's right.

Nita: I'm taking this llama and I'm leaving.

Cole: So this top question from Jamie wants to know, how do we deal with public health messaging fatigue and people getting used to being at risk and starting to ignore it? Do you have any thoughts on that?

Nita: Yeah. This is, I think, a really important question. It's a question that we clearly don't have an answer to because we are struggling with it. But I think one of the things that has been a real problem throughout this pandemic is not just the volume of information, but the volume of either low-quality or false information. And so people are getting bombarded with a lot of information and not really knowing what to trust. Yeah, I mean, I think having credible sources of information that you really rely on is an important thing during a pandemic. But then people are free to make choices about what they think is credible. So I think we have a lot of confounding problems there.

Nita: The issue of fatigue. I mean, I feel you there. The issue of pandemic fatigue and information fatigue, and we've been living in a state of really high alert for two years now because of this. And so there's a point at which you do have to stop. And whether that means that, this goes back to something that you said earlier, whether that means that you sort of settle into a new normal that is a different level of risk than you would've been pre-pandemic, like different behaviors, can be one way to sort of tone down the hyper attentiveness. But really kind of trying to be on high alert all day, every day for two years is not sustainable.

Cole: Yeah. I guess we're still figuring it out as we go in the broadest sense.

Nita: And I think that there's definitely a place for us to sort of... Instead of saying, we started here and we're going to go here for the pandemic and then we're going to go back, I think that there's a way to sort of go from where we are to somewhere that's better for everybody, or better for a lot more people, at least.

Cole: Right on. Could I throw one last one at you?

Nita: Yeah.

Cole: We'll just do one more. If we could put that up, Dan. Are there diseases that could end up like COVID-19 that epidemiologists are worried about right now? Are there any ones that are high up on the alert list for folks like yourself?

Nita: Yeah. So the official answer to this question is that yeah, in 2018, the WHO released a list of Blueprint priority diseases, and it was a list of 10 disease. I think it was 10, and this list is online. It's not classified or anything. You can go look it up. They update it from time to time when they think it needs it. But it's a list that basically represents diseases that they think present a significant risk to the public, or to people or to wildlife. And that they think propose a significant risk of disease that are understudied both for research and for public health. And so they're basically diseases that the WHO says we should probably be focusing on a little bit to improve of our understanding of what the risks really are and how we would manage them if these were to become epidemic problems.

Nita: On that list are a couple of corona viruses that we've seen before. And then some of the diseases that we've talked about that I work on. Hendra virus is one of the diseases on that list. But then additionally, there is this. The last disease on the list is Disease X and Disease X represents a disease that we don't know about but that could emerge that we are unprepared for. And so, yes, there are diseases that we think are diseases we should be paying attention to, but we also have the knowledge that there are going to be diseases that are not on our radar that we need to be prepared to manage.

Cole: And that's just what the more general approach of managing whatever could hit? Is that the idea there with Disease X?

Nita: Yeah.I mean, I think that really sort of highlights the importance of baseline, basic access to healthcare and disease surveillance everywhere. Not just for the 90% of the world it's the most accessible, but really for everybody everywhere.

Cole: Right. With everybody.

Nita: So these issues of health equity really come into play when we talk about these kinds of issues.

Cole: Yeah, for sure. And I should have mentioned earlier, that's a huge passion of yours, is equity. And with our first podcast two years ago, that's where we came down to the money. If money and access to healthcare were evenly distributed throughout the planet, we'd be doing a lot better collectively. Along with not encroaching onto wild spaces, which is something that never quite makes it into the public dialogue about this. We'll talk about was it from a lab? But we won't talk about how much should we be encroaching into these wild spaces. Well, at least the bats know that you're on their side and that there are folks who care and are doing things. So I-

Nita: So I should highlight really quickly, Kelsee Baranowski in my lab is doing a lot of that bat work and a lot of the environmental data analysis. So probably the bats should thank her quite excessively. And then of course, that's part of a much larger project that we've talked about with collaborators all around the world. And that's part of why it's able to make some progress and understand these larger issues.

Cole: Right on. We'll get some battygrams out there. And this time we'll know where they are and hand it off the poor bat so she actually has her battygram to hand to you. So we're learning as we go. But Nita, thank you so much for taking the time and coming out. It's always a pleasure talking with you. Just keep doing. If people want to follow your work, what's the best way to follow you and what you're up to next and where you're going?

Nita: So you can check out our website. We keep our publication list is up to date. And that is humidlab.com. Human infectious disease, so humid, ID. Humidlab.com. And then I'm on Twitter. Some of the people in my lab are on Twitter as well. I'm @Nitanother. So it's N-I-T-A-N-O-T-H-E-R. I'm not used to promoting my Twitter feed, because I feel like it's not a place where I communicate with people, but I do complain about things there as you heard about from Cole.

Cole: We can hear your critique of what sucks this week. No, that's good, though.

Nita: And then of course I also do post about our research papers and our talks at our lab's accomplishments and things. And then of course I boost my colleagues because they're amazing.

Cole: Yeah, absolutely. It's a team effort for sure.

Nita: Well, thanks for having me here, Cole. This is so fun with the plushies.

Cole: My pleasure. It's my pleasure.

Nita: I mean, this is a great setup you've got.

Cole: We're trying to have a good time. We're trying to keep things as positive as we can [inaudible 00:49:28].

Nita: Yeah, you guys are killing it.

Cole: Right on, right on. Well, thanks again. Really appreciate it, Nita. Take care and everybody out there, thanks for joining us. We'll be back in a month with Steve Schiff to talk with him about what he is up to in pushing his own boundaries. And until then just be good. Have the best time you can, and don't stop co-evolving. Thanks a lot. Cheers.

Narrator: The Symbiotic Podcast is a production of the Huck Institutes of the Life Sciences at Penn State University. Our video and livestream producer is Dan Lesher. Our sound engineer is Brennan Dincher. Our web developer is Jodie LeMaster, and our marketing manager is Keith Hickey. Cole Hons hosts and directs the show, and original illustrations and animations are provided by Sam Muller and Bethany Seib. If you enjoy our podcast, we hope you'll subscribe and share it with others. We'd also love to know what you think about our content, so if you want to get in touch, please email symbiotic@psu.edu.