Viruses in the Air

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2:44I've been thinking lately a lot about germs. I'll tell you why. Everyone where I live has been getting hideously sick. It's that time of year. There's been a flu thing going around. There's been norovirus. Lots of my friends describing, in overly vivid terms, what it was like for them when vomit came out of their nose. Lovely stuff. And the season has reminded me of how sickness itself is this mystery that we rarely completely solve. Your body gets taken out for a day, a week, and you wonder, your arms encircling the toilet like a teenager at a high school dance. Was it your sniffling coworker?

3:21Was it when you touched the pole on the subway? Was your body just somehow run down from work? These spells feel to me in an essential way like mysteries. I was talking about all this recently with a science journalist who has studied how we know what we know about sickness. And the conversation really surprised me. In this moment we're in, with measles returning, bird flu on the horizon, my guest had a story about how scientists try to arrive at the right consensus about illnesses and how they actually sometimes fail to reach the right consensus. And this story boggled me. I found myself repeating it to everyone I run into.

4:01Can you introduce yourself? My name's Carl Zimmer. And you're the author of a new book called Airborne, which it's about more than just this, but in the context of this episode, part of what it is about is germs that travel in the air and make people sick. That's right, yes. And that was a seed of the books, certainly, is that during the COVID pandemic, I was wondering, like, how is this virus getting from one person to another? And were you, like, during the pandemic, how much were you finding yourself, like, thinking in a sort of reporter-writer mind versus, like, a person screaming in panic like everybody else?

4:44I had the misfortune, I suppose you could say, having written a lot in previous years about emerging diseases, writing for the New York Times, writing in books. And so, you know, I was anticipating that there would be some virus or bacterium that would be spilling over from some animal host, maybe a bat. and that it would sweep across the world. And I was just wondering if we'd be ready for it. And so in January 2020, there was this news coming out of Wuhan, and they said, it's a coronavirus. And I thought, well, that's not good, because we know from SARS in 2003 that coronaviruses can be pretty nasty.

5:31And then when I heard that Wuhan, a city bigger than New York, had shut down because of this coronavirus, I said, oh boy, I think it might be coming. And my colleagues were talking to various experts and they were like, yeah, we think it's a pandemic. So by February, I was in full, like, let's get ready for a pandemic mode. And all of my friends thought I was crazy. I wish I had not been right on that score, but I was. For Carl Zimmer, the story of COVID wasn't just about a new disease and how quickly it spread. It was also a story about how ideas spread or how sometimes they don't. One of the most remarkable facts about COVID, something that took quite a while to understand, was that it was airborne.

6:16Meaning you could get sick, not just from someone who coughed or sneezed right next to you, but from the tiny droplets of the virus carried in the air. The air in your subway car, at your office, in your grocery store. It took people a while to understand this. The early advice to wash your groceries, but not to worry about masks. Part of the reason that advice was wrong was because the idea that this disease could have been circulating in the air itself was just not something most people believed. Not until well into the pandemic. But to Carl's surprise, this concept of airborne transmission had actually been known to scientists as early as the 1930s.

6:59The story of that idea's discovery and the reasons it never really caught on, it's a very unique kind of tragedy that centers on what happened to the couple who figured this all out. There were just a real visionary couple, husband and wife team, in the 1930s that led the charge named William and Mildred Wells. And what did it mean for them to lead the charge? Like, what was their theory? How did they come up with it? And where were they trying to make their arguments? So William and Mildred Wells were really kind of scientific outsiders. Mildred had been trained as a doctor at the University of Texas.

7:38She got her degree in 1915, so that was pretty rare for a woman in that period to be a doctor. She goes to Washington, D.C., and she starts working in a microbiology lab, a public health lab. And she meets this young sanitary engineer named William Firth Wells. Wells has trained at MIT, studying things like typhoid in the water. And now he is studying not just polluted water, but he's studying how oysters can pick up the bacteria that cause typhoid. Because people were dying in droves eating raw oysters that were contaminated with bacteria. Oh, wow. He goes off to fight in World War I. He actually has the job of delivering clean water to the soldiers.

8:24So he's saving lives with the germ theory of disease. And so he's disinfecting water and delivering it to troops and so on. But they're dying in droves, not of typhoid, but of influenza. And here you have a respiratory disease, and no one's really sure how it's spreading. So some people are putting on masks. Some people are saying that it's spread by those big droplets that smack people in the face. Other people are saying, well, that doesn't seem to make sense because it seemed to be spreading even without that. So there's a huge amount of confusion. Kills 50, 100 million people. This is the Spanish flu?

8:591918 Spanish flu, yeah. And they don't know how it's spreading? No, they know very little. I mean, going into this, the scientific understanding of influenza was shockingly small at this point. Just remember, they didn't even know what caused it. A lot of people thought it was caused by some kind of bacteria. And in fact, someone invented a vaccine for that bacteria and started giving it out in some American cities. Except it's not bacteria. It's a particular virus, but no one had found it yet. Right. So if you don't even know the germ that's causing it, like, it's going to be kind of tricky to figure out how it's spreading.

9:33So the level of confusion and ignorance was enormous. And people paid the price.

9:42The 1918 pandemic was much deadlier than even the highest estimates for COVID. Something like 3 to 5 % of the world population just gone. As Carl says, one of the reasons that that pandemic lasted as long as it did and killed so many people was that unlike with COVID, we never developed a 100 % correct understanding for how it was spreading while it was still ongoing. So some of what we did to prevent the spread worked, some didn't. Really what ultimately happened was that after a lot of death, that flu finally transformed into a less deadly seasonal flu. Back then, the advice Americans were given to stay healthy in flu season sounded like the advice I grew up with.

10:22Cover your mouth when you sneeze. Don't share food or water. Basically, watch out for germs, but don't worry about the air itself. This was a mindset that established itself at a very particular time in history, you know, in the early 1900s. And it hasn't changed all that much since, even though by the 1930s, William and Mildred Wells and other people were amassing evidence that actually these germs can just gradually fill a room like smoke.

11:00The story of how William and his wife Mildred figured all this out, it's an unlikely one. They were working in an era where science had already knocked down this previous consensus view for how disease spread in the air, the miasma theory. The miasma theory held that diseases are caused not by germs, but by foul, corrupted air. Not true. But because the miasma theory was discredited, the idea that germs could spread through the air at all, that idea was thrown out with it by most people. But when Carl Zimmer was trying to understand why it took us so long to realize that COVID and other diseases could be airborne, he would catch glancing references to these long-dead married scientists.

11:43People were saying, like, you need to learn about William and Mildred Wells. Like, if you really want to start to understand this weird history behind the COVID pandemic, start with getting to know the Wells. I had not heard of them before, I confess. There's no biography of them. They have some papers that are floating around in old archives, old library shelves, but there just wasn't that much. So I've done my best with letters and unpublished documents, things that are tucked away in archives to try to reconstruct what happened. And actually, William Wells shouldn't have been the pioneer of airborne infection.

12:23He was the wrong person because he had been trained at MIT by people who were passionate about taking down miasmas and who were passionate about keeping people safe by giving them clean water and clean food. He should have just kept doing that. But for some reason, when he shows up at Harvard desperate for a job at this point in 1930, somehow he starts to think about the air. It might be because some people at the Harvard School of Public Health were studying other aspects of the health of the air, like fumes in factories and so on. They were studying those kind of health issues. And that may have gotten him thinking, maybe we've been too hasty to dismiss the air.

13:07And one insight he had, I think, comes from oysters. So oysters are sitting in the water, and they're filtering that water, and they filter a colossal amount of water every day. And that's how they eat. And so even if there's not that much deadly bacteria in the water, the oyster will get it and it'll trap it in its tissues. And the fact is that we breathe a couple thousand times a day. So we're kind of like oysters. Even if there aren't a whole lot of microbes floating in the air, we're going to probably get to them, you know? And so the Welles's, how were they amassing evidence? What were they doing?

13:48What are their experiments? One of the most basic things that they had to do was to show that there were germs in the air. And so what he decided is, if we're really going to understand whether air is dangerous or not, we need a better tool. We need a better way to measure what's in the air. So William Wells created this ingenious device, an air centrifuge. And basically it was this shaft with a glass cylinder inside of it. And it would spin, and there were like fan blades on the top of the shaft, which is inside a box. And so it would basically be pulling air up through that glass cylinder. And as the cylinder is spinning, the air would rotate.

14:37and any bacteria or viruses or droplets, what have you, would get flung against the walls. And so then you take out the glass cylinder and you just put in an incubator, nice and warm for a few days, and see what grew. And once he did, lo and behold, hey, there's a lot of stuff floating in the air, particularly indoors. And just to make sure I understand, And it's like the orthodoxy that he was diverging from and the thing that he was arriving at, the reason that the consensus view was against the idea of airborne transmission was because it looked too much like the miasma theory. And since the miasma theory, which is just like sort of bad air makes people sick, since that had been thrown out, for him to show up and say, well, I do think something in air makes people sick, it made him look kind of like, to some people, a crackpot, like somebody who was picking up something that scientists had discarded.

15:35That's absolutely right. We know this because William and Mildred, when they started to introduce their theory in papers in the 1930s, they would say, essentially, okay, we know this might sound a little crazy. We know that it might sound like we're talking about miasmas. We know that. And we're not. We're talking about something else. And the thing is that people needed to understand that the physics of our breathing and how the atmosphere works could permit germs to float in the air and become essentially airborne. What the wells had figured out was that when you sneeze, yes, there are big droplets that might fall onto a nearby surface, but smaller droplets might be small enough to catch the air and float and circulate and to spread germs that way.

16:26And the wells were actually able to convince people to take this idea seriously because they were willing to conduct their tests publicly in the real world. In the 1930s, they proved that tuberculosis, streptococcal infections, and influenza, some of the deadliest diseases of the 20th century, could be transmitted through what they called droplet nuclei. This was a huge discovery. The Wells were called geniuses. They were profiled in Time magazine. The New York Times wrote that hopefully the Wells' research would quote, shatter the quote, comforting doctrine that disease only spread via the kind of large droplets emitted by a nearby sneezer.

17:04That's 1934. And the Wells didn't just discover that the air could become contaminated, they actually started devising ways to make indoor air safer to breathe. William Wells created this device called the infection machine. It was a big bell jar, and you could put some mice in there, you could put a rabbit in there if you wanted. And then it was connected up to a long tube. And at the end of that tube, you could generate kind of a deadly mist of tiny droplets that had some germs in it. And so if he put enough influenza virus into that and it made its way down to the bell jar and the animals breathed it in, they got the flu.

17:48And if you put in more of those viruses, they breathed it in and they died of the flu. And that was true for other diseases. Now, if you clipped on an ultraviolet light so that as the air passed along, it got zapped by ultraviolet light, the animals didn't get sick. And that's because the viruses or bacteria were disabled by the ultraviolet light. And that result has completely held up. In 1940, for example, William and Mildred Wells installed ultraviolet lamps in a couple schools in Philadelphia just to show, you know, we can actually protect people with this. You have to bear in mind these are not UV lamps that are just pointing down at kids and blinding them or giving them skin cancer.

18:30They were pointed up towards the ceiling. But as the air is circulating upwards, those droplets would get knocked out by the UV.

18:42This sounded to me like borderline science fiction. A UV light machine killing disease particles as they float through the air. But the much more surprising thing is, what happened when those experimental UV lights were actually put to the test? A huge epidemic of measles hit. And you have to remember, this is the time before there were vaccines. So when a measles epidemic came, it was devastating. And the kids in this school were protected. The rates of measles were far lower than for kids in other parts of Philadelphia. So they showed that it worked and that it worked on people. It's just very strange to me because it goes against my understanding, not of how diseases circulate, but how ideas circulate, which is that if someone has a new idea and they prove it and they prove it's useful, that idea remains durable in the public consciousness and that person remains remembered in the public imagination.

19:45You would think that someone who did something like this school experiment in Philadelphia, they would, I don't know, their names and their ideas would be up there. Why doesn't this stick? Science is a human activity, and so people have to work together. And so there's inevitably a certain kind of political dimension to science, like with everything else. And so when you read through these archives and there are these reports on the wells and what they're up to, people will be quite frank. They'll be like, the wells are just incredibly difficult to work with. They're their own worst enemies. They make things difficult even for their closest friends.

20:24And in which way, like what kind of difficult were these two? I think because they were outsiders, they were always very paranoid that people were going to steal their ideas. The word paranoiac is actually used by a scientist who knew them both very well. People are very honest about it. They're peculiar, they're paranoiac, and they didn't have advanced degrees. And even after they had been making all these discoveries, Harvard fired them. They just said, get out of here. And part of the reason was because the scientists who had lent them the ultraviolet lamps didn't think that they had any chance of working.

21:02And when they did start working, he said, okay, well, I want to have my name on this patent. I want to be a co-author on this paper. And you're going to do all your research in my lab under my direction from now on. And they, of course, rather than trying to find a political solution, just started screaming. And that's how they were. They had a lot of other issues in their life. I suspect that William Wells, I don't know, I think a psychologist could have a field day trying to diagnose what William Wells had. Let's put it that way. He would go on long, long monologues, hours, to anybody who would listen.

21:35And in a way, that undermined his case because he had a compelling case to make, but he delivered it in this just unbearable way that people just didn't want to listen to him after a while. It makes me wonder if, like, I think one of the reasons sometimes as a society we miss certain true things is because most of us are intensely social people and have a desire to fit in with the people around us. And that means, you know, for the most part, believing most of the things that people around us believe. And it's like, doesn't it seem possible that their superpower, which was to see things differently, and their sort of Achilles heel, which was to be very, very difficult people, like those things were maybe bound together?

22:19Sure. I mean, just inventing the air centrifuge was kind of a crazy thing to try. You know, the reason that no one had invented it before because no one thought it would work. And there was literally someone at Harvard who was watching William Wells try to build this thing, he was inspired by the centrifuges people used to separate cream from milk. And so here he is saying, oh, we could do that with air. And so this colleague at Harvard was like, I bet you that's not going to work. That's totally not going to work. And he lost the bet. So you did need someone like Wells maybe to have that originality of thought to try to build something and to have an idea and to pursue it.

23:00But there is that flip side that maybe you are so single-minded that you are actually paranoid that you actually, instead of having conversations with people, you just try to dominate them with your monologues and so on. This is not an uncommon figure in the world of science, this kind of personality type. Part of what makes this story so surprising to Carl Zimmer is that science, frankly, is a place that more than other fields does tolerate brilliant, difficult people. If ever there was a place to put up with some jerkiness, it'd be in the fields where someone's contributions can save lives. The world is not short on heroes of science whose labs you would never have wanted to work in.

23:44The inventor of the germ theory of disease, for instance. A gigantic asshole. You know, Louis Pasteur is this iconic figure that we all know about. And, you know, the fact is that he, in some ways, he was a pretty awful person. He would steal people's ideas. He would try to get his enemies driven out of the field. And in some ways, he was just a really bad person. But he was also very savvy in understanding the politics of science in Paris at the time and ended up being sort of a secular saint to France when he died. So, yeah, I mean, maybe other people get forgotten for other reasons. But for the Wellses, you know, it was partly because they weren't very good at building big alliances.

24:32I think that we all get taught science and the history of science in a certain version where everything seems simple and where ideas just fall into place and everyone says, aha, that's great. Now we can move on. Yeah. And sometimes that happens, but a lot of times it doesn't. And I think the story of William and Mildred Wells really demonstrates that that can actually be the opposite of what happens. You have William and Mildred Wells in the 1930s making all of these discoveries, which in hindsight seem incredibly important and relevant. And we kind of wish we all knew about with the COVID pandemic.

25:15And, you know, within a couple decades, they were gone. They were forgotten. and their ideas were either forgotten or misunderstood, and so their legacy was lost. In the decades that followed, the Welles' ideas were far outside the mainstream of scientific consensus, picked up only occasionally by stray researchers trying to solve very specific problems. For instance, an American tuberculosis researcher trying to stop an outbreak in Boston's homeless shelters in the 1980s tracks down one of the Welles' old lab assistants. Or a Chinese scientist trying to make sense of the SARS outbreak in the 2000s has to convince an American university to send him photocopied pages of a totally forgotten Wells book that had been published in the 1950s.

26:02And that was the way that the Welles' ideas continued to flicker through decades of obscurity. Individual scientists pulling on individual threads in the research. Slowly, over decades, those threads start to come together. By the 2010s, a small community of Wells disciples has coalesced around this theory of airborne transmission. And so there are people like that who slowly were kind of forming this small community up until the COVID pandemic, so that when the COVID pandemic comes, they're all saying, hey folks, this might be airborne. And yet, even then, people in positions of authority are saying, no, it's not.

26:43World Health Organization actually said, COVID is not airborne. So these people were more successful than the Welles' but they still struggled to get this idea across. Oh yes, they were definitely struggling for quite a long time. And I think there was a very high bar too for people to be convinced. Because if you say this disease is airborne then the whole system that you have in place to protect people from getting sick really has to change. And people at the World Health Organization, when these airborne advocates came to them, they said, look, we're not going to be going and telling all these countries with limited health care budgets that suddenly they're going to have to disinfect the air all over the place in these facilities and then in the community as well.