Rodents Don't Book Cabins

Not in a hospital in New York or Boston.

Omaha.

Why Omaha?

Porque en Omaha está la Unidad Nacional de Cuarentena, integrada en el Centro Médico de la Universidad de Nebraska.

Because in Omaha is the National Quarantine Unit, housed within the University of Nebraska Medical Center.

Es una de las pocas instalaciones en el mundo diseñadas específicamente para contener y tratar enfermedades infecciosas de alta consecuencia.

It's one of the few facilities in the world specifically designed to contain and treat high-consequence infectious diseases.

Tiene habitaciones de presión negativa, protocolos de biocontención de nivel cuatro.

It has negative pressure rooms, biosafety level four containment protocols.

That facility treated Ebola patients during the 2014 West Africa outbreak.

I remember reporting on it at the time.

The idea that there are maybe a handful of places in the entire United States that can safely handle certain pathogens is, when you sit with it for a moment, genuinely unsettling.

Y eso nos lleva a una pregunta incómoda: si cinco personas de un barco necesitan cuarentena en uno de esos pocos centros, ¿qué pasa si la próxima vez son cincuenta?

And that takes us to an uncomfortable question: if five people from one ship need quarantine in one of those few centers, what happens if next time it's fifty?

¿O quinientas?

Or five hundred?

La infraestructura global para responder a enfermedades zoonóticas de alta consecuencia sigue siendo extraordinariamente escasa.

The global infrastructure for responding to high-consequence zoonotic diseases remains extraordinarily limited.

Zoonotic.

For listeners who haven't heard that word, or have heard it and tuned out because it sounds technical, it just means a disease that jumps from animals to humans.

And the list of diseases that have done exactly that is basically a summary of the worst public health events of the last century.

Influenza, SARS, MERS, ébola, VIH en su origen, COVID-19 casi con toda certeza.

Influenza, SARS, MERS, Ebola, HIV at its origin, COVID-19 almost certainly.

Y el hantavirus.

And hantavirus.

Lo que los une no es solo el salto entre especies, sino las condiciones que lo hacen posible: la expansión humana hacia hábitats salvajes, el turismo de naturaleza, la perturbación de ecosistemas que llevaban milenios en equilibrio.

What unites them is not just the species jump, but the conditions that make it possible: human expansion into wild habitats, nature tourism, the disruption of ecosystems that had been in balance for millennia.

That's the part that I keep circling back to.

Expedition tourism is a growing industry.

People want to go to places they weren't going twenty years ago, the Falklands, South Georgia, Svalbard.

And those places have wildlife that has had very limited contact with humans.

Y viceversa.

And vice versa.

Los turistas tampoco han tenido contacto con esos ecosistemas, ni con los virus que circulan en ellos.

Tourists haven't had contact with those ecosystems either, nor with the viruses that circulate within them.

Es una especie de encuentro de dos inmunidades vírgenes, por decirlo de alguna manera.

It's a kind of encounter between two virgin immunities, so to speak.

Los roedores de esas latitudes llevan cepas de hantavirus a las que la mayoría de los seres humanos no han estado expuestos nunca.

The rodents in those latitudes carry strains of hantavirus that most humans have never been exposed to.

There's a question I want to press you on, though.

Hantavirus in most of its forms doesn't spread person to person.

So why quarantine five people?

If I can't catch it from you, why does it matter where you are?

Es la pregunta correcta, y la respuesta tiene dos partes.

It's the right question, and the answer has two parts.

La primera: hay una excepción importante, el virus de los Andes, una cepa sudamericana, que sí parece transmitirse entre personas.

The first: there's one important exception, the Andes virus, a South American strain, which does appear to transmit between people.

La segunda: cuando se produce una exposición en condiciones poco claras, como en un barco en una localización remota, los médicos no siempre saben de inmediato a qué cepa exacta se han enfrentado los pacientes.

The second: when exposure occurs in unclear circumstances, like on a ship in a remote location, doctors don't always know immediately which exact strain patients have been exposed to.

So you quarantine while you figure out what you're dealing with.

That's precautionary, not necessarily because you know it spreads, but because you don't yet know that it doesn't.

Exactamente.

Exactly.

Y además el período de incubación del hantavirus puede ser de hasta ocho semanas, lo cual es inusualmente largo.

And on top of that, the incubation period for hantavirus can be up to eight weeks, which is unusually long.

Eso significa que alguien puede estar infectado, sentirse perfectamente bien, viajar de vuelta a su ciudad, reunirse con su familia...

That means someone can be infected, feel perfectly fine, travel back to their city, meet with their family, and weeks later develop serious symptoms.

y semanas después desarrollar síntomas graves.

Eight weeks.

That's a long time to not know.

And if the mortality rate in some strains is thirty to forty percent, and you develop symptoms that quickly progress to respiratory failure, you need to be somewhere that can treat you immediately.

Lo que me parece significativo de esta historia es lo que revela sobre el turismo de expedición como sector.

What strikes me as significant about this story is what it reveals about expedition tourism as a sector.

Es una industria que en los últimos quince años ha crecido de manera exponencial, con compañías que llevan a turistas adinerados a los rincones más salvajes del planeta, pero la regulación sanitaria de ese sector no ha crecido al mismo ritmo.

It's an industry that in the last fifteen years has grown exponentially, with companies taking wealthy tourists to the wildest corners of the planet, but the health regulation of that sector hasn't grown at the same pace.

I want to be fair about this, though.

The system here actually worked.

Somebody recognized a potential exposure.

People were quarantined properly.

They went to the right facility.

They came out healthy.

That's not nothing.

Sí, y merece reconocerse.

Yes, and that deserves acknowledgment.

Pero el sistema funcionó con cinco personas.

But the system worked with five people.

La pregunta que me hago es si funcionaría con un brote mayor a bordo de un barco con doscientos pasajeros en medio del océano Austral, a tres días de navegación del puerto más cercano.

The question I ask myself is whether it would work with a larger outbreak aboard a ship carrying two hundred passengers in the middle of the Southern Ocean, three days' sailing from the nearest port.

When I was embedded in Afghanistan, there was a constant calculation about medical evacuation.

How far are you from a surgical unit?

If something goes wrong, what's the chain?

Remote expedition tourism has a version of that same calculus, and I suspect most passengers never think about it.

No, la mayoría paga una cantidad considerable de dinero precisamente por la sensación de estar lejos de todo, de estar en lo auténtico, en lo salvaje.

No, most people pay a considerable sum precisely for the feeling of being far from everything, of being somewhere authentic, somewhere wild.

El peligro forma parte del atractivo, pero se espera que ese peligro sea estético, una tormenta en el horizonte, un leopardo marino que se acerca al kayak, no un virus.

The danger is part of the appeal, but that danger is expected to be aesthetic, a storm on the horizon, a leopard seal approaching the kayak, not a virus.

That gap between the perceived risk and the actual risk is where public health problems tend to hide.

People accept certain kinds of danger and are completely blindsided by others.

Y aquí hay un componente de clase que no podemos ignorar.

And there's a class dimension here we can't ignore.

El turismo de expedición es, en general, un lujo de personas con mucho dinero y tiempo libre.

Expedition tourism is, in general, a luxury for people with a lot of money and free time.

Son ellas quienes están entrando en estos ecosistemas, perturbándolos, y también ellas quienes tienen el acceso a instalaciones como la Unidad Nacional de Cuarentena de Omaha si algo sale mal.

They are the ones entering these ecosystems, disturbing them, and also the ones with access to facilities like the National Quarantine Unit in Omaha if something goes wrong.

The people who live adjacent to those same ecosystems year-round don't have that option.

A researcher in sub-Antarctic South Georgia, a local community in Patagonia near a rodent-heavy environment.

En Chile y Argentina, el hantavirus es un problema de salud pública real y persistente, especialmente en zonas rurales.

In Chile and Argentina, hantavirus is a real and persistent public health problem, especially in rural areas.

Desde que se describió el síndrome pulmonar en los noventa, ha habido cientos de casos y una mortalidad significativa.

Since the pulmonary syndrome was first described in the nineties, there have been hundreds of cases and significant mortality.

Eso no genera la misma atención mediática que cinco turistas en cuarentena en Nebraska.

That doesn't generate the same media attention as five tourists quarantined in Nebraska.

That asymmetry in coverage is something I spent a lot of years thinking about as a foreign correspondent.

Whose suffering makes the news and whose doesn't.

It doesn't get easier to sit with.

Dicho eso, lo que ocurrió en el Hondius tiene valor como señal de alarma para los reguladores.

That said, what happened on the Hondius has value as a warning signal for regulators.

Las compañías de turismo de expedición operan bajo marcos regulatorios muy dispares según la bandera del barco y el país de origen de los turistas.

Expedition tourism companies operate under very different regulatory frameworks depending on the ship's flag and the tourists' country of origin.

No existe un protocolo sanitario internacional unificado para brotes de enfermedades zoonóticas a bordo de buques de expedición.

There is no unified international health protocol for outbreaks of zoonotic diseases aboard expedition vessels.

Which means the next time this happens, and there will be a next time, the outcome might depend on whether the ship's doctor has ever heard of hantavirus, and whether someone on shore has the presence of mind to call Omaha.

O de si Omaha tiene camas libres.

Or whether Omaha has free beds.

Que en este caso, las tenía.

In this case, it did.

En el próximo brote, con un patógeno diferente o más contagioso, puede que no sea así.

In the next outbreak, with a different or more contagious pathogen, that may not be the case.

Es la fragilidad de depender de instalaciones únicas o casi únicas para responder a amenazas que, por definición, pueden surgir en cualquier parte.

It's the fragility of relying on unique or near-unique facilities to respond to threats that can, by definition, emerge anywhere.

Five people home safe.

That's the headline, and it's a good one.

But reading three levels deep, this story is really about the thin margin between managed and unmanaged, and how that margin depends on a lot of things going right at once.

Sí.

Yes.

Y hay algo que me quedó dando vueltas mientras preparaba esto: la palabra en español que usamos para describir cómo entra un virus animal en una población humana.

And there's something that kept turning over in my head while I was preparing this: the Spanish word we use to describe how an animal virus enters a human population.

Decimos que el virus "da el salto", o más técnicamente, que se produce un "derrame" o "spillover".

We say the virus 'makes the leap,' or more technically, that a 'spillover' occurs.

Pero tú antes dijiste algo diferente.

But you said something different earlier.

I said it jumps.

Which is the English.

Spillover, jump, leap.

But you used a construction earlier that caught my attention: "dar el salto" versus "desbordarse." Are those the same thing?

No exactamente.

Not exactly.

"Dar el salto" implica un movimiento activo, casi intencional, como si el virus eligiera cruzar.

'Dar el salto' implies an active, almost intentional movement, as if the virus chose to cross over.

"Desbordarse" es más preciso científicamente: sugiere que algo que estaba contenido dentro de un reservorio animal se derrama hacia afuera, hacia una nueva especie.

'Desbordarse' is more scientifically precise: it suggests that something that was contained within an animal reservoir spills outward, into a new species.

Es la misma imagen que hay detrás del término en inglés, spillover.

It's the same image behind the English term, spillover.

So the metaphor built into the science word in both languages is a liquid overflowing its container.

The virus was always there, in the reservoir, but something causes it to spill out.

I find it genuinely interesting when the choice of metaphor shapes how we think about a problem.

Y si piensas en el hantavirus en un barco de expedición, la metáfora es casi literal: alguien pisa un ecosistema cerrado durante milenios, agita el recipiente, y algo se derrama.

And if you think about hantavirus on an expedition ship, the metaphor is almost literal: someone steps into an ecosystem that has been sealed for millennia, shakes the container, and something spills out.

No porque el virus haya decidido nada, sino porque perturbamos el equilibrio que lo mantenía dentro.

Not because the virus decided anything, but because we disturbed the balance that was keeping it inside.

That's a good place to leave it.

Five people home.

One quite beautiful and slightly terrifying word: desbordarse.

I'm going to use that in a sentence and I'm sure I'll manage to say something completely wrong.

Probablemente dirás que tu café se ha embarazado.

You'll probably say your coffee got pregnant.

Pero es bueno intentarlo.

But it's good to try.