COVID-19 Update - Gene Food remains open for business Learn more
Published on

#24 – Looking into the Coronavirus Crystal Ball: Lessons From Asia and the Role of Genetics with Dr. Spencer Wells

Most of us are glued to the latest coronavirus news, but how often do we hear new information? Our guest today offers rare and unique insight into the pandemic that is sweeping our globe. Dr. Spencer Wells holds a PhD in biology from Harvard University and is one of the world’s leading population geneticists. From his current location on a remote island in Indonesia, Spencer has been tracking the spread of coronavirus, which he describes as “evolution in action.” We discuss a number of important topics related to the coronavirus pandemic including: asymptomatic spread, the potential for genetic susceptibility, the success of Asia, and how life in our cities may change in the wake of COVID-19.

Listen on Google Play Music
 

 

This Episode Covers:

  • Genetic variants that could impact on COVID-19 risk [7:10];
  • Antibody memory, COVID-19 as “evolution in action,” and vaccines [14:10];
  • Urban living in the coronavirus era [21:00];
  • The Asian response to COVID-19 and contact tracing [29:00];
  • The economic impact [35:30];
  • The state of consumer genomics [41:45]

Transcript:

Spencer: In my opinion, the best response so far to the coronavirus has been in Singapore. The things that they have deployed to deal with this were kind of developed as a result of their exposure to the SARS epidemic, a previous coronavirus epidemic that came out of China in 2002-2003. It infected people in Singapore, and it caught people extremely unaware. They’ve developed an app where, you know, you download it to your phone, and if you come within 6 feet of someone else who’s carrying the app on their phone, it will notify you automatically if they test positive.

John: Welcome to “The Gene Food Podcast.” I’m your host, John O’Connor. Hey everybody, like it or not, the coronavirus is on your mind and you’re probably looking for new information about this global pandemic and the crisis that’s unfolding around the world. We’ve sent out email newsletters to this point that have given a more optimistic bent, using data, but a more optimistic bent on the coronavirus. Today we have a guest on who has some unique things to say about the coronavirus. You’ve probably heard just about everything that you would want to so far, but this is a situation where we have somebody who actually has some unique insights into perhaps genetic variants among individuals that could explain why some people have very bad reactions to the coronavirus, why many of us remain asymptomatic. My guest today, his name is Spencer Wells. He holds a PhD in biology from Harvard University and is one of the world’s leading population geneticists.

Spencer was formerly a National Geographic Explorer in residence, and director of the Genographic Project, where he hosted the National Geographic television series, “The Human Family Tree.” Spencer is the author of “Journey of Man: A Genetic Odyssey” and serves as an adjunct professor of biology at UT Austin. His current project, “Insitome,” is a podcast and nonprofit devoted to educating the public about what genetic variants and what their genetic history means for them. And we’re really excited about the episode we put together. Spencer has a lot of insight, as I said. I think he’s a rare individual that has new information about the coronavirus. Not only because of his background in biology and his research and his professional interests and pedigree, but also because of the fact that he’s actually weathering out the coronavirus in Indonesia right now.

And they have gotten the chance to not only look at the data surrounding the coronavirus, but they’ve also had the opportunity to look at how different countries, particularly Singapore, and some of the Asian countries that have had more success with the coronavirus, and have been able to see firsthand their approach and how their approach maybe differs a little bit from what we’re seeing here in the States. So, I hope that this episode will give you some useful information about the coronavirus that maybe you haven’t heard elsewhere. Without further ado, here’s Spencer Wells.

The first thing I wanted to ask you, you know, we’ve been…we’ve just kind of reconnected, been following you on Twitter, and you are following this very closely. Your background is PhD, Master’s level training in biology from Harvard. You’ve done all the…

Spencer: PhD. PhD level. Yeah.

John: Sorry, PhD level. Have done all the genomic work with National Geographic, and population genetics is your field of specialty. And this is something you’ve been studying quite closely. So, what is the top level message coronavirus-wise? I heard an interview you did a little while back, and I’m sure your thinking has probably evolved since then. So, where are you sitting with this right now?

Spencer: Well, you know, from the outside, i.e., there are currently no infections on the island where we’re living at the moment. You know, so we’re very much observing this from the outside, but, you know, and keeping up with all the news sources. This is not gonna be over anytime soon. And we can go into some of the technical details. We also discussed this on my podcast, “The Insight,” but, you know, there are a lot of people out there that are infected and are showing no symptoms and probably won’t show symptoms, but they serve as a reservoir for, you know, reinfecting people. And so, you know, this lockdown that’s in place is going to certainly need to be in place in the U.S. through the end of April. I personally think it should probably be in place through the end of May. But when you start to relax that, you can’t literally shut down society permanently, no one wants that. But when you start to relax it, you’ve got to be extremely careful, because we now know this thing comes in waves.

And so, you know, Wuhan has gotten it under control in China, but they are headed for another lockdown in all likelihood, because of all the new cases that are popping up. And so, you know, I foresee this, you know, taking several months to, you know, perhaps years, who knows. As, you know, the restrictions are relaxed and people start to go about their daily lives and move and mix and gather in groups, you’ll see another flare up, and maybe the restrictions will be reimposed. And, you know, the hope is that ultimately the science is gonna be able to develop a vaccine, but that also poses some challenges in terms of the evolution of the virus. But, you know, the top line is this is gonna take a while.

John: Yeah, I screenshotted a tweet from Nate Silver today. He said, “I think any epidemiologist would say there are for sure hundreds of thousands of unreported COVID infections in the U.S. In fact, there could be millions. That’s the good news. The bad news is that the deaths are a lagging indicator, and deaths can also be underreported.”

Spencer: That’s absolutely true. And, you know, I did a back of the envelope calculation the other day. There was a scientific paper published a few days ago by the team at Imperial College in London. And they estimated the true infection rates in European countries. And the scary thing is there could be as many as 19 million people in Spain, 15 million people in Italy. That’s at the upper end of their 95% confidence interval. You know, there are potentially hundreds of millions, and I think we’re approaching perhaps a billion or more people infected worldwide, and most of them are not showing symptoms.

John: Right. And that’s the thing that I find simultaneously optimistic and terrifying. You know, it’s optimistic because if this has cycled through, for example, in New York City longer than we realized, there’s a lot of people that it’s hit in a very mild way, and it means the case fatality rate should be lower than what had been estimated initially by the World Health Organization. The problem is, is that it’s everywhere.

Spencer: Yeah, that is the problem. And, you know, I’m in the process of trying to write up my thoughts on this and really kind of formalize it. But, you know, what it means is there are a lot of people who are not gonna show any symptoms, and there are some people who are going to die or be, you know, severely affected and put on respirators in the hospital and, you know, take up all those precious medical resources. And the heterogeneity is partially explainable by things that, you know, the Greeks could have noticed. Age, you know, comorbidities, so hypertension or Type 2 diabetes or existing pulmonary problems. But there’s also a lot of healthy people who are dying from this, and a lot of young people who are dying from this. And so there is some genetic component to, you know, the progression of the disease and the outcome. And, you know, I’ve suggested that, you know, obviously one place to look is in the ACE2 protein, which is the receptor that the virus binds to to infect the cells in your lungs.

But another one is a region known as HLA, the human leukocyte antigen. So, this is what they match when you do a tissue transplant, for instance. It’s highly variable in the genome. And the reason it’s so variable is because it’s involved in fighting off, you know, nasty bugs like viruses. It presents intracellular proteins, like viral proteins, to the immune system so that, you know, those cells can be killed. And I suspect there’s gonna be a strong association with certain HLA types and outcomes in this.

John: When you say highly variable, do you mean like a haplotype? A series of variants in a series of snips? Speak to that in…

Spencer: Yeah. So, I’m talking protein variation. This is the most variable part of the mammalian genome. It’s something that, you know, you see in all mammals. It’s part of this kind of, you know, first line immune response. And again, it’s really focused on the intracellular proteins and displaying those to the immune system, to the T cells, which will go ahead and kill the cells that they recognize as having a foreign protein. But yeah, I mean, this is a region that has a huge amount of protein variation. Some of the alleles, or, you know, HLA types, are perhaps millions of years old and have been maintained by selection, because they’re doing something important for the immune system. It’s also highly variable in terms of the alleles or the versions of the HLA types that you have between populations, because populations have had different exposures to diseases over time. And so, it’s just a really, really important part of the genome.

John: And how does that show up for the layperson listening? How does that show up in terms of like, practical differences between people, like somebody has one variant of the HLA genotype, another one has a different, is characterized by a different version of that protein. What does that do mechanistically in the body that would cause one group of people to have a terrible reaction and another group of people to fight it off more successfully?

Spencer: Well, some HLA types will be better able to present the relevant parts of the viral proteins to the immune system. Some won’t be very good at it. And so, you know, there are tons of medical associations, diseases that are associated with HLA types, inherited diseases as well as infectious diseases. Ankylosing spondylitis, for instance, which is a relatively rare kind of extreme form of arthritis that afflicts some people, is highly associated with HLA-B27, one of these variants. And so, you know, these are just really, really important for human health. And I think, you know, one of the…this is what I’m gonna be pushing in this piece that I’m writing, and I’m hoping to find a, you know, an outlet that will help kind of publicize it more widely. But I think we should be doing mass genotyping on individuals, as well as the testing for COVID, so that, you know, number one, we need the science to be there. We need to know which, you know, regions of the genome, which genetic variants are associated with particular outcomes.

But as we start to think about relaxing the shutdown, you know, in addition to protecting people who are already sick, people who are old, we need to be protecting people who are genetically predisposed to, you know, have horrible outcomes from this.

John: Right. And when they say overactive immune, you mentioned arthritis, associated with certain HLA variants. Is this something where people that have autoimmune conditions could find themselves being more vulnerable to COVID, or is that just getting a little too speculative?

Spencer: No. I think there probably is an association there. You know, it’s entirely possible. I mean, I think everybody on the medical side needs to be thinking outside the box on this. And as we know with, you know, almost almost any disease, you know, whether it’s an inherited disease or a common disease, like hypertension or stroke, you know, there are genetic and environmental components to that. And so, you know, we need to be taking these genetic risks into account as we’re designing strategies for testing, for, you know, allowing people to re-engage with society. It’s just, it’s super important. And unfortunately, you know, right now, we’re just in this kind of terrified phase, where it’s like, we don’t have enough test kits for the virus, and we don’t have enough masks, and gowns and things like that for the hospital workers. But, you know, as we hopefully start to get that under control, I think we need to start being a little smarter about how we’re approaching this.

John: Right. I mean, right now the priority is getting actual tests. And I think one of the big priorities, and maybe you can speak to this, is I think everybody would love to know, you know, we’re talking about this asymptomatic spread. I have reason to believe that I may have, you know, I may not have, but I may have had this in early January. I think I even heard Mike Pence in his, one of his daily briefings talk about how they have intelligence or he implied that they have intelligence that this was spreading in New York City well before what people had acknowledged previously. I think everybody wants to get the antibody tests. When do you think those will be available?

Spencer: Well, those are available already, and they are being used in some countries. I don’t know how widely available they are in the U.S. But, you know, that’s a cheaper, easier test to do than the RT-PCR test for the virus itself. And as you say, it’s really important because even if you’re not showing a positive result with the viral test, you can be positive on the antibody test, which again, you know, would tell you that you have been exposed and you managed to fight it off. And, you know, that’s really important for lots of reasons. Number one, it helps us to get an estimate of the true number of infected people in a population. It also potentially can lead to treatments, because people who have antibodies circulating to the virus can donate plasma, and those antibodies can be concentrated and, you know, you can inject that into someone who’s infected with the virus and it will help them fight it off. I remember when I was growing up, you know, back in the dark ages, before they had a vaccine for hepatitis A, so, in the 1980s, when I was in school, whenever a kid in school would be positive for hepatitis, would come down with hepatitis, they would send out a letter telling the parents you should probably consider taking your kids in for a gamma globulin shot. That’s exactly what we’re talking about. This is gamma globulin focused on the coronavirus.

John: Right. It’s also, like, as an adult, you go and you get the Epstein-Barr test that everybody runs, right? You can see whether there was the antibodies there. Is that a similar type of a thing that we’ve all experienced?

Spencer: Yeah, absolutely, absolutely. And so, we all have been exposed to many, many pathogens over the course of our lives, some of us more than others. But, you know, you’re carrying kind of memories of all of those exposures inside of your body’s molecular machinery and your antibody repertoire. And so, you know, I’ve had Lyme disease. I no longer have an active infection. We caught it early enough that I was able to go on Rocephin, which is an IV antibiotic, really nasty, but it knocked it out. And so, I still have antibodies for Lyme disease circulating in my body. You know, I’ve had vaccinations for literally everything humans can get vaccinated for, because I’ve traveled so much. So, I’ve got rabies antibodies, I’ve got hep C or sorry, hep B antibodies, because I’ve had the hep B vaccine. Unfortunately, we don’t have a hep C vaccine, and I’ve not had hep C. But yeah, I mean, literally you’re carrying the memory of all of these infections around with you.

John: Yeah. And so, you’ve, speaking to all these pathogens we’re supposed to, you’ve described this COVID pandemic as evolution in action. Can you tell the audience kind of what you mean by that and put some meat on that concept for us?

Spencer: Yeah, sure. So, you know, I did my undergraduate degree at the University of Texas in biology, and, you know, did not initially set out to become a, you know, human population geneticist, which is what I do now. And I was really fascinated by virology, when I was an undergrad. I took virology classes, I took epidemiology classes, I worked in a virology lab for several months and did research on a mouse model for HIV back in the 1980s. And so, you know, virology’s always fascinated me, and in part, the reason it fascinates me is because of this evolutionary arms race. The virus is constantly trying to evolve to evade the immune system. And the immune system is constantly trying to evolve or adapt to catch the virus. And so, it’s really interesting to see the evolutionary trajectory of how these things play out. You know, one of the things that I’ve said in a few forums now is that when we do develop a vaccine, that will create some selective pressure for the virus to evolve whatever epitope, whatever piece of the protein that can be seen by the immune system, that the vaccine was developed for, to evolve that away from that conformation, and to change in a direction such that it can evade the immune system, even if someone has been vaccinated. And so, you know, it’s just, it’s really interesting studying the dynamics of this, and obviously it has very important public health consequences.

John: So, we’re saying evolution in action. It sounds like even the evolving virus is potentially has the ability to skirt a vaccine. How bullish are you on a vaccine? How bullish are you on the ability for this problem to be put to bed, as it were?

Spencer: I have mixed feelings. I mean, the best example that I always give to people is the influenza vaccine that everybody, or many people, choose to get every, you know, season in the U.S. That is only between 10% and 60% effective because of the variation in the viral proteins. Now, there is a hell of a lot of variation in influenza virus proteins, in part because they have a segmented genome and they recombine different parts of it, and that’s the reason you classify them as, say, H5N1, that’s hemagglutinin and neuraminidase, different genetic components in their genome, that get literally recombined. And so they, in addition to having the mutational changes, they also get this recombination of different pieces of the genome, and new viruses can arise virtually overnight as a result. You know, I think that a first pass coronavirus vaccine, if it’s done well, and this is part of the reason it takes so much time, like, it seems simple. You inject some people with something, you know, some protein from the virus, and they have an immune response and woohoo, we can start doing that to everybody.

But you gotta make sure that you’re using the right piece and getting the right type of immune response, and also, of course, being safe with whatever you’re injecting, and that takes a lot of testing and a lot of trial and error. So, I think that if, you know, this isn’t rushed, the first line vaccine is going to be effective in most people, but, because of all of the people who have had this infection, because it is probably going to continue to spread silently, over the coming months or years, you know, there’s always gonna be a reservoir to be, you know, reinfecting people. I think this is gonna stick around. This is just part of the repertoire of the human pathogen set moving forward, just like influenza virus and adenoviruses that cause colds, and coronaviruses that cause respiratory infections that are already, you know, circulating in the population, I think this is a new one to add to that. And the question is, like, are we gonna be able to develop a vaccine, or more likely, a series of vaccines, that will allow us to get ahead of it and provide enough herd immunity that, you know, the number of cases drops to the point where we’re not getting, you know, significant reinfection events.

John: I saw you just now speaking to this, us living with the coronavirus. We recently reconnected on Twitter. I saw you responding to a report out of India that there was this potential for a real catastrophe in India. And I don’t know exactly who it was, I can’t remember, but they responded with this whole theory of the weather. And a lot of people have said that they think that once the weather warms, that the coronavirus is going to wane, it could come back in the fall. There was a research paper out of University of Maryland Medical School that identified regions of the world where there’s been community spread to essentially places that are 5 to 11 degrees Celsius in temperature, 30 to 50 degrees north latitude and 47% to 49% humidity during the period in time where the virus spreads. How much value do you put in those weather theories?

Spencer: A fair amount, but not necessarily for the reasons that people are citing. You know, think about the flu season. It happens in the Northern Hemisphere between about October and April, so during the winter months. And that is not because of any physical properties of the air, or the relative humidity, or the temperature. It’s because people are crammed into confined spaces in the Northern Hemisphere during those months, and they’re re-breathing each other’s, you know, droplets and breath and coughs and sneezes and burps and everything else. That’s the reason the flu season happens in the winter. And the Southern Hemisphere is headed into their winter right now. The flu season officially starts in Australia yesterday, actually, our time, April 1st. And so, you know, this thing is going to shift. I think there may be components of, you know, these physical properties of the air that, you know, may or may not make it more or less likely to transmit the virus. But being outside is the best thing you can do.

Because if you are inside with someone who’s infected, you are 18 times, according to a Chinese study that was published about a week ago, you are 18 times more likely to catch it than if you’re standing with that same person outside. And in warm, humid climates like the tropics, people spend a lot of time outdoors. They’re not cramped up in tiny little rooms. So, I think that is the major reason we’re seeing that the correlations with temperature and weather

John: Yeah, there’s so much to unpack there when I hear you say crowded spaces, sharing, you know, droplets, all this kind of, you know, incestuous stuff, urban living. I mean, you’ve got the subway. It’s just an incubator for this kind of thing.

Spencer: Oh, and then the surfaces. I mean, I have to tell you, the sickest I ever got, just in terms of, you know, continuous one after another colds and flu…the last time I had flu was when I was living there…was when I moved from Texas up to Boston to pursue my PhD at Harvard. And I was taking the subway all the time, for the very first time in my life, and was not that careful about washing my hands. And so you hold on to those little bars in the subway, and think about how many people have sneezed into their hands and then grabbed that as they’re hopping on. I mean, it’s frankly disgusting. I’m really super careful about washing my hands now, and I don’t get sick nearly as often. But yeah, I mean, the possibilities for catching this thing in an urban environment are just, you know, they’re huge, huge.

John: There’s a micro response to that and a macro question. So, the micro response is to go into these more situational context that we all face on a daily basis. What about elevators? There’s been some speculation that the coronavirus, now, people are thinking it spreads, that it’s airborne. And what I’m thinking, a logical situation is you’re in a building, let’s say in New York City or even, you know, condo building I’m in right now. And somebody who has been exposed to the coronavirus, they’re asymptomatic like a lot of people are, they’re in the elevator. They were there a minute and a half before you got in. I mean, they were in a confined space. Do we have any evidence that that is a danger point, like being in an elevator even alone, aside from touching, you know, an airborne confined space? So have you seen anything in your research on that?

Spencer: I haven’t yet. But again, it’s early days. I suspect that yes, that that will be, you know, one of the major ways of catching it in, you know, tall apartment buildings and urban areas, because often, the elevators are not as well ventilated as the rest of the building. And that’s part of the reason when you get on, they’re sometimes stuffy and, you know, they’re a little uncomfortable. Well, you know, if you’ve got this thing floating around, and if the relative humidity is right and so on, you know, it can stay airborne for a while, and, you know, if somebody just got off and you just got on, even if you’re alone, potentially you could catch it that way.

John: And then the macro piece to that is, you know, you’re giving this a lot of thought, obviously it’s right in the wheelhouse of your research interest and kind of your…how you’ve spent your career. How do you see this impacting our cities? I mean, your family are kind of refugees from Austin. I’m a refugee right now from New York City, I was in your exact same situation. I was out of the city when this really started bubbling. And I didn’t…I wasn’t somebody that left, but I decided not to go back. So, what is gonna happen to Manhattan? Like, what do you see…what is your…how do you see this unfolding in areas like that?

Spencer: Well, I think if, you know, people really look at the evidence, they might start to reconsider whether they want to live in such a dense environment. I mean, on the other hand, cities are good for the global environment, so to speak. You know, they use fewer resources than large suburbs, people don’t have to commute in cars individually, and so on. But, you know, they’re tremendously susceptible to, you know, black swan events like this. And, you know, we haven’t even gotten to the food supply issue. I mean, you don’t grow your own food in New York. You can’t. And I am very concerned and, you know, it’s kind of, it pleases me to a certain extent that others are starting to sound this alarm. There was an op-ed piece in “The New York Times” yesterday, for instance, but food supply chains are gonna be severely disrupted by this. And if you live in a rural environment, and you have a home garden, and you raise chickens for eggs, and, you know, whatever else you do to be self-sufficient, you’ll be fine.

But if you live in an urban environment, where you literally have to import all of your food using these incredibly complex and easily disruptable supply chains, you’re gonna be in trouble.

John: Yeah, there’s definitely the potential for problem. And then it comes on this issue of kind of social responsibility of, you know, you tweeted out today, “You can’t run from a pandemic.” It looked like one of your buddies said, you know, you seem to have done a pretty decent job of it, which, that was, you know, it was kind of funny. I was thinking that when you [inaudible 00:26:15].

Spencer: Well, for now, for now. And my response to that was, you know, listen, the accounting is gonna be done by the survivors, and we’re not out of this yet. So, who knows what’s gonna happen? You know, there are advantages to being isolated on an island and there are disadvantages as well. We don’t have easy access to any healthcare at all on this island. And it’s getting more and more difficult to imagine trying to charter a seaplane, which would probably be the best option if something went wrong and we had to get out of here. But at that point, you know, Singapore is not allowing people in, Australia is not allowing people in, and the hospital system in Indonesia is gonna be severely overwhelmed in a matter of days or possibly a week. So, you know, there are risks you take by isolating yourself. You know, nobody has the perfect solution to this.

John: Does that mean that your plan tentatively right now is to pretty much stay indefinitely in Indonesia?

Spencer: We’re gonna stay in Indonesia, in part because we have been, you know, kind of semi-adopted by the wonderful general manager of the hotel here and his family, and they are extremely well-connected. And, you know, we have not experienced any issues so far with, you know, things that seem trivial, like, you know, our visas are gonna expire in a few days, and he was able to get that done, via a video chat. So, you know, we’re gonna stick with them, and we are exploring options for leaving, because I don’t think it’s gonna be viable long term to keep this whole resort open, even though they’re only, you know, 15 of these luxury tented rooms. But I don’t think it’s gonna be viable to keep it open, so we’re looking into options and we think we have one on Lombok, which is a nearby island that has not been hit very hard, and they, through, again, connections, have access to, you know, a very private villa, with a wall and so on. And anyway, so, you know, there are lots of options. But really, you know, for us, it’s a question of, you know, the contacts we’ve made here and the trust that has kind of grown up between us and, you know, we’re all in this together.

You know, what’s gonna happen in the long term, who knows, but, you know, for now, I feel pretty confident that we’re gonna be able to stay safe.

John: Yeah, my plan is definitely to stay out of the city for the foreseeable future. It’s not convenient, but it’s definitely something that I’m not planning on rushing back to the city either. So, zooming out from Indonesia, you’re in a unique position because you’ve seen firsthand and have been an eyewitness to what we read about. When I’m looking for more optimistic stories about the coronavirus, I look to South Korea, I look to Singapore, I look to Hong Kong, I look to a certain extent to Japan. So, you’ve recently been in Singapore, and you’re in that region of the world. Speak, if you can, about why you think the Asian model and approach to this has been so successful, and whether you think it’s possible to implement here in the United States.

Spencer: Yeah, well, listen, in my opinion, the best response so far to the coronavirus has been in Singapore. You know, the things that they have deployed to deal with this were kind of developed as a result of their exposure to the SARS epidemic, a previous coronavirus epidemic that came out of China in 2002-2003. It infected people in Singapore and it caught people extremely unaware. And, you know, it was a real shock to the system. And in response to that, they’ve developed these techniques for contact tracing. So, when we were in Singapore, we were there for over a week, every building you went into, you had to give all of your contact details. And if somebody became infected that had been in the building, you know, either a little before you or a little after you, you know, they would get in touch with everybody and, you know, test them and see if they had been infected. So, the contact tracing was really important. People are practicing social distancing there and, you know, it’s a society in Singapore where, you know, people are a little more compliant than we are in the West.

You know, they value, to a certain extent, the collective over the individual, and so people tend to obey the rules. I mean, in Singapore, people do not spit their chewing gum on the sidewalk. And, you know, they don’t have an issue with laws that prohibited that. We would, in New York, or Texas, or California. So, I think, you know, it’s partially that that mindset that values community over individual which has allowed people to put up with the lockdowns, you know, really severe lockdowns that again, we probably wouldn’t be willing to put up with in the U.S. And also just, you know, Singapore is a small city-state, so you can apply technology in ways that you probably couldn’t in the U.S. They’ve developed an app where, you know, you download it to your phone, and they widely broadcast this. It’s available for free, it’s Android, iOS. You download the app, and if you come within 6 feet of someone else who’s carrying the app on their phone, it will notify you automatically if they test positive.

Like, that’s awesome. And I don’t see that being applied in the U.S. anytime soon, even though Singapore has now open sourced it and so you can apply it anywhere. Yeah, I mean, it’s things like that that have allowed them to get ahead of this.

John: Yeah, I have a friend who is reading a lot of the Japanese, from Tokyo, is reading a lot of the Japanese news, and there was a story that, I mean, I haven’t seen it in the American media, but in China… And look, I’m not saying this to suggest that this is some superior system necessarily. I just think it’s interesting anecdotally to hear how other countries are handling this. You literally get on the receipt of your fast food delivery, the name and the temperature of the person that handled your food, which I thought was absolutely amazing. In New York City, there’s so many people that are relying on delivery, and it is kind of a blind spot, I do think, to a certain extent. These people are stretched very thin, and they’re being pressured to go into work. And that’s an easy way that you could…I mean, you don’t wanna be paranoid. You gotta eat, but at the same time, you know, if you’re looking to really be strict about avoiding this, the food issue is definitely one to consider.

Spencer: It is, it is. And, you know, this brings up another point that I think is going to be really important, particularly in the U.S. Namely, there is simply no resilience built into the system anymore, between just-in-time supply chains and manufacturing, and the number of gig workers in the economy, people who literally have, you know, no money coming in if they can’t work. And so, you know, they’re on this knife edge between, am I gonna be able to afford rent and food, or am I gonna die from a coronavirus infection? You know, I think…I hope, that at the end of this, we will start to reevaluate that, because resilience is really important. Freak events do happen. They have happened throughout human history. And if you forget that, you will be doomed to repeat that cycle.

John: And that strikes to the heart of the economy. I mean, you’re a owner of a, it’s called Antone’s, I believe, in Austin.

Spencer:. Antone’s, yep. It’s a 45 year old nightclub. And we’re doing great, and we’re gonna survive this. So, you know, all of the partners have taken financial hits, but we’ve got money in the bank, and we’re retaining our staff and, you know, things are looking good for Antone’s, and I think we’re gonna come through it. Yeah, I mean, listen, I’m an entrepreneur. I’ve started several companies over the last few years, two in the biotech space, started a nonprofit in that space that, you know, we were due to announce this spring, although that’ll be delayed now. And the travel company with my wife, and so, yeah, I mean, I pay close attention to the business news, the economic news. I think maybe today, I saw the first signs of people realizing that this is gonna be long and difficult. This is gonna be much worse than the 2008 financial crisis. This is gonna be more akin to the Great Depression. And I think the sooner people start preparing for that, the better.

But, you know, the hope is, thinking of creative destruction, Schumpeter’s, you know, economic theory from the 20th century, you know, some industries will die, some businesses will die, but others will grow up in their place, and maybe we can create a better future, you know, as a result of this.

John: Well, so when you say prepare, what does that look like to you? I mean, what would you be doing?

Spencer: Well, I would not be buying into the down market right now, for instance, hoping that you’re gonna make some quick money. You know, I’d be extremely careful with my savings. I’d be prioritizing things, you know, in my life in terms of are they necessities or are they simply, you know, wanna haves. And, you know, starting to think about ways of cutting back and maybe developing your own sources of food, growing that garden that you always wanted to plant. You know, there are lots of things people could be doing, because again, this is not gonna go away at the end of April. It’s not gonna go away probably over the summer. It might not even go away before the end of the year. And so, you know, you’ve gotta figure out how to settle in for the long term and really make a change in lifestyle. This is not a temporary, you know, shift.

John: So, what does the future hold for Austin, Texas? I mean, Austin’s a booming city, it’s been doing great with tech. There’s a ton of people moving there for jobs. Apple’s opening a new campus in 2021, there’s a ton of new hotels that have just finished up, like I think it was [inaudible 00:35:39] and I can’t imagine. What are people saying that you’re talking to in Austin, in terms of how is that gonna impact… It’s a kind of a microcosm. So, how do you…how are people hunkering down there in those industries?

Spencer: People are freaking out. You know, the music business is a low margin business, and unless you’ve got some, you know, resilience built into your books, you’re gonna go under during this. Restaurants, I’m very concerned about, because that’s an even lower margin business. You know, high end restaurants, if they make 5%, 6%, they’re lucky. You know, so it’s very difficult to make a living in the best of times in those industries. And, you know, there are gonna be a lot of restaurants that go under. Austin is a party town. People go there to listen to live music, drink, and eat food at cool restaurants. And all of that is shut down. So, big part of the economy. I mean, I was one of the early people to call for shutting down South by Southwest this year, and thank God they decided to do that. Because imagine what would have happened with hundreds of thousands of people descending on Austin, cramming into tight spaces over the course of 10 days. I mean, it’s unimaginable. And the city is gonna take a huge hit as a result of that, but it’ll save people’s lives.

And so, you know, the big question for Austin is, how much resilience is built into the system? You know, you say tech is really important. And I think, you know, tech is a big part of the Austin economy now, but, you know, Austin tends to have a lot of early stage startups. And often, to really scale as you grow as a startup, you need to go to the coasts to attract talent and to attract, you know, financing from the venture capitalists. So, you know, I think Austin will come back on the tech side. I think some tech companies will simply run out of cash during this. But others, I think, will discover that way of being resilient and will live on and will be stronger as a result. Property, I think, is gonna be really hard hit. I mean, you’ve already got developers who are up in arms and screaming at Mayor Adler and the city council for shutting down construction sites, because these people have loans.

And, you know, they’ve got very strict schedules, and property is a long term play, and it’s gotta be orchestrated on a timescale that makes sense, and you’ve gotta have a certain return. And if rents start to drop, and if they can’t finish construction in time, like, companies, again, are gonna go under as a result of this.

John: Yeah, there’s gonna be a lot of financial pressure on finance, real estate for sure. Let’s do this. And I wanna close out with a discussion, a little bit letting people know about your genetics company that you have, Insitome. But before we do, I want to give people some… Let’s play devil’s advocate here and give a couple minutes to some ideas for optimism. One of which is that this could wane in the summer, and the social distancing could work. I think one of the other theories that we touched on at the beginning is that some have speculated that this was circulating in California and New York and some other areas well before we actually recognized that it could have possibly been, and by virtue of the fact that it was spreading, by virtue of the fact that there’s so many asymptomatic carriers, the actual case fatality rate could be very, very low. So, how do you see those… I think it was Ioannidis, Dr. Ioannidis at Stanford, who had a kind of a contrarian position that he wrote up in the STAT news.

So, what do you…if you were gonna put, if you had to, you had to put an optimistic message behind this in terms of your most optimistic, what would you say to people who are looking for something, you know, a little happy to think about? To the extent that…

Spencer: Yeah. I mean, listen, this is not rocket science. There are very simple things we can do to get through this. And the simplest thing that everybody can do is to self isolate. If you’re not in contact with infected people, and no one in your immediate circle, inside of whatever structure you’re in, is infected, then you will be fine, you know. There will be economic problems, but you can dig out from economic hits. You can’t dig out from death. You can’t spend money when you’re dead. And so, just settle in, like, you’ve got to take this in a very kind of Buddhist way. This is an unexpected global life change event for everyone. And you know, life is like that, and you just have to accept that times are gonna be different for a while. And I think if you can get into that mindset, you know, it’ll be somewhat of a relief, you know, because you don’t feel that pressure to, “Oh, we gotta get back into this, we gotta get back out, we gotta start making money again.” Well, no, that’s not gonna happen for a while. So, change your perspective. And I think that will make people much happier if they change that perspective.

John: Yeah, it does afford the time…it does afford the opportunity to spend time with family. We’ve talked about it on previous podcasts, but the hustle culture, I don’t know that we necessarily want it to be negated via global pandemic, but the hustle culture I think is burning a lot of people out. So, a recalibration of that could be positive. Where do you think the fatal…you mentioned, you know, you can’t spend money when you’re dead. Where do you think the fatality rate for this will end up? Like, where do you see it ending up?

Spencer: I think it’ll be around 1%, which means it’s, you know, 10 to 20 times as deadly as the seasonal flu. So it’s serious, but it’s nowhere near as serious as SARS or MERS or these other recent coronavirus outbreaks, where you’ve got 10% to 30% fatality. You know, this is 1% but, you know, if you imagine that, those numbers that I was mentioning before, millions of people in every country infected, that’s still a lot of deaths. And so, you know, it’s a serious disease.

John: Yeah, it very much is. I’m definitely gonna be a customer of the new travel company once this all cools down, whenever that will be. What about the DNA industry? I mean, you have Insitome, do you wanna tell…tell people, if you would, about your platform, your genetics company that you have, and how you’re navigating the stewardship of that company through this?

Spencer: Yeah, sure. So, there have been a lot of changes, and this is part of the announcement that I alluded to before. Going back a little bit, when I first moved to Austin, when I left National Geographic, where I was for over a decade, leading the Genographic project, which was the first major, you know, widely available consumer genomics test. We launched in 2005, two years before 23andMe, and, you know, nearly a decade before Ancestry, even though those guys spent a lot of money on advertising and later became the dominant players. But yeah, I’ve been in this business for a long time, left in 2015, and had always wanted to start my own thing, and had been in, you know, discussions with friends. I had a faculty position at Cornell, visiting faculty while I was in D.C., with National Geographic, and so I’d go up there for several weeks every year.

And one of my contacts there, a guy named Adam Boyko, who is probably the world’s leading expert in canine genomics, dog DNA, so, he and I and his brother Ryan started talking about creating a consumer testing platform for dogs, so we can tell you what breed goes into your mixed breed dog, and we can tell you about predisposition to inherited diseases and all sorts of stuff. And, so that was Embark, and I was co-founder and chief product officer of that, and built out the initial product that we released. But in the meantime, I had been involved with a company called Helix, in the Bay Area, a new company that was spun out of Illumina, which is the dominant player in genomic technology. They essentially have a monopoly on DNA sequencing and genotyping. And Helix was meant to be the consumer app store for genomics. And, you know, I was on the scientific advisory board and was very involved in that company and its launch. But, you know, at one point, they asked me, would you be interested in building apps for this? And I said, “Absolutely,” because you know, what I love about all of this is the storytelling that goes into it. You know, particularly on the Ancestry side, which is what I specialize in.

You know, telling people the stories of how their ancestors migrated out of Africa, down into India, or up into Central Asia and, you know, the changes that happened in their DNA as they adapted to having milk in their diet or whatever it might be. Yeah, so that’s how we founded Insitome in 2016 and, you know, I stayed on as an advisor with Embark and am still involved and still own a significant chunk of the company, but left and became founder and CEO of Insitome. And, you know, the consumer genomics industry has changed a lot in the last year. And so, there’s been a huge drop in sales of these kits. 23andMe and Ancestry have been hit particularly hard. Genographic, which I founded and was still going after I left, shut down last year. And so it’s not the growth industry it once was. Layoffs have happened at 23andMe and Ancestry. And so, last year, we essentially mothballed Insitome as a company selling DNA testing kits, and instead kind of reimagined what we are. And what we are is really an information resource for people to find out about what their DNA means, and about privacy issues.

You know, that’s part of the reason the market dropped off last year, is that people started wondering, well, they’ve collected all this data, and I hear all these stories about, you know, the FBI going in and searching databases and catching the Golden State killer. What are they really doing with all of that? If I am the product, you know, what’s happening then? And so, I think that’s part of the issue. And so, I’m very concerned about those ethical issues. And so, what we’ve done is we have effectively converted Insitome from a Delaware C-Corp into a 501(c)(3). And so, it is a nonprofit now, and we are gonna be focusing on education, we have a podcast, “The Insight” that is, you know, very successful. And we publish blog posts, and we will be doing conferences and presentations at conferences and so on, but also focusing on some of the legal and ethical issues. So that is what is happening with Insitome.

John: Well, yeah, Helix seemed to totally pivot as well. [inaudible 00:45:47] app store for genetics anymore. I mean, I noticed a bunch of the apps that they had on there. Originally, it was envisioned as you can figure out the ideal wine based on your genetics and all these different types of things. And it seems like they’ve gone much more in the direction of medical and diagnostic tools, as opposed to consumer-facing genomics products. Is that [inaudible 00:46:06]

Spencer: Yeah, they’ve effectively become a CRO, a contract research organization. So, they partner with big healthcare systems. You know, think about some of the, you know, HMOs and so on. And they’ll come in and they’ll basically do all the DNA sampling and all the, you know, exome sequencing on 70,000, 100,000, people because the HMO thinks that it will help with diagnosis and treatment and prevention. But they’re basically doing contract research now. They’re focused more on that population health side, which is what they call it.

John: Yeah, it’s a fast and rapidly evolving industry for sure. Well, Spencer, I really appreciate you taking the time. It’s been a very, very, very informative conversation. Is there anything that you wanna get off your chest, anything we haven’t touched on that you wanna close with?

Spencer: Well, listen. As I said before, you know, we’re gonna get through this. Continue to, you know, isolate yourself physically/socially, as much as you can, wash your hands, don’t touch your face when you’re out in public. There’s some really simple things everybody can do. And, you know, keep up with all the information that’s coming out on this. Don’t necessarily believe everything the WHO, the CDC, or the government is telling you, because they’ve been wrong at several points during the development of this whole pandemic. So, you know, keep up with the news yourself, in addition to listening, you know, to those press conferences and so on that we all see every day.

John: No, I mean, it’s a great point. People that I trust, just absolutely 100% bulletproof trust on an issue like nutrition or lipids. It’s such an evolving topic, there’s so much mystery out there. You know, we’re gonna learn a lot in the coming months. You’ve helped us [inaudible 00:47:49] some new information about the coronavirus, which is rare in today’s media cycle. So, we thank you so much. Enjoy Indonesia. Hope you get a tan. Say hi to Holly for me, and we will be in touch on the other side of this crisis.

Spencer: Thanks a lot, John. Stay safe.

John: Yeah, thanks, Spencer. “The Gene Food Podcast” is our attempt to synthesize the latest developments in the fields of genetics, nutrition and medicine, and offer you practical tips and stories you can use in your own unique health journey. If you enjoyed this podcast, you can find more information online at mygenefood.com.

John O'Connor

John O'Connor is the founder of Gene Food, host of the Gene Food Podcast and a health coach trained at Duke's Integrative Medicine Program. Read his full bio here.

The very latest on genetics, nutrition and supplements delivered to your inbox!

Facebook icon Twitter icon Instagram icon Pinterest icon Google+ icon YouTube icon LinkedIn icon Contact icon Info icon