The first podcast interview experience - the birth of Secrets of Survival (S.O.S.) - Where It All Began Interview about the beginning stages of the novel Coronavirus 2019 with Infectious Disease specialist - Dr. Moorjani Discussion about the Ebola virus outbreak in 2014, Tuberculosis and HIV in the prison setting Originally recorded on February 23, 2020. Originally published on February 25, 2020 Remastered and published on October 22, 2023 as part of the Historical Medicine Series
Where It All Began
Narrator: [00:00:00] Rashid Media Productions is proud to introduce Secrets of Survival podcast with Dr. Susan.
Dr. Susan Rashid: [00:00:06] As I sit here reflecting on how it all started, I can't help but feel a sense of nostalgia. It seems like only yesterday when I first got into podcasting, it was a time when the world was on the verge of change and nobody knew what to expect. I remember my first podcast like it was yesterday. It was recorded and produced on Sunday, February 23rd, 2020, and subsequently published on Tuesday, February 25th, 2020. The recording took place at my program Director Dr. Diane Reck Teams House in Orlando, Florida. It was a crisp Sunday morning and I remember that we started setting up the podcast microphone at her home office. I couldn't help but marvel at Dr. Diane wrecked teen's Maternal Grace, despite being my boss and my program director. She was every bit the loving grandmother when she instructed her rambunctious grandson, Jonathan Bearcat, to assist me with setting up the podcast microphone. And Jonathan most certainly did support and help me in this adventure at that time in my life. I was 34 years old. I had just passed my board certification in family medicine and I had just joined the Correctional Medicine Fellowship program at Nova Southeastern University. Dr. Diane Routine had introduced me to the faculty members in correctional medicine, and one of them was Dr. Johnny Wu. Both Dr. Diane Rechtinne and Dr. Johnny Wu introduced me to the groundbreaking ideas around medical education, podcasting dedicated to the field of correctional medicine and exploring how health care services are provided for the incarcerated population.
Dr. Susan Rashid: [00:01:57] As we discussed various topics in the field of correctional health care, the conversation eventually turned to the novel Coronavirus 2019 that had recently emerged from Wuhan, China. None of us knew much about it, but we all agreed that it was something worth exploring. That's when both Dr. Diane Routine and Dr. Johnny Wu suggested that we talk to a brilliant infectious disease specialist named Dr. Haresh Moorjani. It was through Dr. Moorjani that we gathered further information about the Covid 19 virus and its potential impact on our society. Back then, towards the end of February 2020, the novel coronavirus of 2019 was a distant concern for every day Americans. No one masked and no one was social distancing. Meanwhile, in the nations of China and Italy, the virus was spreading exponentially. But here in America, life continued, as it always had. We were, in a way, in a blissful state of being in our normal, everyday life. Little did we know that in a matter of a few weeks, our own lives would change significantly.
Dr. Susan Rashid: [00:03:09] And I sat at her office recording our first episode with Dr. Haresh Majani, I couldn't help but feel excited about what the future held. None of us ever thought that our podcast would become a popular national and international breakthrough hit that became this beacon of hope and information for so many people around the world. To this day, Dr. Johnny Wu, Dr. Haresh Majani and Dr. Diane Rechtinne's grandson Jonathan are still in awe of the success of this podcast and we all truly wish that Dr. Diane Rechtinne was still here with us. Unfortunately, she passed away on August 6th, 2021. I was one of her last correctional medicine fellows, and though my time with her was short, it changed me forever.
Dr. Susan Rashid: [00:03:59] Looking back on that first day I started podcasting, I realize now that it was a destined turning point for me. It was the day I discovered my passion for podcasting. It was the day that I realized that we could really bring people together from all over the world, united in their desire for knowledge and understanding. It's been an exciting journey, and who knows what the future holds or where this journey will take us. But one thing is for certain It all started with that first podcast episode recorded on February 23rd, 2020 at my program director's house. And for that, I'll always be grateful.
Dr. Susan Rashid: [00:04:45] Welcome to the Secrets of Survival podcast. Today we are honored to have Dr. Haresh Moorjani join us. Dr. Moorjani is an infectious disease specialist from Westchester County, New York. Today, he will share with us his rich experience in the field of infectious disease. This rich experience includes medically managing the Ebola outbreak, managing HIV Aids, hepatitis C and tuberculosis. His experience also includes delivering infectious disease, health care services in the hospital and clinical settings, as well as in the jail and prison setting. Dr. Moorjani will also speak on the novel Coronavirus 2019 outbreak that has occurred in Wuhan, China. So, Dr. Moorjani, I give the microphone to you. We look forward to hearing your rich experience in the field of infectious disease, as well as your expert knowledge in the novel Coronavirus 2019.
Dr. Harish Moorjani: [00:05:47] So infectious disease specialist working at Westchester Medical Center in the Department of Health, the infectious disease clinic, running that clinic now for six years, rediscovering the care delivery of outpatient infectious disease services to patients in the underserved Centro setting, and then working as a consultant to New York State. And in face of the use of the last 26 years, helping to design care delivery for HIV, hepatitis, STIs, and to the process in the prison setting from 1994 onwards, I have designed all kinds of policies and the roll out of care delivery programs to take care of infectious diseases and prison.
Dr. Susan Rashid: [00:06:34] How many years have you been doing this for?
Dr. Harish Moorjani: [00:06:37] 26 years.
Dr. Susan Rashid: [00:06:38] 26 years. Okay. So why don't you tell us about your experience with your experience with the Ebola virus when it had its outbreak in 2014?
Dr. Harish Moorjani: [00:06:50] So the Ebola virus outbreak in 2014 was a limited outbreak in the United States, but it started in Africa. And then a few cases, being in a global economy made it down to the US.
Narrator: [00:07:03] September 16th, 2014. President Barack Obama speaks at the Center for Disease Control and Prevention in Atlanta, Georgia. President Obama delivered a powerful speech regarding the United States involvement in the fight against the Ebola epidemic in West Africa, and the United States plan to curb the transmission of the Ebola virus.
President Obama: [00:07:26] First and foremost, I want the American people to know that our experts appear at the CDC and across our government agree that the chances of an Ebola outbreak here in the United States are extremely low. We've been taking the necessary precautions, including working with countries in West Africa to increase screening at airports so that someone with the virus doesn't get on a plane for the United States. In the unlikely event that someone with Ebola does reach our shores. We've taken new measures so that we're prepared here at home. We're working to help flight crew identify people who are sick. And more labs across our country now have the capacity to quickly test for the virus. We're working with hospitals to make sure that they are prepared and to ensure that our doctors or nurses and our medical staff are trained, are ready and are able to deal with a possible case safely.
Dr. Harish Moorjani: [00:08:24] Fortunately, there was no effect on the prisons directly in New York. But, you know, people that I suspect that are exposed to Ebola were either put in jail or prison. And that is actually a good thing because people who are screened and some of these countries who have potential exposures were put in quarantine and access care was taken not to put them in closed settings where transmission could occur. I people that in the prisons, even if it did happen, if there was one case or a few cases, it would be easy to control because the transmission is mostly from direct contact with infected blood. And so you can easily isolate that patient, put the patient in a strict isolation room in a health care facility, and nobody would get exposed in the present setting. So that was, you know, we did design our policies in New York state prisons with the help of the public's help. And in case there was a patient that presented with Ebola to a lot of prison setting, what would we do? And those policies are pretty straightforward, direct where we were so that patients were tested against sort of the Pacific Solution and managed by.
Dr. Susan Rashid: [00:09:39] A tertiary.
Dr. Harish Moorjani: [00:09:39] Facility. Impact on the prison setting was that could be very minimal. We know that.
Dr. Susan Rashid: [00:09:44] So when you created protocols, could you share with us what kind of guidelines you provided for your health care staff within in providing the care in regards to Ebola virus population?
Dr. Harish Moorjani: [00:09:57] So the guidelines or the protocols that were set up in New York City for that time were all taken from the CDC. If you go to the CDC website for Ebola virus, will go to health care personnel and good infection control. We just duplicated those completely. And so it had to do with strict isolation that the protective gear, personal protective equipment, the donning and dosing and the infection control personnel, the nurses that I trained in those procedures and the role of protocol as supervision came in. And it would be strict isolation that worked. Then we would then call the emergency services and have that patient transferred to a tertiary care. And I guess it was going to be my system medical center, the southern hub in the northern hub. It was going to be efficiency of the upstate hub. It was near to the Albany Medical Center. So we identified those hospitals as the one that would. Receiving a patient. Yes, the needle. But there was nothing specific about those guidelines to saying.
Dr. Susan Rashid: [00:10:51] Okay, what other experiences have you had with infectious disease and caring for the incarcerated population?
Dr. Harish Moorjani: [00:10:57] My first biggest challenge was in 1996, when there was a huge outbreak of tuberculosis in the HIV patients. It's been spread to the non HIV patients in the prison setting, and that was all published in the MMW. R And how we got that under control over the next year and two was a very big challenge. But that is what has actually prepared a drug bill dealing with the outbreak of any infectious disease that could happen in the future in the prison setting, at least in New York.
Dr. Susan Rashid: [00:11:25] And so that has provided a lot of guidelines for a lot of clinicians that work in the incarcerated setting.
Dr. Harish Moorjani: [00:11:31] So that's the closest. Yes. And then, you know, based on that process, we then develop guidelines for HIV, hepatitis B, hepatitis C for Epstein and, you know, for disease specific guidelines that are being created for all those infectious diseases and potentially for measles in New York. Fortunately, nothing happened. So that disaster of a city that may have been made to take the CDC guidelines and then we modify them to sitting in the New York State prison and put in measures to make sure that the patients are properly isolated and taken care of if they're present in the prisons. That's what we have to do, For example, with any emerging diseases such as the new Cronulla, I'm declaring a public.
Narrator: [00:12:13] Health emergency of international concern over the global outbreak of novel coronavirus. January 30th, 2020. World Health Organization director Dr. Tedros declares the novel coronavirus a global health emergency.
Dr. Susan Rashid: [00:12:30] Speaking of the Corona virus, would you share with us your impression on the Corona virus? Why don't we start with the signs and symptoms, the clinical presentation? It's good to hear from an expert in infectious disease such as yourself what your clinical to share with us the clinical presentation of Corona virus. What is it that we have to look out for as clinicians?
Dr. Harish Moorjani: [00:12:51] So the guidelines and the and the guidance from the CDC is actually pretty comprehensive. So this is a new coronavirus and it's called the 2019. And for all the new Corona and they're now calling it besides coronavirus 200, which is the last of those viruses. It's based on that. So so that's why they call the column to put on alert and they have the ability to do both because that is from person to person, they are droplets. Okay? The only difference between lots of these coronaviruses is the infectivity and the ability to then create disease by way of this interaction that the human body and the immune system. So different classes have different seasons, different severity of presentation. The presentation is the same with the flu like illness, except that in the flu a lot more people get fever, however. But coronaviruses in those cases that are not fever. But some other common symptoms include fever, cough, sputum, headache, diarrhea, symptoms, nausea. And then of course, when it gets into the lower respiratory tract, you start to get shortness of breath and chest pain and hypoxemia. So it's a typical flu like illness, except this is a lot more severe and it has a much higher mortality. The flu, especially in the elderly, especially in people with underlying diseases of the lung and heart.
Dr. Susan Rashid: [00:14:17] So they have a have a more vulnerable picture because of their underlying disease process to really get it to really have a higher mortality with the novel coronavirus.
Dr. Harish Moorjani: [00:14:28] That's correct. So now along you going to La Jolla? Yeah, definitely and all, but I hate to say new paranoia, but, you know, Covid 19 is the disease that that's been caused now caused by this in February 2019. So the increases in other medical conditions, diabetes, immunosuppression, this virus can really cause a lot of damage in the body and then lead to ammonia and lead to lung sort of lung function collapse. And that leads to a much higher mortality rate of what we are looking at is 2 to 3% in those areas, patients that are under-reported. But also remember, this is relatively new. And in the modeling, we don't really know how many total cases have idea what we are being told by the W.H.O. in general, take this on a daily basis, is that there are 77,000 plus in some cases right now, of which 76,000 plus are in China and there's about 1400 in outside of China and pretty unclear with the mortality rate of approximately 2%. But remember, this does not include patients who maybe is. So this disease may be, you know, a minor illness that never was diagnosed. Never. It is not ignored because a patient is not present in our system. It's a minor illness that just goes away. So a very severe illness they develop. And so that spectrum of disease is still being confirmed. We have no epidemiological set of logical theories for how many people are infected and what the actual ages.
Dr. Susan Rashid: [00:16:12] When we recorded this podcast episode, the world we knew at that time was not the world that it was going to turn into In just a matter of a few weeks, the Covid 19 pandemic swept across the globe with the ferocity that few could have predicted. It began as a mysterious and deadly outbreak in the Wuhan province of China. But soon it had began to spread to every corner of the planet. The death toll rose steadily, with each passing day, bringing news of more and more casualties. As the world continues to grapple with Covid 19, one thing remains clear This pandemic will be remembered for generations to come as one of the most significant events in modern history. Thank you for listening in on Secrets of Survival S.O.S. podcast. Join us next week for part two of this podcast episode where it all began with Dr. Majani, where he discusses further about the novel Coronavirus 2019 pandemic. Do.
Narrator: [00:17:30] Secrets of Survival podcast with Dr. Susan is a health care podcast series that is both captivating and informative. This podcast explores the most compelling medical issues impacting our health care system today. Created and produced by Rashid Media Productions, written by Dr. Susan Rashid. Special thanks to the Harvard Medical Schools training to teach in medicine faculty and the Harvard Medical Schools, media and Medicine faculty. We are deeply humbled by our international fan base that spans over 61 countries to our loyal listeners in Algeria, Argentina, Australia, Bangladesh, Belgium, Brazil, Canada, Chile, China, Colombia. Cuba. Denmark. Dominican Republic. Egypt. France. Ghana. Germany. Greece. Guatemala. Honduras. India. Iran. Ireland. Israel. Italy. Jamaica. Japan. Lebanon. Malaysia. Mexico. Morocco. Mongolia. Nepal. Kingdom of the Netherlands. Nicaragua. Nigeria. Norway. Pakistan. Peru. Poland. Portugal. Qatar. Romania. Russia. Rwanda. Saudi Arabia. Serbia. Singapore. Somalia. South Africa. South Korea. Spain. Sweden. Switzerland. Syria. Thailand. Trinidad and Tobago. Turkey. Ukraine. United Arab Emirates. United Kingdom. United States of America. Venezuela and Vietnam. An emotional and heartfelt thank you from us to you. Listen to the Secrets of Survival podcast on Apple Podcasts. I Heart Radio, Spotify, Simple CAS Podcasts or wherever you get your podcasts.