[RADIOLAB INTRO]

JAD ABUMRAD: Hey, I'm Jad Abumrad. This is Radiolab. So last week, we did a big episode about the 1918 flu, thinking about this invisible enemy. This week we've got two stories about a couple of invisible allies.

SIMON ADLER: Okay. Well, um ...

JAD: And we're gonna kick things off with producer Simon Adler.

SIMON: So we're gonna start at a homeless shelter in Boston ...

JIM O'CONNELL: Hi, this is Jim.

SIMON: … called The Pine Street Inn.

SIMON: Hey Jim, Simon here from Radiolab.

JIM O'CONNELL: Oh, Simon. How are you? Thank you for calling. That's perfect.

SIMON: Oh yeah.

JIM O'CONNELL: How are you?

SIMON: Does now still work for ya?

JIM O'CONNELL: Yeah! No, no it works.

SIMON: And a very busy doctor there, Dr. Jim O'Connell.

JIM O'CONNELL: Internal medicine doc at MGH and the President of the Boston Healthcare for the Homeless Program.

SIMON: And he says back this past winter, as this wave of COVID-19 was making its way towards North America, he and everybody in this community of health care providers who work with the homeless were freaked.

JIM O'CONNELL: You know, really good measures for controlling this is to, you know, physically distance and to quarantine, wash your hands frequently and to shelter at home. And when you crawl into our perspective of being a homeless person or homeless provider, those things are rendered just absurd. And we're looking at 500 people sitting in what we were thinking of as a powder keg.

SIMON: And so to try to head this thing off, they did all sorts of preparations. They built tents in various places. They scrambled to find extra beds around the city.

JIM O'CONNELL: How many beds do we need? We were guessing. Entirely guessing.

SIMON: And every evening as the homeless folks would return to the shelter for the night, they'd get their temperatures taken and have a brief interview with a shelter worker.

JAD: Like just, "Have you experienced any of these symptoms? Yada, yada, yada?"

SIMON: Exactly. Jim and his team just did what they could and braced for that powder keg to ignite.

JIM O'CONNELL: Yes.

SIMON: However, by mid-March, with thousands of cases appearing all over the United States ...

JIM O'CONNELL: We were not seeing anybody turn positive.

SIMON: ... no one seems to be getting sick.

JAD: Huh.

SIMON: Now, this was surprising. But Jim says ...

JIM O'CONNELL: We've seen this before. We've seen infectious diseases hit the homeless population last. And so we sort of laughingly said, none of our folks have traveled to China or Europe.

SIMON: So you know, maybe this thing's just taking its time. But ...

[NEWS CLIP: Another dramatic and deadly turn in the coronavirus outbreak.]

SIMON: ... the end of March draws near ...

[NEWS CLIP: The most-reported coronavirus deaths ...]

SIMON: ... Major cities around the US are in trouble.

[NEWS CLIP: 80,000 confirmed cases in the US.]

SIMON: The shelter? Still nothing.

JIM O'CONNELL: We didn't have anybody positive. It's totally baffling.

SIMON: And it wasn't just them. They call up the Los Angeles homeless shelters. Nobody there.

JIM O'CONNELL: San Francisco had not yet seen anyone at the end of March.

SIMON: Basically, nobody in Atlanta.

JIM O'CONNELL: Even in Seattle, they hadn't seen any among the homeless population.

SIMON: So already they're sort of like, "What the hell is going on? We thought we were gonna be hit hardest. We aren't being hit.” And they're just sort of left in this state of bewilderment until April 2, when they get enough tests from the state to do universal testing.

JIM O'CONNELL: We screened and tested everybody.

SIMON: They put 408 people through the test. They shoved this—the thing up their nose. These are sort of the gold standard in tests at the time. They wait a few days. And the results ...

JIM O'CONNELL: There were 147 positive tests that night out of the 408.

SIMON: That's about 40 percent.

JAD: Whoa. Okay.

SIMON: And of those ...

JIM O'CONNELL: No symptoms whatsoever.

SIMON: Not a single person was symptomatic.

JAD: Really?

JIM O'CONNELL: It blew our mind.

SIMON: They did more tests at other shelters throughout the city.

JIM O'CONNELL: 30 to 40 percent. They were all asymptomatic.

SIMON: Exact same results.

JAD: That is really, really strange.

SIMON: Again, they look to other shelters across the country. Jim O'Connell calls up his friends doing work in other cities. And many of them are seeing this same phenomenon as well.

JAD: Weird. Why?

SIMON: Well oddly, the answer might just be found by looking up. But first ...

SIMON: ... backwards, a century prior. It's September 1918, the Spanish Flu is raging through Boston, killing a massive 40 percent of those who were hospitalized. And in particular, it's hitting sailors, merchant marines, the hardest. In fact, there were so many of them coming off the boats that they had to erect these temporary tent hospitals, including one they named Camp Brooks.

RICARD HOBDAY: Camp Brooks, yes. Yeah, yeah.

SIMON: This is Ricard Hobday, researcher and author. And he says Camp Brooks was special.

RICARD HOBDAY: I mean, what they did was they recognized that what they were doing wasn't working. In effect, they were dying. So they decided, "Right, we'll change—change our direction and do something else."

SIMON: So instead of leaving the sailors in these dank tents ...

RICARD HOBDAY: At Camp Brooks, whenever they were able to do it, the patients were taken outside in their beds and put outside.

JAD: Just roll out their beds? Just push the beds out into the courtyard or something?

SIMON: Exactly. At the time, there was indication that putting people outdoors helped with tuberculosis. And so they thought, why not give it a shot here too?

RICARD HOBDAY: And then at the end of the day when the sun was gone, they'd put them back in. And ...

SIMON: By the end of the first night ...

RICARD HOBDAY: ... almost every patient, without exception, had a lower temperature at night than during the morning and felt decidedly more comfortable. From the first day, the results were startling.

SIMON: And pretty damned quickly, they'd managed to cut the death rate by two-thirds.

JAD: Whoa. Really? Just by pushing them out into the air?

SIMON: Yeah.

JAD: That—that's a stark dif—do you trust those numbers?

SIMON: They're from the Surgeon General of the Massachusetts State Guard, the medical officer responsible for the sailors' care.

JAD: Interesting.

SIMON: And he's saying, "We don't—like, we don't know why this is working, but it's working." And so bringing this back to the present, tying all this together, as researchers were scratching their heads over this homeless shelter mystery and looking back to these sailors, they started to think okay, maybe this has something to do with sunlight.

JAD: Sunlight.

SIMON: Yes.

[ARCHIVE CLIP, Donald Trump: Thank you very much.]

SIMON: Do you remember at that press conference back in April when President Trump made those daffy, unfounded statements about UV lights ...

[ARCHIVE CLIP, Donald Trump: Supposing we hit the body with a tremendous, whether it's ultraviolet or just very powerful light.]

SIMON: ... and injecting disinfectant.

[ARCHIVE CLIP, Donald Trump: Injection inside ...]

SIMON: For which he was berated to no end.

[ARCHIVE CLIP, Donald Trump: It sounds interesting to me.]

SIMON: Well, it turns out others thought that the sun and sunlight were interesting things to look at as well. To be clear, by all indications they were interested in sunlight not for any of the reasons that President Trump was, but because sunlight and the sun is how we get the majority of our Vitamin D.

JAD: Whoa. So the—wow. So they're in—they're in the sun more. That's the thought?

SIMON: Yes. Homeless individuals and the sailors, the idea goes, are less likely to be Vitamin D deficient.

JAD: I've heard people talk about sunlight and Vitamin D, but I don't even really know what Vitamin D is.

SIMON: So Vitamin D actually isn't a vitamin in the traditional sense. Because generally, vitamins are things that exist outside of the body that we need to ingest to get. That's not actually the case with Vitamin D. Our bodies can make the stuff in-house. And the way we do so is sort of cosmically astonishing. Basically, we've got this proto-cholesterol molecule in our skin. And that cholesterol is just sort of sitting there, doing it's thing, but when it gets hit with sunlight, so imagine the tip of your nose as you step out into the sun, in that moment a little portion of that proto-cholesterol molecule on your nose, what's known as a carbon bond, gets broken. Now what exactly a carbon bond is, I couldn't tell you. It's something molecular. But anyways, with that carbon bond broken, that cholesterol molecule becomes untethered from your nose and can now be absorbed into the bloodstream. Goes through the bloodstream, buh, buh, buh, buh, bup, down, down, down from your nose into the liver.

JAD: Okay.

SIMON: Where it picks up hydrogen and oxygen molecules, then back into the bloodstream. Buh, buh, buh, bup. Another stop this time in the kidneys, some more molecular magic, and then finally it pops out the other side as what we now know as Vitamin D. And thinking about this, what's sort of crazy is like, it's as close as we get to being plants. Or it's like the closest connection we have to plants. It's our own little form of photosynthesis that's happening every minute we're out in the sun.

JAD: Yeah.

SIMON: And crazier still, turns out this little photosynthesized vitamin is correlating with COVID in a series of strange ways.

FRANK LAU: Hi, this is Frank.

SIMON: Hey, Frank. Simon here from Radiolab.

FRANK LAU: How's it going?

SIMON: One of which was noticed by this guy, Dr. Frank Lau ...

FRANK LAU: Associate Professor of Plastic Surgery at LSU Health Sciences Center in New Orleans.

SIMON: ... as he was looking at COVID patients in—in the ICU.

FRANK LAU: The core question is okay, what seems to be driving the more severe cases? And so some things popped out like, you know, nutrition, obesity, diabetes rates and so forth, but the one factor that really stood out as being explanatory is Vitamin D insufficiency.*

SIMON: Folks with mild symptoms had plenty of it, while folks in the hospital didn't have much.

FRANK LAU: The ones who were really, really sick, I mean, some of them had undetectable levels of Vitamin D.

SIMON: And well, his paper is pre-published. It hasn't been peer-reviewed yet because the science is moving very fast. This has been seen in other hospitals throughout the United States as well. So that's the sort of local correlation. And then if we zoom out globally, a team from Northwestern recently compared the severity of cases, the mortality rate between different countries. And what they found was that the best predictor of how poorly a country would fare, how high their mortality rate would be, was its rate of Vitamin D deficiency. Basically, the more Vitamin D deficient a country was, the more bad outcomes they were expected to have.

JAD: And so why would this be? I mean, why—how would Vitamin D help us against coronavirus?

SIMON: Well, so Vitamin D helps regulate your immune system, both by turning parts of it up and by turning other parts of it down. Now when it comes to turning things up, your macrophages, the sort of warrior cells of your immune system that go out and kill the bad viruses, germs, etc., Vitamin D soups them up. It makes them better fighters.

JAD: Okay.

SIMON: And while this is definitely important, it's actually Vitamin D's ability to slow things down that's looking more and more vital.

[NEWS CLIP: As the body fights COVID-19, overproduction of molecules called cytokines can trigger a cytokine storm.]

SIMON: So these cytokine storms, which you may have heard about in the news, are essentially your own immune system going haywire.

[NEWS CLIP: Where the immune system attacks the body's own vital organs.]

SIMON: One way it was explained to me is that it's like your immune system switching from being a sniper, precisely targeting individual foes, into a machine gunner, just brazenly firing all around leading to way more damage than protection. And here's the thing: Vitamin D reduces the production of these cytokines.

JAD: Oh, interesting!

SIMON: Possibly preventing that sniper from becoming a machine-gunner in the first place, and reducing your likelihood of having one of these cytokine storms.

JAD: Huh. Has this—where are we in terms of confidence about—that this is, in fact, a thing?

SIMON: Right. We're definitely in the early days here. And as I said, this is still all just correlation. But you are beginning to see some people say that we know enough to act, that we should start recommending Vitamin D supplements, which is controversial in part because those recommendations are often involving race.

[NEWS CLIP: The NHS is to launch an investigation into why people from ethnic minority backgrounds are more likely to be affected by COVID-19.]

SIMON: So leaving the States here for a minute, in the UK, much like in the US, there are racial disparities in the number of COVID deaths. Specifically, when it comes to doctors and medical workers.

[NEWS CLIP: The first 10 doctors to die from the disease were from ethnic minorities.]

[NEWS CLIP: 65 percent of all NHS workers who have died from COVID-19 are from a Black, Asian or minority ethnic background.]

PARAG SINGHAL: Yes, yes. We started noticing this disparity way back in April.

SIMON: This is Dr. Parag Singhal. He is a British endocrinologist and also the National Secretary of the British Association of Physicians of Indian Origin.

PARAG SINGHAL: Our main aim is to offer Indian origin doctors protection from racism, discrimination—which happens.

SIMON: They've got about 8,000 members. And he says back in April, he started hearing from them.

PARAG SINGHAL: Because at that time there were, I think, 13 or 14 deaths of healthcare workers. And all of them were from what you call BAME, which is Black, Asian, Minority, Ethnic population.

SIMON: BAME or doctors of color, I think as we would call them in the United States?

PARAG SINGHAL: Yes, yes. That's right. And that got us worried. So a lot of theories were proposed. More prevalence of diabetes in BAME population, for sure, economic deprivation ...

SIMON: And then also this Vitamin D idea.

PARAG SINGHAL: I mean, we know for a fact that if we are Black, it's very difficult to absorb sunlight and make Vitamin D. That's bottom line. And the prevalence of Vitamin D deficiency in Black population is enormous.

SIMON: And so knowledge of that fact, plus then these early correlational studies that were coming out ...

PARAG SINGHAL: That started us to understand that maybe Vitamin D has something to do with it.

JAD: Huh. So, folks with—just so I can pull that apart for a second. Folks with darker skin have less Vitamin D?

SIMON: Folks with darker skin have a harder time synthesizing Vitamin D. And folks with darker skin are far more likely to be Vitamin D deficient. So in the US here, 82 percent of African Americans are Vitamin D deficient, which is about double that of the general population. And while in the UK those rates aren't identical, they're comparably similar.

JAD: So the thought is that because Vitamin D deficiency correlates well with COVID mortality and because communities of color have greater levels of Vitamin D deficiency, maybe those two are linked in some way?

SIMON: Yes, that is the thought.

PARAG SINGHAL: So we started highlighting this.

SIMON: They sent out a message encouraging all of their 8,000 members and their families to take a Vitamin D supplement.

PARAG SINGHAL: We started a public awareness campaign through TV, and so forth.

SIMON: But then just a couple weeks later ...

PARAG SINGHAL: You know, I was part of a focus group discussing COVID and how disproportionate an effect it has had.

SIMON: This focus group Dr. Singhal was a part of was made up primarily of doctors and politicians of color. And during a meeting, Dr. Singhal brought up this idea of Vitamin D, even offered to pay for Vitamin D supplements for communities of color in that region.

PARAG SINGHAL: And the answer from that BAME politician who was chairing the group, no. These are the exact words: that Vitamin D is a distraction. It's all about racism.

SIMON: To which Dr. Singhal's like, nobody's saying that that is not at play. Of course, access to care, who gets defined as an essential worker, are massive factors here. And I'm not denying there is a terrible tradition of blaming minorities' biology for the shortcomings of society.

PARAG SINGHAL: There is what you call systemic racism. We know there are health inequality. There is deprivation, we know that. And I belong to an Indian community, I'm from Indian background, and I'm well aware of those systemic issues. No doubt about that.

SIMON: But nonetheless, that doesn't seem to be the only thing going on here, particularly when you consider this all started because we were talking about doctors dying.

PARAG SINGHAL: Doctors come from reasonably affluent backgrounds. They are not living in poverty. And interestingly, if you look at the data from first week of May onwards ...

SIMON: So several weeks after their members started taking Vitamin D.

PARAG SINGHAL: ... there have been—according to my understanding, there has not been any health care worker deaths after that due to COVID. Now I'm not saying Vitamin D was the only factor.

SIMON: Right. But you think some of that could be due to Vitamin D.

PARAG SINGHAL: Yes. We believe—very much believe so, yes.

SIMON: And so he's like, come on, there's a possibility that we can save lives here.

SIMON: Like, we can't solve systemic racism overnight, we can solve Vitamin D deficiency in a week.

PARAG SINGHAL: I mean as medics, our first principle and first philosophy has to be, do no harm. And what we have done is, by not pursuing the path of Vitamin D, we have caused harm.

SIMON: So back to your question of how confident we should be in all this. Well, we know that Vitamin D is good for us. If you ask the top brass here in the United States, the CDC, how effective it is against the coronavirus ...

EMILY MOSITES: We do have to, we have to wait a little bit to be able to get enough data to answer these types of questions.

SIMON: They'll tell you—as Dr. Emily Mosites of the CDC told me—it's just still too early to say. And while there is undeniably something remarkable happening here in these homeless shelters, again ...

EMILY MOSITES: It's hard to draw conclusions on what this means. We don't know if it means that people who are homeless have higher proportions of asymptomatic infection than anybody else. To determine that we would need a comparison group.

SIMON: Like, universal testing of a comparable population.

EMILY MOSITES: You know, another group of people living in a congregate setting of a similar age.

SIMON: But since we're still not really doing universal testing anywhere other than in prisons and nursing homes, we're really only testing people showing symptoms, no such comparison group exists. So it's possible that most of us that are infected are carrying it around in an asymptomatic manner. And just to complicate this one final level further, Dr. Mosites points out that as far as Vitamin D levels in homeless people go ...

EMILY MOSITES: People who are experiencing homelessness are pretty undercounted and understudied. So there's not a ton of information, but the information we do have about nutrients and about Vitamin D shows that they're actually more likely to be deficient.

SIMON: Oh really?

EMILY MOSITES: Yeah.

SIMON: Yet another thing we don't have enough data on.

SIMON: Well, okay. So what—where do you go from here? Or at this point, what's the advice that you give? Because clearly you have a more thorough, robust study coming down the pike here, but in the meantime just everybody should be popping their Vitamin D supplements and making sure they're not deficient?

FRANK LAU: Yeah. I mean, I think ... [laughs]

SIMON: Once more, Dr. Frank Lau.

FRANK LAU: I wouldn't even say the supplements necessarily. You know, if you get 10 to 15 minutes of sunlight between 10:00 am and 2:00 pm, that's when peak UVB rays are in—are present in the sunlight, you can get your daily dose of Vitamin D. So ...

[crow cawing]

FRANK LAU: Uh, So the trial that ...

SIMON: Also you outside right now? Are you outside getting your Vitamin D boost?

FRANK LAU: I am, yeah. I am, yeah. [laughs] You can hear the crows all the way in the background.

SIMON: I can, yeah.

ANNIE MCEWEN: So right now we're having a chemical thing happen to us because of the sun?

SIMON: Isn't it crazy to think that?

ANNIE: It is totally crazy.

SIMON: Before I let you go here, Jad ...

ANNIE: This is gonna make or break the episode.

SIMON: As we were finishing this thing out, producer Annie McEwen and I went on a sort of remote bike ride together. Her in Brooklyn. Me here in Wisconsin. Really just to take a moment and take in the majesty that is the sun.

SIMON: The thought I've sort of been having, and I do think it's sort of a lovely thought that even while the natural world has decided that it wants to get us with this tiny little virus, this microscopic orb, that millions of miles away there's a giant orb, huge and golden that is in a small way trying to send us a bit of protection.

ANNIE: It's trying to help us. That's nice, I like that. A car almost just hit a cab. Yes, I'm focusing again.

SIMON: My mother is biking by.

ANNIE: Oh, that's nice.

JAD: Reporter Simon Adler and producer Annie McEwen.

ANNIE: Tell mom I say hi.

SIMON: Annie says hi.

JAD: When we come back, we're gonna get elemental, I guess you could say. We're gonna look at one more invisible ally that we're just now understanding, thanks to this pandemic. Anyhow, that's coming up after the break.

[JAD: Science reporting on Radiolab is supported by Science Sandbox, a Simons Foundation initiative dedicated to engaging everyone with the process of science.]

MOLLY WEBSTER: Can you hear me now?

JAD: I can hear you.

MOLLY: Yay!

JAD: Oh Lord!

MOLLY: Lordy Lordy, look who's 40. I haven't talked to you in, like, a year.

JAD: I know right. What's ...

MOLLY: On our agenda. It's funny ...

JAD: Your hands are over your face right now.

MOLLY: My hands are on my face.

JAD: Hey, I'm Jad Abumrad, this is Radiolab, for this next story about a tiny, invisible thing that might help us in the fight against COVID, we have producer Molly Webster.

MOLLY: Okay, so this whole story is about an element. And I learned about it recently, when I was reading an article from Smithsonian, and it was about this British scientist, this guy Bill Keevil.

BILL KEEVIL: Hi. Hello, good morning.

MOLLY: Hey, how are you?

BILL KEEVIL: I'm well, thank you.

MOLLY: I called Bill Keevil. He's at Southampton University in the UK. And for him, the story started, which is he's a microbiologist, you know, he studies small things. A ways back in his career sort of at the beginning of it ...

BILL KEEVIL: Should be the late 80s.

MOLLY: ... he had inexperienced that basically has come to define his career.

BILL KEEVIL: I worked for the Public Health Laboratory Service at Porton Down, the equivalent of Fort Detrick.

MOLLY: A military lab where they study things like Ebola and smallpox.

BILL KEEVIL: While I was there, we started to get outbreaks of Legionnaires' disease.

[ARCHIVE CLIP: Every so often a new killer disease appears that the immune system can't handle. That's how it is when some 2,000 war veterans come to Philadelphia for the 58th Annual Convention of the American Legion.]

MOLLY: Legionnaires disease was discovered at the end of the '70s.

[ARCHIVE CLIP: In the past few days, a virus-like mystery illness has killed 15 persons and hospitalized of these 42 others. Their symptoms, much like a heavy cold.]

MOLLY: You have coughing, fever, pneumonia, and then you can die.

[ARCHIVE CLIP: In all, 178 persons are stricken, 29 die.]

MOLLY: Eventually scientists figure out it's an airborne bacteria.

BILL KEEVIL: Legionella bacteria, and it was traced to their cooling towers.

MOLLY: The bacteria was growing in stagnant waters in the air conditioning systems but Bill says, even though they knew this, even by the late '80s they hadn't figured out how to stop it and so they were still having outbreaks.

BILL KEEVIL: It hits a big hospital in the Midlands and then it hit the BBC, of all places.

MOLLY: Really?

BILL KEEVIL: Yeah, in London.

MOLLY: Essentially, people are trying to think, how can we keep legionnaires' bacteria from growing in these cooling towers?

BILL KEEVIL: That was the problem.

MOLLY: Bill was working on some stuff that's like it was like tangentially related to water and bacteria in water and so in the middle of this research and discussion ...

BILL KEEVIL: We were approached by the copper industry.

MOLLY: Somebody identified as "the copper industry" reached out to Bill.

JAD: Big copper! Ring, ring!

MOLLY: A big copper. I literally sent him an e-mail the other day that I was like, "Could you be more specific about the copper industry."

JAD: Who is big copper?

MOLLY: The copper industry called Bill.

BILL KEEVIL: Because at the time they were looking for new markets for copper.

MOLLY: They said, "Hey, you." The copper industry. No. They said, "Hey, Bill, what if the tower or parts of the tower were made out of copper?"

JAD: Wait a second. What is motivating big copper to call Keevil, to say, "Hey, listen, there's this Legionnaires' situation, we think that copper."

MOLLY: My guess is ...

JAD: Keevil, I keep calling him weevil. I'm such an ass, I'm sorry.

MOLLY: I think that it's because there is a long history of copper killing bad things.

JOANNA BUCKLEY: The ancient Greeks and the ancient Roman civilizations, they found that drinking water out of copper-containing vessels inhibits bacterial growth far more so than, say something like a wooden cup, for example.

MOLLY: This is chemist Joanna Buckley, and she pointed out it wasn't just the ancient Greeks, the Egyptians used copper plumbing, in ancient China they kept their water in copper.

JOANNA BUCKLEY: They weren't sure why, but it stayed fresher for longer.

MOLLY: Copper was discovered 11,000 years ago. I know, which is a very long time ago.

JAD: Weren't we just barely starting farms at that point?

MOLLY: This was like pre-iron age.

JOANNA BUCKLEY: For a long time, copper was the only metal that was known. It was used for just about anything, where using a metal was required things like armor, weaponry, primitive machinery.

MOLLY: I had never even thought about this but the Bronze Age only happened because bronze is copper and tin. The Bronze Age is in a sense a Copper Age that we the left.

JAD: Really?

MOLLY: Yes. Bill says that for a long time ...

BILL KEEVIL: Copper and particularly, its ally brass were the major materials used in buildings for example, ships, what have you.

MOLLY: Big copper was king.

BILL KEEVIL: For hundreds of years. And then about 40-50 years ago ...

MOLLY: There were all of these new materials that came out of the wars that replaced traditional copper.

BILL KEEVIL: Stainless steel, aluminum, plastics. People thought, "Oh, these look nice, and they're easy to clean. Let's get rid of the copper and the allies because we're going to keep cleaning those because they tarnish.

MOLLY: Copper is expensive. It's like suddenly coming out of the wars you have the invention of a bunch of cheap materials. Then people are like, "Why don't we use these cheap materials in all of our stuff."

JAD: Big copper, when they called Keevil they were like, "Keevil bring back the Bronze Age."

MOLLY: It feels like that.

JAD: That is the Copper Age.

MOLLY: It feels like they're drawing its straws here. They're like, "We heard about something in Stafford. Get on it. Can we get copper in there?" That's how I play this out in my head. Anyways, big copper called Bill and they said, "Can copper help with this Legionnaires' problem." Bill does the experiments. It's like the Legionella bacteria just disappears.

JAD: Really?

MOLLY: Yes. After this very successful collaboration big copper just kept calling Bill. [phone rings] A couple of years after Legionellas, big copper calls and says ...

BILL KEEVIL: There's been this big waterborne outbreak of an E. coli in Walkerton in Canada.

MOLLY: Bill takes a little bit of the E. coli, plops it on some copper and the copper kills it. A few years later ...

BILL KEEVIL: They came back to me and said, "Look, we really want you to focus on MRSA."

MOLLY: The resistant staph infections that pop up in hospitals. People sometimes call them superbugs.

BILL KEEVIL: Plop these superbugs onto a copper surface exactly 10 minutes.

MOLLY: What does zapping mean?

BILL KEEVIL: Oh, sorry.

MOLLY: What's happening?

BILL KEEVIL: Killed, destroyed, annihilated.

MOLLY: As Bill explained it to me, in a sense, literally zapped it.

BILL KEEVIL: Yes. Copper has a free electron that runs around the outside of the atom.

MOLLY: The way that an atom works is there's the nucleus, and then it has the rings of electrons that surround that core. I often think of it as like Neptune. Is it Neptune that has rings or Jupiter that has rings?

JAD: Saturn has rings.

MOLLY: Saturn. I often think of it as Saturn where there's your little core ball, and then there's these rings around it. Those rings are all electrons. Copper has what you could call an extra electron.

BILL KEEVIL: Yes, this electron could really move. If it sees something nice, it transfers to the other.

MOLLY: Oh, it'll leave the copper and it'll pop on over to the other thing.

BILL KEEVIL: Yes.

MOLLY: When it gets near a bacteria, the electrons will travel away and bond in a very loose hang out way with some of the atoms that make up the cell membrane of the bacteria. If there's carbon in the cell membrane of the bacteria, if there's oxygen in the cell membrane of the bacteria, the copper will let one of its electrons cosy up to it and then that loose bond changes the properties of that cell wall.

BILL KEEVIL: You lose this nice smooth membrane integrity. Everything starts to break down.

MOLLY: What would that look like exactly?

BILL KEEVIL: Imagine a balloon. When you push it, it moves in, it moves out again, it's very flexible. Imagine part of that balloon suddenly went very stiff. If you were to push on that, then it just breaks.

MOLLY: It just is brittle and it just breaks.

BILL KEEVIL: Yes, that's the word we're looking for, it's brittle.

JAD: It essentially calcifies a little bit of the balloon exterior and then pops it.

MOLLY: Yes.

BILL KEEVIL: It starts to become porous. We've got some beautiful pictures of bacteria with holes in them and thenleaking their content outside. You can say they're vomiting. What happens next, which is really neat is ...

MOLLY: Oh, there's more.

BILL KEEVIL: Oh, yes, there's a lot more. When the copper gets inside the cell, it reacts with enzymes just destroys them and then finally, which is the best thing of all, I think, the copper destroys the DNA and the bacteria, the nucleic acid.

MOLLY: People also think it might actually wedge itself into the DNA of the bacteria and prevent replication, so it actually embeds itself into the DNA. His whole thing is we should be using copper everywhere, people.

JAD: Let's just make the whole hospital out of copper.

MOLLY: There is a hospital that I found in South Carolina.

MIKE REILLY: Washington Medical Center in Lexington, South Carolina.

MOLLY: It's outside of Columbia, South Carolina, in part managed by this guy.

MIKE REILLY: I'm Mike Reilly, I'm a hospital operations administrator.

MOLLY: They just built a new 10-story patient tower.

MIKE REILLY: We read an article five years ago now, maybe six years ago, all I remember is it said, copper holds some answers to reducing infections.

MOLLY: Basically one of the things in the article was these DOD studies that looked at copper not in the lab, but in hospitals, like what would happen if you put down copper surfaces or copper door handles. One of the studies indicated that it reduced hospital-acquired infections by 58 percent. Mike was like, "Let's just do this."

MIKE REILLY: You would never notice it but the door paddles that you push to enter the door are copper.

MOLLY: They put in copper plating on the doors where you would push the doors open.

MIKE REILLY: Then if you have to go to the bathroom, that same door hardware.

MOLLY: That's all copper.

MIKE REILLY: And then if you're a family member or a nurse and you want to wash your hands in the patient room, those faucet levers are copper. There's something else in the bathroom that's copper, it's the toilet flush handle.

MOLLY: There's the handle on the IV pole.

MIKE REILLY: Which is what the patients do touch when they walk themselves down the hall.

MOLLY: All told, they made six different surfaces copper. Mike says ...

MIKE REILLY: Copper never sleeps, it's always fighting an infection.

MOLLY: He believes that it will save lives.

JAD: Wait, I have two questions for you. Question one, given the fact that copper likes to just throw around its electrons very loosely, does it hurt people at all?

JOANNA BUCKLEY: That's a really great question.

MOLLY: That was my big question too.

JOANNA BUCKLEY: It depends how much you have of it.

MOLLY: Copper is actually an element that the body uses at very, very low levels for so many of its metabolic processes, where it gets toxic because there is a way in which copper gets toxic is if you ingest it ...

JOANNA BUCKLEY: In water, for example or in a pill that you swallow, for example.

MOLLY: If you ingest too much copper you can hurt your liver and your kidneys and your intestine. The thought is, though, is that if it's just on your skin you have so, so, so, so many skin cells, and your skin cells replenish and turn over so quickly and there's so many of them that it can't hurt you.

JAD: That's question number one.

MOLLY: Go ahead, question two.

JAD: Question two is, what about COVID? Go.

MOLLY: There was a study where they took CoV-2 and they put it on copper and they put it on cardboard and stainless steel and one other surface. They saw that within four hours, CoV-2 was totally gone from the copper surface and it took up to 72 hours for it to leave the other surfaces.

JAD: Wow, that's okay.

MOLLY: That's pretty cool. That was done at the National Institutes of Health and the CDC and a few other places here in the States.

JAD: I like those numbers.

MOLLY: Frankly, everybody does. This is why you're seeing ...

[ARCHIVE CLIP: Copper ions infused ...]

MOLLY: ... copper stuff everywhere.

[ARCHIVE CLIP: Introducing copperware masks.]

MOLLY: You can get copper masks and copper gloves and copper pajamas.

[ARCHIVE CLIP: Look how sexy these are in it.]

[ARCHIVE CLIP: You can put the copper into the linen.]

MOLLY: Copper blankets and copper sheets.

[ARCHIVE CLIP: Put the copper stuff in your nose ...]

MOLLY: There's nasal one can stick up your nose.

[ARCHIVE CLIP: It will zap and kill the microbes.]

MOLLY: Copper is blowing up right now.

JAD: Wow, copper pajamas, I think that's where I would draw the line.

MOLLY: I know. The trick here is and there's a couple of tricks, it's like copper mask, is it super-helpful to have a mask with these threads woven through it. The virus would have to sit on there for a long time Maybe if you are going to wear the mask all day and then stick your fingers up your nose or something. Maybe then it's practical. The other thing is, copper is not cheap. The price of a ton of copper today on July 17 is $6,385 per ton.

JAD: For a ton of copper?

MOLLY: For a ton of copper, so then if you're not using copper, you might be using something like steel. I'm doing price of a ton of steel. Oh, wait, hold on, price of steel. This is stainless steel, let's just say stainless steel, because I don't know anything else. There's shreddable steel is 18 cents a pound. It's $360 for a ton of steel.

JAD: It's quite a big difference.

MIKE REILLY: Let me tell you this.

MOLLY: Mike's actually going to go do another 300 rooms in copper.

MIKE REILLY: Oh yes. The rest of the original facility.

MOLLY: The price tag?

MIKE REILLY: $600,000 is what it's going to cost me to do 300 rooms, and a few additional bathrooms and kitchens and things like that.

MOLLY: To retrofit?

MIKE REILLY: Yes, and that's a lot for most hospitals. They're not going to spend $600,000 on copper when they really need to replace the CT or they really need to replace the X-ray unit in the ED. A new CT cost you 460,000, a new MRI cost you a million. They're not going to spend $600,000 on 300 rooms. Most hospitals are struggling to survive a third loose, a third breakeven, and a third are fortunate to make a small bottom line to reinvest.

MOLLY: Mike says if he can afford it, he's going to do it.

MIKE REILLY: Yes, I am not above grinding up some copper and walking around.

JAD: I love that idea. I'm going to get some copper dust and I'm going to dust my children every morning.

MOLLY: It's like there is so many things here where you're like, "How do I do the story without sounding like I'm also funded by the copper industry?"

JAD: This is exactly according to their plan.

MOLLY: They're like, "We didn't need to call you, Molly, because we heard you around the case all on your own."

JAD: Big copper, give us a call.

MOLLY: I know.

JAD: That was producer Molly Webster. This episode was reported by Simon Adler and Molly Webster, and produced by Annie McEwen and Pat Walters.

MOLLY: Special thanks to Mike Schmidt and Joe Schwartz.

SIMON: I'd like to say a special thanks to Dr. Vadim Backman and Adrian Gombert.

JAD: I'm Jad Abumrad. Thanks for listening. We will catch you next time.

[LISTENER: Hi, this is Nikaya from Port Townsend in Washington State. Radiolab is created by Jad Abumrad with Robert Krulwich and produced by Soren Wheeler. Dylan Keefe is our director of sound design. Suzie Lichtenberg is our executive producer. Our staff includes: Simon Adler, Jeremy Bloom, Becca Bressler, Rachael Cusick, David Gebel, Bethel Habte, Tracie Hunte, Matt Kielty, Tobin Lowe, Annie McEwen, Latif Nasser, Sarah Qari, Arianne Wack, Pat Walters and Molly Webster. With help from Shima Oliaee, W. Harry Fortuna, Sarah Sandbach, Tad Davis and Russell Gragg. Our fact-checker is Michelle Harris.]

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