Episode 199: Flu Takes Charge

Chris: Hello and welcome to the Osterholm update, a podcast about infectious diseases and public health featuring Doctor Michael Osterholm. Doctor Osterholm is an internationally recognized medical detective and director of the center for Infectious Disease Research and Policy, or Cidrap, at the University of Minnesota. In this podcast, Doctor Osterholm draws on over 50 years of experience in infectious disease epidemiology to provide straight talk on the latest infectious disease outbreaks, counter misinformation and disinformation about vaccines, and distill the complex and ever evolving public health threats facing our world. I'm Chris Dahl, reporter for Cidrap news, and I'm your host for these conversations. Welcome back, everyone, to another episode of the Osterholm Update podcast. Happy New Year, and here's to hoping for some more encouraging public health news in 2026. Hope, of course, isn't a strategy. As Doctor Osterholm likes to say. As we all know, 2025 was a profoundly challenging year for public health, with the Trump administration and Health and Human Services Secretary Robert F Kennedy Jr taking a sledgehammer to both the federal public health workforce and U.S. vaccine policy. While the full implications of these moves are still unknown, they portend significant challenges for this year and beyond. We'll also discuss which parts of the country are getting hit hardest by influenza, bring you an update on US measles outbreaks, and we'll bring you the latest installment of this week in Public health history. But before we get started, we'll begin with Doctor Osterholm's opening comments and dedication.

Dr. Osterholm: Thanks, Chris, and welcome back to the podcast family, to this new Year. Happy New Year to all of you. I hope that your holidays were as delightful and as satisfying as you could want them to be. And knowing that, as we talked about on this podcast in previous episodes, sometimes these seasons could be challenging. And today, we're going to actually take an intentional effort to bring in the new year with a smile and a sense of hope. And I do want to also update all of you because I've had a number of questions about it. Yes, I was successful the 40th consecutive year of reading the Polar Express to my kids and grandkids. It was done on Christmas Eve. Again, what a magnificent experience it was. Uh, I am the luckiest man in the world to have that kind of relationship where a children's book that, to me holds a meaning for all ages would be shared with my family and the fact that we hold it so very dear to us. And I would encourage all of you to actually think about, uh, doing a similar kind of thing with your families. It's amazing how traditions can become very, very special events. As I just noted, we intentionally are putting forward what I would call our best foot forward for this podcast. Specifically, this episode is dedicated to the people who carry hope into the new year for science, public health, and medicine. Not because you're oblivious to how difficult this past year has been for the field, but because you understand how hard it's been and you choose to still fight for something better.

Dr. Osterholm: Hope in public health is the decision to keep showing up in the face of burnout, polarization, underfunding and misinformation. This year tested the field in profound ways. We watched outbreaks exploit gaps in coverage. We saw evidence dismissed, expertise attacked, and institutions strained. And yet quietly and persistently, progress continued. In 2025, we saw the arrival of the first effective gonorrhea vaccine a breakthrough years in the making against a pathogen that had steadily outpaced antibiotics. We saw malaria vaccines continue to roll out and scale up, protecting children in regions that have carried the weight of the disease for generations, W.H.O. s World Health Statistics 2025 report showed that 1.4 billion more people enjoyed healthier lives thanks to reduced tobacco use, cleaner air, and better water and sanitation. Hiv and tuberculosis rates are falling and fewer people need treatment for neglected tropical diseases. These are not abstract victories. They are lives protected and suffering prevented. We also saw something quite rare: a renewed attempt at global cooperation. The adoption of a global pandemic agreement did not solve every problem, and it will not prevent the next pandemic on its own. But it acknowledges that preparedness, equity, transparency and shared Responsibility really does matter. This kind of progress does not come from optimism alone. It comes from people who are willing to work within imperfect systems while still pushing them to be better. For those who understand, the public health advances are often incremental, fragile and easy to overlook, but they are cumulative over time.

Dr. Osterholm: So this dedication is for the people who refuse to give up on the idea that prevention is worth fighting for, who believe that evidence still matters, who choose solidarity over cynicism and persistence over despair. Hope in this field is an act of courage. And this podcast is dedicated to everyone who carries it forward into the year ahead. Now, let me move on to that part of the podcast which I love others tolerate. Thank you. Some of you actually love it. Also, I know I hear from you. I'm very happy to report that here on January 2nd in Minneapolis, Saint Paul sun rises at 751, sunset at 443. It's gaining every day about 55 seconds. Today we will have eight hours, 52 minutes and four seconds of sunlight. I can see we've turned the corner. And to our dear, dear friends at the Occidental Belgian Beer House in Vulcan Lane in Auckland, New Zealand. Today your sunrise was at 605, your sunset at 843. You have 14 hours, 37 minutes and 44 seconds of sunlight. Now that's quite a bit more than us, but you're losing sunlight at about 38 seconds a day, and that is going to accelerate in the near term. So the bottom line message is there's still a lot of sunlight around the world. And I can see ours increasing every day, which gives me that warm feeling to know that summer is coming. Yes it is.

Chris: Mike, let's start this episode with an update on the emerging flu season. As someone who's just getting over a bout with the flu, I can tell our listeners that it packs a punch this year. So which parts of the country are feeling the brunt right now?

Dr. Osterholm: I'm glad to hear you're starting to sound and feel better, Chris. Many of our listeners did detect in that voice viewers, with the last podcast recording that you were in the early hours of your influenza infection. Now, I know so many people who are getting hit hard by flu right now, and I'm sure many of our listeners are in the same boat. The delayed start to the flu season was a nice grace period, but we knew it wouldn't last forever. And this season is turning out to be a real challenge. Every metric we use to monitor activity is increasing, and we're seeing these increases across the country. Last week, 6% of all outpatient visits were for influenza-like illness, or what we call Ili, nearly double the 3.2% during the last episode two weeks ago. Remember, we will not declare an end to the flu season until the percentage of outpatient visits drops below the national baseline of 3.1%, based on the same Ili metric. At the state level, flu activity is considered minimal in just two states Montana and South Dakota, low in ten states but now moderate in eight and nine. States in the District of Columbia are considered high, while now 20 states overall are considered very high. Let me repeat that 20 states are now considered very high in Colorado. Emergency department visits and hospitalizations are increasing rapidly. Flu related emergency department visits have surpassed their peak from last year, and hospitalizations are close to doing the same. And in New Jersey, the cases have now reached last season's peak level of outpatient visits for Ili at 11%.

Dr. Osterholm: I won't be surprised if that figure climbs even much higher in the coming days and weeks nationally. Emergency department visits and hospitalizations are also increasing with laboratory confirmed influenza hospitalizations highest in the 65 and older age group, followed by the 0 to 4 year olds and Ed visits highest in the 5 to 17 year old age group, followed by the 0 to 4 year olds. Since our last episode, we have had seven additional pediatric deaths, bringing the season's total to eight. One other aspect to this emerging influenza activity is that if you're trying to be seen in an emergency department or an urgent care right now, get ready to wait. We know of hospitals right here in Minnesota that are 90 to 100 people deep, waiting in the waiting room to be seen with influenza. The national wastewater concentration for influenza is now considered moderate and continues to increase. Each region is experiencing rising concentrations, though the Midwest and West still remain low, while the South is considered moderate and the northeast is high. Connecticut and Nevada are the only states considered very high, while Georgia. Maine, Massachusetts, New York and Rhode Island are the five considered high and all others are considered moderate, low, or very low. Bottom line is, I believe that the wastewater data, along with what we're seeing with the clinical data, will merge in the weeks ahead and you'll see both of them increasing substantially. Nationally. Test positivity is actually tripled since our last episode, now at 25.6%. Let me just emphasize these numbers, because this is a really large jump in two weeks.

Dr. Osterholm: During the last episode, we reported that test positivity for flu surveillance for week 49 was 8.5%. During the week off, which was surveillance week 50, it jumped to 14.8%. And during the week 51 test positivity is now up to 25.6%. By the way, week 51 means that it was the second to last week in the year for that week around Christmas time. For reference for last flu season. From week 50 to 51, test positivity jumped from 8.6 to 14.2%, then to 18.2% in week 52, where it stayed for three weeks before increasing again and ultimately peaking at about 32% a few weeks later in February of 2025. While the trend looked eerily similar last week, it's no longer the case this week. We can only hope we can peak below 32% again this year, or will mark the highest test positivity we've seen in the past ten flu seasons. In other words, take this flu season seriously. It is significant. We'll touch more on this subtype breakdown later in the episode, but for now, I'll just add that the overwhelming majority 92% of cases are in fact H3n2 virus. Remember last year we were predominantly hit with H1N1 influenza? We're really in the thick of it right now, and things will continue to get worse before they get better. For now, the best thing you can do is get your flu shot if you haven't already. And please, please, please stay at home if you have symptoms of influenza.

Chris: We talked earlier about the flu, Mike, and we've gotten a lot of questions recently about what we know, if anything, about the effectiveness of this year's flu shot, especially given the mutations in the dominant strain that's circulating. What can you tell our listeners?

Dr. Osterholm: Well, Chris, as I just noted, we're seeing more flu cases and hospitalizations, which is often the situation with influenza a dominant season with lower vaccine effectiveness and more severe illness in older adults than in an H1N1 dominant year. But I have to say, there is one other factor that plays heavily into this whole situation. At the same time that we're seeing this flu activity, we are 2.1 million fewer doses of flu vaccine that have been given in retail pharmacies this year and at the same point last year, and 873,000 fewer doses have been administered in doctor's offices. In other words, almost 3 million people who were vaccinated last year at this time are not vaccinated this year. What's happening? Well, since February, this administration has not done anything to promote seasonal vaccine use. In the past years, the Department of Health and Human Services was CDC, as the lead would work closely with medical societies, with public health organizations, with even healthcare organizations to make sure those at highest risk for serious illness, hospitalizations and deaths got vaccinated. This year, these people are not, and it would not surprise me if we were to see an increased number of deaths because of the fact that these vaccines often prevented death in previous epidemic years. So just make note that again, this is one of the impacts of this administration's approach to vaccine promotion in our community.

Dr. Osterholm: It's really a very significant statement about what public health can do versus what we are doing. Now. Let me just update you on what's happening with the viruses and how this might relate to the vaccine. Nearly all of the flu viruses that are circulating in the United States were influenza A, 90% of them were age three and two, and 90% of the H3n2 viruses collected since late September actually underwent additional genetic testing and were found to be the newly emerged H3n2 variant called subclade K. This fast spreading subclade emerged at the very end of the Southern Hemisphere season, which precedes the Northern hemisphere season because of the late emergence of the variant. Australia experienced a longer than normal flu season. Unfortunately, based on data available at the time, the World Health Organization had already recommended H3 into subclass J2 for this year's vaccine, and other vaccines were made with that strain, so they're not the subclade K. However, let me provide some additional clarification. Early data from the United Kingdom and Japan showed that subclade K actually represented almost 90% of all the flu sampled, but vaccine effectiveness against flu related emergency department visits and hospitalizations remained within typical ranges, at about 72 to 75% in children and adolescents and 32 to 39% in adults.

Dr. Osterholm: And after an early surge of flu infections and hospitalizations, the UK Health Security Agency said last week that flu activity had decreased as now circulating at moderate levels. Regardless of the strain mismatch, it's still important to get vaccinated against flu because even in seasons with lower vaccine effectiveness against infection, the vaccine still provides some protection, including against other strains and reduces the risk of severe illness. So if you haven't gotten vaccinated, please do so now and do it as soon as possible. You may not have much time left because this virus is going to continue to spread quickly in our communities. And in order to achieve immunity, you need at least a week or two following vaccination to be sure that your body's immune system is revved up and ready to go. One other point to note is that at this time, it appears that the antiviral drugs we have for influenza are effective in treating this virus. So if you do develop influenza, and in particular, if you're someone at increased risk for hospitalization or even death, namely the older the younger, you surely consider getting a prescription for one of the antiviral drugs so that it can be there to support you in your recovery.

Chris: Covid activity has been very quiet throughout the fall and early winter. Is that still the case and does that have anything to do with flu season hitting a little earlier than normal.

Dr. Osterholm: Christmas is fortunately still the case, but we're starting to see a few signs that our luck may be running thin, as there are some hints of increasing activity. The question of why Covid has remained silent through the fall and early winter is very difficult, if not impossible, to answer. This SARS-CoV-2 virus has proven over and over that it is, first of all, not a seasonal virus and second, completely unpredictable. Wastewater levels remain low across the country, with every region now seeing increasing concentrations. Concentrations in the Midwest are now considered high, while the northeast is moderate and the South and West are still considered very low. Three states, Indiana, Nebraska, and Oklahoma, are considered very high, while eight, including right here in Minnesota, are considered high. The other states with high levels include Arkansas. Connecticut. Kentucky. Massachusetts. Michigan, Ohio, and South Dakota. Ten states are moderate, nine are low, and 20 are very low. I think you're going to see a convergence again here of also more of these states with low levels reaching moderate in some cases, high levels in the next 3 to 5 weeks. Hospitalizations continue to increase and emergency department visits are also slightly increased from oh point 4% to 0.6% since our last episode. Test positivity for SARS-CoV-2 also increased from 3.6% reported in our last episode to 3.8% the week of December 20th. The most recent monthly variant update from CDC, which was posted on the 19th of December, shows that FCG still accounts for the vast majority of US cases, about 61%, but that FCG 14.1, a subvariant of Zsg, is increasing in prevalence, now accounting for 15% of US cases, up from 10% the month before. In short, if you ask me what this means, I don't know. It doesn't mean that we're likely to see increased numbers of cases with this subvariant becoming more common again. I don't see any evidence to support that. But we'll keep reporting the variant data for you. Although again, realizing if I can't interpret it, I'm not sure how much better you all are going to be to do the same thing.

Chris: And Mike, what are we seeing in terms of RSV activity?

Dr. Osterholm: Well, you know what? This is one of those good news situations. For now, RSV activity remains low and actually lower than we'd expect in a typical year. We're starting to see a few signs that activity may be increasing, but nothing at all is a ringing. Any alarm bells yet? Wastewater concentrations are considered very low in the Midwest, northeast, and West, while concentrations in the South have increased over the past two weeks and are considered low. Concentrations are very high in Arkansas, Louisiana, and Virginia, while none are considered high. Five in the District of Columbia are considered moderate, those five being Alabama, Connecticut, Florida, Georgia, and Maryland, and all the other states are either low or very low. I do quickly want to add that when we're talking about wastewater concentrations, we're talking about the amount of virus measured in waste disposed of within the wastewater system. I bring this up because if waste is disposed of outside of the wastewater system, for example, because of diaper use, the viral activity would not be detected. So while RSV activity is very low, this may not account for all the viral activity occurring, especially in the youngest population. Test positivity is increasing now at 4.1%, up from 2.9% during our last episode. Emergency department visits associated with RSV increased slightly from 0.4 percent after remaining steady at 0.3% throughout the first three weeks of December. For reference, last season, emergency room department visits for RSV peaked at 1.1% right after the new year. Overall, hospitalizations are also low but slightly increasing, especially in the 0 to 4 year old age group that remind you that much of the viral activity occurring in this age group may not be accounted for in the wastewater concentrations, as we just discussed. We can't ever forget about those diapers and how much virus there are, in fact, moving to landfills as opposed to the wastewater treatment system. Ultimately, Chris, we are in a pretty good place right now when it comes to RSV, but as we know, that could change at any minute.

Chris: Mike. On December 23rd, the US officially passed 2000 measles cases for the year. Is there any reason to believe 2026 will be any different, especially when a new poll from the Annenberg Public Policy Center shows that fewer Americans are willing to recommend their family member receive the measles, mumps and rubella vaccine.

Dr. Osterholm: Chris, let me just put this into perspective. 2000 cases of measles in this country in one year is a really very sobering milestone. The largest outbreaks in the country right now is South Carolina, and along the Arizona Utah border are still growing. And unfortunately, even as case counts rise, the public health crisis isn't resulting in more Americans recommending that MMR vaccination to their friends and family. As you noted, a nationally representative poll conducted by the Annenberg Public Policy Center at the University of Pennsylvania surveyed American households in November 2024 and again in 2025 compared to the last year. Fewer people say they would recommend the MMR vaccine to someone in their household. That number dropped from 90% to 86%. While still reassuring that the vast majority of Americans still recommend the shot, it raises red flags to know that the number is in decline and that it is well below the 95% threshold that we target to maintain herd immunity for measles. This poll from Annenberg had a few more findings worth mentioning. First, Americans confidence in the safety and effectiveness of the MMR vaccine has declined, which helps to explain the observed decrease in public acceptance. In 2022, 87% of households reported believing that the vaccine was effective.

Dr. Osterholm: That has since fallen four percentage points to 83%. Similarly, perceived safety of the vaccine dropped five percentage points from 88% to 83%. Again, these are still relatively large proportions of the total population, but it's an alarming trend that only seems to be fueled by ongoing vaccine misinformation coming from this federal administration. Another important finding from the survey was a small but significant decrease in the proportion of households that would recommend polio or human papillomavirus, or, as we know, as HPV virus vaccines. These vaccines have had great success in reducing disease burden across the world. I think it's a good reminder to all of us that public health progress needs continued, continued and continued support and maintenance. Infectious diseases don't take breaks, and neither can public health systems. Disease surveillance and transparency and reporting are especially critical this month. A reminder that the United States could lose its measles elimination status for the first time in more than 20 years, if we can document sustained transmission for 12 months. The West Texas outbreak began in January of 2025. We will need to hear from state and federal officials on and whether the same strain is continuing to spread as opposed to ongoing.

Dr. Osterholm: Pop up outbreaks from other sources. We seem to be stuck in a game of measles. Whack a mole. I'm incredibly grateful for the many state and local public health programs doing their best to contain this horrible disease. I also want to leave all of us with a reminder Canada, a country whose border we share for thousands and thousands of miles, is in fact, experiencing an even much worse year with measles than we are here in the United States. But as I've said on multiple occasions, those more than 5000 cases occurring among the 40 million residents could very likely be a harbinger of things to come for us here in this country. Imagine with 340 million people, how many cases that would be in this country if we had the same rates of measles next year as Canada has this year? And there are a lot of reasons to believe that that's a possibility. So we have a lot of work ahead of us with regard to measles, and to think of this year as being something very different. It is. But we could actually find ourselves in the years ahead, wishing we were only as bad as we were in 2025.

Chris: Finally, Cidrap Vaccine Integrity Project recently posted a video that highlighted the efforts by political appointees in Washington to undermine confidence in US vaccine policy and recommendations. But it also provides a hopeful note. Mike, what's the message you were trying to send with this video? And given that Annenberg poll that we discussed earlier, how do you win back those people that were losing to vaccine hesitancy?

Dr. Osterholm: Well, I'll start by making sure listeners know the video is available on our Vaccine Integrity Project website, and we'll be sure to link it to our podcast show description as well. The video begins by taking viewers through an animated timeline of several setbacks in vaccine policy since the new administration took office. These include the cancellation of vaccine communication campaigns, which we've already talked about today, the rollback of recommendations to exclude certain groups from coverage, the sudden dismissal of the sitting ACIp members, the defunding of mRNA research, and more. Most recently, news stories broke about an HHS plan to align without debate or discussion the US childhood vaccine schedule with Denmark. You can also read more in the accompanying viewpoint article, written by the Vaccine Integrity Project staff and advisors, and posted on the Cidrap website. And as disheartening as it may be to look back on the erosion of federal vaccine policymaking we witnessed in the last year, it's important to track these events so that we know where to direct the work and fill the gaps in response. At the end of the video, the Vaccine Integrity Project reminds everyone that our group is continuing to partner with health allies to protect the public's health.

Dr. Osterholm: As frequent listeners will know, we have published two evidence based reviews so far to share with medical societies so that they may have the best data and information to write vaccine guidelines for health practitioners to share with their patients. And there are more to come focusing on other vaccines, we anticipate, which will come under fire. We are committed to continuing our rigorous and transparent research, convening and communication in 2026 and beyond. I hope that is a positive message for all of our audience in terms of restoring trust among vaccine hesitant Americans. I'm afraid there is no easy response for this ominous trend in terms of the childhood immunization schedule. Parents may feel unsure for a range of reasons. In the last year, one major contributing factor has been the systematic dismantling of trusted government health authorities, leaving the door open for bad actors to spread inflammatory or misleading information about vaccines. And in the age of communication overload, especially online. It is understandable that the public may feel overwhelmed and confused. What the Vaccine Integrity Project can offer is a stronghold for reliable evidence that will ultimately benefit providers and patients who must be protected. We will not give up.

Chris: Now it's time for this week in public health history. Mike, who or what are we commemorating today?

Dr. Osterholm: Well, Chris, today we're commemorating the founding of the organization March of Dimes, 88 years ago this week. The National Foundation for Infantile Paralysis, the original name for the March of Dimes, was officially incorporated. The story of the March of Dimes began with a comedian and President Franklin Delano Roosevelt's birthday in the late 1930s. Fundraising parties were commonly held on January 30th to celebrate FDR's birthday and to raise money to end polio, a disease that afflicted the president himself. Hoping to contribute to the cause. Vaudeville actor and comedian Eddie Cantor and his Hollywood collaborators thought a 32nd radio spot, asking for donations to help those with infantile paralysis, a known complication of polio infection, would be a great way to raise money as a joke. They called the effort the March of Dimes, a pun on the famous newsreel at the time called The March of Time. The radio ad was a great success as Americans all over the country mailed in dimes to the white House. After one month, over 80,000 letters with dimes and dollars flooded the white House mailroom. A total of almost 2.7 million dimes, or $70,000 were submitted. Considering inflation since that time, that would translate to more than $5 million today. The fundraising never stopped, and neither did the effort to end polio or the tremendous impact it left on children. The nonprofit funded research, advocacy and outreach one dime at a time. In fact, the dimes relationship to polio was so popular is the reason why we currently see FDR on the dime. When treatment and prevention of polio were well controlled in the United States. The nonprofit pivoted to helping prevent birth defects. It also officially changed its name from the National Foundation for Infantile Paralysis to the March of Dimes Foundation. Today, their efforts have helped thousands of families avoid premature infant deaths and receive quality medical care. We wish the March of Dimes a happy anniversary, as well as a very big thank you.

Chris: Mike, what are your take home messages for today?

Dr. Osterholm: Well, Chris, again, it's always a challenge to try to summarize them in just three different talking points. But I think today it's very obvious of which at least several of those are influenza influenza and influenza. The flu season is here. It does not look good. Please, if you have not received your flu shot yet, and in particular, you're someone who has an increased risk of serious illness. Younger children, the older population, people are immune compromised. Now is the time to get your shot. And I mean now in the next 72 hours. The second thing is our vaccine system is under attack. It is simply no other way to describe it. I shared with you today the pullback on support for influenza and seasonal vaccines in general has resulted in us seeing a much, much larger part of our high risk population not vaccinated Today compared to previous influenza seasons, now is the time for us to remember that vaccines across the board are such an absolutely critical weapon against infectious diseases. That's why the Vaccine Integrity Project is here. We're going to continue to do what we must to assure the supply, the safety and the effectiveness of these vaccines.

Dr. Osterholm: And then finally, the third point is what's next? What's going to happen next? And all I can say is, is that we don't know, particularly with vaccines, what the next steps will be to limit their use. But we're going to be here to take that on. I hope you will go look at the Vaccine Integrity Project web pages on our Cidrap website. Go look at the video, read the viewpoints. That'll help give you a sense of what we're up to. And I'm very proud of the fact that we have seen so many people from around the country come together to help support our effort. That includes both those who are financially supportive, as well as those who are bringing their professional skills. We are very fortunate to be able to work together with so many outstanding professionals and with the support of so many people from this community who understand the importance of the vaccines for their grandchildren or their children. And thank you for your support.

Chris: Mike, our closing song today fits in with the hopeful message of the dedication, and I think it will be familiar to our listeners. What song have you chosen to start off 2026?

Dr. Osterholm: Well, first of all, Chris, as you know, we have used this song before and it's one that, uh, however I think captures the moment of that. I would like to leave us with this podcast episode. I recognize the many challenges that we have today. They're daunting. Some days I wonder, you know, just what is going to happen today that will only make things worse. But at the same time, at my very heart, I also believe we can make a real difference. I noted at the beginning of the podcast that I had the opportunity for the 40th consecutive year to read The Polar Express on Christmas Eve to my children and grandchildren. That by itself gives me hope. That by itself tells me, yes, we can do so much to fight back against all the challenges that we see. And so it was really for that reason that we picked this song. What a Wonderful World is a song written by Bob Thiele, known also as George Douglas and George David Weiss. It was first recorded by Louis Armstrong on August 16th, 1967. In April 1968. It topped the pop chart in the United Kingdom, but performed poorly in the United States because Larry Newton, the president of ABC records, disliked the song and refused to promote it after it was heard in the film Good Morning Vietnam.

Dr. Osterholm: It was reissued as a single in 1988, and rose to number 32 on the Billboard Hot 100. Armstrong's recording was inducted into the Grammy Hall of Fame in 1999. Bob Thiele said the following regarding his inspiration for the song. In the mid 1960s, during the deepening national traumas of the Kennedy assassination, Vietnam, racial strife and turmoil everywhere, my co-writer George David Weiss and I had an idea to write a different song, especially for Louis Armstrong that would be called What a Wonderful World. Thiele also produced the original recording of the song in Graham Nash's book Off the Record. Songwriters. On songwriting George Weiss said he specifically wrote the song for Louis Armstrong, as he was inspired by Armstrong's ability to bring together people of different races. So here it is, a song to open this new year. What a wonderful world. I see trees of green. Red roses too. I see them bloom for me and you. And I think to myself. What a wonderful world I see. Skies of blue and clouds of white. The bright blessed days, the dark sacred nights. And I think to myself. What a wonderful world. The colors of the rainbow. So pretty in the sky. And also on the faces of people going by. I see friends shaking hands saying, how do you do? They're really saying I love you.

Dr. Osterholm: I hear babies cry. I watch them grow. They'll learn much more than I'll ever know. And I think to myself, what a wonderful world. Yes, I think to myself, what a wonderful world. Oh yeah. Well, thank you again for joining us for another episode. I hope we're able to provide you with the kind of information you're looking for. We will stay on top of the influenza issue. Follow our Cidrap news site as we will provide you, hopefully almost daily updates of what's happening and what it means in your community. And again, I want to thank all of you for the support over the past year and for looking forward to the future. For those of you who do consider yourself part of this podcast family, thank you. It is a very, very special feeling to know that you're out there. We as a team, as a podcast team, very much appreciate your support, your ideas, your thoughts, your cards, your letters. We really do feel very much as a family with you. So just be kind, be thoughtful. It's going to be frustrating. It's going to be challenging, but be kind right now, if there was any time that we ever needed this, it's a wonderful world when we can be kind. Thank you. Thank you. Thank you.

Chris: Thanks for listening to the latest episode of the Osterholm update. If you enjoyed the podcast, please subscribe, rate and review wherever you get your podcasts, and be sure to keep up with the latest infectious disease news by visiting our website cidrap. This podcast is supported in part by you, our listeners. If you would like to donate, please go to cidrap. Support. The Osterholm Update is produced by Sydney Elise Holmes and Aaron Lacy. Our researchers are Corey Anderson, Meredith Arpi, Liam Ott, Emily Smith, Claire Stoddart, Angela Ulrich, and Mary Van Beusekom.