Chapter Content
Okay, so, chapter, uh, whatever, it's about the Biogen meeting and the Marriott outbreak. So, you know, back then, Biogen, this biotech company, they had this annual leadership retreat at the Marriott Long Wharf in Boston. Like, around 175 people flew in from all over the world. Can you imagine? They're all, like, hugging and shaking hands, catching up, you know, how you do at these things. They even had an awards dinner and the mood was just, like, super upbeat. Profits were up, everything was looking great.
But, like, in hindsight, it was a total disaster waiting to happen. It was, you know, early 2020, and this new virus, the one we now know as COVID, was just starting to show up. People were, you know, cautiously optimistic, or maybe just ignorant, because they didn't fully grasp what was coming.
Anyway, after the meeting, people started getting sick. Like, one executive ended up in the hospital, then another, and then, like, boom, fifty people were feeling terrible. Biogen was, understandably, freaking out. They sent out an email telling everyone who'd been there to see a doctor, and then they contacted the health department. Eventually, they realized they had a full-blown outbreak on their hands.
And here's where it gets really scary. Some of the people from that Marriott meeting went straight to another investment conference at another Marriott. And guess what? More people started getting sick there too. One guy even flew to a conference in Florida and got sick while he was there! So, it just kept spreading. And then there was North Carolina, with a Biogen facility there. People came back, went to work, and *they* started getting sick. It was like a domino effect.
It dawned on everyone that this meeting had caused, like, a massive public health disaster. So many people had gotten infected and then just hopped on planes and spread it everywhere. It was unbelievable.
Then the conversation shifted towards trying to figure out *why* this happened. I mean, Boston had its first case like a month earlier, right? A student came back from Wuhan, felt sick, but didn't infect anyone. Like, nobody. So how come *this* meeting was so different?
Turns out, some scientists at the Broad Institute started analyzing the genetic signature of the virus in different patients. They realized that this particular strain, they called it C2416T, came from the Marriott meeting. It hadn't even been seen in the US before that, like only a couple of cases in France.
And when the scientists traced this strain, they figured out that it had spread *everywhere*. I'm talking like twenty-nine states, Australia, Sweden, like all over the globe! They estimated that the Biogen meeting led to well over 300,000 infections. Crazy, right?
And, get this, they think it all started with *one* person. They were like, "We assume it was introduced by one person." One meeting. One person. Three hundred thousand infections.
So, what was so special about that one person? Well, some researchers call it the "Law of the Few." It's like this idea that a small number of people or things can be responsible for a really large impact. I mean, there's a classic example about car emissions. Like, a tiny percentage of cars are responsible for the majority of the pollution. So, you know, you think about smog checks, and how everyone's got to get their car checked. But it turns out, like, you could focus on the real polluters and actually make a big difference.
Anyway, what about epidemics? This is where the aerosol scientists come in. They're the ones who study these tiny particles that float through the air, you know, aerosols. And they started to realize that COVID might be spread through these aerosols, especially when people are talking.
See, early on, the World Health Organization was saying that COVID wasn't airborne, that it was spread through droplets from coughs and sneezes. The aerosol scientists were like, "Hold on a minute! What about talking? You exhale way more particles when you're talking than when you sneeze."
They thought that COVID was spreading through these tiny bubbles of saliva that come out when you talk. And these bubbles are light, they float around like cigarette smoke. They can stay in a room for a long time, even after the person who exhaled them is gone. This would explain why so many people got infected at the Biogen meeting. It wasn't just about coughing on someone, it was just about being in the same room while someone was talking and breathing.
But then the question became, if the virus is spread through something as simple as talking, why weren't there a thousand outbreaks like the Marriott meeting? Why was *that* meeting so, so bad? That's when researchers started looking at the idea of "superspreaders."
Basically, the idea is that some people are just way better at infecting others than other people are. And I'm talking *way* better. There was even this study from way back where a girl in second grade somehow infected kids in like fourteen different classrooms with measles. And the only way that could have happened is if she was, like, exhaling ten times more virus particles than the average person!
These aerosol scientists started doing studies and they found that some people release a *ton* more aerosols than others. And I’m talking like an order of magnitude more!
And there's this challenge study where researchers deliberately infected people with COVID, and it turned out that the vast majority of the virus particles came from just two people. Two people!
So, it's not just the "Law of the Few", it's the "Law of the Very, Very, Very Few."
So, what makes someone a superspreader? Well, scientists are still trying to figure it out. One theory is that their saliva is different, like it's more elastic and viscous, you know, thicker and stickier. That's the saliva then that produces more aerosols. Another theory is that it has to do with hydration. If you're dehydrated, your upper airways don't work as well, and virus particles can get into your lungs more easily. Then, when you exhale, you release a concentrated spray of aerosols. It's even thought that age and body mass index might be factors too, because older and heavier people tend to be more dehydrated.
So, what does all this mean for the future? Well, if we can figure out who the superspreaders are, we could target interventions to block transmission. But it also raises a lot of ethical questions. Would we refuse to sit next to overweight people on planes? Would restaurants require saliva tests at the door? It's like the same dilemma we face with air pollution. Do we single out a few big polluters, or do we just make everyone get smog checks? It's a really difficult decision. And who are you targeting, right? What does that do in terms of, like, “us” and “them.”
So, back to the Marriott Long Wharf. Imagine this guy, Mr. Index, right? He's the index case, the person who started the outbreak. He works for Biogen in Europe. He gets infected right before he flies to Boston. He's still in the incubation phase, so he doesn't infect anyone on the plane, but he gets dehydrated because it's a long flight and the air is dry. By the time he gets to the hotel, his upper respiratory tract is a desert.
He's also older and heavy-set, so he needs to drink more water, but he doesn't realize it. And his surging infection has made his natural inclination to overproduce aerosols much worse. So, he has breakfast with the group in the Harbor View Ballroom. Then he goes to the Grand Ballroom and gives a presentation. He speaks loudly, because he's excited, and millions of aerosolized particles come out of his mouth. And everyone is gathering around him afterwards with hugs, handshakes and kisses.
And then, a couple of days later, Mr. Index wakes up with a raging fever and realizes that he's infected a lot of other people. So, it was the perfect storm. A superspreader, a crowded meeting, and a virus that spreads through the air. All of these things combined to create one of the worst outbreaks of the pandemic. And it all started with one person, Mr. Index, at the Marriott Long Wharf.