I AM LIS NEISLOSS.

TONIGHT ON GREATER BOSTON AS WE HEAD INTO THE SECOND YEAR OF THE WAR IN UKRAINE VLADIMIR PUTIN IS DIGGING IN ON RUSSIAN AGGRESSION WHILE BIDEN PLEDGES UNWAVERING SUPPORT FOR UKRAINE.

WE TAKE STOCK OF WHAT HAS HAPPENED SO FAR AND WHERE THE WAR MAY BE HEADED.

THEN, THE APOCALYPTIC OUTBREAK HAD THE HBO SERIES "THE LAST OF US" IS BASED ON A REAL FUNGUS.

HOW MUCH DID THE SHOW GET RIGHT?

COULD ANY OF IT HAPPEN IN REAL LIFE?

A DOCTOR JOINS ME WITH ANSWERS AHEAD.

THIS WEEK MARKS ONE YEAR SINCE RUSSIA BEGAN ITS BRUTAL ASSAULT ON UKRAINE.

THOUSANDS OF UKRAINIAN SOLDIERS AND CIVILIANS HAVE BEEN KILLED IN THE WAR THAT FOLLOWED.

MILLIONS OF OTHERS WERE FORCED TO FLEE THEIR HOMES.

TO MARK THE SOMBER ANNIVERSARY PRESIDENT JOE BIDEN MADE A RISKY SURPRISE VISIT TO KYIV, MEETING WITH PRESIDENT VOLODYMYR ZELENSKYY.

AND SENDING A WARNING TO THE KREMLIN.

>>VLADIMIR PUTIN'’S WAR OF -- CONQUEST IS FAILING.

ONE YEAR LATER KYIV STANDS.

AND UKRAINE STANDS.

DEMOCRACY STANDS.

THAT IS HOW LONG WE WILL BE WITH YOU, MR. PRESIDENT, FOR AS LONG AS IT TAKES.

>> BIDEN PLEDGED TO FURTHER ESCALATE SANCTIONS TARGETING RUSSIA'’S FINANCIAL AND ENERGY SECTORS AND MORE MILITARY AID WORTH $.5 BILLION.

RUSSIAN PRESIDENT VLADIMIR PUTIN SHOWED NO SIGNS OF CHANGE, INSTEAD IN HIS ANNUAL STATE OF THE NATION SPEECH EARLIER THIS WEEK, HE SEEMED TO PREPARE RUSSIANS FOR HIS VERSION OF AS LONG AS IT TAKES AND DIRECTED BLAME FOR THE WAR TO THE WEST AND THE U.S.. >> THE ELITE OF THE WEST DO NOT CONCEAL THEIR AMBITION TO STRATEGICALLY DEFEAT RUSSIA, FINISH US OFF, ONCE AND FOR ALL.

>> THROWING DOWN ANOTHER GAUNTLET, VLADIMIR PUTIN ALSO ITS PARTICIPATION IN THE ONLY REMAINING NUCLEAR ARMS CONTROL TREATY IT HAS MADE WITH THE U.S.. WHERE DOES THAT LEAVE US AND WHAT CAN WE EXPECT IN YOUR TWO?

TO DISCUSS THIS -- YEAR TWO?

TO DISCUSS THIS I AM JOINED BY EMILY CHANNELL-JUSTICE, THE DIRECTOR OF THE TEMERTY CONTEMPORARY UKRAINE PROGRAM AT THE HARVARD UKRAINE INSTITUTE AND JOSHUA SHIFRINSON, AN ASSOCIATE PROFESSOR WITH THE UNIVERSITY OF MARYLAND SCHOOL OF PUBLIC POLICY.

LET'’S START WITH POWERFUL OPTICS.

JOSHUA, MAYBE YOU CAN WAY AND.

-- WEIGH IN.

A STRONG STATEMENT MADE BY THIS SURPRISE VISIT.

IS IT A WORLD CONVINCING MOMENT?

>> HAVE ALREADY SEEN THE EVIDENCE OF THIS.

CHINA HAS NOTE TAKEN UP THE U.S.

BANNER.

WE SEE RETICENCE AMONG MANY EUROPEAN ALLIES FOLLOWING UP THE U.S.

MESSAGE WITH AS LONG AS IT TAKES WITH INDEFINITE CONFLICT SUPPORTING UKRAINE AGAINST RUSSIA.

IT WAS VERY SUPPORTIVE OR HELPFUL TO BIDEN'’S DOMESTIC AGENDA.

>> EMILY, BIDEN LEFT KYIV, THEN WENT TO POLAND.

HE MADE ANOTHER SPEECH.

VLADIMIR PUTIN MADE HIS ANNUAL ADDRESS.

SOME PEOPLE WERE CALLING THEM ALMOST DUELING SPEECHES.

WHAT DID YOU SEE IN WHAT YOU HEARD?

>> I THINK IT WAS IMPORTANT CERTAINLY FOR BIDEN TO VISIT KYIV AND IN THE WAKE OF THE VISIT, CERTAINLY, TO SPEAK IN POLAND.

POLAND HAS LED UKRAINE'’S EUROPEAN ALLIES AND TRIED TO SET THIS EXAMPLE DESPITE THE FACT THAT THEY DO NOT HAVE THE STRONGEST ECONOMY IN EUROPE, OR THE LARGEST ECONOMY, OR ANYTHING.

BUT THEY ARE THE CLOSEST TO UNDERSTANDING WHAT UKRAINE IS GOING THROUGH.

I THINK THAT IS A SIGNIFICANT MOVE.

THE THING WITH VLADIMIR PUTIN'’S SPEECH IS FRIENDLY YOU REPEATED A LOT OF WHAT HE SAID.

IT WAS NOT REALLY NEW MATERIAL.

I THINK THAT IS KIND OF -- HE DOES NOT REALLY HAVE MUCH MORE TO SAY.

THERE IS NOT A LOT MORE DETAIL IN HIS POSITION.

HE IS DOUBLING DOWN ON WHERE HE ALREADY IS.

WHEREAS, BIDEN'’S VISIT SHOWS UKRAINE'’S ALLIES ARE PROCESSING WHAT IS HAPPENING.

THEY ARE CONSTANTLY RESPONDING TO WHAT IS GOING ON.

IT SHOWS A LITTLE MORE MOMENTUM ON THAT SIDE.

>> WHILE VLADIMIR PUTIN THROW WHAT WE WOULD CALL, ON THIS SIDE OF THE WORLD, POLITICAL SOPS TO THE RUSSIAN PEOPLE, MAY SOME ECONOMIC CONCESSIONS.

BUT REALLY, DO YOU SEE THAT HE NEEDS TO WORRY ABOUT THAT DOMESTIC SUPPORT FOR HIS AGENDA, EMILY?

>> WELL, YOU KNOW, VLADIMIR PUTIN REALLY CREATED THIS STRUCTURE IN WHICH DISSENTERS DIFFICULT -- DISSENT IS A DIFFICULT, NOT JUST BECAUSE OF THE MEDIA NARRATIVE THAT IS LIMITED.

BUT, BECAUSE OF THE POSSIBILITIES FOR PARTICIPATION THAT ARE ALSO LIMITED.

ONE OF THE REALLY BIG TURNING POINTS I WOULD SEE NOW IS WHETHER OR NOT A VLADIMIR PUTIN WILL HAVE TO CALL FOR FURTHER MOBILIZATION OF RUSSIAN TROOPS, OR PEOPLE THAT HAVE NOT YET GONE TO THE FRONT.

THE PREVIOUS MOBILIZATION, THE BORDER STAYED OPEN.

SO PEOPLE THAT DO NOT WANT TO FIGHT WERE ABLE TO LEAVE RUSSIA.

I DON'’T KNOW IF HE CAN WOULD LIKE THAT AGAIN.

THAT IS THE THING THAT, IF ANYTHING, AND I AM NOT TREMENDOUSLY OPTIMISTIC THAT DOMESTIC OPINION WILL CHANGE, BUT IF ANYTHING WOULD TURN THE TIDE AGAINST VLADIMIR PUTIN IT WOULD BE FORCIBLY MOBILIZING PEOPLE WHO ALREADY HAVE SHOWN THEY DON'’T HAVE MUCH INTEREST IN GOING TO THE FRONT.

>> JOSHUA, IN TERMS OF SUPPORT IN THE U.S., HOW DO YOU THINK BIDEN DID WITH THE SURPRISE VISIT?

WHAT DO YOU THINK THAT DID FOR SUPPORT HERE?

THERE IS CERTAINLY WEAKENED SUPPORT FROM REPUBLICANS.

CRACKS ARE SHOWING.

THERE ARE CALLS THAT MAY BE HE SHOULD HAVE BEEN ATTENDING TO A TOXIC SPILL IN OHIO, NOT OVERSEAS, INFLATING WHAT IS HAPPENING DOMESTICALLY, PUSHING DOWN THE SIGNIFICANCE OF UKRAINE.

WHAT IS YOUR TAKE?

>> FIRST, I WOULD BE RELUCTANT TO FLAME -- FRAME THIS AS A DEMOCRAT VERSUS REPUBLICAN ISSUE.

IN NOVEMBER THEIR CHICAGO COUNCIL RELEASED A POLL SHOWING 49% OF AMERICANS TOWARD AIDING UKRAINE FOR AS LONG AS IT TAKES WHEREAS 47%, ALMOST THE SAME NUMBER, SUPPORT BRINGING ABOUT AN IMMEDIATE PEACE DEAL EVEN IF THAT MEANS UKRAINE HAS TO LET GO OF TERRITORY.

I DON'’T THINK THAT MATCHES NEATLY INTO REPUBLICAN VERSUS DEMOCRAT, BUT BIDEN HAS BEEN ATTEMPTING TO GET AHEAD, WITH THIS TRIP, OF GETTING AHEAD OF ANY REPUBLICAN OR PROGRESSIVE DEMOCRAT OPPOSITION TO CONTINUE INTO YOU -- UKRAINE.

WE ARE NEARING THE LIMIT FOR AMERICAN OR WESTERN TOLERANCE FOR INDEFINITE A SPIGOT THAT AID -- AID SPIGOTING.

>> HE STILL NEEDS REPUBLICAN SUPPORT.

DO YOU THINK HE IS FRAMING THE MESSAGE CORRECTLY ON WHY THE U.S.

NEEDS TO BE INVOLVED IN UKRAINE?

>> IN MY OPINION, NO.

AT THE OUTSET HE FRAMED THIS AS A WAR THAT PRESERVED UKRAINIAN SOVEREIGNTY.

BY HIS OWN STATEMENTS IN WARSAW THIS MISSION HAS BEEN ACCOMPLISHED.

IN A SENSE HE IS REPEATING THE SAME MESSAGE AS TO WHY THAT U.S. IS CONTINUING IN UKRAINE, THOUGH BY HIS OWN DEFINITION, THE WAR GAINS OF THE U.S. HAVE BEEN OBTAINED.

THERE IS A DISCONNECT WITH PRESIDENT BIDEN'’S STRATEGY AND I AM NOT SURE THIS WILL BE SIGNIFICANT IMMOBILIZED THE MASSIVE REPUBLICAN AND DEMOCRATIC SUPPORT HE WILL NEED TO CONTINUES TO STAND BY UKRAINE FOR HOWEVER LONG IT TAKES.

>> EMILY, ISN'’T THIS ABOUT MORE THAN JUST UKRAINE?

>> ABSOLUTELY.

I HAVE SAID THIS UNFORTUNATELY FOR THE PAST YEAR.

THIS IS ABOUT WHETHER OR NOT WE WANT TO LIVE IN A WORLD WHERE PEOPLE LIKE VLADIMIR PUTIN CALL THE SHOTS.

UKRAINE WAS NOT A PERFECT DEMOCRACY WHEN THE INVASION HAPPENED BUT IT MADE A LOT OF SIGNIFICANT ADVANCES, ESPECIALLY IN THE PAST SEVEN OR EIGHT YEARS.

SO TO ME, AND CERTAINLY, UKRAINE'’S CLAIMS TO TERRITORIAL INTEGRITY AND ITS OWN SELF-DETERMINATION ARE THE SAME AS ANY OTHER DEMOCRACIES CLAIMS TO THOSE THINGS.

SO TO ME, THIS IS REALLY ABOUT VLADIMIR PUTIN AND RUSSIA SAYING COMING TO UKRAINE, WE DO NOT CARE ABOUT THOSE THINGS.

WE HAVE DECIDED YOU DO NOT GET TO HAVE THOSE.

THE REST OF THE WORLD NEEDS TO DECIDE IF THAT IS ACCEPTABLE.

IF IT IS, WE HAVE TO REALLY RETHINK THE WORLD ORDER WE HAVE YET AGAIN, THAT WORLD ORDER IS IMPERFECT AND I RECOGNIZE THAT.

THE AIMS HERE ARE ABOUT MUCH GREATER CONCERNS, I THINK, THAT JUST SIMPLY HOW LONG IT WILL TAKE TO SUPPORT UKRAINE, OR CURRENT CONVINCE REPUBLICANS TO KEEP SUPPORTING UKRAINE.

>> SO, YOUR COLLEAGUES, COLLECTIVELY, AT BROOKINGS BELIEVE THAT THE DEBATE HAS BEEN MUDDIED.

THAT IT HAS BEEN FRAMED AS, YOU KNOW, WE NEED TO WEAKEN RUSSIA, AND MAY BECOME VLADIMIR VLADIMIR PUTIN HAS TO BE OVERTHROWN AND DEMOCRACIES SHOULD LINE UP AGAINST AUTOCRACIES.

BUT, THAT POSITION, THEIR POSITION, IS REALLY THAT, YOU KNOW, WE SHOULD BE TALKING ABOUT THE TERRITORIAL INTEGRITY THAT HAS BEEN VIOLATED AND DATA THAT IS A PRETTY BASIC ISSUE AND THIS COULD HAPPEN TO ANY NUMBER OF COUNTRIES.

JOSHUA, DO YOU THINK THIS IS AN ARGUMENT THAT HOLDS WEIGHT?

>> NOTE.

-- NO.

I WOULD PUSH BACK ON EMILY'’S PRIOR ARGUMENT THAT THIS IS ABOUT FREEDOM OR LARGE.

PRESIDENT BIDEN HIMSELF AT THE OUTSET OF THE WAR MADE THIS ABOUT SOVEREIGNTY, NOT FREEDOM PER SE.

TO MAKE THIS ABOUT FREEDOM IS TO TRANSFORM THE WAR BETWEEN RUSSIA AND UKRAINE INTO A GLOBAL ARGUMENT THAT I DON'’T THINK CARRIES MUCH WATER BECAUSE WE HAVE SEEN MANY COUNTRIES VIOLATE OTHER COUNTRIES SOVEREIGNTIES, FREEDOMS, AND TERRITORIAL RIGHTS WITH VERY LITTLE OPPOSITION.

THIS IS NOT A QUESTION ABOUT THE NATURE OF INTERNATIONAL ORDER OR THE IN VIABILITY OF TERRITORIAL BOUNDARIES.

THIS IS A CONTEST ABOUT WHETHER UKRAINE WAS TO BE SUBSERVIENT TO RUSSIA AND HAVE RUSSIA DOMINATE THE UKRAINIAN GOVERNMENT.

>> THE FACT THAT RUSSIA MAKES IT TO HER UKRAINE MIGHT NOT BE THE END OF IT, THAT IS NOT CONCERNING?

YOU KNOW, MAKING, PERHAPS -- DESIGNED ON POLAND.

THREATENING VAGUELY ESTONIAN TOWNS, THAT KIND OF THING.

IT IS DISCONCERTING.

THAT IS EXACTLY WHY PRESIDENT BIDEN'’S AFFIRMATION OR REAFFIRMATION THAT ARTICLE FIVE OF THE NATO TREATY, THE WASHINGTON TREATY IS SACROSANCT, IN HIS VIEW, IS SO IMPORTANT.

BUT UKRAINE VERSUS RUSSIA, IT MAY BE THE TIP OF THE ICEBERG OR A ONE-OFF ISSUE.

WE HAVE SYSTEMS TO HEDGE AGAINST THAT DOWNSIDE RISK.

>> WHAT SYSTEMS DO THINK WOULD WORK?

>> WE HAVE THE WHOLE NATO ALLIANCE IN THIS CASE.

COUNTRIES LIKE THE BALTIC STATES AND POLAND IN NATO.

THAT IS PART OF THE LOGIC OF THEIR SEEKING TO JOIN NATO IN THE 1990'’S AND 2000'’S.

THEIR DESIRE TO HEDGE AGAINST THEIRS AND PART OF THE REASON THE U.S.

SUPPORTED THEIR ENTRY INTO NATO.

>> SO, WE HAVE A BREAKING PLACE.

I SHOULD NOT -- WE SHOULD NOT PRETEND IT DOES NOT EXIST.

>> IT IS WHETHER WE DECIDE TO EXERCISE THE TRUE POWER OF THE FIRE BREAK.

SOME SUGGEST PERHAPS ONE WAY TO ACHIEVE THESE IS -- PEACE IS TO SAY, OK, NATO WILL NOT EXPAND.

WILLIE WILL -- WE WILL STAND WHERE WE ARE.

WOULD THAT DO IT?

>> NOTE.

-- NO.

THIS WAS NEVER ABOUT NATO IN THE FIRST PLACE TO -- PLACE.

TO GO BACK TO WHAT WE ARE SAYING PREVIOUSLY COMMITTED -- PREVIOUSLY, THIS DID NOT START IN FEBRUARY 2020 TWO.

IT STARTED IN UKRAINE 2014.

WE SHOULD BE TRACING IT BACK TO UKRAINE'’S INVASION OF GEORGIA, 2008.

THIS IS NOT THE FIRST TIME RUSSIA HAS DECIDED THEY WANT TO HAVE CONTROL OR SAY OVER COUNTRIES IN THE REGION.

FOR THAT REASON, I DO NOT THINK ANY CONCESSION ABOUT NATO WILL BE A SO-CALLED OFFRAMP FOR VLADIMIR PUTIN TO DISENGAGE FROM UKRAINE.

FRANKLY, I THINK IT WOULD BE AN INVITATION.

OF COURSE, WE HAVE NOT TRIED.

>> IT IS VERY HARD TO COME TO CONCLUSIONS ABOUT THAT.

>> RIGHT.

EXCEPT FOR WHEN WE KNOW WHEN RUSSIA FIRST INVADED UKRAINE IN 2014, UKRAINE HAD NO DESIGNS ON JOINING NATO IN THE FIRST PLACE.

IT WAS NOT A POPULAR THING TO EVEN THINK ABOUT UKRAINE IN NATO THEN.

SO, UKRAINE WAS TECHNICALLY NEUTRAL.

IF UKRAINE COMMITS TO NEUTRALITY, WHAT IS TO SAY RUSSIA WILL NOT JUST RE-INVADE?

THAT IS WHAT THEY DID BEFORE WHEN UKRAINE WAS NOT PART OF NATO OR DID NOT HAVE ANY PROMISES TO BE PART OF NATO.

>> EXCEPT FOR THE 2008 BUCHAREST SUMMIT WHICH SAID THE ALLIANCE IS COMMITTED TO UKRAINE JOINING NATO.

IT'’S NOT QUITE RIGHT TO SAY THERE WAS NO PATH FOR UKRAINE TO JOIN NATO.

X RIGHT.

-- >> RIGHT.

IN 1994 UKRAINE WAS ALSO GIVEN TO GUARANTEES BY RUSSIA THAT THEY WOULD NOT INVADE A TERRITORY.

>> IN 1990 THE SOVIET UNION WAS GIVEN ASSURANCES THAT NATO WOULD NOT EXPAND IT TO EASTERN EUROPE.

THERE IS DIPLOMACY WE ARE GLIDING OVER WITH A LITTLE FLIPPANCY.

>> THERE IS ONE OTHER PIECE THE U.S. IS LOBBYING IN AGAIN.

TWO MORE PIECES.

MORE MILITARY AID.

AND, THE POSSIBILITY OF RATCHETING UP SANCTIONS.

THAT SEEMS SO FAR TO BE A PRETTY USELESS TOOL.

WHAT DO YOU SAY, JOSHUA?

>> IT DEPENDS WHAT SANCTIONS ARE INTENDED TO DO.

IF THEY WERE ATTENDED -- INTENDED TO BRING ABOUT THE RUSSIAN WITHDRAWAL FROM UKRAINE, THEY ARE USELESS.

>> THEY HAVE NOT HAD ANY DETERRENT EFFECT.

>> NOT AT ALL.

THEY HAVE NOT BEEN SUCCESSFUL IN CARESSING -- IS, HAVE THEY BEEN SLOWING DOWN RUSSIAN WARGAMES?

THE FACT THAT RUSSIA HAS TURNED TO COUNTRIES LIKE IRAN AND CHINA SUGGEST IMPEDIMENTS IMPOSED ON THE RUSSIAN WAR.

>> SOME WOULD SAY THAT DEEPENS THE CONFLICT EVEN FURTHER.

EMILY, DO YOU BELIEVE SANCTIONS HAVE ANY EFFICACY?

WHETHER TO DETER OR SLOW DOWN?

>> YOU KNOW, I STILL HAVE SOME HOPE THAT, POTENTIALLY, THEY WILL IN THE FUTURE.

THE ROLE OF IRAN AND CHINA HERE IS REALLY ESSENTIAL.

OBVIOUSLY, WE HAVE SEEN INFLUENCE FROM BOTH COUNTRIES.

IRAN SUPPLYING PARTS FOR RUSSIAN MILITARY EQUIPMENT THAT HELPS THEM CONTINUE TO BOMBARD UKRAINE.

WE HAVE JUST GOTTEN WORD OVER THE PAST FEW DAYS THAT CHINA HAS ALSO BEEN DATING RUSSIA.

SO, -- BEEN AIDING RUSSIA.

IT IS OBVIOUS THERE ARE TOO MANY LOOPHOLES IN SANCTIONS TO MAKE THEM REALLY EFFECTIVE.

THAT SAID, THERE ARE THINGS THAT CAN BE DONE IN TERMS OF SEIZING RUSSIAN ASSETS AND THAT KIND OF THING.

I THINK IT IS IN THE SYMBOLISM OF SO MANY COUNTRIES UNITING AROUND THE TACTIC OF SANCTIONS.

THAT IS STILL IMPORTANT IN TERMS OF GREATER RESPONSE.

>> IT IS NOT EVEN 40 COUNTRIES.

JOSHUA, DO YOU THINK THAT THE U.S. HAS ANY FURTHER ABILITY TO COUNTER RUSSIA'’S INFLUENCE OUTSIDE OF EUROPE WHERE IT HAS MANAGED SOME SUCCESS?

>> TO COUNTER RUSSIAN EUROPE -- INFLUENCE OUTSIDE OF EUROPE?

>> IN TERMS OF COUNTERING UKRAINE, IN TERMS OF RALLYING OUTSIDE OF THE EUROPEAN COALITION THAT IT HAS MANAGED TO PUT TOGETHER.

>> WELL, IT'’S VERY HARD.

RIGHT NOW A LOT OF THE COUNTRIES THAT STILL DO BUSINESS WITH RUSSIA HAVE MASSIVE FINANCIAL INCENTIVES TO DO SO.

CHINA IS ABLE TO GAIN A LARGER MARKET FOR GOODS AND SERVICES.

THE TAIWAN/CHINA INDUSTRIAL POTENTIAL IS LARGE.

INDIA HAS BEEN BENEFITING FROM VERY CHEAP OIL.

THERE ARE REAL FINANCIAL AND POLITICAL LIMITS TO WHAT ELSE THE UNITED STATES CAN DO TO FURTHER SQUEEZE THE RUSSIAN WAR ECONOMY.

WHICH IS A TRAGEDY, UNFORTUNATELY.

>> I THINK WE WILL HAVE TO LEAVE IT THERE.

MONEY, JOSHUA, THANK YOU VERY MUCH.

-- EMILY, JOSHUA, THANK YOU VERY MUCH.

NEXT, IF YOU ARE ANYTHING LIKE ME YOU HAVE BEEN RIVETED BY HBO'’S NEW SHOW "THE LAST OF US" BASED ON AN ACTION-ADVENTURE VIDEO GAME THE SAME NAME.

THE SERIES FOLLOWS CHARACTERS TRYING TO SURVIVE IN A POST-APOCALYPTIC UNITED STATES.

THE CAUSE OF THE APOCALYPSE WAS A MASS OUTBREAK OF A FUNGUS THAT ESSENTIALLY TURNS INFECTED HUMAN BEINGS INTO ZOMBIES.

EVEN THOSE LIKE ME THAT ARE NOT EXACTLY ZOMBIE ACTION FANS FIND IT COMPELLING.

THE SCARIEST PART IS IT IS BASED AT LEAST IN PART IN SOME REALITY.

THE VILLAIN IN THE SERIES, THE CORDIS UPS FUNGUS, ACTUALLY EXISTS, THOUGH NOT IN THE WAY IT APPEARS IN THE SHOW.

THAT MIGHT BE THE MONSTER UNDER YOUR BED.

WHERE DOES REALITY IN INTO AND SCIENCE-FICTION BEGIN?

IS THIS REALLY A PROBLEM FOR HUMANITY?

JOINING ME TO SORT OUT FACT FROM FICTION AS DR. SCOTT ROBERTS, AN ASSISTANT PROFESSOR AND ASSOCIATE MEDICAL DIRECTOR AT THE YELL SCHOOL OF MEDICINE.

DR., I CANNOT ASK YOU WHAT YOU THINK OF THE SHOW.

BUT, BECAUSE YOU HAVE NOT SEEN IT YET.

BUT I AM SURE YOU WILL AFTER THIS.

HOW ACCURATE IS THE IDEA THAT A CORDYCEPS FUNGUS COULD TAKE OVER A HUMAN BEING.

IT HAS SOME PEOPLE PONDERING.

>> THIS IS A REAL FUNGUS.

IT INFECTS CERTAIN TYPES OF ANTS AND CAUSES THEM TO CHANGE BEHAVIOR.

THE FUNGUS DOES WOULD IT NEED TO TO REPRODUCE AND FRED -- SPREAD SPORTS.

FORTUNATELY FOR US, THIS IS A VERY SPECIES SPECIFIC INTERACTION WITH THE ANTS.

THIS CORDYCEPS SPECIES IS UNABLE TO SPREAD AMONG EVEN OTHER AND SPECIES.

IT LIKELY EVOLVED OVER MANY THOUSANDS OF YEARS.

I THINK THE RISK OF IT JUMPING TO HUMANS IS EXTREMELY LOW.

>> DID YOU SEE THAT THERE WAS A BBC DOCUMENTARY THAT WAS SOMETHING OF THE GENESIS FOR THIS PLANET EARTH EPISODE THAT CALLED IT THE ATTACK OF THE KILLER FUNGUS?

THAT ANTS CAN BE TAKEN OVER BY A FUNGUS.

BECAUSE, THEIR BRAINS WERE BEING CONTROLLED.

CAN YOU WAY IN --WEIGH IN ON ANY OF THIS?

THERE ARE DEBATES ABOUT WHAT EXACTLY THE FUNGUS IS DOING TO THE END.

>> IT IS LIKELY NOT ACTUALLY BRAIN CONTROL.

IT IS MORE THAT ONCE THE AUNT DIES FROM INFECTION, IT SORT OF HIJACKS THE MOVEMENTS OF THE ANT THROUGH THE NERVOUS SYSTEM CAUSING IT TO MOVE TO AN AREA WHERE IT CAN DISSEMINATE SPORES.

THE RISK THIS WILL ULTIMATELY INFECT HUMANS, KILL HUMANS, AND BECAUSE THAT BEHAVIOR CHANGE IS NEXT TO NONE.

WE HAVE FUNGAL AND MOLD SPECIES IN THE AIR WE BREATHE IN EVERY DAY AND VERY FEW ACTUALLY CAUSE INFECTIONS AND THE ONES THAT DO, IN VERY RARE CIRCUMSTANCES, CANNOT SPREAD PERSON-TO-PERSON.

>> WE HAVE A CLIP.

BECAUSE, WE HAVE TO ACTUALLY SHOW WITH THE ISSUE IS HERE.

THIS IS A CLIP OF -- FROM THE LAST OF US.

IT SHOWS A MY COLLEGE JUST --MYCOLOGIST EXAMINING A PATIENT.

>>SO, DR., CLEARLY, YOU SEE THE PROBLEM WITH WHAT IS BEING CONVEYED.

I THINK PEOPLE REALLY HAVE A CONCERN THAT IT CAN INVADE THE BODY.

BUT, THEREBY FUNGAL INFECTIONS.

THERE ARE FUNGI THAT INVADED THE HUMAN BODY.

WHAT SHOULD WE REALLY BE FOCUSED ON?

>> THE REASON I AM GLAD FOR THE SHOW IS IT IS RAISING AWARENESS FOR FUNGAL INFECTION IN GENERAL AND I CAN SAY THAT MOST FUNGAL INFECTION OCCURS EITHER THROUGH THE PULMONARY SYSTEM, SUCH AS PNEUMONIA.

A VALLEY FEVER IN THE SOUTHWEST UNITED STATES OR HISTOPLASMOSIS OR LAST OF MY SEATS MORE IN OUR REGION.

THAT OCCURS THROUGH THE INHALATION OF SPORES AND USUALLY ONLY IN THE MOST EXTREME CASES CAUSES A PNEUMONIA.

IN SOME SCENARIOS AND A CERTAIN PATIENT CHARACTERISTICS SUCH AS THOSE THAT ARE HEAVILY IMMUNOCOMPROMISED OR WITH DEVICES OR CATHETERS, THEY CAN DEVELOP FUNGAL INFECTIONS THAT ARE WHAT WE DETERMINED TO BE INVASIVE.

USUALLY THIS MEANS WE FIND THE FUNGUS IN THE BLOODSTREAM OR OTHER DEEPER BODY SITES.

BUT, REALLY ISOLATING WHAT LOOKS LIKE SPECIFIC DEGREE -- DEBRIS OF THE FUNGUS LIKE THEY PULLOUT IN THE SHOW IS NOT HOW WE SEE FUNGAL INFECTION PRESENT IN NORMAL HUMAN INFECTION.

>> BUT FUNGAL INFECTIONS HAS BEEN ON THE RISE, IS THAT ACCURATE, IN 2021?

SOMETHING LIKE 1.7 MILLION PEOPLE GLOBALLY DIED AS A RESULT OF SOME SORT OF FUNGAL INFECTION.

SO, IS AT THE RISE WORRISOME?

>> ABSOLUTELY.

THESE ARE ON THE RISE AND IT IS CERTAINLY WORRISOME.

WE RCN FUNGAL INFECTIONS THAT ARE -- WE ARE SEEING FUNGAL INFECTIONS USUALLY RESTRICTIVE TO A CERTAIN AREA LIKE HISTOPLASMOSIS IN THE U.S. -- MIDWEST.

WE ARE SEEING IT CREEP INTO OTHER STATES AND REGIONS.

WE ARE SEEING NEW FUNGAL SPECIES INVOLVED WITH GLOBAL WARMING.

THERE IS ONE THAT AROSE IN THE PAST 10 YEARS WE WORRY ABOUT IN HOSPITAL SETTINGS CALLED CANNADA ORIS THAT MANY THINK AROSE BECAUSE OF GLOBAL WARMING AND FUNGAL SPECIES ARE ABLE TO ADAPT TO A WARMER ENVIRONMENT.

ONE REASON FUNGAL INFECTIONS DO NOT INFECT HUMANS FREQUENTLY IS OUR BODY TEMPERATURES ARE HIGH.

CERTAINLY, MORE SO THAN BLOODED SPECIES.

SO, WITH THAT, WE ARE SEEING FUNGAL INFECTIONS THAT MAY BE ABLE TO ADAPT -- INFECT HUMANS WITH HIGHER FREQUENCIES.

>> FUNGAL INFLECTIONS -- INFECTIONS, FUNGI HAVE NOT GOTTEN THE ATTENTION, THE LOVE, YOU COULD SAY, VIRUSES AND BACTERIA HAVE GOTTEN.

THAT MEANS, I SUPPOSE, REDUCED RESOURCES FOR RESEARCH.

WHAT YOU THINK THE ISSUE IS?

>> I THINK IN GENERAL THESE ARE NOT THAT PREVALENT.

WHEN THEY ARE, THEY REALLY DO NOT CAUSE SEVERE PROBLEMS.

THE ONES THAT DO REALLY REALLY INFECT VERY SPECIFIC PATIENT POPULATIONS THAT ARE FAR LESS NUMBERS THAN THAT OF A VIRUS LIKE, FOR INSTANCE.

JUST TODAY IN OUR HOSPITAL WE HAD TSITSIPAS PATIENTS WITH COVID.

MAYBE ONLY ONE OR TWO WILL HAVE AN INVASIVE FUNGAL INFECTION.

THE GOOD THING IS THE SHOW IS RAISING AWARENESS.

IF YOU WERE TO ASK ME AS AN INFECTIOUS DISEASE PHYSICIAN WHAT KEEPS ME UP AT NIGHT, IT WILL STILL BE THE NEXT VIRUS AROUND THE CORNER, WHETHER IT IS A COVID VARIANT OR AN AVIAN FLU RATHER THAN A FUNGAL INFECTION.

JUST DUE TO THE SHEER NUMBER OF INFECTIONS PEOPLE COME DOWN WITH.

HOWEVER, I AM CONCERNED IN GENERAL WITH THE RISE IN FUNGAL INFECTIONS.

THE NEW SPECIES WE ARE SEEING.

THE FACT MORE AND MORE PEOPLE ARE GETTING INFECTED WITH THESE OVERTIME.

>> IS THERE A CONCERN ABOUT HOW WE TREAT THESE FUNGAL INFECTIONS?

OUR ABILITY TO DEAL WITH THEM.

>> ARE RIGHT NOW, WE HAVE REALLY GREAT TREATMENTS FOR ALMOST ALL TYPES OF FUNGAL INFECTIONS.

THERE ARE A HANDFUL THAT GIVE ME CONCERN.

ONE IS THE SPECIES I MENTIONED THAT AROSE WITH CLIMATE CHANGE.

A FEW ISOLATES HAVE BEEN FULLY RESISTANT TO ALL OF HER ANTIFUNGAL DRUGS.

SO I THINK THAT THE GOOD NEWS ABOUT THE SHOW RAISING AWARENESS TO THIS IS HOPEFULLY WE CAN DEDICATE MORE RESOURCES TOWARDS COMBATING THIS AND DEVELOPING NEW DRUGS IF THESE CONTINUE TO EVOLVE.

>> THE W.H.O.

FOR THE FIRST TIME LAST YEAR PUT OUT A LIST OF WHAT IT CAN TATERS -- WHAT IT CONSIDERS THE TOP 19 MOST CONCERNING FUNGI.

DO YOU THINK THAT WILL MOTIVATE MORE RESEARCH, MORE RESOURCES?

>> I CERTAINLY HOPE SO.

I THINK THE W.H.O.

AND THE CDC REALLY MAKING A POINT TO INCLUDE THESE ON THEIR LIST OF EMERGING THREATS WILL HELP THE CAUSE OF COMBATING FUNGAL INFECTION IN THE FUTURE.

I AM VERY GLAD TO SEE THAT.

>> AS YOU POINTED OUT, WE HAVE A PANDEMIC THAT IS STILL SO WORRISOME.

YOU WOULD THINK PEOPLE WOULD NOT WANT TO ESCAPE INTO MORE EPIDEMIC FICTION WHEN WE HAVE, YOU KNOW, THIS KIND OF PANDEMIC REALITY.

WHY DO YOU THINK PEOPLE ARE DRAWN TO THIS KIND OF THING?

>> YEAH, I THINK THAT THE PRODUCERS OF THIS SHOW REALLY TOOK A UNIQUE PART OF NATURE THAT HAS BEEN HIGHLIGHTED BY PLANET EARTH AND EXPANDED UPON IT AND HAVE CREATED THIS INCREDIBLE SHOW.

AND, PERHAPS, IT IS JUST THE PANDEMIC REALLY IMPACTING US.

BUT, IT SEEMS THAT AUDIENCES ARE RIGHT FOR APOCALYPTIC SHOWS AND I THINK THIS IS SEIZING THE MOMENT RIGHT NOW.

I AM CERTAINLY VERY EAGER FOR THIS PANDEMIC TO END.

OTHERS ARE AS WELL.

HOWEVER, I HAVE HEARD THE SHOW IS GREAT AND I PLAN TO WATCH IT AS SOON AS I AM ABLE.

>> OK. DO YOU HAVE ANY ADVICE FOR PEOPLE ABOUT -- YOU ARE CONCERNED ABOUT DIFFERENT FUNGI?

>> I THINK IN GENERAL THE RISK TO THE AVERAGE PATIENT IS LOW.

REALLY, DOING WHAT PEOPLE CAN TO REALLY ENSURE HEALTHY PRACTICES THAT REDUCE THE RISK OF FUNGAL INFECTION.

SO, A HEALTHY LICE -- LIFESTYLE.

PREVENTING DIABETES.

CONTROLLING COMORBIDITIES THAT PUT PATIENTS AT RISK IN THE HOSPITAL WHERE THEY MIGHT NEED CATHETERS OR IMMUNOSUPPRESSION.

THAT PREDISPOSES PEOPLE TO FUNGAL INFECTION.

IN GENERAL THE RISK IS LOW.

I DON'’T WANT TO -- I WANT TO EMPHASIZE THIS SHOW IS A POTENTIAL REALISTIC TAKE OF WHAT COULD HAPPEN WITH A FUNGAL INFECTION.

THOUGH WE DO SEE FUNGAL INFECTIONS IN DIFFERENT WAYS AND PATIENTS ON A DAILY BASIS HERE IN OUR HOSPITAL.

>> DR. ROBERTS, THANK YOU FOR JOINING US.

>> ALL RIGHT.

TAKE CARE.

>> THAT IS IT FOR TONIGHT.

I WILL BE BACK TOMORROW.