Vital Sings: Iceland

Premieres: May 18, 2020.

00:16 SANJAY – VO

THIS — IS ICELAND…DESOLATE…REMOTE…ISOLATED. A NATURAL WONDER BOASTING DRAMATIC WATERFALLS, AND ICY GLACIERS. WHAT’S HAPPENING ON THIS VOLCANIC ROCK IN THE MIDDLE OF THE ATLANTIC — IS A RESEARCH REVOLUTION

THAT COULD CHANGE THE MEDICAL LANDSCAPE FOR US ALL.

01:09 SANJAY – VO

FEBRUARY IN ICELAND — AND IT’S COLD. ALTERNATING BETWEEN WHITE-OUT BLIZZARDS, AND BRILLIANT SUNLIGHT. WE’RE IN REYKJAVIK, ICELAND’S CAPITAL CITY…HOME TO A THIRD OF THE COUNTRY’S POPULATION. THAT MIGHT SOUND LIKE A LOT…BUT THE TOTAL POPULATION HERE ONLY NUMBERS SOME 330-THOUSAND PEOPLE.

 

01:33 KARI – ON CAM

We have made probably as much contribution as the rest of Europe put together.

01:39 SANJAY – VO

MEET KARI STEFANSSON. 20 YEARS AGO, HE HAD AN AMBITIOUS IDEA — TO MAP THE GENOME OF ICELAND’S ENTIRE POPULATION, THROUGH HIS COMPANY CALLED DECODE.

01:50 KARI – ON CAM

When you begin to look at genetics,

DR. KARI STEFANSSON

Founder/CEO, deCODE Genetics

01:53 KARI – ON CAM

when you begin to think about life in general, it turns out that all life on earth is rooted in DNA. There is no life on earth that is not based on information that lies in this miraculous macromolecule that we call DNA.

02:07 SANJAY – VO

SO WHAT DOES THAT MEAN EXACTLY? WELL THE GENOME IS OUR ENTIRE SET OF D-N-A — THE CHEMICAL COMPOUND THAT CONTAINS GENETIC INSTRUCTIONS. IT IS THE CODE THAT TELLS OUR BODIES HOW TO FUNCTION — FROM OUR ORGANS TO OUR CELLS. ULTIMATELY, WE’RE TALKING ABOUT 6 BILLION PIECES OF DATA…ARRANGED IN SOME 3 BILLION BASE PAIRS MAKING UP TENS OF THOUSANDS OF GENES.

02:30 SANJAY – ON CAM

We have been able to map the human genome..

DR. SANJAY GUPTA

CNN Chief Medical Correspondent

..for the last 16-17 years now. But where are we in the world of genetics right now?

02:39 KARI – ON CAM

We claim that we can sequence the whole genomes for very very large number of people. For example in this building we have sequenced the whole genomes of 40,000 people. But that claim is not completely authentic. It’s a little bit false. Because yes we can we can we have sequenced it down to individual basis, but there are certain features in the sequence that we have yet to figure out.

[00:03:36;20] But I think that the key to developing understanding of the function of the brain, which is the only organ in the body that we don’t understand adequately. I think that the key to that lies in the use of genetics.

03:21 SANJAY – VO

DOCTOR STEFANSSON’S TEAM AT DECODE HAS IDENTIFIED GENES THAT IMPACT SOMEONE’S CHANCES OF DEVELOPING EVERYTHING FROM ALZHEIMER’S TO HEART DISEASE TO BREAST CANCER…AND THEY’RE EVEN DOWN TO A LEVEL OF PROBLEM SOLVING AND CREATIVITY. HE CAN TELL YOU, FOR EXAMPLE, BASED ON YOUR GENETIC MAKEUP — IF YOU LIKE CROSSWORD PUZZLES, OR HAVE AN ARTISTIC MIND.

03:41 KARI – ON CAM

Human genetics is the study of human diversity. And what you are trying to do is to figure out how information that lies in the genome has impact on human diversity. And having for example the genealogy gives you the avenue by which this information is passed from one generation to the next. And I am absolutely convinced that we have been leading this field for the past 15 years at least, because of the advantage that lies in having all of this data.

04:09 SANJAY – ON CAM

In case you’re wondering what all this looks like, this is it. This is the basement of deCODE. And as far as the eye can see, you see vials and vials of blood. This represents more than half the country’s genetic material. 150,000 people. It’s negative 15 degrees in here, and that will make sure these vials can be stored here in perpetuity.

04:32 SANJAY – VO

THERE’S SOMETHING ELSE ALSO IMPORTANT ABOUT ICELAND. THE SMALL POPULATION IS RELATIVELY HOMOGENOUS — AS MUCH AS 90 PERCENT OF THE PEOPLE HERE, ARE CONSIDERED PURE ICELANDIC.

THAT MEANS NOT MUCH DIVERSITY IN THE GENE POOL — THE PERFECT CONTROL GROUP FOR SCIENTISTS AT DECODE. WHEN THEY FIND A MUTATION — OR VARIANT, IT’S EASIER TO TRACE.

04:55 KARI – ON CAM

That is what’s so interesting about this, is that many of these variants that we are finding, will probably turn out to be double-edged swords. In some instances they may be a liability, in other instances they may be assets.

05:10 KARI – ON CAM

For example, we discovered a variant a few years back, three, four years back, that confers protection against the Alzheimer’s disease. It’s a rare variance we found in about 1% of the Icelandic population and if you carry that variant, you are almost completely protected against the Alzheimer’s disease.

05:29 SANJAY – VO

THE IDEA IS THIS — REPLICATE WHAT THE GENE IS DOING NATURALLY — IN MEDICINE. DECODE IS PRIVATELY-OWNED — AND ITS PARENT COMPANY, AMGEN — IS IN THE PHARMACEUTICALS BUSINESS.

AMGEN IS TAKING THE INFORMATION COMING FROM DECODE — AND THEN WORKING TO TURN IT INTO MEDICATIONS.

05:46 SANJAY – VO

SEAN HARPER IS THE HEAD OF RESEARCH AND DEVELOPMENT FOR AMGEN. HE VISITS DECODE SEVERAL TIMES A YEAR… AND SAYS ONE OF THE MOST PROMISING PROJECTS AT THE MOMENT — IS A DRUG FOR HEART DISEASE.

05:57 SEAN – ON CAM

We start our work with the certainty..

SEAN HARPER

VP, Amgen Research and Development

06:00 SEAN – ON CAM

..that the target that we’re going after is actually relevant in humans in the path of physiology of the disease. That’s what the genetics is telling you. What’s amazing about the human genetics is they can actually establish causality of the link of these genes with disease.

06:19 SANJAY – VO

HARPER SAYS HALF OF AMGEN’S CURRENT RESEARCH PROJECTS ARE INFLUENCED DIRECTLY BY GENETICS…AND OF THAT, AT LEAST 90 PERCENT IS FROM THE WORK HAPPENING IN THIS BUILDING.

DECODE DOES PUBLISH ALL OF THEIR FINDINGS, SO THE RESEARCH IS AVAILABLE FOR ANYONE TO SEE.

06:36 SANJAY – VO

YET IT’S IMPORTANT TO POINT OUT NOT EVERYONE AGREES WITH WHAT DECODE IS DOING.

CRITICS ARE RAISING QUESTIONS ABOUT PRIVACY, AND WHAT TO DO WITH  ALL THIS INFORMATION.

FOR NOW, ALL THE DATA HERE IS ENCRYPTED, AND ANONYMOUS.

KARI STEFANSSON HOPES THAT WILL SOON CHANGE.

06:52 KARI – ON CAM

We have insight into the genome of all Icelanders today. We do. And one of the big question is, “How can society here take advantage of it?” And there are some obstacles that society has to get over before it will use it. And I can give you a very good example of that.

07:15 KARI – ON CAM

There is, as I said before, there is just one mutation in the BRCA2, or the BRCA2 gene in Iceland. It is carried by 0.8% of the population. Women who carry this mutation have 86% probability of developing a lethal cancer. We can, at the push of a button, find all of these carriers, or find encrypted ID of all of these carriers. So if society would want to use this, they could find these women, they could approach them, and they could mitigate most of this risk.

07:49 KARI – ON CAM

It has always been considered a virtue in our culture to know as much about yourself as possible. And I don’t think that in that there is any exception for genetics. We just want to know who we are.

08:08 SANJAY – VO

UNDERSTANDING WHO THEY ARE — IT’S A HUGE PART OF ICELANDIC CULTURE.

AND IT HAS A HISTORY — ROOTED IN VIKING TIMES…GOING BACK MORE THAN A THOUSAND YEARS.

08:27 SANJAY – VO

ICELAND — A LAND MASS NO LARGER THAN THE U-S STATE OF KENTUCKY…FORMED BY VOLCANIC ACTIVITY WITH A POPULATION SHAPED BY THE ISOLATION AND EXTREME NATURAL LANDSCAPE.

THERE’S A TIGHT BOND HERE — FUELED BY A STRONG KNOWLEDGE OF IDENTITY — ENABLING RESEARCHERS TO DO EXTENSIVE GENETIC STUDIES.

08:48 SANJAY – ON CAM

Of course, none of what we’re talking about works as well unless you have really detailed historical records.

DR. SANJAY GUPTA

CNN Chief Medical Correspondent

08:54 SANJAY – ON CAM

That’s particularly unique about Iceland. They have these genealogical records that go back more than a 1,000 years, and they treat them like gold.

09:07 SANJAY – VO

THIS IS THE MANUSCRIPT INSTITUTE AT THE UNIVERSITY OF ICELAND IN REYKJAVIK. IN THIS VAULT — ORIGINAL MANUSCRIPTS THAT DATE BACK HUNDREDS OF YEARS — SOME, NEARLY A MILLENNIUM OLD.

09:20 SANJAY – VO

GISLI SIGURDSSON IS A RESEARCH PROFESSOR HERE. TODAY, HE’S PULLED ONE OF THE ICELANDIC SETTLEMENT BOOKS FOR US.

09:27 (NAT-SOT OF GISLI READING THE BOOK IN ICELANDIC)

09:33 SANJAY – VO

THIS MANUSCRIPT WAS HANDWRITTEN IN THE 1600s — BELIEVED TO BE A COPY OF A BOOK FROM THE 14TH CENTURY AND THAT ONE IS BELIEVED TO BE A COPY FROM THE 1200s.YOU GET THE IDEA.

09:45 SANJAY – ON CAM

How far back are we talking here?

09:48 GISLI – ON CAM

We know from Irish sources, Dicuil, who was writing in Ireland around 825, that the Irish hermits were here

GISLI SIGURDSSON

Research Professor, Árni Magnússon Institute

09:57 GISLI – ON CAM

around 790 

09:59 SANJAY – ON CAM

790?

10:00 GISLI – ON CAM

or thereabouts.

10:01 SANJAY – ON CAM

Wow.

10:02 GISLI – ON CAM

They were exploring the island. They were sailing across, coming up with several suggestions for a name, Snæland, so land of snow, Garðarshólmur, that was a self-obsessed character by the name of Garðar, and then Floki, who saw the drift ice from Greenland from a mountain that he climbed and he came up with the Iceland name.

10:24 SANJAY – ON CAM

If you think about genealogy around the world, how unique is Iceland? How unique is a document like this?

10:31 GISLI – ON CAM

I think it’s just as unique as they come. In the Olympics in cultural heritage, we would be, I think, receiving the gold medal for this book,

10:41 SANJAY – ON CAM

It’s that good huh?

10:41 GISLI – ON CAM

because nowhere else do you have a such a complete coverage, as I say, of an entire country. Even though it doesn’t cover the entire population, it covers the entire country.

10:53 SANJAY – ON CAM

I mean, you read a book like this and somehow you know you’re probably reading about your ancestors.

10:58 GISLI – ON CAM

Oh yeah, and Halldór Lexness, great 20th century writer, he claimed that Icelanders would be the only nation who originates in a book.

11:10 SANJAY – VO

AT THE DECODE OFFICES, THERE ARE REMINDERS OF WHAT’S POSSIBLE HERE, AND WHY…

11:15 KARI – ON CAM

This is a family tree of asthma. This is one big family, and the last two generations you have patients with asthma, and they can be traced to one ancestor who is probably, if I remember correctly born in 1651.

11:34 SANJAY – ON CAM

So going back in over 400 years, whatever, one ancestor and then all this family tree, and then the red.

11:42 KARI – ON CAM

In the last two generations there are asthma patients but (2:37) before that, people were rarely diagnosed with asthma, so it doesn’t mean that among the others there weren’t people who suffered from the same disease, it’s just that medicine or health care wasn’t available for people and we hadn’t defined the condition until relatively recently.

12:02 KARI – ON CAM

So here they are testing all kinds of parameters of function and structure of the eye

12:08 SANJAY – VO

FOR KARI STEFANSSON’S TEAM AT DECODE — THESE GENEALOGICAL RECORDS ARE A CRUCIAL CLUE… PROVIDING A LOOK AT THE PAST THAT COULD HELP RESEARCHERS TREAT US IN THE FUTURE. THE TEAM EVEN DIGITIZED THE TRADITIONAL BOOK OF ICELANDERS — MEANING EVERY PERSON IN ICELAND CAN LOG ON TO A WEBSITE, AND TRACE THEIR ANCESTRY. IT’S A STRONG PULL OF NATIONAL IDENTITY — ONE THAT BROUGHT DOCTOR STEFANSSON BACK, AFTER 20 YEARS AWAY.

12:34 KARI – ON CAM

You see my family has lived here for 1100 years. So no matter whether I like this place or not, I fit into this place.

We have evolved to adjust to this place,..

DR. KARI STEFANSSON

Founder/CEO, deCODE Genetics

12:45 KARI – ON CAM

..to the darkness of the winter, to the you know relentless daylight during the summer. So I probably I was probably destined to come here in the end but what made me come here, probably what sort of pushed me at that point in time, was the desire to put together a large genetic project.

13:05 KARI – ON CAM

And the advantage of doing it in this way that we did it, is that we have the genealogy of the entire nation on a computer database going thousand years back in time. Having access to longitudinal data. Having access to the birth weight, the birth length or all of the patients with heart attack in the country. Having cohesive longitudinal data gives you miraculous possibilities when it comes to figuring out what is behind disease.

13:38 SANJAY – VO

THIS INTERSECTION OF GENEALOGY AND GENETICS IS INSPIRING OTHER STUDIES AS WELL. 40 MINUTES FROM REYKJAVIK — SITS THE FISHING TOWN OF AKRANES.

FOR REASONS STILL UNCLEAR TO SCIENTISTS, THIS SMALL TOWN HAS A HIGHER THAN AVERAGE RATE OF MULTIPLE MYELOMA — THAT’S A RELATIVELY RARE CANCER THAT FORMS IN BONE MARROW.

13:59 BRIAN – ON CAM

What we know is that Myeloma..

DR. BRIAN DURIE

Founder, International Myeloma Foundation

14:02 BRIAN – ON CAM

..is always preceded by the precursor state. So what we’re hoping to learn is why do people develop that precursor state and, perhaps even more importantly, why do they progress from the precursor into the act of Myeloma?

14:17 SANJAY – VO

DOCTOR BRIAN DURIE IS THE HEAD OF THE INTERNATIONAL MYELOMA FOUNDATION. THE I-M-F FORMED A PARTNERSHIP WITH THE TEAM IN ICELAND — HEADED BY SIGURDUR KRISTINSSON TO STUDY MYELOMA IN ICELAND. USING ROUTINE BLOOD TESTS, PARTICIPANTS WILL BE MONITORED FOR THE PRECURSOR — AND TREATED IMMEDIATELY, IF SIGNS OF THE DISEASE EXIST.

14:37 SANJAY – VO

THE GOAL TO ENROLL EVERY ADULT OVER THE AGE OF 40. THAT ADDS UP TO MORE THAN 140-THOUSAND PEOPLE — IT’S AN UNPRECEDENTED STUDY. ALREADY, IN JUST A FEW MONTHS, THEY’RE HALFWAY THERE. AND IT ALL STARTED — IN AKRANES.

14:52 SANJAY – ON CAM

The question of nature versus nurture always comes up, I imagine, right? Why do people develop multiple myeloma?

15:01  SIGURDUR – ON CAM

That’s a very interesting question. We actually don’t know. That’s the honest answer. There are some risk factors. We know that Africans and African-Americans have..

DR. SIGURDUR KRISTINSSON

Principal Investigator, iStopMM Project

15:12 SIGURDUR – ON CAM

..about twice the incidence of myeloma. We know that it runs a little bit in the family, but actually, most people that we diagnose with myeloma today, they have none of these risk factors. So most people just turn up with myeloma out of nowhere.

15:28 BRIAN – ON CAM

Exactly. So when I first came to Iceland in September, to this beautiful place, this pristine place, it seemed like, “Why would people get cancer here? You know, everything is so beautiful.” And so then I looked across the bay to Akranes and I said, “What is that over there?” And it’s a very large aluminum smelter, and so I realized that even in a pristine place like Iceland, there are some aspects where people could be exposed to toxic chemicals, and maybe this could be a risk factor that we could evaluate here. Because we have such an amazing genetic understanding, we can overlay the nurture and see what aspect is maybe contributing.

16:11 SANJAY – VO

SO…THE POPULATION, THE GENEALOGY, THE GENETICS… ALL THE PIECES THAT COME TOGETHER TO MAKE ICELAND WHAT IT IS. AND THERE’S ONE MORE CURIOSITY HERE…DESPITE THE WINTER COLD…AND LACK OF SUN…ICELAND IS A VERY HAPPY COUNTRY. WHY?  WELL LET’S JUST SAY THERE MIGHT BE SOMETHING IN THE WATER…

16:34 SANJAY – VO

ICELAND IS A COUNTRY OF BRILLIANT COLORS — AND IN THE WINTER, YOU’RE MOST LIKELY TO FIND THEM UP IN THE SKY. THE NORTHERN LIGHTS — ONE OF EARTH’S MOST BEAUTIFUL VIEWS.

LIGHT FROM THE ATMOSPHERE DANCES ACROSS THE NIGHT SKY. AT 2 A-M ON A MOUNTAINSIDE, OUR CAMERAMAN CAPTURED THIS STUNNING DISPLAY.

16:59 SANJAY – VO

DURING THE DAY, WINTER OFTEN PRESENTS A DIFFERENT COLOR IN ICELAND — MOSTLY, GRAY OR WHITE, FROM OVERCAST SKIES AND SNOWSTORMS. BUT YOU CAN FIND MORE COLOR, IF YOU KNOW WHERE TO LOOK.

17:12 SANJAY – VO

THE TURQUOISE WATERS…BLACK LAVA ROCKS…AND — WHITE MUD? MUST BE THE BLUE LAGOON.

THIS IS ONE OF ICELAND’S MOST ICONIC DESTINATIONS. YEAR-ROUND, DAY AND NIGHT — REGARDLESS OF WEATHER, YOU’LL FIND PEOPLE FROM ALL OVER THE WORLD BOBBING IN THE WATERS OF THE BLUE LAGOON.

17:32 SANJAY – VO

VALDIMAR HAFSTEIN IS A PROFESSOR AT THE UNIVERSITY OF ICELAND.

FOR THE PAST FEW YEARS, HE AND A GROUP OF COLLEAGUES HAVE BEEN STUDYING ICELAND’S POOLS.

17:41 VALDIMAR – ON CAM

There is just down the road from here, not 200 feet, is a geothermal energy plant, and this is the runoff water from the energy plant. And if you could look just beyond that hill which they

VALDIMAR HAFSTEIN

Professor, University of Iceland

17:54 VALDIMAR – ON CAM

probably put there so you can’t see it, you’d see that you’re basically bathing in factory runoff. And it’s a gorgeous place and it’s a nice spa it’s a..

18:03 SANJAY – ON CAM

You think people here know that they’re bathing in factory runoff water?

18:07 VALDIMAR – ON CAM

Well I don’t think that’s what it says on the brochure.

18:09 SANJAY – ON CAM

That’s right. But it works though, right? I mean so this is this is considered clean, it’s considered safe, and obviously very very warm.

18:19 VALDIMAR – ON CAM

Exactly. It’s clean, safe, and warm, and if you look around you’ll see these strange ghostly faces of white, these white masks of silica that people have put on, silica mud.

18:30 SANJAY – VO

RESEARCHERS AT THE BLUE LAGOON HAVE BEEN STUDYING THIS — AND THEY’VE FOUND THAT THE SILICA MUD CAN HELP TREAT SKIN CONDITIONS LIKE PSORIASIS…DRAWING IN VISITORS FROM AROUND THE GLOBE.

18:41 SANJAY – ON CAM

So the Blue Lagoon is one thing, but those are mainly for the tourists.

DR. SANJAY GUPTA

CNN Chief Medical Correspondent

18:45 SANJAY – ON CAM

If you want to go see the people who live in the community, you gotta come to a pool like this. Right in the neighborhood, the same geothermal sort of thing. But this is where the locals hang out. You know what, I’m gonna give it a shot.

18:59 SANJAY – VO

THIS IS THE WEST END POOL, IN REYKJAVIK. WE’LL SPARE YOU MY MAD DASH FROM THE LOCKER ROOM TO THE HOT TUB…ALSO KNOWN AS A HOT POT. I COULDN’T GET IN THE WATER FAST ENOUGH. THE AIR TEMPERATURE WAS HOVERING AROUND FREEZING — BUT THE WATER TEMPERATURE WAS HOT — AROUND 38 DEGREES CELSIUS, SO 100 DEGREES FAHRENHEIT.

19:18 SANJAY – VO

SWIMMING POOLS EXIST ALL ACROSS ICELAND — BECAUSE OF THE SWITCH TO GEOTHERMAL ENERGY IN THE 1950s AND 60s…THAT’S WHEN THE COUNTRY DECIDED TO HARNESS THE AWESOME POWER OF THE WATER BUBBLING UNDER THE SURFACE HERE…

ALL HEATED BY VOLCANIC ACTIVITY UNDERGROUND.

19:34 VALDIMAR – ON CAM

Every neighborhood in the country, every neighborhood in town, every small town in the country, has one of these communal pools, and it’s at this point considered more or less a civil right to have one within walking distance of your home, and it’s become a focus point of public life, really.

19:50 VALDIMAR – ON CAM

This is a cold country, look around you, look at us here twitching in the cold, it’s a we don’t have the Mediterranean plaza culture, we don’t have the town square as a meeting place that much, it’s a limited window in the year anyway, beer was actually illegal in this country until 1989, so the pub didn’t develop as a social space either, but what did as of the 50s and 60s, was the neighborhood pool

20:16 VALDIMAR – ON CAM

And It’s a Nordic country, we’re not very outgoing, but when we meet in the pool, we chat, that’s a space of liberty where you’re at ease to talk to others.

20:25 SANJAY – ON CAM

What is it about the pool that sort of breaks down that barrier?

20:29 VALDIMAR – ON CAM

People from all walks of life, go to the pool and so you have mixing in the same hot tub people living in the area whether it’s the professor or the student, the construction worker or the businessman, the billionaire, the car salesman, they all meet up and you know topics of public interest at any given moment, are hammered through in the hot tubs.

20:51 SANJAY – VO

DESPITE THE HARSH ELEMENTS — ICELAND OFTEN FINDS ITSELF IN THE TOP THREE OF THE WORLD’S HAPPIEST COUNTRIES. VALDIMAR AND HIS FELLOW RESEARCHERS BELIEVE THE POOLS ARE A BIG REASON FOR IT.

21:03 SANJAY – ON CAM

Why is this place so happy?

21:05 VALDIMAR – ON CAM

If you think of health and wellness not just as a matter of physical health and you know being free from disease, but also the mental and social aspects of health and wellness, I think the heat, the geothermal heat and the communal pools have a lot to do with that. That we feel good there.

21:26 SANJAY – VO

LIKE KARI STEFANSSON, VALDIMAR LEFT ICELAND — AND THEN CAME BACK HOME.

21:32 VALDIMAR – ON CAM

Life is good here. You know, and if I weren’t from here, this wouldn’t be my first choice of a place to live, but there’s a tight-knit network of friends and family here, so the pools are a part of good part of social life here, geothermal living is good here.

21:48 SANJAY – VO

APPROPRIATELY, IT WAS SNOWING WHILE WE WERE IN THE POOL.NO ONE EVEN BATTED AN EYE.

ANOTHER EXPERIENCE AS UNIQUELY ICELANDIC AS THIS PLACE, AND ITS PEOPLE… MOLDED BY THE EXTREME ELEMENTS…A LANDSCAPE THAT COULD CHANGE SCIENCE AND MEDICINE ALL OVER THE WORLD.

THE END