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episode.
Welcome to another special episode of the drive. This is a follow-up to our recent covid-19 podcast with doctors. Marty macree and Zubin. Damania that
So was released on January 3rd, it was very popular recently received a lot of follow-up questions and requests from listeners to revisit the subject matter. So, for this episode in addition to being joined by Marty and Zubin, we're also joined by dr. Monica Gandhi. Monica is an infectious disease specialist and professor of medicine at the University of California, San Francisco. She earned her MD from Harvard Medical School did her Internal Medicine, Residency, in ID fellowship. At UCSF. She also holds an mph in epidemiology and biostatistics from UC Berkeley. So before getting into kind of
The Leia. What we discussed I want to highlight a couple of things first along with the previous podcast on this subject matter. This is kind of different from a traditional podcast. It's more of a discussion between the group of us that format seemed to resonate quite well based on the feedback. So we thought we'd revisit that along those lines. We again tried to call out the distinction between fact and opinion and I think in this episode we have a pretty healthy mix of both of those things. My hope is that going into this? You're familiar with at least what we spoke about in the previous episode. If not, it might be worth going.
Back to listen to that. This episode was recorded on January, 17th, 2022, in an effort to get it out as soon as possible. It's not going to have the most robust set of show notes. And of course it will be Audio Only not video. Now with that Preamble. Let's talk about the episode itself. The things that we get into in some detail are the newest data on Omicron since our initial conversation. And of course, we have a lot more information on Omicron since that discussion, we talked about how viruses evolve and change over time and how that affects antibodies Monica, gives a great explanation of what B cells and T cells.
Cells do and how antibodies work and what the implications of that are four different types of immunity vaccine and natural talk about the ideal timing and the number of vaccines for long-term immunity and how natural immunity plays into this and whether or not you should be boosted depending on those things. We also discuss some of the side effects of current vaccines. We get into the controversial topics of vaccine mandates. Masking, Canada's lockdowns kids in school Sweden's approach to covid Robert. Malone's recent podcast on Joe Rogan, where Zubin does a pretty good.
Point-by-point discussion of where he thinks Malone is Off the Mark and where he's potentially saying something valid. We spend quite a bit of time talking about this sort of fact, versus fear approach to discussing covid and it's clear that we're still in largely a fear based approach. Although it's not entirely clear to me, why that's the case. In fact, this morning shortly before, even recording this intro and it's January 20th. Today. I just saw an article that talked about how by March the United States, could see an additional
all 50,000 to 300,000 deaths and the reality of it is that's simply fear-based thinking is very unlikely. We're going to see 300,000 deaths in the next 40 days. So it's not clear to me. Why that type of language is being used and I think we try to do a good job here of bringing this back to facts as opposed to wildly extrapolated models and things like that. We end this conversation again talking a little bit about the future and what the exit strategy looks like here. I think it's very
Clear to anybody who's paying attention that we are in an endemic. This is no longer a pandemic and therefore we should have strategies geared towards that. So, without further delay. I hope you enjoy my follow-up discussion with Marty Zubin and Monica. Hey guys, wonderful to have you all here. Monica. Thank you so much for joining the trio and increasing the average IQ of this group, by 40 points.
We're really looking forward to this. So Monica is, you know, Zubin Marty and I sat down couple of weeks ago kind of had a relatively informal discussion on the topic. We couched much of what we said. As this was opinion. This was fact the format seemed to resonate a lot with people and the follow-up was surprising. I thought it would be a one-and-done, thought it would be this one discussion. We would have put to rest as many of the misconceptions as we felt we could. But the reality of it is people appreciated it but said look, we have more questions.
And so we decided, I guess we should do this again and we're really grateful that you could join us. So, where do we want to start here? There's so much to get into. Marty. You probably spend a lot of time in the last couple of days. Looking at some of the questions. Is there. Is there anything you want to just jump into right out of the gate? Sure. Well, I think it might be worth talking about the new data on Omicron that came out since our last conversation. It is great. Having Monica. Here. I deleted my up-to-date app when I got to know, Monica, because I just call her now and she answers all my questions.
Questions, that's so funny. You say that Marty. I literally just canceled my up-to-date subscription last week as well. That's
the app. A lot of doctors
used to look things up quickly. Now, I just call Monica big study came out on the preprint server from Kaiser Southern California. That looked at Omicron specific cases and they found fifty two thousand cases of Omicron. None required mechanical ventilation. And remember 52,000 documented means
There's four or five cases out there in the community for everyone that we're picking up with testing about roughly half may be asymptomatic and a lot of people have tough getting access to testing. So we're really looking at a population of say, a quarter million people with Omicron and nobody required a ventilator. Now, there was one death in that group, not through the ICU and intubated. But remember the test they use, which is the S. Gene. Deletion is not a perfect test for Omicron.
And it can pick up an occasional rare Delta virus plus. They didn't have absolute confirmation. That anyone hospitalized was hospitalized for the virus as opposed to with the virus. They looked at the presence of symptoms on their record, but regardless we're looking at a net total of 154 people who are hospitalized out of say, a quarter million with Omicron. Now of those hospitalized 83% where they're in the hospital for less than 48 hours.
Now, if you remember way back about two months ago, this is exactly what the South African doctors observed early on. They noticed people were in the hospital about two days. Instead of eight days and they proclaimed to the world. This is a mild infection. There is no need to panic and we basically did the exact opposite but this data is pretty compelling right now. Now, the reason it's so important is that 98.3% of new cases of covid in the United States are
Omicron according to the most recent CDC numbers on December 10th, it hit 73%. Now we're at 98.3%. So we're dealing with a different virus and I personally wish it had a different name because people know it comes from the lineage of covid. And we've got the raw memories of the destruction of covid and the loss of life and how our hospitals were overwhelmed. We think of it in terms of covid, but it's really functioning and behaving like a different virus. Now you
Say well look, we're in the Nomicon wave. People are still in the hospital. The vast majority are people who came in with Delta, who were infected with Delta, who were unvaccinated and got Delta and remember, people stay in the hospital a long time, especially right now and it's very difficult to discharge a covid, positive, patient to a skilled facility or rehab. So that's inflating the numbers a little bit, but hospitals are truly strained, but it's really those who had Delta. If we look at the future Omicron promises to be a mild virus based on all of this data.
Question for anybody. But Marty, it sounds like you might even know the answer already. Do we have a sense of how many people are in the hospital with Omicron? Because of them are KRON? Or, because that's an incidental finding along the way. So, somebody's in there for cancer treatment, but they happen to be testing positive, or they are in there because of chest pain that's related to cardiovascular disease. And then, of course, they're covid positive along the way. So, I just actually look this up. There's a bunch of hospitals in the country that report this number on a daily basis. And why you for
Well, reported 53% are not therefore covid but they're covid positive there, incidental, covid, admissions, Jackson, Memorial in Florida, 65% are incidental covid positive cases. So think of it in terms of 50 to 60 percent are incidental
that latter question also depends on how highly vaccinated the region is. So, for example, the numbers are even higher out in California for people with covid in their noses because we swab everyone. So
So LA County, reported 67 percent, which was closest to what we saw in South Africa, during the Omicron surge, which was 63% and it wasn't that South Africa was a highly vaccinated region is about 25% vaccinated region. There was a Sarah, prevalent study in Sardis, Kofi to in South Africa that showed 79 percent of adults had SARS Covey to antibody. So, meaning think of South Africa, with between natural immunity and vaccines as having the same.
Some degree of immunity likely as California sewing the higher, the vaccinated region, the higher, the incidental rate is. I'd like to add just to a couple of your Omicron studies because they just came out yesterday. Hot off the press that very verifying what you just said. Marty one was from South Africa, which was really well documented. What's the contribution of immunity versus the more milder aspect of Omicron contributing to the better outcomes with Omicron?
And they tried to tease this out, essentially, by looking at the fourth wave in South Africa. Hopefully, we can post all these links but in the fourth wave of, in South Africa, compared to the prior three, waves. And essentially, what this study showed that was just this week was that absolutely immunity is contributing to why? In December 20, 21, January 2020. To were having a better outcome with the latest variant. It is absolutely the contribution of immunity both natural immunity and
Seen induced estimated vaccination, probably led to a point to for hazards ratio of a severe outcome.
Monica. Can you tell folks what that mean, who don't live in the hazard ratio world.
So, there's been a great debate since Thanksgiving, which is when the South African scientists were amazing. Scientists. I thought God treated not very well because they kept it going on TV saying, this is more mild, and then people would say, ah, let's wait till the UK or the US says this. So was I thought really unfair and these are mine.
Colleagues because I'm an HIV doctor. So I know them, but they kept on saying this fundamental question became. Okay, is Omicron more mild because we have so much immunity in the population at this point. January 2020 to now that are T cells and B cells are attacking that SARS Covey to variant takes a while for the B cells to make antibodies. You may not have antibodies right away. Maybe if you just got boosted, you may have antibodies right away for older. But say you have the vaccines or you've had natural infection. You have your T cells, your B cells, they produce.
Antibodies that attack that virus, they bring down the viral load quickly. They make it less infectious, and they help you do well with the virus. And so immunity. Of course, we'll help you do. Well, this is probably what happened in 1918, when we were transitioning from pandemic to an endemic, had a lot of immunity in the influenza world in the world. However, the next question is also is Omicron less variant inherently than the other strains that we've had so far, the other variants we've had so far.
And yes, it seems to be not just based on the six laboratory studies including to and ex Vivo lung transplant Services, human lung tissue and then also animal studies that show. It can't infect long sells very well Six studies now, but what the South Africa study showed us that I just told you about is that you can distinguish. They did a very good job as very good analysis, distinguishing between immunity making it more mild and also having fewer less very lent and the estimated 25%.
Must very want the Delta above and beyond immunity. So it's not just our increasing immunity in the population. That's making Omicron more mild, but it's something to do with the virus itself likely that it can affect lung cells. Well, and then another study that would verify what I just said get over the weekend was in young children who are less than 5. They are all on vaccinated by definitions. We can't vaccinate those less than 5. We don't have it in this country. So US based study and also they didn't have prior covid infection so they could have had not
Community and severe outcomes in that population is already very low, but severe outcomes with Omicron versus delta. Meaning going to the ER, was about two-thirds less meaning going to the, ER, or hospitals. Ice was about two-thirds last. So, Delta Omicron seems a third at least in young children. I was very own interests Delta. So putting all these studies together and just really made a very big point. I think that Omicron by itself, Beyond immunity is less virulent.
And when I see another question about,
Monica, because you're the expert. Certainly amongst all of us when it comes to viruses, be on this one. Marty and zubrin. And I actually speculated on this, I think, in the last episode. So we kind of came up with at Elia logic idea around. This, is it likely that as pandemics become endemic, they become milder the argument, we came up with is look, its evolutionarily in the best interest of this virus to become less and less virulent as it goes on. And if it wants to coexist with us,
Us indefinitely. It probably shouldn't be killing us. You referenced obviously the Spanish Flu in 1918. As it went from this deadly, pandemic into basically the fluke. The thing that we have every year notwithstanding the genetic drift, that comes with it. If you were to look into a crystal ball, do you believe that the czar's Covey to that? We will live with indefinitely? Which I think there's no question. We will be living with Sorrows Covey to indefinitely. Is it going to be a very mild version of this? That's going to be somewhere between?
All the other coronavirus has and influenza,
it makes sense. And that's been the pattern in history and it makes sense evolutionarily. It's exactly what you said a bowl, is a really dumb virus because it kills its host and a virus that makes more copies of itself, but doesn't kill its host. That's more evolutionary advantageous just like organisms want more children. On the other hand. I would say this and I think this is a very key point because now because this Omicron is less variant. There's now been a lot of
of fear that. Well, we're going to get him more very own variant later. If you have immunity to the entire virus, then even if you do get a more virulent variant that arises not in humans, but from an animal Reservoir, you have a more virulent variant. If you have immunity across the entire virus, like, B cells, T cells and antibodies, which will come down with time. That's okay. That's what they do, but be
Cells and T cells formed across the whole virus. A lot of people have seen Omicron, probably 50% of people in Europe. It's estimated of quarter of Americans. Probably more have seen Omicron. Then you have the T cells and B cells to fight that new variant in the future. Even if it's more real. And I think that's a really key Point. People are really, they're not taking comfort for Omicron being more or less very like, there's a lot of anxiety right now. Well, okay, then what's going to be the next thing if you have immunity?
T across the whole virus then you can fight Zeta that comes out later. If you've seen the virus and what Omicron did is it made a lot of us. See the virus. I mean both FDA Chief and the NIH Chief Nia chief of several going to see Omicron.
Sorry Monica. I just want to keep asking you questions before entering this more into an interview of you. I apologize, but we'll get back to a discussion is the implication then that the immunity acquired Naturally by being infected by Omicron, whether you've either
In vaccinated or not vaccinated but you're getting some additional immunity. How would you qualitatively or quantitatively assess that relative to a person who has been vaccinated? But has not seen Omicron
a very important study and there's been multiple ones of these shows us that if you get natural Omicron infection on top of your vaccines, you form broadly neutralizing, antibodies against all the variants, totally makes sense Alpha Beta Gamma Delta, but importantly your form T cells and B cells.
Across all the variants at me again. That totally makes sense. You just seen the whole virus. It is qualitatively true. I would say that if you see Alma, chronic top of your vaccine that you have a more in-depth and in-breath immune response against the whole virus, because remember the vaccines we have in this country only expose us to the spike protein of the virus. So just one piece of the virus as opposed to the whole virus. Now, then people would say, hey, I want nothing to do with Omicron. I am going to stay in my house right now, and I won't see Omicron.
One thing I've been really thinking about lately is why we don't have Kovacs in in this country, but we don't want to go off on too much of a tangent. But Kovacs in is a whole inactivated very on Made in India, and it's of or traditional vaccine. It may have increased. Our uptake, Cove accent filed for an EU a 73 days ago with the FDA, you get to see the whole virus. So if you never wanted to see the virus Omicron, which again, it's not. Like people are going out and getting on the ground, but just living right now, a lot of people exposed, but if you don't see on,
Kind, I wish the booster could be Cove accent. My new thing is pushing Cove accent and seeing why the FDA is approving it, but I don't want to go into too much of tons of, but I do think that would have increased our uptake in our country, because I'm already vaccines got a reputation. Can I ask a question to follow up on this? I don't know. We know the answer to but you have the whole virus exposure. Kovacs in vaccinated whole virus exposure. Natural infection Omicron, exposure versus a pure Spike protein, deltoid exposure from an mRNA.
Seen, is there a difference in mucosal antibody immunity between those mechanisms because now we have a mucosal virus that replicates rapidly in the mucosa and vairy. Mia is not a major part of its pathogenesis until later. And so that's why we prevent severe disease with blood-borne antibodies, but we might be able to actually make a dent in transmission and infection in the first place if we had more mucosal defense, so I'm curious, your thoughts. What happens is when were exposed to the virus. We do.
Gallup, IGA antibodies in our nose and then those go down with time or if even were exposed to the vaccine. We develop IGA antibodies in her nose, in those go with time. So like you just said, there's a great interest in mucosal mazal vaccines to help decrease transmission, but it is true that if you get Kovac sanur, you get exposure to the actual virus, you develop IGA against multiple parts of the virus. It's just it's what it is. You just developing IGA against the spike protein.
Mmmmm, if you get an mRNA vaccine because by definition to mRNA vaccines, and the adenovirus DNA, vaccines, only give you exposure to the spike protein of source coding to.
And, you know, Monica, this makes me think back to gosh, early days of vaccine call, it March of a year ago was moderna first out of the gate or Pfizer. I can't remember. They basically came out within weeks of each other and then J&J Pfizer was November
9th, and then Moderne was November 16th. There's literally a week
later. That's right. And then
And Jay and AstraZeneca followed shortly thereafter single dose. One of the things I recall that didn't get enough attention and it was difficult to figure this out, reading headlines and abstracts, you had to go through the raw data. Was the absolute risk. Reduction was greater with J&J than both Pfizer and moderna. Again. This was in the original strain, not Delta, and that got easily missed. It makes me wonder if based on what you're saying. That's not surprising, because the J&J.
Scene would have provided a more robust picture to the immune system of the virus than Moderne are Pfizer, correct?
Well, it's interesting. Both Johnson & Johnson and AstraZeneca are adenovirus DNA Vector, vaccines. They show you a different part of the spike protein, which is why mixing them give you more of this pipe protein antigen you see, on engines across a longer piece of this pie protein, but actually I think what happened with the DNA and a viral vectors is they produced a more robust T Cell receptor.
Bonds, then the MRNA vaccines and T cells. Are your long lasting friends? Remember those who've got survive Stars? Cool. Be the First Once Ours from 2003 late, 2002 do early 2003. There are people 17 years later that they have strong T Cell immunity against our scobie. So your T cells are your long-lasting arm of the immune system antibodies always come down. If I add antibodies for every cold I've ever had in my body. I couldn't move because I'd be so thick. So
Antibodies will always come down, but T cells are enduring, and at Rosetta seems to produce and Johnson Johnson stronger, T Cell response. I think it's
maybe worth actually spending a minute on this because I think we can easily take for granted here because of our familiarity with B cells and T cells, and how antibodies work MHC class works. Is there a way that you can maybe explain to folks the difference between a b-cell and T-cell and how they work in response to viruses specifically because this is going to be coming.
Ding, Marty has spoken at length about the idea that if we're going to get into a mindset where your antibody levels are determining the value of your worth, in society. We're in, for a really rough slog. It's going to be weekly boosters, maybe monthly boosters if we're being generous. So why is that the wrong metric if you were to exclusively focus on it? As opposed to understanding how the T cells work, what's happening in your bone marrow?
So like there's no reasonable person to my knowledge, that doesn't agree that SARS Covey to is never going away. So anything we're talking about should be in the context of Eternity here. So why does this matter? What's the difference between these B cells and T cells and how they actually kill viruses.
I'll explain it really fast and simply I hope which is T cells are actually the main arm of the immune system that fight viruses. So for example and HIV doctor so as T cells go
Out, people are susceptible to very severe viral infections their cells. They last for a long time. They're called cellular memory. And then what b-cells do is, they become the recipe book or the template to produce more antibodies, but they have to be aided by T cells to do. So, and so your antibodies which are pieces of protein. They will come down with time. They will come down even after a rooster, say 10 weeks or so, but what your B cells do and we know
Do you develop these cells to the vaccines? Because they biopsied bone marrows from people, that natural infection lymph nodes. From people who've had the RNA vaccines and you produce strong B cells in these, what are called terminal centers. The B cells will, if they see the virus again, aided by your T cells will produce antibodies directed against that tsarskoe V2. And they sit in the future and not only will they produce antibodies, but they will actually adapt those antibodies to the
Variant. They see they see Delta will make Delta specific antibodies Omicron Omicron specific antibodies Zeta Theta specific antibiotics because that's what adaptive immunity is. It's like they vary the recipe based on the conditions. That's what adaptive immunity means. So they B cells will produce antibodies against the variant. They see aided by T cells and then T cells line. The whole virus and directly kill the virus itself. So your T cells and B cells which are formed by the vaccines and natural.
T will last a long time and will enable us to have ongoing immunity to the virus in the future, even different variants if that's lost. If that very simple fact is lost and we then we can be very anxious when new bearing its emergence Ted of feeling calm about it and knowing that the adaptive immunity Works B cells could last 90 years. There's people who've gotten influenza in 1918 and then they found these nine year old hundred year old people. They looked at their B cells and they said oh
You actually can produce antibodies directed against the influenza strain from nineteen eighteen. Ninety years later. B cells last a long time.
Marty. Just give me a quick approval status on all vaccines at the moment. So the Kovacs in is interesting. I want to also hear a little bit about Novak's, but the exact status of moderna and Pfizer their off EU a correct. Those are fully approved today. Are they still under emergency use
authorization? Actually, just Pfizer though, right? I think they're still waiting for the final
Moderne. Divisor fully approved. Modern, it still under
Urgency use authorization, J and J. What is the status of J&J in the u.s.? It seems to be persona. Non grata. Is that official or unofficial?
Even CDC? Has sort of given a preferential guidance saying they prefer the MRNA vaccines to J&J and it Paul often others have speculated that J&J, really always should have been a two dose vaccine as a single dose. It had a lot of Promise initially, but it's looking more like it should have been a double dose vaccine and then you have the vaccine induced thrombotic thrombocytopenic, an issue, which seems to be a class.
With the adenovirus vector vaccines, because AstraZeneca has it as well. And so, for those reasons CDC is given that preferential guidance, and I think it's still under EU a right Monica. Yeah, and you're totally right, Sputnik 5. Also another and no virus DNA Vector. They all have this rare side effect. So it got dirty, even though I think that's interesting because it's still really rare.
Why is it that that side effect? Which is incredibly rare. Basically led to a complete halt Ting of the use of That vaccine.
Whereas the myocarditis that seen in young men specifically under 25 specifically, with moderna doesn't seem to Warrant the same level of consideration, though, by my math. It's more prevalent concern.
I would speculate that. It's a question of severity. So the outcomes of people who get vaccine induced thrombotic thrombocytopenic. I can be very bad to fatal. It's very rare, but it is catastrophic if it happens. Whereas
Myocarditis at least from the early series that we have generally reversible, although requiring hospitalization still terrifying for parents and children, but less of a catastrophic issue, and then there's that whole controversy of which, maybe Marty and Monica can speak to of well, what's worse for generating myocarditis natural coronavirus infection or the vaccine. And this is where datasets seem to disagree, and how you interpret them.
Who wants to take that one. Maybe I'm just looking at the wrong data, but I'm looking at nature.
Looking at circulation. This doesn't seem ambiguous to me. Can someone explain that? That's right. Those studies pretty well, did a head-to-head comparison and found that the rates of myocarditis after vaccination were higher particularly with moderna. And if you go to Europe, parts of Europe, they've basically restricted moderna in anyone under age 30. Something we haven't really talked about much the United States. There's also this interesting idea, the myocarditis from vaccination Maybe,
Different than the myocarditis from the infection itself. There may be more delayed contrast uptake in the heart that they're noticing in the studies of the myocarditis from vaccination. So there's a feeling among cardiologist that it's not the exact same Apples to Apples. Myocarditis. Have you guys heard that as well? Yeah,
and I will say, as you know, let me down as a hundred micrograms visors, 30 micrograms. So that dose difference. Probably explains.
Why it could be more seen with them Moderne back. See it's just literally a higher dose which is why I like you said not used under 30 and so many countries and that I think the best study on this is from Canada that showed that the risk of myocarditis after the second dose is more with a higher dose Moderne and also more, if you have a shorter period between your two doses, which is why spacing the doses has been such a strategy in Canada of
Weeks not even longer between doses.
We speculated on this during the last episode Monica, but I'm curious, if you have an immunologic rationale for, why the MRNA vaccines were dosed at four weeks. Apart. Is there a clear rationale for why that would have been the way to do
it? I think it was just expediency because the trials wanted a hurry. I mean we're in the middle of a pandemic. So they gave Pfizer three weeks apart Madonna, four weeks apart, but you know, I think dr. Stanley Plotkin wrote a
Clinical infectious disease article in January and he's our infectious disease. Society of America. We named our vaccine lecture after him. He really knows vaccine. He was saying we need to space them out. Longer for two reasons, one was to save more lives because if you get T Cell immunity, you can be of limited Supply you want to save more lives by giving people just one dose while your and then give him the second was later. And then the second was he said that in any field of vaccinology and now this has been shown in a Cell people if you give longer time,
Between doses, you get a better response. Not just antibody. Responses increased antibody responses, but fundamentally, what we're talking about is we want to develop cellular memory and there's better T Cell responses. If you space them out the doses by eight weeks or so. This was a cell paper. So Canada is always spaced out dose especially for you.
I knew of dr. Hopkins surgeon a brown-skinned guy, Marty something member dzasta, but he was he was making this point about
About trying to get everybody. The first shot before people got there. S and boy, he really got hammered for that. I mean, he was, by the way, this is both fact and opinion, Monica going back to that point if you were playing the long game, so not the antibody game. I kind of think of antibodies as like a vanity metric. Like you can brag about how high your antibodies are. It's a cool vanity thing. But if you're playing the really long game, what would be the ideal time to give a booster to somebody who has had,
Two shots of moderna are Pfizer. And I guess almost nobody would be one year out from their second shot now because these things only kind of came on board in about January, and healthcare workers in high-risk, people were first. So most people listening to this will not even have been fully vaccinated a year ago and yet many people are boosted suggesting that giving a booster in less than a year is the optimal way to boost long-term immunity, but is that true based on what we know about the immune?
System would we be better off boosting less frequently. How would we think about
that? We have to extrapolate on the three-dose, vaccines from hepatitis B, vaccine, human, papillomavirus vaccine and the longer between the second and third dose has the better mean. Dr. Plotkin talks about this in the CID article. I think what happened here with the booster is that we had a lot of high transmission with Omicron and then the idea was okay, if we give the booster, maybe we can bring transmission down and that's actually all I can see is why?
There were widespread booster recommendations as opposed to more selected booster recommendations for those who are more at risk for severe disease. So I think it was an attempt to increase antibodies to bring transmission down. I'm trying to think of a reason.
What's the efficacy of that? Do we have data on how the vaccine reduces transmission,
it will increase your antibodies. And it could there was a Nomicon peeper that in households. Giving a booster did decrease Transmission in the household setting. However, I
I will say that in any risk versus benefit analysis, and I know you spoke about this last time. What you do is you decide about the boosters based, usually on what it does for the patient, if the patient benefits from a booster to reduce severe disease than, that's when you would give a booster in how we usually do infectious disease, not for this purpose of transmission because later say we get a different variant and virus goes up in the community. We probably won't give booster to
Decrease transmission. I don't
think how long does that affect
blast. The UK study, Marty, and Zubin 10 weeks for made the antibodies, go up and then right back down after 10 weeks. It's just never been done that we could boosters to decrease transmission. We usually give boosters in a risk versus benefit analysis for the patient's. Want to make sure it's safe for the patient. And then also want to make sure that it does something beneficial for the patient, which in this case would be keeping them out of the hospital.
So older people immunocompromised people, people who have medical conditions, may be everyone over 40, you know, something that's helpful for the patient.
So if we were to speculate, I won't single out any of my favorite universities, but if we were to speculate based on the policies that are in place of providing boosters to healthy college kids, in an effort to prevent transmission. The only logically consistent thing to do would be to make sure college kids, get boosters every 10 weeks for the rest of their lives.
Because at least that way we might have some ability to reduce the transmission from college kids who would be unharmed by this virus to potentially anybody in their orbit who could be and of course that ignores what you said before which is this would be a first in class episode of putting somebody outside of the patient ahead of the patient for whom you're putting the booster. Is that a fair assessment. I just like being logically consistent. I mean, I think that's one of my pet peeves in life.
Right. Is like when we say things that are illogical, if we're going to live in a world where we're going to make college kids, get booster shots. They're going to have to get them every 10 weeks,
of course. Now would never happen because we can't do that. We do have to focus in on the but wait, why
can't we do that Monica? I mean says, who can't we do that? We're doing it.
Now, like you said, it wouldn't be logically consistent. And also I think it ignores and I think actually everything that's been going on over the last couple months, especially since I'm a cripple
Time to clear it ignores how well the vaccine to work for the individual? So the staff member the older adult who's teaching the student? I think this is profoundly not recognized is how well the vaccines work for them. Even two doses, certainly three doses if they're older Marty and doing, you'll have to tell me if I think the health care worker study in the New England Journal from Israel. Showed anyone over 50 really benefits from a third dose, even in reducing severe disease. So say you have
a staff member. So you have the teacher, what the CDC showed us just in a study two weeks ago. Is that even the two-dose vaccines, your risk of a severe outcome from covid with just a two dose vaccine across the entire swath of the population, your chance of dying from covid-19 2003. Please remember that, I said 40s and then three and then there were specific risk groups that were risk for severe outcomes. They were older people over 75 with
Comorbidities for comorbidities not only should those patients be boosted, maybe even get a fourth booster, but they should certainly be one way masking for themselves to help protect themselves. All of that putting together means that we have underestimated that. Those college students, if they're around vaccinated staff, members and teachers those vaccinated staff, members and teachers are doing great, these vaccines work so well for them, it can see what were so scared of which was covid, severe disease. So,
I think we are under playing the vaccines, when you just put that to The Logical, conclusion for everyone around those college. Students. Can I ask a question? Because I think relating to this. This Peters proposing is this hypothetical Q10. Week booster that bumps up our antibodies and who, and EMA, the European medicines agency. Just recently said, this is probably a bad idea from an immune system standpoint, but they did not elaborate. So are we talking about immune tolerance from giving the same antigen again and again and again like what's the rationale?
Against doing that they term. It original antigenic sin, but it seems that you see you keep on seeing the same piece of protein that you make the same Spike protein to the ancestral strain again, and again, but what adaptive immunity does is allow you to produce trained immunity adapted, immunity to whatever virus, you see in front of them and they don't want to train the immune system to respond to the ancestral strain,
but it's interesting what she says, Zubin that the European CDC, basically,
Lee said specifically that repeated boosters could cause quote-unquote problems with the immune system and they clearly have some concerns there, right? Even if they're not, well, how can you study something that we have? Not yet done. I mean, there were an Uncharted Territory. We have anecdotally colleagues of mine, and I seen cases that are just raise questions, like, new-onset autoimmune diseases, either immediately after the second dose, or
After a mild, very mild infection in somebody fully vaccinated. So maybe that immune system was revved up. Cause juvenile diabetes in an adult. How often do you see that on day? Two of a very mild infection? Well, maybe that immune system was all revved up. Now. The risk-benefit still favors vaccination. This is not an argument to say hold off on vaccines because there's concerned. This is an argument to say only give boosters if there's a clinical benefit and the frustrating thing.
It is as you alluded to Peter. If we would have spaced out these doses. We might not even be talking about boosters to put a number behind. What Monica is referring to this University of Birmingham, study, Birmingham, UK, not Alabama. Found that the immune response was 3.5 times greater when the doses were spaced out three months versus three weeks. And that was in 175 patients over age, 80 so they develop a weak immune.
It's in general to vaccines. So it's going to be even further magnified in young people. That's why I got my two fives, or doses, three months apart. And the, most frustrating question I get is, I'm fully vaccinated. I just got covid. When do I get my booster or
it's like, I get those questions booster. Yeah. Exactly. You just got the best Booster of all because, what that study showed us, especially the Omicron, but it would be a true of any natural infection is that, you develop profound TB.
B and T cell b-cell and Broad neutralizing antibodies across the whole virus. So that is the best Booster of all, unless you got a callback some booster. So, when these B cells are retriggered, you get another process of what they call somatic hypermutation, right? So, the B cells are constantly undergoing, mutational process to diversify. And so it's almost like if you have natural exposure to vaccine and vaccine and maybe the two doses plus, or minus a booster at that.
You have a diversity of antibody response that should cover a lot of potential variant options. Correct? Yes. I mean there's now actually for papers that show this but the most recent since in Journal of infectious disease, but the best one I think was in science that again if you see a variant in the future say right now, we only know about the variance from Mostly across the spike protein course, the on the crown has 50 mutations across its entire genome. There's 32 is our in the spike protein that you produce antibodies.
He's directed. They evolve the word adaptive, truly means you adapt your own immune system to what you see
switch gears for a second and continued on the path of vaccines. But again, talk about it through a very polarizing discussion, which is that of mandates. And again, I'll sort of ask everybody this question. But what is the best argument in favor of mandates?
I'm going to be the odds. Now.
I went looking for a diversity and I'm looking for arguments in favor and arguments again. So tell me what the
Best argument is to mandate vaccination.
Okay, because Zubin and I had this discussion the last time we spoke and I favored vaccine mandates and he did not and I know that one argument is that the vaccines reduced transmission and that argument with each successive variant has been lessened not just because the variance evade at least I'm kind of eats antibodies more even though T cells and B cells are intact, but because just with time,
I'm from your vaccine. You're not a body's decrease. The transmission argument is become weaker. However, the reason I did support vaccine mandates is because I work in a hospital and there is no doubt that the people in the ICU and the people who are sick are unvaccinated adults. And if our entire purpose of a lot of what we did throughout this, pandemic was to save hospitals, then not having hospitals, have on that.
People when they could have gotten the vaccine allows us to work on other aspects of hospitalization. I recognize this is not a popular opinion, but that was my opinion until this and
people, I'm not convinced. It's an unpopular opinion. I seem to think that has anyone ever done a straw man pole. Is there a Gallup poll on what percentage of Americans favor vaccine mandates versus not? I don't actually know the answer to this remotely.
I think the vaccinated are more concerned about thinking that their vaccines don't work than the unvaccinated which is a very interesting poll that was recent.
Those who are vaccinated are more concerned about covid than those were unvaccinated. People are more fearful. They don't trust the vaccines in a way if they're vaccinated. I think it's a failure, Public Health messaging
that reminds me of an interesting anecdote. I had to negotiate or mediates, probably a better word mediate. A familial turmoil conflict about an unvaccinated member of a family. So there's a member of the family. So is the son of the family. So someone in his 30s, healthy did not want to get vaccinated the parents, of course.
Were vaccinated and they kind of brought me in to mediate the discussion. Why could I not talk their idiotic son into getting vaccinated? I don't have any mediating skills, but I had an insight as I was listening to the debate between them and I decided to ask a very simple question of the father who was particularly distressed at the fact that his son was not getting vaccinated and I said to him I said, what do you believe?
Believe is the risk that your son will be hospitalized or die if he contracts covid in an unvaccinated State. I want you to remember his son was in his late 30s and is very healthy. I'd like each of you to take a guess at what his response was. Meaning, what? He believed the risk of hospitalization or death, could be to his unvaccinated 38 issue year old son.
I suspect you overestimated. It's something like 50% or something
higher. Any other guesses I think is think I saw a survey when they looked at this that something like a quarter of people from one particular Vantage Point felt that the hospitalization rate was over 40%. Yeah. Do you have a guest Monica? What? He thought was his son's fate.
Yeah. I mean even if he said 10 percent, it would be way too high. I mean, he
said 50%, He said 50%. So goodness is guys who I win.
I went
and then I said, well look and it's really funny. This was one of the few times when my I actually had some emotional intelligence because I don't feel like I have a very high EQ and I think my knee-jerk reaction would have been to, like, be you idiot. How could you possibly think that don't, you know, the data
instead? I flipped it and I was like, oh my God, I Now understand why you
are so torn up about this. If I thought my child was making a decision that was turning their risk of
Death in to 50%, I would turn everything on its head to prevent it
and I said, well, let's look at the data. This
is actually his risk of hospitalization or death without the vaccine, and this is his risk of hospitalization or death with the vaccine. There's got a 10-fold difference orders, a log difference. But it, you know, it was the difference between 0.001 and 0.001. It was incredibly small but that feeds to your point Monica, I think which is, I really wonder how many people
Who are emotionally full of anxiety. Need a little bit of a, maybe like a prep course on this stuff. Let's just do the facts again about how deadly this thing is. What's your risk going to the hospital? What's your risk of X y&z? You'd think that we would know that by now, but I don't think that's the case at least based on this one anecdote. Right?
You're so right that. All that data is available, how much lower risk you are when you're younger. And it's a very interesting and different virus in the sense.
Young children are very low risk for severe disease, which isn't true of, for example, influenza, which affects young children in the extremes of age. And it has to do with receptors in noses of young children and also their innate immune system, and how our innate immune system. Probably mediates pathophysiology, but you're right, that somehow people are so not aware of the epidemiology and I will blame Public Health officials also for not clearly laying it out. How much more risk you are when you're older, I
I'll blame Public Health officials for not even putting out this data of how vaccines really make you almost immune to the severe outcomes even to those of covid unless you're in specific risk groups, in which case those specific risk groups really must be protected and they're vulnerable. I think it's a failure messaging. One. Interesting thing. I think Peter kind of put his finger on it here is emotion. So emotion and morality and our moral sort of taste buds. So when Monica says, listen as doctors, we see, it's clear. It's unvaccinated people that are suffering the most in the
And anything we can do from a care versus harm standpoint to ensure that people get vaccinated would be a good thing. And actually, so this is my personal take looking at the emotions of this for mandates. If I could wave a magic wand magically and have every single person in this country that's eligible to be vaccinated vaccinated at a minimal level that prevent severe disease, I would do it. I would do it in an instant because I know the net area under the curve of suffering would be much, much less where Monica, and I have a different emotional spin on mandates would
Be, I see the emotional reactants, the psychological reactance, to a government that nobody trusts and a public health apparatus that people don't trust mandating something, which then generates a response of you're not going to tell me to do this because I don't trust you which then damages our ability to vaccinate in the future or with future pandemics. And that's why I am always nervous about the public health policy tool of mandates being spun around because I worry that it will backfire in a longer emotional.
With a segment of the population that we could reach otherwise with education, like the swedes. They don't have to mandate anything. They trust their government. They've built distrust over years and the vast majority of them are vaccinated. So I think we both agree that we want the best thing for the most people. And then it's just a question of how, to wield the policy to make it happen.
And I think there's something else to dig a bit deeper into that now, obviously we're well out of fact, and now into opinion-based thought, but I just can't think of too many case studies in my life. And this again, goes back to things. I learned in the
Hospital. Marty think about all the times. I mean, all of us have had these discussions with patients when family members are on life support and their brain dead. And you're having these discussions about withdrawing care. And if you go in there in a condescending way, using guilt and shame and Brute Force, the outcome is always a disaster. I saw a quote somewhere. It wasn't even talking about this. It was about something else and it said like, never in the history of civilization.
Has shame and fear forced someone to do the right thing. It was a little more profound than that. It was more nuanced than that, but that was the gist of it. And,
and I think
that's what's interesting to me. Is there something about the Mandate that feels very shaming and very fear-based, and I'm not convinced that that strategy works. And I agree with YouTube and I think that if we could take every person who would be protected by this and get them vaccinated, you would absolutely reduce the suffering to both.
Individuals and to society, right to the healthcare system and all these other things, but I don't know, maybe I'm just naive. I really wish it could be done with honest information. And not with fear. I pulled this analysis together, yesterday. I actually asked one of my analysts to pull these data and then I wanted to make some graphs and we'll show them to folks, but I want to show you guys this, I was sort of surprised that the magnitude of this. So can you guys see my screen? I know the listener will have to look at this in the show notes. But so I had them. Pull up, mortality data.
For people in the US under the age of 35. And I just wanted to look at four categories, besides covid, so motor vehicle accidents, suicides homicides and Drug overdoses, and I looked at the data and I thought, okay, what's the easiest way to represent this and it turned out that just by dividing every one of those by covid mortality. So you would make covid mortality, Unity, then you could look at what the relative mortality was. So if you look at this graph here, what I'm basically showing you is by age group. So the
Under five year olds, the 5 to 14 year olds, the 15 to 25 year olds at 25, to 35 year olds and the y axis is showing you how much greater that cause of death is then covid for that individual. So, for example, when you're looking at motor vehicle in the under five year olds, it's like 11 times greater homicide is almost 10 times greater and drug overdose, which seems hard to imagine, you know, they're probably accidentally taking Tylenol or something is two times. Greater fortunately. There are no suicides in that bin.
As you go higher. As you look at now 5 to 14 year, olds motor vehicle accidents more than 10 times greater mortality than covid, suicide. This is the most tragic to me in 5 to 14 year olds. The risk of suicide is six and a half times greater than that of covid. The risk of homicide is 5 times greater and the risk of a drug overdose is the exact same as that of covid. And now, you look at 15 to 24 year-olds. It's basically across the board nine to ten times.
Greater risk of death in the United States, due to motor vehicle accidents, suicides homicides and Drug overdoses, and even in the 25 to 35 year olds where we're now seeing. Hey, I think the adjusted number is six point nine deaths, per hundred thousand. You're still seeing a drug overdose. That is six and a half times higher than that. And then when you look at motor vehicle accident suicide homicide there more than two times that I guess. I'm keep coming back to this thing about
People are so
phosphorylated about young people not being vaccinated and this comes back to my point about being logically inconsistent. If we're going to be this phosphorylated about a 30 year-old, not being vaccinated. That's fine. But then, I expect you to be seven times more phosphorylated about how many of them are being killed by their own hands by the hands of somebody else by drug overdose or in a motor vehicle crash. Isn't that the right thing to do? If we're going to get so phosphorylated about a
Thirty-year-old not having a vaccine especially when we've already established with this variant and the variants that are to come. It doesn't necessarily prevent transmission all that much. So we're really talking about the risk to the individual. I just think we need to get very upset about a lot of other things. Gosh. That's so compelling, Peter. I mean, what you're showing is, basically that motor vehicle accident independently each separately suicide homicide drug overdoses compared to covid, just blow covid out of the
water, not even close. These are the major public health threats facing young people. That doesn't mean that covid-19 concern. It just shows how we have had massive blind spots during this entire pandemic. People. Don't just die of covid. They die of depression, and poverty, and hopelessness, and alcohol, and stress, and deferred Cancer, Care and drug abuse. And that is the broader perspective. That's the context that I think we've lost, and if you remember,
When Joe Rogan had Sanjay Gupta kind of joke around and say on the witness stand, but it was on his podcast and he pressed Sanjay Gupta. He said, do you feel good that you're immune about your immunity your vaccination status. Do you do stuff and he started parading around? Yeah, I think people should feel good about their immunity and I mean 50 or so. I'm healthy. I'm vaccinated. I feel good and he said well, so you're not concerned about covid and basically said, I'm not concerned because I'm vaccinated and then
Rogan points, out the data that a young unvaccinated healthy child. And that's an important stratification, because the death and hospitalizations are significantly clustered and kids with comorbid conditions. And those are the ones that should be priority for vaccination. But for a healthy child, the risk. Stratification is different. And he said, you understand how your risk is still greater than that of a young child unvaccinated, and he's not suggesting. We don't vaccinate kids, but he's saying, do you understand how parents are
Not that concerned. Just like you're not concerned and I think he was trying to elicit, this sort of perspective that there's a lot of threats out there. Let's put them in context and I don't know who you're the parent. Was that asked you, that thought there was a 50% risk of their 30-year old healthy child. Getting vaccinated getting covid forgetting Co was it Sonia Sotomayor by any chance? He can't disclose my patients. Sorry. Marty. Okay, whether it was her somebody else.
Else the risk from covid net. From the cdc's website is the risk of all people in the United States unvaccinated. Getting hospitalized is 65.9% hundred thousand per week. And that was roughly at the peak of Delta that ended up being about one in 1500 people in the population. Now, that one person is not a young healthy thirty-year-old in general. They tend to be the profile that Monica was
Adjusting. In other words older. So we've never really talked about stratifying by comorbid condition and to answer your question. I think immunity requirements makes sense. I think in health care for those who are patient facing. I don't think it's the same calculus for an accountant who's working by home for the hospital. We've been sitting stagnant at 85 to 86 percent of the adult population in the United States vaccinated for a long time. And what I think happened is
All these discussions of the mandates, hardened, a lot of people and a lot of these immunity requirements do not account for natural immunity. So, you have a hospital system in Washington, state. They're in Tacoma and Olympus. It's called multi care, and multi care, laid off, 55 staff for not being vaccinated, and that's on top of the people who left before the vaccine, requirement took an account. So, a lot of these people had natural immunity healthcare workers, as, you know, especially at risk and more.
F natural immunity. So they were working on a real skeleton crew. And then what happened is they got more patients as you always do in the winter viral season, a lot of them with covid, this skeleton crew was so short-staffed. The hospital asked, people who called in sick with covid to
come in back and work. In
the hospital in this is a memo. This is reporting from Jason trance where the memo is online. I tweeted at the other day and it says basically even if you have symptoms, if you
I've tested positive come back, unless the symptom is fever. Then they told the managers. Hey, when you assign these workers, try not to assign them to people. Immunosuppressed. If anything try to assign them to patients, who have covid, the covid staff, take care of code patients. I mean, this is the insanity of blanket policies. Hardening people, requirements that do not account for natural immunity. Ironically, the state had this harsh few exception, no exception vaccine.
And a in Washington state. Well, a lot of the snowplow workers, it work alone. They drive a snow truck and they were fired. One of the main highways in Washington state than got snowed. It was undriveable. So the county can attest County offers to then plow this road for the state. The state should be plowing it but they don't have enough drivers snow plowers. So they offer to plow it. The state says, no, you're not allowed to because your snowplow workers do not have the
Vaccine mandate, they're not under their axiomatic. This is the lunacy of the hardening of the positions. Around this mandate talk. So Monica, I want to bring it back to you because I really do want you to help me except vaccine mandates. I respect you so much. But as you can see, my bias is that they're not logically consistent and their bad policy. So, in light of Marty's story, what's the case for why we should be mandating a
vaccine. It's fair and I learn from everyone as I feared.
I just heard, I mean, I definitely think we cover e or having had natural infection has to always be taken into account always. And so, for example, there's a steady soon to be published. They already actually published this in the med archive. So I won't say anything that we don't know. That healthcare workers were equally as likely to be reinfected if they had been vaccinated versus had natural immunity. And severe disease was equally as protected, so recovery immunity always has to be taken into account.
Count for any mandate. I think that our country is unable to have nuanced about covid. What you just did and showed us the differential risk of code in The Young and the old was so powerful and yet our country more than any other country has kept schools closed in only certain political regions have, in a way. Restricted the young more than the old in this very strange backwards.
In a way that Europe didn't do without that lack of nuance. Maybe I was saying vaccine mandates because we seem to have unable to have non shaming. Nuanced conversations in this country. We will have a lot to do. After this to figure out why we allowed healthcare workers to not drive the conversation about covid. And we allowed people who don't have a lot of expertise in a way to drive the conversation. Maybe that's because of social media, or maybe it's politicians or political.
But I just know that I lived through HIV and I continue to because I'm an HIV doctor and never did someone with few credentials, could drive the whole conversation. So I think it's a very complex topic. It's done. The supreme court has only said for healthcare workers. So I feel like they absolutely made a decision together. That vaccine mandates aren't going to be
over. The reality of it is the mandates are still happening. I have a previous podcast, guess. And this person will remain nameless because I've spoke with them last week, and
They said that they would prefer. I not tell their story with attribution. They're fine with me telling the story but not without tribution. This is a person who is a professor at an ivy league university who does really remarkable work. I'm not just saying that because I interviewed them on the podcast. I interviewed them because they do really remarkable work. This individual was fired from the ivy league university for not getting vaccinated. The point being is the University could have its own mandate program.
I'm absent, the federal government. This person was fired in November of last year in 2021. I read an article today. I believe said I don't get the number right? This is a conservative. I think it was 150 of the Fortune, 500 companies in the US are going to continue with mandates, even in the context of what the Supreme Court said. So in other words, I don't think this issue is over because of the Supreme Court. It sounds like States may choose to do this. I mean, certainly the states, like, California, New York.
Maybe still deciding. Hey, we're going to create our own mandate. So I don't think this issue goes away. I would do want to ask you about something that I've never heard a straight answer to my resume and I discussed this. So, I don't know if you guys Marty's even have thoughts. Since we last spoke about it or Monica, you have thoughts to interject. Natural immunity seems to be this taboo word. If you say the words natural and Immunity juxtaposed. It's like you're not on the covid team. You're on the what do we call ourselves? The covariance your Covidien as a
Opposed to a branch Covidien. Is there a technical challenge in determining? If someone is naturally immune, again, there's no other example, I can think of in the entire world of virology, when natural immunity isn't a good thing. Why is it with covid? We've decided it's irrelevant. It's as though it doesn't occur. Is there an operational reason for that? That it's too hard to measure or that somehow the antibodies when you're naturally, immune are not amenable to our
Test kits. Like I know that that's not the case, but I'm trying to come up with some reason why we've decided natural immunity does not count
the no other place does this. So it's a u.s. Thing Europe, almost every single country now to me that he's taken into account and passports and whatnot. So, I think we have to cut this short and say something political in the US but doesn't have, can I speculate one thing that's been speculated before? And I'm going to use a word that you would think wouldn't apply to.
Science. But it's called religion. So in a way, what we've done is we've created a god-shaped hole in our society over multiple years of secularization, which is that's all fine. But what's happened now is you have a situation that polarizes people almost the way a religion would. So look at the natural immunity vs. Vaccine immunity. It is a sanctity versus degradation issue for people of Purity issue. So if you're a Covidien and you're in the thesis camp and you're like, no vaccines are the answer we get through this through vaccine-related immunity.
You are unclean, unpure, undesirable and unwelcome. If you are not vaccinated, if you've gotten the disease previously, you already have a strike because you didn't mask up, you didn't distance and you are unclean. So I think people will never say that, but they will feel that innately especially when it's reinforced by mass media and culture at work and so on and so forth. Now, on the other side, there's an equal religious fervor. And that is this. Holy sacraments of hydroxychloroquine.
And Ivermectin and the conspiracy end times Revelation. Aspect of these guys are trying to hide something from us poisoning Us by injecting our holy temples, our bodies with vaccines. So both of the sides on this that are polarized have a religious aspect to it, I think. And that's why it's been so hard to understand why this is going
on. First of all, that is a really interesting insight about the shame of having got covid early in the days, right? Because if you're riding natural immunity from 2020,
I mean, you must be a filthy person, right? You are of low moral character. If you dare had covid. I mean, I actually know somebody, my brother. I'm ashamed to admit. This, my brother had covid in q1 of 2020. Can you believe what a
shame? He
is a filthy human being, or having let himself come into contact with someone who went to Florida in 2020.
Yeah, I think I love him. I would go so far. So Micron is actually D stigmatizing though. And that's good in a way, very highly, transmissible respiratory variant. It can't be eradicated. And like you just said at the beginning, Peter. This is now being recognized Now by almost everyone. I don't think, and it's not shame. It's not that we weren't good enough. It's not that we weren't Masky enough to highly transmissible respiratory variant with animal.
As a pre-symptomatic period, a long infectious period and non sterilizing immunity to the vaccines. All of that means it cannot be eradicated but it can be made in dumb. It can be controlled and since everyone's realize that now and now we're in this phase where people are converging and saying the same thing when they used to say different things. It is the time where the shame of getting pathogen is being destigmatize. I think you said being an agent, you will I really revolt against giving shame and stigma.
Nothing getting an infection. We used to hate people who did that in HIV in the early eighties. And now those same people are stigmatizing and shaming people who get a virus, but it's okay because everything is changing now. And I think there's a convergence of thought
so what are little bit about masks because again, I think what's nice about this group is we have different views on things and Monica. I know that you're going to make a good case for why people should be wearing masks. So let's just start with the facts. What do we know today about?
The efficacy both at preventing transmission and preventing the receipt of the virus, whatever. The right way to describe that is, right, protecting you versus protecting others. When it comes to the following groups of masks and 95 and cayenne 95. And if there's a difference between them, please tell us. Secondly, a surgical mask, third a cloth mask. Can you comment on those three categories of masks and in the two domains, which is giving versus receiving virus.
So actually
Lee. I've had a very consistent position masks. My first podcast was Zubin was that cloth masks seem to reduce the severity of illness and then there was some NIH studies that showed that actually it's probably the humidification of are when you're wearing a cloth mask that reduces the severity of symptoms. However, we're in 2022. The best way to reduce the severity of symptoms is to get vaccinated. Which one would I rather do where o'clock mask my whole life or get vaccinated? That is
On out the window because that was a very specific utility for cloth mask for the individual. That's gone out the window now that we have vaccines. So, this is how I feel about mass. Now. I have a very clear opinion. There are certain masks that seem to work best for the individual. We cannot be mandating mask mandates for the whole population anymore. Because transmission doesn't seem to be reduced by cloth. Masks doesn't seem to be reduced by even Surgical.
Cool masks unless you really tuck them in and double Loop them until for the South people, use them. So the Bangladesh, randomized, controlled study of mask was reanalyzed by a group at Berkley and cloth, massive surgical masks did little for the population level. But what a mask does is it one way protects you. And so what I would do, if I were the cdc's, I would say the right masks which are n95. Can 95 SKF 94s F of P2 s double masks or even tucked in surgical mask, put them on their website, which they did the other day.
And say, hey population, anyone who's worried about an exposure. Please wear these type of masks. There are some people who want no exposure to Omicron. There are some people who really feel protected by their vaccine, and even if they have mild symptoms, they feel okay about that. There are some people who have no risk tolerance there. Some people who have high risk tolerance. You can't mandate for the whole population. I want my father to wear an n95, because he happens to be getting chemotherapy right now and he's 87. I want my child who's low risk and pull.
We vaccinated I don't have risk tolerance for him. So it could no longer be mandated. But if you tell people, the right type of mass and one way masking works that a teacher in a classroom can wear the right type of mask and the students in the classroom. If a parent feels concerned, they can put that mask on their student on their child. And a parent is not concerned after they've been back seat, already been not vaccinated then they don't have to wear that mask. So that's where I think we are with mass One Way masking.
So just to be clear is the implication of what you just said. Monica that the
Masks don't prevent you from transmitting, the virus to someone
else. My interest in clock mass and my interest in masking work for the individual for reducing severe disease and I think we do have that data. Now from the NIH with humidification of are however the Bangladesh RCT mask study which was published in science has now been corrected because the raw data got put out and so three groups looked at the right data and it didn't look like cloth, mask, reduce transmission and even surgical masks.
Actually was much less than originally said in the interpretation of the Bangladesh, RCT in villages. Probably if you maybe, like, tucked it in and double looped it and like really sucked at your face. You can make surgical mask work better because our polypropylene material, but at this point we are this far into the pandemic. We have vaccines. There are some people who want to wear masks and never have a risk. There are some people who don't and are okay with having a mild infection or getting exposed because they feel secure about their vaccines. And I think the entire
Your equation has changed with Mast. No tolerance for my father getting exposed because he's getting
chemotherapy just to be clear. Monica, when you go and visit your father. You're going to wear a mask as well. I assume I mean I can understand why he should be in the Cayenne 95 or n95. Yeah. Do you wear one then to go and see him
haven't seen him since he's gotten his third dose of chemo. But when I see him, I will see him in a couple weeks. I'll either test and make sure that I'm - before I hug him or I'll wear a good mask on.
I'm waiting for the test. Of course, I can't expose he is in that category where he can have a severe break through. Yeah.
So the implication is that the mask, he wears a mask to protect him and you will wear a mask to protect him.
I will do that. But the point is that in where we are with that scenes, that may be my choice, but it is a difference between a mandate and I'm telling you I'm in a state that mandates not. So I'm really saying this very clearly if we can tell people.
The right type of mask to protect themselves. Actually his mask will protect himself. I may not need to wear something because he's in 95. Protects them. Just fine. It's why he is right now wearing and 95. When he goes out to the grocery store, his Mass, protect him. If you tell people, the right type of mass, they are going to be people for the next three years. Who wear those right? Type of masks for themselves everywhere. They go. I don't need to wear a mask to protect him.
I'm really pushing on this because on the last podcast,
First, I was very vocal about my personal choice, which is I don't wear a mask. I never wear a mask. Luckily. I live in a state. That is what can I say without offending people free. And so we don't have to wear masks anywhere and very few of us choose to kids, don't wear masks in schools. It's just, it's a free-for-all here in Texas and the amount of
hate mail. I got for that statement
was boy.
I'm surprised by that
in a cute way. I couldn't.
Leave. How many people got so angry at me for not wearing a mask.
They must be aware of data. I'm not aware of no. No, the data is very clear. Now, at this point, because we've had two years of data on masks and I have been a huge mass proponent until the vaccines came out. So I was really, really in Manassas. Like all people would interview me about. It was
hoping you were going to smack me, silly for not wearing a mask because I want to hear the case, right? I want to
know at this point. I would actually advise people to look at Joseph. Allen's work.
Shira Donna's work. One way masking works. We have vaccines anyone who wants to wear a mask. Should anyone who wants to know exposure should and it should be specific type of mass. Those six that I just said and that can be for a child that can be for an adult.
Can we recite those again?
OK. Yes in 95 scan, 95 F FP 2. S KF 94s a double Mas with cloth and surgical or the final option is actually a cloth masks.
A surgical filter inside a filter inside. That's polypropylene material, that probably the most comfortable option. So, cloth mask with a filter inside, whose of all been studied, very well. They all protect the individual, and if I want no exposure, I can wear one of those masks. I want my father to have no exposure, you can wear one of those masks. But if I am comfortable with having some exposure because I'm fully vaccinated, then I don't have to wear that mask and that's where we should go to in this country. And again, I will refer everyone to Joseph.
Holland's work because he has been working on covid mitigation for this entire time. And he wants one name asking now and so do I.
So what's the group consensus on how long people will need to wear masks on airplanes and in airports and in federal buildings and in places like California, California, I think they're going to start unmasking in 2050 for General, but
I will say, I live here. Everything is changing. There is the acceptance of end.
The city is now being talked about at very high loans. So the by an Administration task force advisors wrote a piece in Jama. Just two weeks ago. It was similar to P side written in time. That said you have to accept that we have to live with covid. And so I think there's going to be four things that happen that are different now than before. What used to happen in the world. We have to protect ourselves from respiratory pathogens. As a whole. We're probably going to always facts need we need better treatments and we need more of those
Hence, the third thing is probably going to be more attention paid to ventilation for all respiratory pathogens. And then finally, there will be people and there will be recommendations by the CDC that anyone who wants to mask can wear those six types of masks from now on. But I don't think it could be mandated and I don't think he'll be mounted in California after February 15th, nor do I think it will be mandated in travel after March or whatever date. Biden has said
that is fantastic news to hear.
One name asking works. It's like your vaccine protects yourself, your mass protest.
Yourself too and for those were very concerned. I'm so happy for them that we now have such good data on which Mass they should wear, including my father.
I was doing some video work last week for documentary that I'm doing and everybody has to get a covid test, right before and everyone has to be negative. So, you got a whole group of people that just had a PCR test, that demonstrates their - we're all on this very small intimate set. And it's one of these things where I have to talk directly to a camera, which I can't do. I have a real block when it comes to talking directly to a
So the only time I can talk to a camera is when I have this thing called an inheritor on, which allows me to look at a person's face who happens to be sitting next to the camera. So everybody on the set is in a mask, except me. I say to the woman who's in the intera tron, who I'm supposed to be looking at. Can you please take your mask off? Because the whole purpose of me being able to look at your face is to be able to read your facial expression so that I can be speaking to you properly and she said, well, I don't think the rules allow me to take the mask off and I was like, but everybody just had a negative PCR test. I
I think everybody's vaccinated here as well for what it's worth. Why are we wearing masks? Oh, and by the way, you're about six feet away from me. It was just like part of the rules of how this thing had to be done. You sort of know. I know a little bit about my personality, which is just how logically inconsistent things. Really are a challenge for my endothelial function via my blood
pressure zooming. You brought up the idea of religion. I mean you brought up the idea of secularization in a society leading to almost semi-religious.
Reefs around different topics and masks have become one of those in this country, but the data is super clear. The I think you nailed it. So Peter, you are an impure etre. There's again, of dirty sanctity, issue that comes up where people who are very conditioned about masks, who don't see it. Logically feel it emotionally, and they see someone without a mask, and they feel like this is a dirty person coming to invade the sanctity of their body. And this is how we've conditioned people. Unfortunately. Like the way Monica talks about masses, how I feel about Mass. It's now an individual.
Ways and it's great like for my parents who are elderly with multiple comorbidities, absolutely, but the logical inconsistency. Let you know, I have people in my studio where now four feet three feet across from each other talking. Very loudly were all vaccinated. We're all comfortable with our risk, even in the setting of Omicron where again, the great shaming mechanism has been leveled. And so hopefully some of the religiosity starts to dissipate but I wouldn't hold my breath. I think it's going to take some time.
Marty. Do you have any sense of how many children in the United States are still being mandated to wear masks at school is
The majority or minority at this point, I would say it's the majority. I mean it's up to local school districts in many states, but I would say it's a majority. And unfortunately, a lot of them are wearing the cloth masks. They're getting all the downside of hiding, their faces, not learning, how to read facial expressions, all those other things and none of the supposed upside. Now the benefit, we talked about that Brown University study that talked about significant cognitive and motor delays in children that can only be ascribed to the loss of the human connection.
When you look at the risk stratification and kids, it's just a whole different ballpark as we've talked about. And honestly, we are now using policies designed around beta and Delta in an era of Omicron, which is behaving very differently. So, what happens when Omicron is essentially gone and now we've got a wave a year from now, but it's parainfluenza or we have a rhinovirus wave, which we have every year, then what are we going to cover their?
Says again, so they're basically covered K through 12. And then of course, when they hit universities, are going to have to wear a spacesuit or something. There is a study that just came out since we chatted last time, maybe Monica, you refer to this, but the proceedings of the National Academy of the Sciences on masks that looked at, in 95s with a nose piece and 95s without a nose piece and a surgical mask. They didn't even study cloth masks. I think because they recognize there's no value in it. So what they found is that if you have an infected
odd person with direct contact with somebody else for 20 minutes, the risk of transmission with surgical masks was 10.4% with an n95 without a nose piece. It was 4.2% and an n95 with a nose piece. In other words, a good seal 0.14%. So that tells us a lot that tells us that not only if you're infected and around somebody you can significantly reduce the risk of transmitting but it also tells us that
The quality of the Mask matters. Now, why are we learning this two years into the pandemic from a public policy standpoint, which is the perspective I've come from and I've had to dive deep into the Immunology of it. But really public policy is always been my interest and what we're seeing here is a complete absence of fulfilling, the role of providing data to the public by the NIH and CDC. So for two years with their gigantic budgets, they couldn't do this basic stuff.
Dion masks. We're learning it on the very tail end of the Omicron wave. I mean, this is why we have so many political arguments about it. And I think given where we are, we need to, and I would encourage people respect people with their opinion on massive. You see somebody wearing a mask. Don't make fun of them. We need to respect each other. I saw someone playing golf by themselves with two masks. On my immediate reaction. Was that person lives with a lot of anxiety, but you know what, let them be. We got to get away.
We don't want kids bullying, each other. We want your
way that anxiety has. I mean, it's so deep in our society right now because of how we messaged are covid, but I feel a great deal of compassion for people who feel that degree of anxiety because facts isn't going to change their mind and you have done a fear, not facts messaging instead of a facts, not fear and I feel great compassion for people who are so scared right now.
So Monica, I know that we've only
Got you for about another 10 minutes. Luckily. The rest of us here, can keep going because there's so many other topics that people have asked about one of the things that people did ask about that. I know you are an expert in. And in fact, your institution is now doing a clinical trial that actually tried to get somebody into. I want to talk about long covid. So can you tell folks technically how we Define long covid and give us any other insights you have as to what it's about, what the incidence is, what the potential for treatments are and anything else that you think is Jermaine?
So you're right.
Institution. I'm not in that City, but are at UCSF, has a great study on pose too. Cute Stars Covey to sequelae and essentially, actually it's true of any severe viral infection. If you have severe viral infections, you can get lingering, symptoms, influenza included, and the pathophysiology seems to be twofold. One, is that if you have no immunity to the virus, it can go. Multiple places. Won't stay in your body long term, like it.
HIV. But it can go multiple places. That's one mechanism. And the second is that you are innate immune response. If you have no immunity to the virus can lead to inflammation. That lingers, luckily after vaccination two things happen or after immunity, after you've had the infection before you get adaptive immune responses. So quickly when you get the virus in your system, like you're having a mild breakthrough infection, your immune response swoops in there actually T-cell Island.
The nose, despite the antibodies going down there to Solomon Islands in the nose, your immune response actually swoops in makes that virus, not go everywhere. It's usually why the Breakthrough infections are mild and up in the upper respiratory tract. So you've just lost one pathophysiologic mechanisms by being vaccinated or immune because it doesn't go everywhere. And then this second is it's not your innate immune response that reacts it to your adaptive immune response. So you don't have that kind of massive information that can occur before a community. So there was just a study this
Morning in Israel that those who are vaccinated, don't get long covid, symptoms. After having a mild breakthrough. In fact, they have long covid symptoms at the same rate as people who've never had covid at all. There's people who have had a lot of anxiety and depression during this time understandably, and that can be mistaken for long covid symptoms.
I don't care was aware that Monica you're saying that there are people who are being quote, unquote diagnosed with long covid, who have never had covid. And it's really just a manifestation of anxiety.
There are some studies that what's
On in the world right now. And how miserable everyone is, is making people have less cognitive function because it's just a miserable time. But this very good study just from this morning and essentially shows us that if you've had two vaccine doses that you have fewer long covid, symptoms than people who have never had covid. So basically vaccination both brings your long covid symptoms and check so getting vaccinated for long.
Covid is one way to treat, lung covid. And then also, those who have mild symptomatic, breakthroughs who have been vaccinated, don't seem to get along covid symptoms. There's basically three studies that show this now, including one from Israel this morning. So putting that all together, the biggest fear of the fact that this virus is endemic and not going to be able to be eradicated among people, who are getting mild infections are, could they get long?
Covid symptoms and there hasn't been any evidence of that and we have a lot of breakthrough infections to Delta and now through all the crime. And these are very good studies. That shows our adaptive immunity prevents us from getting these longer symptoms. So I think that's very good news for long covid.
Do we have a sense of what the incidence is of long covid in presumably the unvaccinated, which is the majority of people that it's being seen in
it depended on if you had severe disease.
Or mild disease. So, those who had severe disease. This is a very good nature study. You're more likely to get longer symptoms after that and it was about 30%, if you had mild disease, it was very low. So it really depends on your severity of initial infection. However, this point we have so many people have been vaccinated and we have so much natural immunity that are long covid population is going down and we're still treating because I know this from the clinic people who had initial severe infection before the vaccines were available.
And the reason I'm
To in this question is as we've all noted. There's still a substantial portion of the young population. That's not vaccinated. So Marty you said about what 15 percent of Americans are unvaccinated, is that right? 15% of Americans over five years old are unvaccinated, over 18 and about 20% over age 12. Okay, so we could do the math on that. In reverse engineer, what fraction of people aged 20 to 40 or unvaccinated really, to me that might be one of the more potentially compelling reasons to
Be vaccinated if you're otherwise young and healthy is to mitigate the risk and the downside of long covid. Is that a fair assessment?
I agree. I mean, not only does vaccination help you, not get long covid if you get Co head, but also it seems to be able to treat lung covid because you were more dysregulated. Immunity goes into more adaptive and organized immunity. So again, I think it's profoundly important to say vaccination helps long covid, either a
For the fact or before the fact. So, adaptive immunity seems to be the way to get to all roads lead to where we need to get to with this virus, which is having a lot of immunity to the virus. It's why, before in 2020, we don't have any weed be the virus and we will watch more nervous. Now in this stage of the pandemic. We have so much more immunity the virus. Again, 79 percent of people in South Africa, even though it's a 25% vaccination rate. There's a lot more immunity in the world and then that relates to school. So I think
say a little bit more about
that. Again. This is kind of facts not fear versus fear not facts messaging, you really win over for us. How much lower the risk is among the young, especially children for severe covid and it has to do with there's clear mechanisms by why children are less likely to get severe covid with these two receptors and their innate immune response and that's true Blanco, but as well, so all of that put together, we have to refocus our
Is now on schools, not being a place of fear because I think what Marty just said was really significant to me. That there will be parainfluenza, Rhino, virus, influenza. There'll be other viruses that cause infections from now on. And we have to think of children's holistically as the place where they need to learn. I think that ill effects of school closures. I became a very few people now who deny them, two years into that pandemic.
They all effects include mental illness, anxiety, depression, eating disorders, and learning loss. And all of that put together means if I were in charge of the mission, I would put my emphasis on schools because children are most, I mean, any society is from the beginning of history is the most precious resource. So we put a lot of fear. We ask children to shoulder a burden for older adults. And we have the vaccines and we've had the vaccines now for a year. We need to now move towards
Malady for children in schools. You see it like Harvard just said, they're not going to do a systematic testing or contact tracing starting in the spring semester that we have normal College. Johns. Hopkins is still not having normal College. Some colleges are going normal. Some aren't Harvard being ivy league. Hopefully, we'll have an emphasis on others. Maybe Joseph Allen being. There is helpful for the one-way masking argument, if you want no exposure where your but mask. So you're seeing things change.
Will they still be requiring
boosters? They just announced
just over this weekend that they're going to have normal school in spring semester.
I'll need to see the fine print on that because I still, as you can tell, it's a real bone to pick with me. That were mandating vaccines in anybody, but boy, especially in college kids, and then to mandate boosters, I'm struggling.
Yeah. Yeah. So fair enough, I will say that. The idea that college students mean, Marti wrote a really putting a piece on this, but the college students to be more restricted than all those adults in the restaurants and bars and Sport.
Venson, it would be the college students. That would be most restricted. It was a very poignant article and Harvard of all places saying we're gonna have normal school in the spring semester and accepting that we can't eradicate the virus. For me was very hopeful this
weekend. Well, Monica, really appreciate it. Thank you for making time today. I know you have to run Zubin and Marty and I will have a lot to continue talking about, and we'll try not to talk about you too much, and you're crazy being on.
I will tell you that.
That we just talked about this entire podcast was based on data, and I think it's good. We don't use a fear, not facts approach, but data is the only way to get through this pandemic. We knew this in medical school the whole time, but it hasn't been data-driven in a lot of cases. It's been fear-driven. So, I hope we can change people's minds with the data
likewise. Thank you Monica.
Thank you very much. It was great to talk to all of you. Thanks, Monica. Great to see ya. Thank you.
So guys, one thing I want to build on that Monica indirectly.
Loaded to write, which was the importance of keeping kids in school. He kind of reminded me of, we're going in the Wayback machine now, but you remember in spring summer of 2020, when Sweden didn't lock down and everybody looked at Sweden as though it was crazy. I have not gone back and looked at Swedish outcomes. Do either of you guys know anything about how the situation shook down.
I think Marty has more data and I have more anecdote. So maybe I'll start with the anecdote and then
Artie can fill in the blanks. So I get a lot of messages from swedes recently. Got a really good detailed, one of somebody who's not in healthcare, but who studies this stuff in general and said, remember I think a lot of this that we're talking about we have as people failed to see context where it context is absolutely crucial. And so putting Sweden and context. You have a Nordic country that actually over years has developed a relationship between its population and its government. That is trusting and it took a lot of different approaches to
That their Healthcare Systems a certain way their Public Welfare systems a certain way, and they have a certain type of population. A lot of whom live in single homes. It's easier a little bit to distance things like that. So that all being said, they took attack that said, okay, large events, large Gatherings, there were rules about that. So it wasn't just like Let, er, Rip in the early days, but their Public Health officials, I Condors technology. These guys were saying, listen in those days. They did not know when a vaccine was coming. It could have been years. So they said, we need to design a
public health approach. That's going to be a long game approach thinking years. So they said we cannot shut down schools and they did not if anything for like, a period of a couple weeks. It was never months there. Early on what they found was. They did have a higher mortality per capita rate than their neighbors largely. Because the one big mistake that was made early on is failing to protect nursing home patients, who are the highest mortality? Highest risk in the early days after that though. So 2020 in 2021, it seemed the data.
Shifted to where actually know their excess. Mortality was not higher than their neighbors, and they actually did quite well, they continue to have trust, although there was a little bit of controversy and overall. They've stayed mostly opened. They had some businesses that suffered that the government directly stepped in and paid salaries and things like that. So there was more of a social support network, but they really were playing the long game and it seems like so far, they've done quite well, so, Marty, what are your data points on this?
Yeah. So Sweden is a fascinating case study because
As they took a radically different approach. And while there was early criticism of their strategy. Nobody talks about them since that time and it turns out that their data are very impressive. So the total population rate of the mortality per capita in Sweden, all in all cumulative. This entire pandemic has been one in 663 Now by comparison in the United States, it's one in 387. We're talking about a radically different.
Friend confirmed deaths per capita rate now. That's according to statistical. And if you look at where Sweden Falls it's around the middle. But remember most of the countries in the bottom half are not reporting. Reliably Burundi is you know, one of the lowest mortality rates in the world. They're obviously just not capturing a lot of cases. So it's a fascinating example of what happens. If you do a selective protect vulnerable people strategy,
And then figure out a way to continue living life. Now, the real question is, what is their excess mortality from non covid deaths in the United States. There's a suggestion that excess mortality. You may have seen this report. Come out, is somewhere in the range of 20% higher than the covid mortality rate. So there's been something, like, last year, 385,000 covid, deaths in 2020, but the total excess deaths that year. We're about four hundred and thirty thousand.
Things like that. So there's some explaining to do there and no one's taking a deep dive yet. We know about some very broad statistics on opioid or substance abuse desk, but if you go to the cdc's web sites and this is where the politics that I may be playing in or just government incompetence. Good luck, finding numbers on suicide during the pandemic. Good luck finding numbers on substance abuse. Their very crude their broaden, their early. They're more delay than they need to be
one thing guys that this guy mentioned to is that their degree of vaccine up.
Take in 2021 is quite stunning. They did a very good job because they already have an eight levels of trust in public health officials. It was public health officials like onder's who were doing the messaging, it was not politicians during much of covid. So they did very well in 2021 probably partially because they got to vaccine. They've never focused on masks and they did focus on protecting vulnerable. Although there was an unspoken sort of idea among their leadership. It's felt that they were willing to sacrifice some old and vulnerable.
On to keep society as a whole running and younger people functioning in the economy going and they never said this publicly because obviously that's a poisonous message, but that was the feeling. So they made these compromises that were really quite interesting. And then, in the long run, the area under the curve of excess mortalities May well have been impacted positively by what they've done. Although, I think it's going to take some years to really unwind what's going on everywhere.
Many of us sort of found it morally offensive, that you would take a let it rip strategy, but those who
Defend what Sweden did will actually tell you. It was not really a let it rip strategy. What they did is they tried to evolve the strategy based on the data and early on there was a very focused attempt to protect the elderly and vulnerable. If you went to a restaurant early on in the pandemic in the semi open Society, in Sweden, they were distancing. They were still using some mitigation. So it was not a truly let it rip strategy and I think to their benefit, I mean, the kids have been in school throughout and they've not been
Asked European CDC, recommends against masking people in Primary School looking back. There's I think some lessons there and the people who advocated for us to do with Sweden has done. I mean, they are partially Vindicated now with some of this data
last thing I think it's worth reading a line from what this guy sent me says my 15 year old daughter spends, a lot of time on YouTube. And when I asked her if there's anything she wants to add to what I'm telling you. She immediately said that she cannot relate to the covid experience. Many talk about online. Her life is basically.
Continued as before. And I don't see any long-term effects in terms of a distrust and fear that sweetness held together in a way. That's very encouraging. There. Haven't been big Draconian measures or big demonstrations of discontent and families and friends, torn apart due to different views. So that's really quite interesting. That's social fabric has held together and that's important. It's like we ignore that at our Peril again the context of the whole thing rather than just the little fragments that people tend to focus on what's the overall
context, or you can just sort of digressing into anecdote.
I have very close friends in Canada.
And a number of them are
very seriously considering doing something. I would have never imagined possible a year ago, two years ago, any point in time which is moving to the US Canadians are very proud people. They tend to have this superiority complex over Americans, you know, the swaggering arrogant Americans and stuff like that. And but when you look at the truly Draconian measures in my home Province where I
Yup, Ontario a group in Toronto. There are people that have basically said, look, we've historically loved Canada, but enough is enough. They're really looking to move to US states that have been far more open, and it's really extreme. So, to give you some perspective, referring to a friend who had covid didn't get vaccinated. Kids are not vaccinated. As a result of the fact that the parents had covid, but are not vaccinated in the kids are not vaccinated, the kids can't play sports. They're not permitted to play.
Sports. You have to think about that for a second. So like, what is the implication when you take kids age? Twelve? Thirteen, six, seven, eight and you say sorry, your parents aren't vaccinated. You haven't been vaccinated. You don't get to play organized Sports. And of course, you're wearing masks in school and all these other things. And I'm sure people have heard that the province of Quebec is now trying to tax the unvaccinated. It's a syntax now, think about that for a moment. Again, if we're going to be logically consistent.
If we're going to say we're going to tax the unvaccinated boy. We are going to be taxing, a lot of people, right? I mean, if your BMI is over 25, we should probably be taxing you to, if you're clumsy and you're doing high-risk Sports. I mean, you should probably be taxed for that because you're more likely to end up in the hospital anyway. And going back to this example, of a friend of mine. Do you realize that an unvaccinated person in Canada? Cannot travel in Canada, so they can't
Get on an airplane. They can't get on a bus. There are only permitted to drive themselves and they still won't be allowed to cross. The border.
There are countries that do stuff like this. It's called Sharia law, very aggressive, sort of fundamentalist countries that do this kind of thing based on religious belief in a way because I'm not sure we'd find data to support these activities. This is now again, I'll reiterate falling into the vestiges of religion. And the question is
I want to say something even more provocative.
Zubin, which is isn't that almost now, as radical as the most radical form at the opposite, end of the Spectrum, which is the most radical form of fascism. Right? I mean, think about what was going on in Poland, in the 1930s. So it's the totally opposite end of that Spectrum, but you couldn't leave that country. You would have needed to escape that country for your safety. I'm not trying to for a moment to compare this to Nazism. I'm simply saying at some point these
Completely opposite ideologic things meet in terms of its so restrictive. They are. Yeah,
actually you really think about that. You're in a country that can effectively be landlocked and you cannot Escape. You cannot leave Canada. It sounds like a great movie escape from Canada. And Toronto is a post-apocalyptic flaming wreck, but I could see Marty starring in that the first Brown like leading actor. I think we need
them. As I remember the dean of the Harvard School of Public Health said it?
It is essentially an unarmed American with health insurance. Yes, where the argument falls apart Peter with data. What happens if that same individual that you're describing is infected with influenza or parainfluenza, then what? Oh, that's okay, I guess right. Even though the case fatality rate, presumably, they're allowed to get on an airplane and they could probably even get on a bus or a train and
maybe even kill people, they can kill people with it.
Ends up very easily. I mean this is the influenza kills so many people per
year, you know. Another thing that doesn't get a lot of attention. We have so many remarkable antiviral treatments for covid. Now, I don't know about. You guys. Have you guys ever had influenza the actual real deal? Oh, gee flu. Yeah. Yeah. I've had it twice in my life. It sucks. It's the worst.
That is a bad virus, and
we don't really have anything to good. Remember Tamiflu, how useless that turned out to be.
People were stockpiling
Tamiflu, like, it did nothing
influenza, which is about as bad as Omicron. Marty. Correct me if I'm wrong. Oh, worse influences, worse than Omicron. I mean, you're talking about the study 52,000. People 1-0. I mean, I haven't got Omicron yet. I've been trying actually super annoyed that I don't have it yet because I feel like I'm missing out on a booster shot or something. But when I look at all of my patients and friends who have had Omicron, yeah, I would say it. Certainly anecdotally appears far less severe than
Influenza and yet, when you get influenza, you don't have a drug that you could take, if it gets really bad, the way we have fluvoxamine and the other more recent Pfizer and Merck drugs. So that's another thing that doesn't really seem to get in the spirit of what can you do as an individual to protect yourself. While step one, get vaccinated step to have access to Therapeutics step 3, have access to a Health Care system that has literally just spent the last two years doing
in a fellowship on how to treat this disease. I think one of you said it earlier, right? We're operating under assumptions that are two years old and infection fatality rate of a prior virus Omicron needs a PR firm because as long as it's covid, people think they're using all the covid historical data. And when you add population immunity in a more mild virus, it does change the calculus. It doesn't mean people don't get sick, doesn't mean that any of us would ever wish anyone become infected.
And deal with this virus. Nobody would want that. But I'll tell you, I just talked to doctors in Egypt there this morning. They've had a real tough time. Getting people vaccinated. They've tried everything. They're very thankful to God. That Omicron is what it is, because it is going to confer large broad population immunity. And otherwise there were just no other strategies to get there. The question is, how did we become so dependent on the CDC to adjudicate on every aspect of American?
Eric in life and we know typically they draw on data from their mmwr reports. That's historical. Everybody is so upset at the CDC over so-called messaging. In terms of, I done my 5 day, quarantine. Do I get one test or to test? Do I get antigen test or PCR? Test? Stop? Let's ask the bigger question. Why are we even quarantining immune people who are low risk from other? Immune people, right? Would we ever do this for?
Influenza or rhinovirus? This is where we've just sort of developed this intense dependency. And as long as we're waiting for the CDC to tell us, whether or not we get one or two antigen test, because the sensitivity in the pre-symptomatic, phase are asymptomatic face is below 50%. So, after you've done your five days of quarantine, you're still not getting a definitive answer. So why are we having these arguments? When we need to just get back to Common Sense? Which means if you've been exposed then wear a mask then matter what virus if you
You are around someone vulnerable. Be careful. Maybe, stay your distance. And if you're sick stay home, that is a
pan viral
strategy that we need to adopt for General Public Health hygiene that gets us away from these crazy deliberations that we're having right now.
It requires a culture shift to write because people have to understand that going in to work sick without a mask. Say, is really a taboo. That should become a social taboo. It's not something that you do. It's not where we are or where we were certainly pre-pandemic one interesting thing too. Is that
Context issue. There are a lot of doctors on say, in the coastal cities that have been victimized. I called victimized because I'm biased, right? I'm gonna say bias. Now. This is editorializing mask mandates, kids Mass mandates, vaccine mandates, all of this and they see a society that's actually a pretty highly vaccinated group. And they're like, come on guys. Let's stop this. We need to open up. Why are we doing this? And people like say maybe you and me, Marty have been messaging this more balanced message of. Hey, some of these restrictions don't make sense. Now, where I get pushed back, which I think is interesting is
From doctors, say in the midwest or in parts of Texas or rural parts of the country who say, listen these doctors skew more liberal, say they're in very conservative areas and they're seeing maskless people, lots of morbidity in the ICU and their response is no, their messaging is the opposite. We need mask mandates. We need to do vaccine mandates and we need to be very monolithic in a public health messaging. So where you are even determines kind of how your mindset is and how you communicate and how you might see somebody like say
Marty McCary who sing these things. They may see that as dangerous in a setting like that. Whereas someone like me make a while say it louder Marty. It's interesting.
I was reflecting on an extension of that theme again thinking about how we were going to be talking about this stuff today and sort of getting into some of the philosophy of it. But since the last podcast came out, just a couple of weeks ago. I've obviously been a little more attentive to all things related to covid in the news in the literature. Etc and truthfully. It hasn't been good.
Good for me. So my blood pressure has been running about 10 millimeters of mercury higher. Unfortunately, most that is just social media. And again, part of it is just I have this anaphylactic reaction to things that are logically inconsistent, but it serves no purpose other than to hurt
me, but I got thinking, why
is that? We all have an agenda and I've been really trying to understand my agenda because I have an agenda, you have an agenda, everybody has an agenda and I wish we could all wear t-shirts that said,
This is my agenda. So if I'm talking to you, I see your agenda and I can use that to help me interpret what you're saying. I think I understand my agenda really. Well, right, my agenda because I'm not a contrarian. Like, I'm not the guy who wants to disagree with the mainstream view, just to be different. Sometimes I disagree. Sometimes I agree. I think my agenda here we talked about this a little bit before is, I'm worried about the Integrity of the profession and the broader
Appling of science. I really have concern for the Integrity of this, and I have many friends and some patients who have completely lost faith in this profession. That's my axe. That's the thing. I'm grinding. I am very upset about what the implications of this are down the line and I think that's what's coloring for better and worse. How I feel about the situation that were in today. You guys have a sense of
Your agendas.
Absolutely. By the way, this is the kind of self-reflection that every single person should do when they think about this. Because it then frames the whole conversation, very differently, and it involves a degree. You said, you have no emotional intelligence. Actually, you just showed that you do because I'll tell you the same thing since we did the show the another couple weeks ago, and honestly, I've been weaning off talking about covid, prior to that, and you kind of reignited me thinking about this stuff and it's been nothing but suffering for me. But, ever since there is a feeling of like,
First of all, now you're interested in seeing what people say about it and it becomes this agenda versus agenda and it's an unconscious sort of thing. So my agenda with this from the early days has been somewhat shared with your so much. Share with Marty somewhat share with Monica's which is trying to find a synthesis of what is the best policy versus science thing. For the most people and trying to bridge across this divide of misunderstanding and Division. And to try to understand all these positions. I call it alt middle. I've started to think of it as like a
Corpus callosum, that binds the left and right. Hemispheres. Like how do we build those fibers that connect these things together and help us think rationally and my bias is always been that. Now the way I'm criticized for that by so it's good. So you put it on your T-shirt. I'm all middle. Zdoggmd. Want to be the corpus callosum. And the conversation people will attack directly and say there is no middle ground here. It's mask or don't mask, or it's this, or it to that, and that's fine. But at least now we know where our agendas are and where our biases are whose hive mind is captured us, that's important to
Durst. And because otherwise, you'll never be able to bridge these different gaps and have some sanity.
And what about you? Marty? What would your T-shirt say? What's your deep dark agenda here? I want us to be as open and as we can about this, I would say to end tribalism because that is the most offensive thing. It's not a different opinion. I'll hear somebody articulated different perspective and they'll come out entirely differently on what we should be doing or should be recommending. That is okay in the
Context of Civility in my mind. And my thought is, you know, let's show the data on both sides to the best of our ability and let people make a decision. One of the few things that will be morally, offensive is the automatic tribalism, the dismissal of people because of something that they thought early on and nothing captures, that better than how Jay bhattacharya was dismissed early on. And now you see like a the data is playing out just as he said, I also feel that
We made a tremendous sacrifice as a country. We're living like Grizzly Adams. I mean I was at risk of growing a ponytail we come out of this thing and you have people that are saying that was absolutely the right thing to do. And we need to go back into the cave because of speculation of a more dangerous virus coming out of South Africa. And you want to say, stop. Let's look at the data that's sort of retreat. I think many times as scientifically dishonest, when I see the University's who ironically are supposed.
Be champions of data and scientific reason revert to these sort of primitive practices that are almost barbaric. They're definitely cruel on students. You want to say, I remember in college, they would insist that everybody at a liberal arts college. Take a science course so that you understand the scientific method and process, right? They would force these philosophy Majors to memorize rocks in geology class thinking. Why do they have to memorize the names of rocks for their future? Well, if
To understand the scientific mind in the scientific process and then they do this. Complete rejection of any open, scientific debate and cancel people with different opinions to me. It's the tribalism that bothers me and it's just sad to see it play out. I'll say one last thing on this and then we'll get back to what people care about, which is not our griping, but it's more the fact that stuff. But I was actually really surprised at some of the hate mail. I got after the last podcast now, I haven't gone back and listen to it guys.
I got to be honest with you. I don't really have the time to go back and listen to podcast I record. So I mean, I guess it's possible. I came across as a racist homophobe, but I don't think I did because I'm not actually racist or homophobic but some of the hate mail I got was you are a racist homophobic piece of shit who lives in Texas, how can you say the things that you are saying covid?
Am I racist against white? I mean, like just tell me help me understand more where my racism is coming from. These were people that just went off like they went completely off. Somehow my not wearing a mask and moving from California to Texas which technically happened before covid, but that's another story is really all a sign of. I don't know, misogyny racism.
A phobic Behavior. Like sometimes I get upset when I get nasty comments. This couldn't even upset me because I couldn't even understand. I was like, literally interested in this as like, wow. I'm looking at the grammar of the person who wrote it like were they saying is this a person who is having you know, kind of a mental break? Yeah, like a shiny. Yeah, like anyway, I'm sure you guys experienced the same
thing, right? Marty unless you wanted to say something. I have some thoughts on this and this actually relates to say the Robert Malone interview on Rogan.
We're going to talk about this.
Because I want to make sure we spend some good time on this. We all get asked a lot about it. So,
absolutely. And actually, this is an epiphenomenon of that interview in my mind because he talked about Mass formation psychosis in that interview. And this is a garbage term that he kind of made up from some crazy guy in Europe. But here's what's actually happening in my opinion and why you see what you're seeing Peter. And we're all seeing it. Everybody's seeing it. And I don't know if I said this in our last podcast, if I have you just stop me and say you already talked about this, but this is what I think is happening. And others have been talking about this in the sense making
Entity online, people who are focused on, trying to figure out, how do we make sense of the world in a fractured information economy and so on? So David Fuller treble, wisdom and other people like that. BJ Campbell, there's an idea that individual humans actually do instantiate these higher elements of thinking, we call them different things, groupthink. Hive mind. He actually calls them egregores, which is a demon that emerges from groups of people and their thinking and it used to be in the old days you would share information in very
Low and uniform ways. Like whether it was mass media, just a few channels or whether it's money. As a way to exchange information because they're economic incentives. Like you build a city on a river because it's easy access to Ports and so on. But now with social media, you effectively have turned every human with a smartphone into an addicted machine. That behaves like a neuron and it's neurotransmitters are likes dislikes, comments shares. So each of us is part of a network of people that acts again were
Ron's and we instantiate through these instant connections. These hivemind groupthink tribes that Marty said, hey, we're trying to reduce tribalism. So this is why they even exist, because instantly, you can be a part of this and then be controlled by it without even knowing it, and it's lubricated by social media because now, the neurotransmitters, like, we get our dendrite receives the information from social media, we process it. We make a decision. We send it out. And what happens is, whatever, hive mind. You're in, has certain rules, and
It is competing against other Hive Minds in a way that we're not even able to access. And so, when you say something Peter like you say, you know what, I don't think we should wear masks and I don't wear mass that particular hive mind that says, you know, what Master important were liberal in our political ideology. And these are the rules of that will say, okay. We recognized here in a etre who left to go to Texas, which is a sign of disloyalty to this particular Hive. And he's not saying the right things about masks.
Or he is absolutely evil Outsider must be stopped. And the people who are acting as the neuron in that Network. Don't even know they're doing it. They actually believe this, but until they really introspect, or they talk to you in person or something, happens at breaks the spell, but I think that's what's happening. So, the Malone's of the world are captured by the antithesis, groupthink, hivemind, the say fauci, zarek. Topos of the world are more captured by the thesis hive mind and who are we in this life?
All middle corpus callosum hive mind were hated by everyone. That's my thinking on it.
Well, I will say this some of the messages that meant the most to me were I have been morally opposed and opposed in every manner to getting vaccinated until I heard this podcast. I actually think I might get vaccinated. Now that's worth all the hate mail in the world and by the I don't think the purpose of these podcasts is to, hey, let's make sure we figure out a way to get everybody vaccinated, right? It's how about we give people the
Raishin, so they can make the best decision in their best interest. But when someone says a buddy of mine who's the most Anti vax, human being in the history of civilization, just got vaccinated because of that podcast, I think wow, that's fantastic. There is hope that information. Can Trump
fear? I get the same thing and I'll say this that I get a lot of criticism from Hardcore vaccine absolutist, in my messaging saying, it opens the door. You and Marty McCarey and vinaya, Prasad and Peter Atiya. And Monica Gandhi, opened the door for people not to vaccinate. It's criminal and you shouldn't do it. And making videos that say vaccinated.
And chill is irresponsible in the setting of Omicron. That's killing so many people and so on and so forth. And it again, I just feel that Hive Minds rejection. Where as we're seeing the outcome, which is people are actually making reasonable decisions based on information. That's non judgy and non Shamy
why I think you were effective in convincing that person to get vaccinated or the discussion was. I don't think it was me. I think was just the podcast to be clear. It wasn't anything. I did per se. I think it's the honesty. I think
people are starving out there for
Honesty on this topic, that's not
tribal. It's not an allegiance to a party line on what we have handed down to us as an edict. I think it's this very genuine humility around the data and a virus that changes and evolves and we have to change our thinking in real-time. So, I personally think people are starving for honesty out there and data, and I also get millions of comments and emails and most of them are, you know, thank you. Bye.
But like all of you, I can't keep up and we've had these conversations offline, but the one email or the one inquiry that I will actually carve time out of my day to have a conversation with is somebody who is on the fence about getting vaccinated spending time and just explaining things with a non-judgmental approach. By the way, we've been doing this as Physicians, our whole careers. We don't mandate somebody does dressing changes. That's what we don't mandate Whipple procedures for patients with pancreatic cancer.
Like, yeah, look, I mean, if you don't operate the odds of it, killing you, or X, and if you operate the odds or Y, which are lower than x, but in the short term, there's this risk. I mean, yeah, it's like Physicians are very good at having naturally Bayesian discussions. Can you imagine if you don't have this Whipple procedure, you won't be able to travel because they'll catch you at the TSA, and you will lose your job and they'll treat you like crap. When
You come to the emergency room next time because your unwittingly eyes. If your A1C goes above 7, you're not allowed to work here anymore because it demonstrates you're eating too much and not exercising enough and we can't have you in this place of work. I'm sorry. You just can't do it. Your potential future diabetes and diabetes-related complications. Could overwhelm the Health Care System. We want their A1c to be lower. Right? But it's the approach. Is it a judgmental or a loving? Approach the throat? You can't shame somebody.
Lowering their hemoglobin
A1c. He know what shames people into that. The fact that they attract ants when they urinate that's enough. Spilling that much sugar in your urine. We had to talk about those things, all joking. Aside. This is exactly what Monica's entire career has been based on. How do you message to say, people at high risk for HIV? You don't shame them. You don't mandate they wear condoms. You don't mandate abstinence. It doesn't work. You have conversations that are by Nature Bayesian. Here's the risks. And here's our priors and how you think about it?
It. So let's get back to some fact-based insight for people. Where are we? Marty on monoclonal antibodies as a therapeutic option. So let's come back to early 2020 to everybody's getting Omicron. Some people are getting a bad case of it. Are monoclonal antibodies effective. If so, which ones so two out of the three only work on the Delta variant. And by the way, the people over the last few weeks who have been showing up in the hospital in deep trouble medically.
Tend to be heavily skewed towards the remaining Delta variant. Now, if the CDC estimates are correct, Delta is 1.7 percent of new cases as of January 14th or so that tells us that the influx that sort of the ongoing damage that this is causing in terms of severe illness, is really letting up right now, just by the dominance of Omicron. So we only have one monoclonal, that really works. Well, so tear mab. It's a GS cave, your bio.
A pharmaceutical product. It's a monoclonal called Superior mab. And that's the only one that really works. Well on Omicron but if Omicron is as mild as we're seeing, that tells us we should be using it. Selectively in high-risk individuals. We don't do a good job of that in healthcare. We can barely hold back throwing the kitchen sink at people even when it's excessive. I mean, it's just a general pattern. And so what you're seeing is these industrial-strength big guns like packs Levin.
And so term, a bar being used in very low risk. People sometimes people with wealth and power and access that tend to get. And that's where we need to say. Hey, wait a minute. We have all these tools in the toolbox. Let's use them selectively and wisely based on somebody's individual risk and any emerging data on the efficacy of fluvoxamine against Omicron specifically. Because obviously the Lancet trial, the JAMA trial were all in Delta anecdotally. Do we know anything?
Thing or has there been any way to update that Insight? The only thing new is some new data on lunacy at the NIH because they wrote a summary of who Fox. I mean where they described its benefit and impact on reducing hospitalizations and survival and concluded at the end of it, that there was insufficient data to recommend it, which was that conclusion? That should not have been derived from that summary. So, unfortunately now you have this sort of
Everyone just Falls in line mentality and Medicine by some Physicians. Now, many of them are creative and smart enough, and they're like, hey, I read the studies. The reduction is dramatic just because there's not an official authorization around it at the FDA. I'm going to use it for my patients. Those are the doctors we hear from. Those are the doctors saying? Thank you. And that's by the way, a lot of doctors maybe most. And then there's some that just say, well, the CDC doesn't say. It took for me to use it or they say, the NIH is not officially endorsing it.
So they're up against that. Now the people who did that study have told Zubin and I that there are close to what they believe might be some good news at the FDA around an authorization. That's just a Gestalt and it's not an Insider information. But unfortunately, this is a drug that has reduced mortality among people compliant, by 91%, in high-risk covid patients and we still have very little awareness around. It's matter of fact, there was a paper that just came out on the preprint that showed. It was a survey of doctors saying, basically, when you get somebody with covid-19
Do you recommend to them? What they said was kind of pathetic or sad? It was vitamin D. Vitamin C, zinc, and something else that has no evidence really behind it. Now, maybe there's some value to vitamin D. Who knows? But I mean, that's it. I mean, no discussion of convalescent plasma which now in concentrated form reduces hospitalizations by 50%. That's been around by the way, for two years. No mention of fluvoxamine. Let's tell people about that. So convalescent plasma was talked about
Ali in March and April of 2020, when we truly had nothing on the horizon and then it kind of went away and I don't know if it went away because it didn't have efficacy and it was demonstrated or because we finally got monoclonal antibodies later that year. First. I'll tell people what convalescent plasma is and talk a little bit about it as a therapeutic. So I'm just close to it because the authors of that study on convalescent plasma early on.
Put a piece in medpage today, and I remember talking to them. So, this was an exciting development, convalescent plasma is the plasma from someone who recovered from covid illness. That's what convalescent means. It means they've recovered. And so, the plasma is not the red cells. It's not red in color. It's other fluid that the red cells circulating in your blood system and that plasma contains antibodies. So, basically, what you're getting is you're getting infused a
Partially intact immune system, that is, you're getting infused real antibodies and essentially, monoclonal antibodies that Pharma companies make is the same thing. They're just antibodies made in a laboratory and they tend to be all one type and monoclonal as opposed to polyclonal antibodies. So in the convalescent plasma, you're getting a more diverse antibody profile. Arguably, that's better for the reasons. Monica just laid out. So there was a lot of enthusiasm around it. It's been used by the way, for a century. I mean, there's stories from people.
Getting infections from gunshot wounds and War getting convalescent plasma. And so there's a lot of experience with it was the one of the first levers, the medical community reached for when covid hit us. And so people were getting it and there was a benefit, but the benefit was small. I think it was a reduced hospital stays from like thirteen percent to 9 percent or something like that. So what you had was an announcement by Trump Administration officials that had a lot of enthusiasm and they use the term
Head of the FDA at the time said there was an absolute risk reduction. And the technically proper term is a relative risk reduction. So people who may just hate the administration hit anything that comes out of it just pounced, including in the medical community. They pounced in. This is a unfair representation of the data and they just went. So there was this sort of backlash has in part my opinion, politically driven. So then you didn't get a lot of attention around at there was sort of this confusion and the head of the NIH Francis Collins.
I was asked to weigh in on convalescent plasma and he said we need a randomized control trial which is in my opinion kind of a cop out here. We had strong data in a non randomized fashion because they were telling people. Hey, we've got this. Do you want to try this on a trial by the way in his defense? I think that's a totally reasonable answer. Even if done in parallel, right? It's like we should have an RCT of this stuff. Yep, we should. But what he did is he threw water on any sort of interest in using it?
Clinically it with a lot of it was in that sort of a news media distorted. But I agree. So then you had Pharma companies, basically saying, hey, we're making antibodies, why? Use convalescent antibodies, but there just wasn't enough to go around and kind of lesson plasma fell to the Wayside. Now, the authors of that study had told me, hey, we're not using this therapy. It's only forty bucks. No, Pharma executive gets rich off of donated plasma. We need to start talking about this more well around that.
Another study, another study critical came out and said, it doesn't really work hardly as well as the original trial showed. Now. I reached out to the study authors of the first trial that showed a benefit, the New England Journal and they said that study was flawed. Their design was flawed. We need more research and trust us. It's coming and they were very frustrated. So they eventually published a study that came out. Very recently that looked at concentrated convalescent plasma concentrated suggesting you're getting more.
Or antibodies in that infusion and it showed a dramatic reduction in hospitalization of reduction by 50%. Well done. Study still. Nobody talks about it. You don't hear about it much. It's oh my gosh. Can you believe there's not enough, monoclonal antibodies from regeneron? Well, here's another therapy. It's not getting attention, the attention, it deserves. Is it safe to say that convalescent plasma? Presumably has a greater diversity of antibodies than a mano.
No, antibody sure. Yes, but we don't yet know how effective convalescing plasma will be against Omicron, but we know obviously, for understandable, reasons that at least, two of the three. Monoclonal, these are not effective because presumably they're no longer binding to epitopes. That are sufficient to kill the virus. That's right. In general when you are exposed to a virus you get a more diverse antibody response or profile than you do with just a monoclonal.
Infusion, there's two reasons why people think natural immunity is stronger and more effective than vaccinated. Immunity one is you get a more diverse antibody portfolio in the response. And the other is the reason, Monica alluded to and that is natural immunity is based in the mucosa. It's more mucosal based community. So it's more on the front lines of Defense. Okay. So Therapeutics do we want to talk a little bit about Robert Malone? Tell folks who he is Zubin.
And why his name is on the lips of many, both disciples and non disciples. Are those who want to banish him from the
universe? Yes, Robert Malone is an interesting epiphenomenon. I think of our division around this into these two churches of Covidien and covid yet. And he's an interesting guy. He's definitely a scientist who was involved early on in some of the work on the MRNA technology and
General. And in particular, wrapping that mRNA molecule in a lipid particle in a fat particle that allows it to be taken up by cells. In that case. It was Mouse cells looking at an HIV protein expression to work on an HIV vaccine, which it turned out. Didn't quite work out because it didn't generate an immune response. But the technology was there. So he was one contributor in a vast chain of contribution that actually LED ultimately to where we are now, but his particular contribution.
And patton said he had had expired a while ago. He'd given up looking at that and had moved on into different directions, on DNA, vaccines, and things like that. So he builds himself as the inventor of mRNA Technology based on what I just said where he is a small piece of this puzzle, but using that credibility and also the credibility of working as a consultant in different government entities and things like that. He makes a series of claims about vaccine safety, that ultimately got him banned from Twitter, which got Joe Rogan's.
Tension and rogin then gave him his platform to say, okay, if you're banned on Twitter, what are you saying here? And so there are multiple claims that he's made and I'll start by saying this. I think some of the things that he said that were correct, are things like a, you don't just give infinite boosters to people because that's not a good idea that we already talked about earlier. He does question the financial incentives of Pharma and different entities within Healthcare to focus on vaccines, and I think that's not
Reasonable. I think he downplays the point that there's lots of money in Therapeutics. Do those are the main things that I think establish his credentials as a heterodox thinker. Now that's all. And then, every major point that he makes is fundamentally flawed. If not, a parenting of an extreme anti-vaccine position on these things, and we can go through some of them unless you want to stop me and
I'd like to go through some of them specifically. So
maybe take them in kind of a point-counterpoint fashion if you will.
Yeah. So one of the things he says is that PCR is over estimating the number of covid cases and that it's not accurate. The truth is, it is quite accurate. It's very sensitive and it's quite specific. So that's just not quite right? And it's point is, you know, we're over counting cases and so on.
Does he provide an estimate of the magnitude by which it's being over counted? I
don't remember if he did but I don't recall him saying specifically T does make
Magnitude estimates, for example, he says if we had just provided early treatments in the form of hydroxychloroquine, ivermectin, monoclonal Etc. It is a fact that we would have saved 500,000 us lives and he provides no data to actually support this. That's I think an unsupportable claim based on information that we have especially since there's not evidence that hydroxychloroquine and Ivermectin actually do anything that's compelling. That's still being studied with Ivermectin. Both hydroxychloroquine. It was quite
Clear, he said that hydroxychloroquine was shown to be active against the original SARS. But this is a bit misleading. The original SARS in vitro. They used chloroquine and it inhibited the virus in vitro, but there are millions of compounds that will do that. It was never shown to be anything beyond that. So that's a misleading statement. He then discusses that the spike protein that is used in current vaccines, by Pfizer moderna Etc. Was never tested for safety.
Their Spike protein was never tested for safety, but he then either is deliberately misleading or misunderstands. The scientific process with this because that's what the clinical trials with tens of thousands of people were doing was showing. Oh the spike protein that we've coded for with this mRNA is safe and effective in a human population. So that's just not true. The other thing he says that's abject Leon true is that there were no preclinical or animal studies on these particular vaccines or mRNA constructs. And that those
Are findable, they're all there. So that's just simply not true. Let me see here. There's a lot. He made so many claims pulling up some of them here. He made the claim that hospitals in particular are mischaracterizing covid, cases. Now. This is a claim that actually has some validity in the sense, hospitals are paid more for covid patients. This is true. So there is some incentive to code in a medical billing situation up code. This is covid even though it
Be like, pneumonia or something else going on, am I? But he also has covid in the early days. They've kind of looked at this and it's not clear that, that was happening because to some degree, there's a fraudulent component there, like, that's just straight-up fraud. So he specifically said there are gunshot victims being coded as covid patients.
And by the way, that could be true. If a gunshot wound, patient has covid. And if there's a greater Financial incentive to take care of a covid patient, you could do that. It would be unethical.
Michael. I think it would be against the spirit of how one is to code, and I guess you could argue, it could Verge on fraud. If the billing entities are rigorous enough to say, why was he admitted to the hospital and asked that question, right?
Yes, that's exactly right. You nailed it. So it's fully within the realm of the possible, but I don't think in practice that it happens at a level where it would explain anything, that would move the needle on the pandemic. And actually, you can just look at excess mortality figures in the u.s. To know that something is
It's a combination of covid and the Perry covid phenomenon of our response to covid and other things that covid
does, by the way, what was the excess mortality in 2020 and do we have 20 21 data, yet? Absolute lives lost above and beyond 2019.
I don't remember the excess mortality at the end of 2020 because I'd done a show on this. In the mid-2020s.
I looked at it in 2021 and I actually have the exact number. So I almost don't want to say because I'm sure I'm going to bastardize it. I want to say it.
Has close to 250,000 excess deaths in 2020 relative to 2019. But anyway got it. So I have got the numbers here. Okay, perfect. 477. Thousand excess deaths. From March 1st to December, twenty first, twenty twenty. So basically, the 2020 numbers for 77074 percent of them were due to covid that is match up with the covid mortality. So it was four hundred thousand three hundred of which are covid 385,000 were covid.
Total, okay, so half a million excess deaths. So you can't explain this with coding if that's part of the argument. Yeah.
Well beyond coating. Now, some of it may be ancillary effects if lockdowns and so on, but some of it maybe even undercounting of covid cases. People just dying at home and not being diagnosed. So there's lots of different potential explanations,
this sort of begs, the question, which is where the people who disproportionately died, people who were going to die within the next two to three years. And does that imply that there may be a
Reduction of death in 2022 2023, when a lot of the people who were going to die of natural causes of heart disease, cancer, and things like that. The most vulnerable people who died in 2020 and 2021. Basically died ahead of schedule, their lives were shortened by a year or two and you'll see fewer people dying in 22 and 20 23. Does that matter? No, but it's just kind of a curious epidemiologic phenomenon, right?
This has been discussed actually quite a bit particularly in online circles. This is dry Tinder.
That you took out people that were going to, they had a life expectancy. Like you said that was quite short, and all this did was knock them over. We see this every winter in the hospital, like flu. That's why they say, pneumonia is the old man's friend. Right? Like it's the final thing that in a very medically frail person. So, again, what's the ramifications of it actually think it has this ramification in the sense that how much of the overall suffering under the curve was just expedited by a year versus how much is cutting off, five years, ten years of quality, adjusted life years. That's quite high. That then would
Defy or D justify certain social policies that we put in place. So it's a good question. And I think relating to this. He Malone asserts that we don't have good vaccine monitoring at all and asserts that there are lots of vaccine injuries and damage that we are not counting, and he talks about tver which is really a hypothesis generating system where anybody can report and so on. But he does not talk about prism or V safer. The vsd, the
Scene, safety data link. These are very robust vaccine monitoring systems that actually help to catch things, like very rare events, like the vaccine induced thrombotic thrombocytopenic of the Johnson and Johnson AstraZeneca vaccine. So I think that's quite misleading to say that it's good. That he's asking these questions and I think people should ask questions about vaccine safety, but he's a little misleading here now where he's directly misleading as he makes the asportation. That the lipid nanoparticles from the MRNA, vaccines concentrate into
Shoes such as over. He's explaining things like infertility and menstrual cycle abnormalities and women and the truth is he's the data he's citing is a rat study out of. I think I forget where where they pounded these rats with super normal levels of this lipid nanoparticle mRNA and they saw accumulations in various tissues, but no tissue damage actually. And this has not been seen in humans. There are menstrual cycle abnormalities. So that's where he is correct. And NIH is actually funded studies on this.
And what they're seeing is what women have reported. If we'd actually listen to women that their menstrual cycles are abnormal for a cycler to either heavier or lighter. They skip a period in Oregon study. I think was preliminary released with this funding actually showed that. Yeah. This may be true at least for a period or two but then reverts back we have not seen widespread effects on fertility,
on that topic Zubin. I remember the first one of my female patients to tell me this. She's an especially funny woman, and she said thank you. She said we were actually uses there.
In a social setting as well. So we weren't like in the office having this discussion. She said, you know, it's really funny. It seems like I was stabbed in the vagina. Is that possible? And I was like, Wow,
say more.
And he's like, yeah. She's like, look, I've never had so much bleeding in my life and that lasted for two cycles for her
interesting. The speculation on why this maybe has been rampant. Some of it is just with any infection with an immune response that can be abnormalities in menstrual cycle.
And it's that whole hypothalamic ovarian axis thing that I wish I understood better Peter. I've never understood the lady Parts. I'm going to be fully honest. My wife will confirm this, but I think the fact that we take it, seriously is important. So I'm glad at least Malone mentions it. He just mentions it in combination with just the wrong. Thinking he mentions other things about Ivermectin that are incorrect, like Japan, recommending ivermectin, for treatment of covid. They did not. He says that the Chinese were using
Hydroxychloroquine to great effect early on and use that. As an example, of reason of why we should be using it, simply not true. So things like that along those
lines and those are the types of claims that are difficult because you can't counter a negative. In other words. If someone says, look, it mean it's been well known that the so-and-so Hospital in China, pioneered, a study that then led to the mass adoption of this therapy. Well, you can't search the anti truth to that like it's just
You can say, well, show me the data, but when someone's rapid-fire giving you state after state after State, it's very difficult to counter
that, then this is why I think many people will not. They constantly want to debate. So Malone and others will say, well, we'll debate anybody. But of course, we want our friend Steve kirsh with us. Who's funding some of the stuff and Steve is known to do this. He will just throw out. What about this study? What about this? What about this data out of uttar Pradesh. When you actually have days to look at the data, you realize, wow, that's total bullshit, but I could
I'd never have respond to that in real time.
Yeah, I've often thought that the only way to do a debate like that is to do it the way, a court interacts, which is using a discovery, right? So you can't present evidence in court without the opposite side. Seeing the data in Discovery, seeing the evidence and Discovery, so that you don't get the surprises. You can surprise somebody with your interpretation or a question. You're going to ask there, can't be any, gotcha moments with new data and I've often thought the only way you could have an online.
This debate in any format, whether it's an awkward style, debate or otherwise is to have everybody say, this is the only data we're going to debate. Everybody can get as familiar with it as they want. And now let's talk about the opposing views and the opposing ways that we might interpret this to mean, that would be a much more honest way.
That's a correct way to do it. Exactly. And you want to bait, you want conversations. I could stifling. That is a terrible. The fact that Malone was D platform down. These other platforms is why he's on Rogan. So it actually gives people like this that
And I have no idea what his motivations are, right. I mean, you can speculate but that's all ad hominem stuff and I'm not going to do it today. But the one interesting thing other thing I'll say about Malone is it's important. Actually, when you're judging the veracity of somebody or The credibility of somebody, it's important to see who they cite to, right. So at one point. He says, listen Peter duesberg. You guys remember Peter duesberg? He's a legendary guy in science because he was an esteemed virologist based out of UC Berkeley. My alma mater. He taught a course.
That I took actually and he was known for denying that HIV the virus caused aids to the point where he questioned that HIV didn't fulfill Koch's postulates of infectious agent and he proposal was its gay Behavior IV drug. Use nitrate poppers basically sin, that was causing the immunosuppression and that AZT in the drugs. We were giving were making it worse. He would say things in his German accent like AZT is AIDS by prescription. He got famous for this because he went to South Africa.
Erica and actually convince the president of South Africa that this might be true. And it may well have cost. Lots of people their lives because they were slow to uptake. Protease Inhibitors. Etc. So Malone actually sites duisburg as the esteemed virologist, who was canceled by fauci in the early days. This is not true. Actually duisburg continue to teach at Berkeley where I took his class where he presented his ideas and we got to debate them and he was since proved remarkably wrong and in the same breath. He actually associated with Robert. F Kennedy Jr. Who is a known?
Sort of anti-vaccine activist not a physician. So he's kind of aligned with that camp. And right, after Rogan, he went on Infowars with Alex Jones and started talking about the great reset various conspiracies along those lines.
That's the deep end,
Alex. Yeah. Yeah,
one of the things I want to ask you about, is the only term that I keep hearing from that because I have not seen that podcast. Is that mass formation psychosis term. Can you say more about what that is? Because I literally have no idea.
So the way Malone
John describes mass formation psychosis. And again, I'd earlier in this podcast talked about what I think is actually happening with groupthink and these neuronal networks and the fact that it's important to understand this any human now can create information and put it out in the world and form a hive mind around it. It's easy to do. You don't need a mainstream position to do it. Now what Malone is saying is the mainstream which does control major media like CNN MSNBC a lot of the scientific community Through funding.
Things like that big pharmaceutical companies has created what he terms based on the work of a European psychologist. I think I forget the guys name is created a mass formation psychosis. Any parallels it to what happened with Nazi Germany. Which again when if you're resorting to the Nazis, you've kind of already lost a discussion, but
I just sort of did something like that. Tried to caveat it so that it wouldn't be as idiotic. But I kind of made the point that moment ago that when you prevent people from
Traveling within or outside of their country. It's within the hemisphere of the most extreme fascist threats,
right? Yes, and you immunize yourself by wrapping it in reason and I think Malone actually did that to where he was talking here because this is what he said. I think he's correct in this sense. He said the rules for having a mass formation psychosis where the population is. This is what his words hypnotized into believing something to the detriment of actual.
Truth is the following. You need an isolated population where there's been isolation and dissatisfaction. And again, going back to Nazi Germany, pre-war. You need a sense of Economic destabilization and crisis. You need to kind of Silo people off. I forget all the things he listed, but one of them is then you need a entity in authority to say, we have the solution and it is one solution and that's it. And so his argument is, is that he says, then really good people. The German people who are hyper educated go and do crazy things.
And he said, now we're in a situation where the mainstream has created this Mass formation psychosis, where the only way out. We're like, we're in this dangerous situation. You have to lock down. You have to close schools. You have to shut down your way of life and wear masks and the solution is just this vaccines, forget about Therapeutics forget about Ivermectin, forget about monoclonal. It's just this, and this is the only way out and people start to believe it because they're so destabilized, from all the other stuff happening. And so, they go along with the mass formation where I think he's correct. Is that we
Are all victims of groupthink, what he ignores is that so is he? And he's part of the reactionary tribe mind that says, no, I'm not comfortable with this and here, all the crazy things we believe. So, that's what Mass formation psychosis is from his angle.
I really appreciate that. By the way. That was a remarkable Tour De Forest. Do you recommend that people go and watch the podcast? So they can hear his arguments out in full and contrast that with what you're saying or just as you did with Peter McCullough where you put out a really nice podcast, where you
Completely unemotional. He went through all of his arguments and stated where you thought they were reasonable. And unreasonable. Have you done the same thing for this
podcast, man? I knew you were going to ask that people have been asking me to do it and I'm just honestly, I'm so resistant because it's so exhausting to do but I might just do it. I know Vani is writing an article on it. He was asked to write a piece on it. So he's going to be addressing the points Point by point. At some point. I probably will have to do that. There's a guy you did one online but he is such a thesis guy like he's
So, hardcore Covidien, it's so biased that you can't really take some of the points seriously. And I think people who would believe Malone will never believe this guy.
That's right. It actually forces people to kind of dig their heels
in on that. Yes, I agree.
So if you guys have some time at, there's still a few other things I want to talk about. And one of them is, what is the exit strategy? We talked about this a couple of weeks ago, which is it's always a good idea to have your exit in mind. Whether you're talking about war, whether you're talking about,
An investment in a company, whatever it is, you're doing a vacation, should always have an exit in mind. You should always have a plan for when you're going to change this thing, back to the new Norm. So, what's your reflection on that? I mean, I take some comfort in what Monica presented to us, which was that. Hey, it might be the case that in the spring colleges are going to say, you don't have to wear masks to sit in class anymore. That would be fantastic for young people for every person. If airplanes, if the TMJ.
Say and airline's, say you no longer have to wear masks who's mandating that we have to wear masks in airports. I don't even know who that is. Yeah. Hey. Yeah, TSA. They're doing enough to
So, okay. Like do you guys think that in three months there will be no more mandatory masking anywhere in the country. I think in a matter of a month or two, you can have very low levels of Omicron around. Almost. Nobody left who is not already had it or strong immunity and I think people are going to be so giddy to move on that. The fatigue is just going to hit all-time highs and people are going to turn the page and I think you're going to see
As sentiment really flipped in most of the country. Now, if you remember, the opioid epidemic was Nightly News every night. We all were sort of in touch with it and then overnight. In one day, the media shifted, their attention. And it was almost as if within 24 hours, people forgot. We even had an opioid epidemic, and I think there's going to be an even bigger flip pretty soon. It may be something distracting and maybe other news it may be at concert and Central,
Park where people just finally feel liberated. It may be a landmark event. But I do think people are going to shift their attention very soon when we get to very low levels of Omicron, which the UK and South Africa, would suggest in a preview that that's about a month or two away, just to push back on that. Marty. We're going to either have Omicron come back next winter or we're going to have Epsilon show up next winter. And presumably case rates will be high again and mortality and hospitals.
Will be relatively low. But what will prevent us from backsliding into the state of panic? Well, I think part of it is going to be geography. I've really enjoyed my time in Florida during the pandemic. I feel like I'm just enjoying life. I'm a million times happier here. I don't have to get a colonoscopy to go into our restaurant in New York or anything like that. So I think about all those missed polyps though. Marty. I mean, yeah, there's a down
it's not very good Public Health messaging.
So I think it's going to be Regional. I do think there's going to be a big part of the country that's going to say, hey, wait a minute. We could be looking at a new variant in the fall. There's going to be respiratory pathogens. Circulating this fall for sure. 10 to 25% of the public is going to get some respiratory infection almost every year in perpetuity. That's the way. Respiratory pathogens, worked. So are we going to put up a serious guard? And have this sort of anxiety that we've had with the new
Of the fall or The Following fall, but it's we're definitely going to see more variance or are we going to realize what Monica was describing? And that is the beautiful amazing? Gorgeous. Immune system of the human body where adaptive immunity will increase our protection against future variance, regardless of what they are? And I think there might be some anxiety, but at some point, people are just going to say, I believe in the adaptive immunity. So then, what are the implications than for vaccine mandates? Where do we see this going?
Let's put Federal aside. So there's not going to be a federal mandate but States and employers universities. Where is that going to go? And look, he's become a bit of a meme. But let's look at Djokovic right now. I mean, the guy just got kicked out of Australia. Does not get to defend his title in the Australian Open. I think there's two ways. People are talking about. This one is the rules are the rules. You're not exempt and I think that's a fair statement. Right? If Australia has this Rule and it applies to everyone, then it should also apply to the best tennis player in the world.
Maybe the more important question is is that a good rule to have period. But I read a story today that said look he's not going to be allowed in France. So he's not going to get to defend his title at the French Open. And if he's not going to defend their I mean is he not going to get to defend his title at Wimbledon? I mean, it's Djokovic. Never going to play another major because he's not vaccinated to me until this question gets resolved. There's no exit strategy. Where do we see this going?
See? This is why we need to have these discussions because what is the incremental?
Value now of mandating vaccines. And vinay talks about this a lot. Vinaya Prasad. He says, how many people are actually at risk of high complications and of those, how many are unvaccinated and of those, how many will mandates actually reach them. And the answer is probably much less than you think. So instead. They're the sort of shotgun mandates that affect a lot of people that really, it matters much less. You have these epiphenomenon like joke of it should. Now can't play, and we're polarizing Society more.
These like Perry religious lines. So at some point we just have to say what I think. We've all been saying a little bit and Monica is effectively saying which is it's now an individual choice. You can vaccinate you can wear a mask or not and you can take the precautions that you need to and Omicron will be the great equalizer that immunizes a lot of people and will then be on the other side of this where we don't need mandates and policy stuff. We have to have those conversations, but even opening your mouth about it is taboo within certain.
Hive mind States. I think it also requires a degree of thick skin. Peter you and I both have attested to being, it's a state of suffering having to even deal with this stuff because of the amount of craziness that we see. So we have to just thicken our skin and say, no, but we're going to keep talking about it because what's the endpoint? What's the exit
strategy? I don't know why I find myself. We talked about this last time and having much more empathy for people who don't see eye to eye with me on vaccines, who are anti-vaccine. And even though I do,
Re with them scientifically and I don't agree with the facts that they cite in some circumstances. If not most circumstances. I'm curious as to what it says about me as a person good bad or indifferent that, I can't imagine that you would for somebody to get a vaccine in this situation. I reserve the right to say maybe one day a pathogen will come along that is so deadly for which there is no treatment for which transmission is eliminated by a vaccine.
Mmmmm, and for which the vaccine is so incredibly safe where I might change my mind. I might reserve the right to say, you know what, we're going to mandate this shit but I can't say it with this factset.
What she just did where you said. This is what would convince me to do something is a key thing. Because I think what separates your thinking, which is nuanced from say a hardcore anti-vaccine person who's just that condition say or even a probe acts person is there is no situation. Like, if you ask Robert F, Kennedy jr. Is there any example that you have of a vaccine?
Done some good and I was part of this documentary. They were he was involved. So I've seen this, it's not been released. He says something to the effect of. I don't know if I can even point to anything. It's like well, so there's nothing that would convince you. There's no status that stuff. Then you're talking about a real belief, based thing instead of a, like you said before, Peter strong convictions loosely held. Like what would dislodge that conviction?
I think when you know how the sausage is made. When you see the decision-making, add say a state.
Permit level, that is requiring. A 25-year old forest, ranger to get a booster who's thin and already had covid and you see the absurdity of how they've brushed over the data. How there's this bandwagon effect? How the leadership has been dismissive of some of the data and cherry-picking other day? When you have that back knowledge. That's what makes it particularly difficult to watch to address your point Peter because you see, intrinsically this ad
22 of your stupid, don't ask questions, just do it and it's like hey, wait a minute. That's not how I'm wired. So I do worry about another pandemic that has a case fatality rate not of two-tenths of one percent which is probably retrospectively what it's panning out to be with covid to an infection with a case fatality rate of 5% Spanish. Flu had a case fatality rate of 2% Ebola has a case fatality rate of 50%. What happens when we get
Get a virus with a case fatality rate of truly 10% as we were worried about from the early reports of China. And we are acting like this sort of dysfunctional tribal big Tech censored. I mean, we might be hosed. We've got to have an NIH that responds in seven days with bedside clinical trials, to tell us what's happening. What works, what's effective? We cannot be ignoring some Therapeutics and parading around others. I mean, we've got to have a completely different mindset. There's going to be
Popular and charged question, but I guess we can talk about it. What are the ethics of having the people at the top of the NIH? Be both in charge of funding any academic in this country and yet also being the Arbiters of what is appropriate to be set in. Not to be said I've spoken very privately with people who have shared this Middle Ground view who have said I am not
Permitted to speak about this. I'm told I cannot speak about this or I will lose my funding and my entire career is based on what the NIH gives me. And I've been told explicitly by the way, not implicitly. I have been told explicitly by my department chair. If I ever say anything that counteracts The Narrative of the NIH, I will lose my funding. So we think about all the careers that are being ruined, this person that I mentioned, who got fired in November for not being vaccinated for
Very prestigious University talk about the Djokovic is of the world. This is a guy's Legacy, who could be altered by this? And then you talk about people who are now being silenced and not permitted to say anything that is at odds with The Narrative of their funder. I mean, that's very problematic to me, especially with in science. Science has a currency of objectivity. It's taken the single most, precious currency and said, let's put that in.
The
closet. I mean, look at the duisburg thing that we talked about with Malone. This guy, Peter duesberg. He kept his job. He's tenured professor. He got to say what he wanted. Other people proved him wrong. It was a scientific process. I don't know what happened with his funding. I think he was affected actually funding wise. So this is a conflict. I mean it's clear because it doesn't force a kind of group think. In this case. There's a physical effector inhibition from the group mind down to the individual. Neuron. Do not misbehave, or you will lose.
Or a tepee, you lose your glucose, you'll lose your source of energy and that's problematic. Scientific freedom is a key component of actually being able to do science because science isn't a Dogma, it's a process. So I think your concerns about like, further, damaging The credibility, the trustworthiness of Science in the future is valid. I don't think I saw the movie. Don't look up on Netflix. Oh man, it was depressing because it was so accurate. It was like, wow, this is exactly what would happen if we had a
True existential threat, humans would be so divided. So untrustworthy, social media siloed and behave like jackasses to the degree that we deserve to be wiped up.
It's funny. You say that at the end of that movie. I was like, well at least they had the right outcome here.
Yeah. Yeah. Me too. Yeah, I'm like, yeah. Good riddance. Yeah,
but Peter I have had so many doctors. Tell me exactly what you just described. I've been threatened. I've
Bullied by my media relations, department at my hospital. My department chair directly told me, don't put this out, don't write this op at. I've had people submit things for publication, and then immediately, you know, insist before they're published, that it be withdrawn because they're worried about how it could be. Perceived and often tell me I'm already, I believe in everything that you're talking about. I believe in natural immunity confers a lot of
Of protection, I believe in spacing out. The second dose is to save more lives and give better durability of the immunity. I believe in open schools that cloth Mass don't work, but I can't say anything for my position. Keep going, keep being out there and saying things, you get it. Peter. I know Zubin, you get it and you look at this National dialogue and you recognize the one. Common thing people say, is that their local institutions are concerned, how could be perceived. So, basically Twitter is now the ultimate arbitrator of whether or not
Institutions are willing to put things out. And the other thing you hear is, they're worried about their NIH funding, and if there is one currency of academic medicine, it is NIH funding. It is a direct requirement for every step of the promotion's process. And sometimes I do notice that those who tend to be more outspoken, or those who are already tenured, and it's not because they're just Boulder. It's because they have less of that concern, and that is a direct conflict. And we saw it with the lab leak, hypothesis being discussed.
Just, why can't we just all agree that to have no more gain-of-function research. There's something where there should be broad consensus and I think people are afraid to go against dr. Fauci. Dr. Collins that is a tremendous amount of power in concentrated in one human being dr. Fauci. And it's even magnified because he's such a nice gentleman. He's a great guy. I mean, if you've ever talked to him, so you have this very Charming, very influential editor of Harrisons.
Who's on every media outlet that has an FCC license every day and he's talking controlling the narrative. And so, for example, if he talked about fluvoxamine, once this entire pandemic, people would say, no, this interesting. Let's take a look at it. Oh, you know what? It's on the Therapeutics page of covid at the John the Johns Hopkins website. It's on the list of recommended treatments under the University of Washington Medical Center site. Has so much influence.
Since it is too concentrated, it's not that he's bad or diabolical. I actually think he's very well-intended. I've just disagreed with them on almost every aspect of the strategy, but that I think is too much concentration of power, especially when he controls the NIH funding dollars, by the way, final point. I just heard from a doctor who been funded by the NIH for 30 years. Who tells me he submitted a very elegant and extensive Grant to study natural immunity got a near-perfect score and
Not been funded. That's the kind of thing where it's like look if you've got forty two billion dollars at your disposal at the NIH. That's one question that should deserve funding and to get an answer rather than say, we don't know how many Studies have been funded by the NIH. That look at disparities in covid rates. Marty. We just put the study out. My research team, didn't put it on the preprint server, 254 studies, looking at covid research on health, disparities and social disparities, and then there's been
154 studies on natural immunity as well, right, funded by NIH. There's one prevalent study. We don't have the results to yet and it's outdated. Anyway, and the other question is, how does the virus spread and they funded for studies on that and number of Grants on masks one. So you had 250 for Grants the NIH put out there on Social and Health disparities in covid, for on how it spreads.
One on masks. I'm all for addressing Social and Health disparities. By the wave you agree. With me? You should be offended. That Princeton is testing people three times a week, even though they're asymptomatic and triple faxed, you talk about a disparity high-risk people in the community or can't get a test when they're sick and vulnerable. And yet we're testing the hell out of these young healthy triple vax people. So I mean that is on addressed but I'm all for addressing Health disparities, but how about knowing how it's
Spreads because we were propagating surface transmission for way too long, or actually understanding what the natural history of the disease is vis-à-vis, the immune system in the people who were infected without a vaccine. But yeah, no, no, these are tried questions. Gentlemen, any thoughts before we wrap this up, we promised we were going to keep this short and we kind of
failed. I gotta say this. I'm gonna defend fauci for a second. From one particular entity the New York.
Ran a piece about factories finances, that were disclosed and I took personal offense to this because the guys 80 and this is what he has Peter you'll appreciate this as a financially literate individual Marty not so much. I know Marty's fast and loose with his money. He's all over Swiss bank accounts. He's just crazy. So fauci had 10 million dollars in retirement stock assets that were Diversified across very boring mutual funds at age, 80 something, right? And also a like 50
A thousand dollar stake in a small Italian restaurant in San Francisco. And this particular collection of stuff was billed as some kind of egregious, wealth and conflict and all of this. And I'm like, dude, the guy saved his money and happened to believe in the power of compounding and very generic mutual funds. It's not like he owns directly like Pfizer or something, but I thought that was interesting. I'm like, man, I God I hope no one ever looks at my finances because first of all, they laugh at why I'm not rich. Like what?
Sky doing?
Yeah, that's interesting point. Well, first of all, I mean, that's a great example of because he's a public servant, right? I mean, it's been a public servant his whole life. It's wonderful to see that he's been fastidious Lee saving investing and letting the miracle of compounding do its thing in his favor. And I mean, I think that's the problem with both sides of this when you view him is the pope and he's so holy that. Any questioning of him is tantamount to treason, you're equally egregious to win. You just
That everything he does is horrible and when we've established that Nuance is not the Forte of the mob. So anyway, gentlemen, I thank you again for this. And I know we were all made infinitely better by Monica's presents here. She elevated the game quite a bit. Yes, his awesome. All right, guys. Well, I keep saying will never do this again, but I'm not going to say
no.
I don't think I'll be doing it for a while. I think we've said all we need to say on this subject.
Thank you Peter and thanks for a diversifying, our crew with
Estrogen and keeping it really interesting and relevant. I think the people who are starving for again, some honest
discussion. Yeah, great to see if Peter good to see the zoomit. Thank you for listening to this week's episode of the drive. If you're interested in diving deeper into any topics, we discuss, we've created a membership program that allows us to bring you more in-depth exclusive content without relying on paid ads. It's our goal to ensure members, get back much more than the price. The subscription at that end membership. Benefits include a bunch of
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