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1:13

Lemonada.

1:36

This is In the Bubble with Andy Slavin. Welcome

1:39

to the show. Thank you all for

1:41

the very kind emails that you sent in

1:45

over the last week

1:47

or so, since we announced that this would be

1:49

our last couple shows. It was really

1:51

kind of you, really nice to read. And of course, keep sending

1:54

them if you'd like. Andy at

1:56

LemonadaMedia.com. going

2:00

to play some voicemails on our last

2:18

episode which is next week. And if you want to

2:21

leave a voicemail and

2:22

have us play it on the show, it's pretty simple. Just call

2:24

833-4-Lemonata or if you don't know

2:28

what it is, some of the people who have been really stalwart

2:30

talking about COVID throughout the last few years. But

2:33

first I've got a few things to say and look,

2:36

well I still have this mic, I might as well say them. So

2:39

buckle in. A lot

2:41

of you writing to me in the last week made

2:44

a similar point to

2:46

me which was that this show helps you through

2:49

hard times. So when the show's

2:51

not here again, you're gonna kind of go, oh my god,

2:53

hard times again, what am I gonna do without in the bubble?

2:56

So I'm gonna, the next second really so you can

2:58

play it over and over and over again every

3:00

time you need to. It's gonna be that insightful.

3:03

But really I think that a lot of what this show was

3:05

intended to be about was to help us all together

3:08

through those hard times. And please don't think

3:10

that I wasn't going through them at the same time. I

3:12

learned a lot from the guests on this show.

3:15

I'm gonna go through kind of

3:17

five of the lessons that stood out to

3:19

me. And these are lessons

3:21

that kind of consistent with

3:23

the way the show operates. Some

3:26

of them were very fact-based, right? Some of them

3:28

were like, I need to know the truth. I need to know

3:30

what's going on out there. A lot of

3:32

them were also emotional based.

3:35

How do we talk to each other? How do we hear information?

3:38

How are we feeling? Is it okay

3:40

to be feeling the way we're feeling? And

3:42

some of them were a little more gut-based.

3:45

They were just more of the what's the right thing

3:47

to do here? Can you take a stand?

3:49

And is there black and white issue here? It's

3:52

kind of like what the Romans used to call ethos, pathos,

3:54

lojos, right? Which is you gotta think with all

3:57

of those parts of yourself.

4:00

And by the way, like if you want

4:03

to think about that

4:05

lesson, I mean people like Larry Brilliant

4:08

and his kind of way of thinking

4:10

and reasoning and talking to people, Ashish

4:13

Jha, just people who very much keep that mentality

4:17

with you. So lesson one,

4:20

search for the commonality with

4:22

others, not just

4:25

the differences. The differences

4:27

are actually quite easy to spot. So

4:30

do better and try to find the commonality,

4:33

particularly with people that you think you might

4:35

disagree with. Matthew McConaughey

4:37

and I had a great conversation about this, if

4:40

you want to go back and listen to that episode. And

4:42

he really demonstrated that. There

4:45

was an article that was written about me a

4:48

number of years ago in the New York Times magazine

4:50

entitled, Andy Slavitt Wants to Unite

4:52

America on Healthcare. This is a title we were very divided.

4:56

And it says in the article that

4:58

Andy says, if you give him 15 minutes

5:00

with any American, he'll create a common bond around

5:02

healthcare. Well, what did I mean by that?

5:05

What I meant was, we all have all these opinions

5:09

about healthcare and policy

5:11

and we start to argue but

5:14

show me somebody who spent an hour in

5:16

a waiting room while their wife or husband

5:19

or child or parent was going through

5:21

surgery. And I'll show you

5:23

somebody who I can really connect with because

5:27

that experience penetrates

5:29

what we think in our heads and

5:32

it creates something we can all talk about and share. And

5:36

people can feel visible and seen and heard in

5:38

those moments and I really believe that.

5:41

It's also about embracing dualities, right?

5:44

We can think that we know the answer

5:46

to things. We can think that there's one

5:48

way of doing things. But it's

5:51

true that belonging matters

5:54

but so does independence. It's

5:56

true that community is really important.

7:59

That's obviously Fred Rogers is one of the influence

8:02

for this show. But I would also

8:04

say, don't just find the helper, be

8:06

the helper. Because at various points

8:09

in time, you're going to be going through

8:11

absolute hell and other

8:13

people are going to be fine. And

8:16

there's going to be other times when you're going to be doing fine,

8:19

but other people are going to be going through challenges. And

8:22

I really do believe this is one of the greatest gifts that

8:25

we've been given. Each other. It's

8:28

each other. And so use that ability

8:32

you have to make someone's day better, their

8:34

week better, five seconds better.

8:38

And have people

8:40

who you care about around you when you need that

8:43

as well. I don't think there's more important

8:45

advice. If you want to hear

8:48

about episodes where I

8:50

really learned that lesson, you can listen to an early episode

8:52

we did with Pete Buttigieg talking about

8:54

the allies that supported him in his life. And

8:57

Adam Smith, I talked about his own anxiety.

8:59

He's a prominent congressperson with

9:02

phenomenal episode. Number

9:04

four, speak

9:06

up and call out bullies

9:09

when you see them. There is no

9:11

situation that

9:14

is more intolerable than

9:16

someone being bullied. And

9:20

I really, when

9:22

I ask myself, when are there moments of life

9:24

that I would like to do over again? Well, anytime

9:26

I was in a situation where someone was getting bullied

9:29

and I didn't have the courage to speak up. Steve

9:32

Kerr, who is the great

9:35

NBA basketball coach, talked

9:37

a lot about this on the episode he was on after

9:39

his father was murdered. He

9:42

speaks up on any topic and every topic

9:44

no matter. Lori Leifut,

9:46

who was being bullied herself by

9:49

the police unions came on the show. She's the mayor

9:51

of Chicago. Adam Earl, Rachel

9:53

Levine talking about trans

9:55

kids getting bullied and just

9:57

simply letting them know that you've

10:00

got their back and you're on their side means

10:02

so much. And it's

10:05

really consistent with this idea

10:08

around actions and intentions that

10:10

I think are so important. We

10:13

all want to be judged based on our

10:15

intentions as if people

10:17

can see them, but we only judge others based

10:20

on their actions, what they actually do. And

10:24

I just wonder what would it be like if we tried

10:26

for a day to just judge ourselves

10:28

based on our actions and judge others based

10:30

on their intentions. It would be much more forgiving. But

10:33

this action orientation was really

10:36

driven home to me by Jose

10:38

Andres, the great chef who is in all

10:41

the disaster zones and was such

10:43

a great help to people during the pandemic. I

10:45

strive to be as action oriented as

10:47

he is.

10:49

Final

10:51

point I'd make number five here is

10:54

to remember the year of miracle.

10:57

So am I by the way. What is that? Am

11:00

I a religious miracle, a scientific miracle? I

11:03

don't really care how you want to look at it, but the

11:06

scientists had estimated that the

11:09

likelihood that we even had intelligent

11:12

life on this planet

11:15

could be as little as one in a million billion,

11:19

which strikes me as very small, one in a million

11:21

billion. He took an asteroid

11:25

destroying the Earth for us to be here. Talk about dualities,

11:27

destruction, and then

11:29

life. And

11:32

for us to be here with intelligent

11:35

life as we have for the last couple

11:37

of billion years is

11:39

pretty astounding. And this is the life

11:42

we have. And

11:44

not only do we have it, but we have it at a

11:46

really glorious time. And I think just

11:49

ask somebody who came out of the

11:51

Middle Ages or the Mesozoic

11:55

era to look at our lives and say,

11:58

I think we understand how

11:59

lucky we are at a very different level.

12:03

And look, not only are you here but whatever

12:06

has been thrown at you, whatever has been hard, whatever the

12:08

bad stuff has been, the hard

12:10

times, you survived. You

12:13

ducked it all down. So

12:16

that's a miracle in and of itself too. Anyway,

12:20

the sense of this miracle that we are, there's

12:22

a bunch of episodes that comes to

12:24

mind but Laurie Leshen from NASA is

12:26

someone that I think really helps you put

12:29

some of that in perspective. So anyway,

12:32

thanks for letting me have the mic. It's not

12:34

just for these few minutes here this morning but for the last

12:37

few years. Don't forget you can leave us a voicemail 833

12:40

4536662. Hit 4. Leave us a voicemail. We'll

12:42

try to play it on the last

12:49

show. And now I'm

12:51

going to bring in guests who I think exemplify

12:54

a lot of lessons that we talked about on

12:56

this show. You've heard them before? A number

12:59

of times, Eric Topol, Bob

13:02

Wachter, Caitlyn Jettalina, Ashish

13:05

Jha, four people who really helped us get through

13:07

the pandemic. Here

13:09

they are. Appreciate

13:19

you all being

13:22

here. I should go without saying how much

13:24

respect I have for you that I wanted to do this. I'm

13:27

going to go back to this concept

13:30

of ethos, pathos, lojos,

13:33

you know, which means starting with the facts, lojos.

13:37

My guests today did that. They

13:40

informed us and

13:42

then they connected also with how

13:45

we were feeling, the

13:47

overlying of pathos. My

13:50

guests were exemplars of

13:52

staying true to the truth

13:56

as they knew it, but

13:58

communicating in ways that accounted for for people's

14:00

feelings and the human pressures

14:02

we were all under, the emotions

14:05

that helped them and the emotions that blocked them. And

14:08

then, of course, what I really admire about

14:11

my guests today is

14:14

that they had an ethos, an

14:17

ethos for the truth, an

14:19

ethos to support science, an

14:22

ethos to speak up no matter the

14:24

personal consequences. At

14:27

a time when we needed guidance, they

14:30

were the eyes and the back of our heads.

14:33

They were the voices that stirred us

14:35

and

14:36

assurance that there were adults in the room. We've

14:39

had many great guests. I could have chosen from

14:41

a number of them. But today, you

14:44

will not be surprised that I'm joined by Eric

14:46

Topol, Bob

14:49

Wachter, Caitlin Jettalina,

14:51

and soon, Ashish Jha.

14:55

They I think are best to help me with

14:57

three things, to help us reflect a

15:00

bit, to help us predict, and then to

15:02

make sure to provide you with great resources. Welcome

15:06

everyone. Welcome Caitlin.

15:09

Andy, you're going to make me cry. Really?

15:11

That was so kind. Yeah.

15:14

You too. Oh, yeah.

15:17

Eric, how are you, buddy? Oh, good. It's

15:19

great to be with you, Caitlin, Bob,

15:22

and Ashish. Wow.

15:25

And Dr. Wachter, Dr. Bob,

15:27

how are you? I'm

15:30

already crying. It's an honor to be here, Andy,

15:32

not just with you, but these are

15:35

in some ways my – this is the pantheon

15:37

of my heroes over the last three years.

15:39

So it's really an honor to be part of it. Yeah.

15:42

Well, you guys have done so much during

15:45

the course of this pandemic. And

15:47

I don't know that as a nation or even

15:49

us as individuals have had a perfect chance to reflect.

15:52

There has never been really a breaking point. We

15:55

were sort of in the middle of it and then things changed a little

15:57

bit. So let's reflect a little bit. What's

16:00

everybody's most memorable moments from the pandemic?

16:04

Andy, this is going to sound, I

16:06

think, cheesy, especially being on your

16:08

show. But as everyone

16:10

knows, my work, I don't know if anyone knows, but

16:13

my newsletter started from nothing. It

16:15

started from me talking to students and faculty

16:17

about what was going on. And it

16:19

grew and it grew. And

16:22

then Omicron hit and it exploded.

16:26

And one of the reasons I knew it exploded

16:28

with Seth MacFarlane,

16:31

we tweeted one of my

16:35

articles and then you, Andy,

16:38

reached out to me to go

16:40

on in the bubble. And I was

16:42

freaking out because it

16:47

showed the need for really information

16:50

in such a

16:53

confusing time and in such a rapidly

16:55

changing time.

16:56

I think we should come back and talk about your newsletter

16:59

and we'll do that in the last segment into why it

17:01

took off because it really did. Yeah.

17:04

Caitlin went from your local

17:06

epidemiologist to your national, your

17:08

global epidemiologist. You know,

17:10

for me, Andy, the

17:13

moment I'll never forget was

17:15

the day that we came together that

17:17

coincided by happenstance with

17:19

the first vaccine to

17:22

get out. And that would be

17:24

Pfizer

17:25

November to

17:26

get the trial results that

17:29

exceeded all expectations. And

17:32

it was a day in the history

17:34

of biomedicine that I don't think anybody can ever

17:36

forget because we were

17:39

facing this existential

17:41

crisis. We had these ideas

17:44

that it could take till 2033

17:47

to get a vaccine that would be effective

17:49

against SARS-CoV-2. And

17:51

within months, literally

17:53

from the time of the virus being

17:55

sequenced in January to the same

17:58

year, completing trials of... over 70,000

18:00

people with 95% efficacy. I

18:05

mean, you just can't even dream this stuff out.

18:07

And we shared that excitement together.

18:10

I'll never forget it because it was so exhilarating

18:12

and it just happened

18:15

by accident. It wasn't even, you know, that

18:17

wasn't even the plan or that was gonna be the morning

18:20

of the big news. And in reflecting

18:22

back, you know, how we take

18:24

that for granted, you know, it's extraordinary.

18:27

That's so true. Do

18:30

you guys wanna listen to a clip of that? When

18:32

Eric was on, it really did happen just

18:34

as Eric said.

18:35

Let's do it. Sure.

18:39

Hello there. Hey here. Hey

18:42

Andy. How are you? All right,

18:44

good to see you. What is A to be doing in the show, huh?

18:47

Oh, it's a big day. The best day of the pandemic,

18:50

I think, right here today. Yeah.

18:52

So there's a lot of things to be excited about, but

18:55

for those who don't know, we're talking about news

18:58

this morning out of Pfizer

19:02

and a German company that I think is called

19:04

Bio and Tech. How excited

19:06

were you this morning when you heard personal? Tell us what the

19:08

news is and then tell us what

19:11

you felt like when you heard the news.

19:13

Well, I

19:14

woke up this morning, it was

19:16

about 5 a.m. and I'm looking

19:18

at my emails and I'm seeing,

19:20

oh my gosh, Pfizer is announcing 90%,

19:23

at least 90% of it. I said, whoa.

19:27

As you know, Andy, we were looking at, they were

19:29

looking at 60%. We'd be happy

19:31

if it met 60%. So the

19:34

fact that it was 90 plus, the fact that it was 94

19:36

events rather than 32, which

19:38

was going to be their first interim, it

19:42

was enthralling. It was definitely

19:44

the kind of news we need right now because

19:46

things are overall looking so bleak. And

19:49

this is the beginning of the turnaround. This is a

19:51

day of inflection.

19:54

So Bob, you could hear it in our voices

19:56

and I'm sure you must've felt similarly.

19:59

It's hard. for me to even recall the state of mind

20:01

we had back then, like the

20:03

day before we heard that a vaccine

20:06

was going to be here soon. Yeah,

20:09

I had the same feeling. I remember when that news

20:11

came out, I literally jumped for

20:13

joy and I don't jump very

20:15

well or very high. It

20:17

was as it

20:19

was very clear what I used to play a little basketball. It

20:23

was an astounding moment because it was

20:25

clear that the end, whatever the end,

20:27

and it was also clear the end was gonna be messy, but

20:29

that the end was near. I think as

20:31

Eric said, it was a true inflection point

20:34

and up to that point all the news was grim

20:37

and for all we knew that this

20:39

vaccine would be 50 or 60% effective

20:42

or it would take another six months or another year.

20:44

I mean there was no way to be sure these things

20:46

were going to work and the fact that they work with a

20:48

novel technology that had never been used

20:51

this way before it

20:54

was astounding. Do you remember a moment when you were

20:56

most scared? Yeah,

20:59

I remember

21:01

the first death of a physician,

21:04

of a prominent physician, was John Murray who

21:06

Eric will remember from his residency at UCSF.

21:09

John was a spectacular pulmonary

21:11

critical care physician at San Francisco General

21:13

Hospital and died in Paris

21:16

very early in

21:18

the pandemic and that was when it felt super

21:21

real. And I also

21:23

remember, I think it was March 18th,

21:25

the first day I started tweeting, was

21:28

I was really kind

21:30

of sitting there feeling like

21:33

you know this could be the end of our society,

21:35

this could be end of my life, my

21:37

family's life. It really had that kind of gravity.

21:41

Let's take a quick break. I see John's gonna

21:43

join us all in a moment. We're gonna keep talking. We'll

21:46

be right back.

21:55

This message is sponsored by Cola Guard. Hi,

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25:10

Ashesha is joining us now. So let's

25:13

add Ashesha into the show.

25:16

Let's wait for Ashesha to get situated here and we'll

25:19

pull him in. Can I ask you a question

25:22

while we're warming up there? Andy,

25:25

you were recruited to the White

25:27

House and you had to give

25:29

up your life, your

25:32

family to live in DC.

25:35

That must not have been such an easy call, right?

25:39

You know, I had for a lot of reasons

25:43

pledged not to go back into the Biden administration

25:47

and had received a couple of calls sort of feeling

25:49

me out about different roles and I

25:51

had politely declined them and

25:53

in fact in general felt

25:56

really good about the fact that there are a number of younger

25:58

people who I've worked with. who

26:00

were really ready for those challenges, ready for those jobs.

26:02

I hadn't had a chance to serve in the way that I had, but

26:05

I got a third call around Christmas time

26:08

in 2020 and

26:10

that was, I was almost no

26:14

longer being asked. I was being told in some

26:16

ways that I had

26:18

to come in and do this and, you know,

26:21

she obviously came in and served

26:24

after I did in a far, far easier period.

26:30

But, you know, the truth is

26:32

like I didn't bring anything

26:34

unique other than the fact that the

26:37

set of people who were around the table at the

26:39

time around clean Jeff Sience knew

26:42

me and I had worked with them before and I had worked with them on a crisis

26:45

and they basically said, we don't have time. We

26:48

need people we know, we need to be able to move fast

26:51

and, you know, you need to come in. But,

26:54

you know, so it was a completely

26:59

scary set of moments, a complete

27:01

honor to serve. But

27:03

yeah, it was one of those things

27:05

that just I think happened

27:07

and then it happened later to you, Ashish.

27:10

Yes. I mean,

27:12

it's been a very long train of house, almost four

27:14

years. I think obviously

27:17

the very early days and just like when

27:19

it first really hit me, what

27:22

we were about

27:23

to go through as a country, I

27:25

remember in March of 2020, I think some of

27:27

those moments really stand out. I

27:31

remember my first call with Debbie Burks when

27:33

she was at the White House and she had

27:36

a whole series of questions. And

27:38

I remember getting back to her with answers

27:40

and thoughts on a lot of those things and realizing

27:43

that her ability to translate

27:46

those into real policy actions

27:48

was being very much stymied by

27:51

others in the White House. I

27:53

obviously remember like on a very personal level

27:55

getting the call from the White House, Ron

27:58

Klain, about potentially coming

28:00

in, then meeting the president.

28:03

And in terms of joyous

28:05

moments, I did feel

28:07

an incredible amount of joy

28:10

when President Biden was elected, because

28:12

I really thought it would change the trajectory

28:14

of the pandemic, and it did.

28:16

I think it made a very, very large difference.

28:19

And I don't just say that because I worked

28:22

and obviously served under the president. I

28:24

really think it was a very different

28:26

response. I spend a lot of time

28:28

thinking about what would have happened if Donald

28:31

Trump had been reelected. What

28:33

would that first year of the response,

28:35

or even the following time, what would that have looked

28:37

like? I think it would have been much,

28:39

much worse. So there are a lot of important

28:42

moments. Those are just some of the first ones I

28:44

think of as you were speaking, Andy.

28:47

If only the country valued competency

28:50

more, we'd feel good. So

28:53

Eric talked about a joyous moment certainly. Caitlin,

28:56

Bob, putting aside the personal

28:59

success of obviously that both

29:02

of you have had in communicating to the public in

29:04

response, but just in terms of the arc

29:07

of the pandemic, was there a moment either

29:09

of you felt was a particularly

29:13

positive moment coming out of this?

29:16

I mean, I'll just back up what

29:18

I said earlier about the

29:20

ability to get the vaccine and standing

29:24

in that stadium,

29:27

honestly, to get a vaccine. And

29:29

I think mine was January 4th

29:32

and the amount of joy and

29:34

relief I felt as a public health person

29:37

on the ground. That help was here and it was

29:39

coming. And I've

29:42

not felt that much joy

29:44

in my

29:45

field. Was one

29:47

of the most, I sort of almost

29:49

hate saying this because it sounds like we were having

29:52

fun. Nobody was having fun, but it

29:54

was one of the most dynamic, scientifically

29:58

and politically interesting. and

30:02

gratifying things I've certainly ever

30:04

done in my life. And a lot

30:06

of it is owing to the people

30:08

on this call. I mean the idea

30:10

of waking up in the morning and seeing

30:14

something Eric had put together, annotating some article

30:16

in science that I probably would not have

30:18

seen, and then reading

30:20

Caitlin's interpretation of what it would mean

30:23

from an epidemiologic standpoint, listening

30:25

to your show about it, Andy, listening to Ashish

30:28

on one of the 7,000 news appearances he would

30:30

make that day. You know,

30:34

it was coming fast and furious, and

30:36

those of us who I think were privileged

30:39

to be people that folks, not

30:42

everybody, but at least many folks trusted,

30:45

to take this fire hose of information,

30:47

translate it into something that was accessible

30:49

and useful in an environment

30:52

that obviously was politically challenging, where

30:54

the facts were changing all

30:56

the time, because they were, because we were learning new

30:58

things all the time. That

31:00

wasn't fun, but it was really

31:03

gratifying, and you know, a lot of us, part

31:06

of what we do every day is try

31:08

to make a difference in people's health and healthcare,

31:11

and it will be hard to top that

31:13

feeling of that kind of reach, that

31:15

kind of access, and filling that kind

31:17

of need. This wasn't, you know, this was

31:20

an area where everybody in the world wanted

31:22

to know what was going on and what they should

31:24

do, and there was no textbook that

31:26

they could pick up to figure that out, so it was immensely

31:29

gratifying. I do remember

31:32

my own moment of really

31:35

profound emotion was,

31:37

you know, you'll recall

31:39

that there were family members that had been separated

31:42

from one another for the entire,

31:45

you know, an entire year, if not more, you know,

31:47

people in nursing homes who couldn't

31:50

see their kids or their grandkids couldn't have visitors,

31:54

and we were all working very

31:56

hard on making progress

31:58

on a number of fronts. And

32:00

I kept wondering, well, what's it going to feel

32:02

like when we get to a different

32:04

place? And then

32:06

somebody, so a woman tweeted out

32:09

a picture of her and

32:11

her newborn baby after they'd

32:13

been vaccinated, visiting her

32:15

grandmother, so the child's great-grandmother, in

32:17

a nursing home after seeing

32:20

so many pictures of

32:22

people who were just, you know, separated

32:24

by a window or glass or waving

32:26

to each other from, you know, 20 feet

32:28

away. And it was a

32:31

very, very first picture I saw.

32:33

It was posted on the

32:35

platform that we all used to call Twitter. And

32:38

it actually began

32:40

a deluge. Like, the

32:42

next couple weeks after that, it was like a few

32:45

weeks after the first vaccines had gone in, we

32:47

started to see hundreds and hundreds of those pictures. But

32:50

man, I looked at that picture of this

32:52

little baby, this older woman, and

32:54

this young lady standing

32:56

next to each other, finally doing something

32:59

very simple, just being near each other. And

33:01

man, that was, I felt like, an incredible

33:04

burst of energy from that. Let's

33:08

just go quickly through kind of what we think we

33:10

got most right and what we got most wrong,

33:14

whether there's lessons to learn.

33:16

And I'm not talking about a fixing blame. And I'm not talking

33:18

about saying, of course, we did

33:21

what we only knew at the time. You know, I think

33:23

we've all we all say that all

33:25

the time. But when we think about

33:27

something that we got most, let's

33:29

start with what we got most wrong. What

33:31

do you look at and say that either you as an

33:33

individual or us as

33:36

a collective set of experts

33:40

got wrong?

33:42

Well, the fast-sail answer is the schools. And I

33:44

think that's probably right. You know, I think it's probably

33:46

correct that we got that wrong,

33:50

not because the decisions at the time were reasonable,

33:52

because to me, I think they were, is I think

33:55

we've come to understand the toll that

33:59

closing the schools has. on education,

34:01

on socialization, on mental health. And

34:04

you know for each of these decisions you're

34:06

weighing risks and benefits as you

34:08

decide to enforce mandates,

34:11

as you make all these decisions. So I

34:13

think the next time I think

34:15

we've got to do a better job of appreciating

34:18

weighing the downsides of that.

34:20

And I think as you talked about your example Andy, I

34:22

think the same thing probably is true of

34:24

some of the isolation precautions in

34:27

hospitals and nursing homes. You know we had plenty

34:29

of people die isolated,

34:32

their family were not allowed to come in and visit them.

34:34

I think we could have figured out a way to facilitate

34:37

that. And again these were not irrational

34:39

decisions at the time knowing what we know, but I think

34:41

we learned something and I hope we'll do better next time.

34:44

Yeah I think Andy

34:45

the thing that was

34:47

so disappointing is that we didn't unite

34:49

against the common enemy of the virus.

34:52

That in fact that was an opportunity

34:55

to diminish the

34:58

divisiveness you know to come together

35:01

to fight what

35:03

was such a serious threat. In fact

35:06

all that happened throughout this time is

35:08

just in the growing gap

35:11

and a toxic type of situation

35:13

with the missing disinformation and clearly

35:16

unfortunate. I would have

35:18

not thought that that could be the outcome

35:21

when we had such a

35:24

common purpose of getting

35:26

through this and you know such good fortune

35:29

of having you know not just

35:31

the course of that scene but then as

35:33

a sheesh led the whole Paxovid

35:36

campaign to get it to be

35:38

out there practically and you know so

35:40

many victories that were

35:43

unprecedented if you go back in the history

35:46

the animals of medicine but instead

35:48

we had you know all the infighting

35:51

and accusations of you

35:53

know misinformation from the people who were

35:56

doing their best to

35:59

give it straight. to tell the truth.

36:01

It's a sad recollection that we

36:04

went through all that.

36:06

The teacher Caitlin, did you get out? Well,

36:08

I'm going to iterate two things that were,

36:10

I do think we got a lot of school policies wrong

36:12

and I do think we got a lot of hospital visitor

36:14

policies wrong. And those, both of those were

36:16

very costly in very personal

36:18

ways and policy wise.

36:21

I have to say, I have been thinking about,

36:23

you know, I was very supportive of

36:25

vaccine mandates. My record

36:28

on that is unequivocal. I

36:30

do wonder to what extent

36:33

that further polarized our country

36:35

in a way that ultimately was

36:37

not helpful. I think it saved a lot of lives

36:39

when we did it, when the

36:42

administration did it. I wasn't there, but I certainly

36:44

advocated for it. But I think as we

36:46

unwound those vaccine mandates, when I

36:48

was there,

36:50

I've had a lot of chance to go back and think about to

36:52

what extent that contributed. Maybe

36:54

one last quick point is,

36:57

you know, I, one of the lessons I

36:59

have personally learned is

37:01

I spent a lot of time thinking about

37:05

what's the best way to share this information? How do

37:07

I share it in a way that's honest and authentic

37:09

and sort of really that supply side of information? And

37:12

I spent less time thinking

37:14

about the demand side of information, of

37:16

what's on people's minds, what are they worried

37:18

about? And I

37:21

worry that if we keep thinking

37:23

about the right messenger, the right message,

37:26

but not enough on what

37:28

really is

37:29

bothering people, upsetting people, what's on their minds,

37:32

what do they want to know? We don't spend

37:34

more time thinking about demand of information.

37:37

We are never going to fix this problem of

37:39

meeting people where they are. And that is something

37:41

that I think we just got to do way, way

37:44

better than we did this.

37:45

That's pretty profound. I actually

37:48

think it's really wise.

37:49

Yeah, she took my idea,

37:52

but I...

37:53

Sorry. It's okay.

37:55

But I mean, thinking about all

37:57

of this, I think there is one theme and

37:59

I think it's...

37:59

the greatest lesson I personally learned

38:02

was the value of listening and the

38:04

value of opening up a bi-directional

38:06

relationship. I was

38:09

helping the response in Texas and

38:12

I will forever be thankful

38:14

for that because it quite

38:17

literally forced me to listen. I mean

38:19

we opened schools in August of 2020 and

38:22

I was certainly not happy about that but

38:25

it really made me listen

38:27

to how other people are interpreting

38:30

data and how they're also assigning

38:32

their values to that data and how

38:34

we all kind of assign our different values

38:37

to this foundation and in order

38:39

to understand each other better we we just

38:41

have to figure out how to

38:44

listen in a systematic

38:46

way in order to provide

38:48

that information like Ashish said

38:50

in a useful way so people can make

38:53

evidence-based decisions. We don't make decisions

38:55

for them and also to

38:59

help them wade through all this noise

39:01

that we all kind of had to figure out together.

39:04

Yeah

39:05

and I think what we believed

39:07

about the vaccine before

39:10

Delta and then what

39:12

Delta

39:13

changed

39:15

taught me so much

39:17

lesson in humility and

39:20

being a little more cautious. You

39:23

know we certainly believed that people

39:26

couldn't get bounced back infections. We believed that the virus

39:29

once you get vaccinated there's a lot of things we believe

39:31

to be true and communicated between

39:34

you know call it December of 2020 and June of 2021 that I

39:36

think caused us to lose a lot of credibility

39:43

with people because things didn't turn

39:45

out the way we I think quite confidently communicated.

39:49

Can I jump in on that for one second Andy? Yeah.

39:52

I learned something about this

39:54

really from Eric and I want to give

39:56

a shout out to Eric. I in May

39:59

and June even into July,

40:01

as the data on the

40:04

booster was becoming clearer and clearer.

40:07

I was so still very

40:10

stuck on this model that people did not need

40:12

the booster. And

40:14

this is probably June into early July. And

40:16

Eric sent me some stuff, sent me papers,

40:18

was writing about it. And I realized

40:21

I so deeply wanted to believe

40:23

that two shots was enough, because I wanted

40:25

more Americans to get the two shots and

40:27

the world to get two shots. And I

40:30

was not being an honest broker of evidence

40:32

at that moment because of my own biases. And

40:34

I remember the day, like, he sent me something.

40:37

I pushed back. And then I realized,

40:39

I'm just pushing back because I don't want to believe, not

40:41

because it's not true. And I, at

40:43

that point, did a 180. But

40:47

it was a great reminder of how

40:49

we all can get stuck in our views

40:53

and stop reading the evidence thoughtfully

40:55

and carefully. And I have huge

40:57

respect for Eric for not doing that

41:00

and a lesson learned from me of I got

41:02

to do better when I get caught up in my

41:06

own

41:07

sort of stated public positions. But

41:10

let me shout out to you, Ashish, that when

41:13

you were in the White House, you had a group,

41:15

I think probably all of us, who you would

41:17

call and you would honestly say,

41:19

here's what I'm thinking or here's what

41:21

the policy might be. What do you

41:23

think? You were

41:26

wide open to alternative views

41:28

and recognizing that you were in a bubble and might

41:30

make the wrong call. And sometimes

41:33

that shifted what you were going to do. I thought that

41:35

was very impressive that you were

41:37

open to that and that you actually sought that kind of input.

41:40

Thank you, Bob. All right.

41:41

Let's take one final break and we're going to come

41:43

back. And we're going to leave you

41:46

with the best sources that we

41:48

think are available to

41:50

you around the pandemic

41:52

and public health. Hint, hint. I

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think you'll find one of them. Actually, it's one of our

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guests.

42:08

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42:11

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42:13

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42:24

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42:33

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43:39

Okay, back from break. We're

43:41

going to finish up

43:42

with Bob

43:44

and Caitlin, two of our mainstays.

43:47

Bob was obviously a guest

43:50

host for quite a while, and

43:52

Caitlin has been just

43:54

such a great warrior and a great guest.

43:57

So, before we get to predictions,

44:00

I'm curious what we think we got most correct.

44:03

I think the biggest success,

44:06

and I think this is something that you

44:08

Bob said earlier, was just the spirit

44:11

of teamwork. I have never

44:13

seen this level of

44:17

collaboration on such a global

44:19

scale. I mean, we're now friends

44:21

with virologists in Germany and

44:24

England and South Africa, all because

44:27

we're trying to work together to figure

44:29

out what was happening and

44:32

then translate that further. It

44:35

was quite an honor to

44:37

be a part of that and watch it unfold,

44:39

honestly. I've never seen

44:41

a globe work towards

44:44

one problem before and stay

44:46

so focused on it that it was certainly

44:49

something I thought we got right, at least

44:52

in the scientific world.

44:54

Yeah, and Matt, as terrible

44:57

as our current information ecosystem

44:59

is and how much

45:02

bad stuff happens via social media, it

45:04

also was magical. It was remarkable

45:08

for someone like me, who's a generalist, to

45:10

be able to say, I need to follow

45:13

world-class epidemiologists and virologists

45:15

and aerosol scientists and political scientists and

45:17

sociologists,

45:20

and who are they, and then just

45:23

tap into their brain and be able to see what they're

45:25

thinking and what they're reading in real time was enormously

45:28

helpful. And yeah, I don't

45:30

think anything has ever happened exactly

45:32

like it before. In answer to your question, Andy, I

45:35

have a hard time not saying that Warp Speed

45:37

was the most impressive... Yeah,

45:40

I

45:40

was just going to say public-private partnership.

45:43

Yes, and that's exactly where I was going

45:45

to go with it. That, you know, I

45:48

think most people would guess my political

45:51

predilections and my feelings about the former

45:53

president. But on that one,

45:56

they got it right and got it right in

45:58

a way that I'm not trying to do. sure the Democrats

46:00

would have gotten right. I think if it was the Dems,

46:03

it would have been more strings

46:05

attached, more process, more

46:08

a whole lot of stuff that maybe

46:10

less trusting of the private sector. And

46:13

this may be just sort of good

46:16

luck that it worked out that way. But the

46:18

idea of giving a ton of money

46:20

to the private sector and mostly trusting

46:23

them to get it right with a fair amount of oversight,

46:26

but not stifling amount of oversight, in

46:28

retrospect, was genius and led

46:31

to a vaccine coming out, I think far

46:33

faster than one can envision under

46:36

many other circumstances and under other

46:39

administrations that I happen to like better. Although

46:41

don't forget that Pfizer didn't participate

46:44

and was still first. And

46:46

look, and the part about

46:49

Warfbeat that I liked the best was that they

46:51

took a portfolio play, they bet on six or eight

46:53

candidates, and then they embedded FDA

46:55

folks in the team to shorten the

46:57

process. And I loved seeing

47:00

development processes shortened by collaboration.

47:03

I thought that was terrific. And they give

47:05

the FDA particularly who dreamed

47:07

that up a lot of credit. Now the

47:11

reality is Pfizer, which had one of the

47:13

two best vaccines at first, the

47:16

Trump administration didn't want to buy and didn't buy

47:18

enough and made actually more mistakes.

47:21

We bailed them out, but they

47:24

were offered many times to buy the vaccine

47:26

in the US and they didn't. But

47:29

I agree with you in general, the portfolio play

47:31

is smart.

47:32

I mean, and there are many other, I think, examples

47:35

of public-private partnerships that worked out really well.

47:38

CVS, Walgreens, and vaccine distribution,

47:40

Google data and looking

47:42

at trends on epidemiological

47:45

trends on where are people moving so we

47:47

can understand antigen tests

47:50

and the United States Postal Office.

47:53

And so I think they're...

47:55

Totally cool. Yeah. Private-public partnerships...

47:59

They happen fast and you know what?

48:02

The public health world is not comfortable with

48:04

these because they

48:06

make it easy because businesses

48:09

are out for the bottom line.

48:11

Someone's making some money. Yeah,

48:13

they do. But you know, I think that

48:15

what it proved to me was that

48:18

it brings public health to a whole

48:20

new level and that

48:22

we need this whole new level in order

48:25

to reimagine public health for the 21st century. And

48:29

so I'm all for

48:30

it. That's cool. Now. That's

48:33

cool. That's a good read. I will say like

48:35

Bob, you're in a much better position than I am to

48:37

speak to this, but I was impressed

48:40

with the speed at which best practices

48:42

adapted with inpatient

48:44

treatment being one notable example.

48:48

We always hear about how it takes years,

48:51

seven years is the standard people use. 17 is

48:54

the standard. 17 years. And innovation

48:57

to make it into widespread practice. Yeah.

49:00

Right. Right. And

49:02

you know, there was so much experimentation going on in terms

49:05

of how who went in a ventilator and

49:08

the idea that they should be prone, you

49:11

know, and a bunch of these other things that,

49:13

you know, I don't know about you, but I imagine

49:16

you heard like someone saying, oh, there's a realization

49:18

that this isn't the right way. And

49:21

when I heard those things, I was like, oh, wow, how

49:23

are we going to get that information out to people

49:26

that insight because in healthcare,

49:28

it just doesn't happen. And there's

49:30

so much resistance. And I thought

49:33

that the adaptability of the healthcare system

49:35

to things like that, to things like virtual healthcare,

49:37

to all the sort of innovative

49:40

things, I thought was a pretty interesting thread.

49:43

Okay. Enough reflection. Let's get to some predictions.

49:46

Always dangerous. We're coming up on

49:48

the winter 2023, 2024 season. What's

49:52

COVID going to feel like? Do we

49:54

think over this next period

49:56

of time when we have historically in the past

49:59

bit where we've seen some peaks. I

50:02

guess I would say that the most

50:05

surprising thing about the last 18

50:07

months is how unsurprising

50:10

it has been. It feels like we

50:12

have settled into

50:15

a pattern that has by

50:17

and large not been violated since

50:20

probably March, a year and a half ago, that

50:23

there's a surge and it comes down and there's

50:26

a surge and then it comes down and it's usually

50:28

not always associated with a new variant that's

50:30

a little bit better at its business of infecting

50:33

people and or evading immunity than the one before

50:35

it. And packs of it will

50:37

still work and your vaccines will still work

50:39

and you need a booster when it's time for you to get a booster

50:41

and your home tests will still work. I mean,

50:44

that to me, if you think about the first two

50:46

years where there was a surprise

50:49

curveball every three months,

50:52

I'd say the last two years have been pretty predictable.

50:55

And so I don't see any good reason to think that the

50:57

next year, two or five

50:59

will violate that pattern. Of course

51:02

it could, but at

51:04

least based on the evidence that we have

51:06

now, it's probably, you know, we'll see another winter surge.

51:09

I think the difference is that in most

51:11

parts of the country, no one is pulling their masks

51:13

out anymore. A lot of people,

51:15

most people are not getting vaccinated anymore. And so

51:18

we're increasingly dependent

51:20

on the immunity that you have from your infection

51:22

and the vaccine that you got a year and a half

51:24

ago and very few people are going to wear

51:27

masks anymore, even if there's a surge, which is

51:29

unfortunate, but I think represents what

51:32

people, it's their revealed preferences. I

51:34

mean, wearing a mask people

51:37

seem to feel is enough of a bummer, whether

51:39

it's because it's truly uncomfortable or it

51:41

just reminds them of something they don't want to think about, but

51:43

they're just not pulling it out anymore.

51:45

Yeah. I mean, I, I think I, I think I agree

51:48

with you, Bob, um,

51:50

that the story is going to get less and

51:52

less exciting over time. I think

51:55

there's a couple of reasons for that. One

51:57

is hopefully this virus is.

52:00

finding this ladder like a pattern

52:02

of evolution where small incremental changes,

52:04

of course that could change any moment.

52:07

And we saw it already changed with like the 2.86. But

52:09

I also

52:12

think that what's also changing is more behavioral

52:14

is that we're getting more used, our anxiety

52:17

is decreasing, we're getting more used to having

52:19

SARS-CoV-2 and our repertoire of threats. So

52:22

I don't know. And then, but then some porn.

52:25

Then I go back to the 1918 flu,

52:28

where after the emergency was the biggest

52:30

surge of deaths because of

52:34

people kind of relaxing. So

52:36

I don't, I'm not good at making

52:38

predictions. But I will

52:41

say it's been absolutely fascinating

52:43

to watch all of this play

52:45

out in real time. It's something that

52:48

us in public health haven't really been able to

52:50

do in modern times, to see

52:52

how a virus becomes endemic.

52:55

And the surprises along the

52:57

way. So we'll see.

52:59

Let me ask another question. Last

53:01

prediction question. You

53:04

know, we went 100 years without

53:07

something that became a national public

53:09

health emergency. I'm not going to ask you when something

53:12

comes up again, but we all know that there

53:14

were scares in between certainly,

53:17

MRRS, SARS-CoV-1, Ebola,

53:20

other bad flus. And

53:22

now I think we have stuck in our mind and our imagination

53:26

that this is what a pandemic looks like and feels

53:28

like. But of course, Ebola

53:31

behaves very differently. Each of these things

53:33

behave very differently and help

53:35

us understand as we're looking

53:38

forward, the kinds of things

53:40

that are potentially different that

53:42

the public should be prepared to think about

53:45

as what's coming next. And then give

53:48

a little prognosis on how

53:51

at least from a science standpoint, we'll

53:54

be able to respond when something new

53:56

and different things happens. I

53:58

guess I'd start by amplifying what I said. which is I

54:00

think a misinformation engine has gotten

54:03

much better at its job. And

54:05

think about how that gets amplified with

54:08

GPT and deepfakes

54:10

and the ability to have anybody appear

54:12

to say anything. That's the part

54:14

that scares me more than whether the pathogen

54:17

will be better at its job than SARS-CoV-2

54:20

was, although that scares me too. I remember interviewing

54:23

Mike Osterholm for

54:25

my grand round. You know, somebody

54:27

studied pandemics for 30, 40 years and I said, how did

54:30

it feel after talking about

54:32

and warning about the big one for 40 years

54:34

to finally have it? And he said, this wasn't

54:36

the big one. He says, you

54:39

can easily envision something that's this

54:41

infectious, but is far, far more lethal

54:43

than this. And so, you know,

54:45

there's that, there's bioterrorism, there's climate, there's

54:48

so many threats. It's almost hard to get up

54:50

in the morning. But I think the misinformation,

54:52

if you don't start with everybody believing

54:55

the facts and being able to act on

54:57

them, I don't know how you get to

54:59

your goal. And

55:02

I think we're in that position now where the

55:05

misinformation machine is really good and it's

55:07

only going to get better because the tools are getting better.

55:10

Yeah, I mean, I agree that misinformation will

55:12

act as a catalyst among

55:15

any emergency. I mean, we're seeing that play

55:17

out right now in Israel and Gaza. But

55:22

considering epidemiological, yeah,

55:24

I mean, there's always emerging threats,

55:26

but I'm

55:29

a bit more concerned about

55:32

three other things. One is antibiotic

55:34

resistance. The second

55:37

is tropical diseases

55:39

becoming endemic in the United States because

55:41

of climate change. And then the third

55:44

is just our old diseases

55:46

coming back because of a

55:48

decrease in trust in vaccines and trust

55:50

in institutions and trust in public health

55:53

like measles and polio. That

55:56

unfortunately, I think a lot of generations

55:58

just have to kind of see what that disease is. is

56:01

to talk them into getting vaccinated again.

56:05

And so like I said, yeah, there's always

56:07

going to be biosecurity threats. There's always

56:09

going to be emerging threats. But really,

56:12

it's these closer

56:14

threats

56:14

that I'm most concerned about,

56:17

at least in the shorter term.

56:19

OK, let's

56:21

finish up by talking about

56:23

predictions and advice for people. And

56:26

there's not going to have in the bubble

56:29

around, I would argue,

56:31

that the bubble hasn't really played that role predominantly

56:34

for quite some time. And

56:37

certainly some of the guests, the two

56:39

of you, for sure, when

56:42

we had things going on, K-Monor played that role

56:44

intermittently. But unlike

56:46

the beginning of the pandemic, there

56:49

are plenty of good sources out there now for

56:52

people.

56:53

So

56:54

maybe we could just close. I will go

56:56

two rounds. First, Bob,

56:58

what are some of the best sources for information

57:01

you would advise people? What general

57:03

advice would you give people if they're

57:05

feeling like they need a place to connect

57:07

to should something happen? Well,

57:11

this will sound odd, but I would say Caitlin's newsletter

57:13

and Eric's newsletter are the two best things that

57:16

I see out there that are still summarizing

57:18

the state of the universe in ways that are

57:21

supremely helpful. I also think

57:23

that the threat has gone down

57:25

considerably. There's less interest in

57:27

what's new because what's new is not that

57:30

new anymore. I think it's perfectly

57:32

reasonable, even someone who's fairly COVID careful,

57:35

to basically keep half an eye on the news

57:38

and see if there's a surge. And if there's a surge,

57:40

then it's time to pull the mask out and

57:42

think again about indoor dining. And if

57:44

there's not a surge, whatever lifestyle you've

57:46

decided to live these days is feels

57:49

appropriate. So I don't think you have to

57:51

have the granularity of information that we needed

57:53

a year, a year and a half ago, about number of

57:55

cases per hundred thousand. You can't get it anyway,

57:58

but I... You

58:00

don't need to be that up to date every minute

58:03

in order to decide on how to live your life

58:05

COVID-wise. Kaitlyn, love

58:07

your answer and then maybe asking the additional

58:09

question, which will come out of the web on this. Just give

58:12

us any closing thoughts as our second to

58:14

last episode. So finish up

58:16

with anything you'd like.

58:19

Yeah, so related to health

58:22

care information.

58:25

I mean, COVID, yeah, Eric Topol's is

58:27

great. Kaitlyn Rivers,

58:29

force of infection has been a fantastic

58:32

kind of weather report that I've appreciated.

58:35

I know that the health care alliance is

58:38

putting out some really helpful information

58:40

around businesses

58:42

and how to keep their employers healthy. But

58:45

I will tell you that

58:47

it's, that's

58:49

about it. Like I can't, AAP

58:52

is great. There's

58:55

the normal players.

58:56

We'll put all of these links into the

58:58

show notes for people. Just so people don't

59:00

feel like they've got to write all this down. We'll put some

59:03

of it. But are those the places that inform you

59:05

best for when you put your newsletter together?

59:08

They inform me best. You know, what helps

59:10

me a lot is also really great health

59:12

science reporters at

59:14

the Atlantic, at NPR, at

59:17

Politico, Washington. I mean, they're

59:20

doing some incredible work and they're scientists themselves.

59:22

So I trust a lot about what they

59:24

write. But unfortunately,

59:27

there isn't a very great space. And so I'm thinking

59:29

through with a lot of people on what

59:31

is a health trust initiative? Where can

59:33

people go? What is what

59:35

misinformation is circulating? And so

59:38

I do know that people

59:40

are working towards a

59:42

better place and source

59:45

for health information. But it's it's

59:47

probably going to take time. But I

59:49

do know that is one of the biggest lessons

59:52

learned during this pandemic is the

59:54

need for timely, nimble, helpful

59:57

evidence based political information.

1:00:00

And we need to do better

1:00:01

than that. Got it. Any closing thoughts you

1:00:03

want to give us?

1:00:04

No, but thank you, Andy, for everything.

1:00:07

You don't have to put this on the recording, but thank you so

1:00:09

much for everything you did, truly.

1:00:14

It was a lot of work and it helped

1:00:17

me personally,

1:00:18

but it also helped me professionally, so. Of

1:00:20

course. Well, thank you, Caitlin. Don't be a stranger.

1:00:23

Appreciate it. I know you're going to have to have my own, but

1:00:25

I'll just finish up. Okay.

1:00:27

Bye, guys.

1:00:28

See ya. Well, certainly I think Caitlin's

1:00:30

newsletter is just one of the reasons why

1:00:33

I feel very comfortable that people will have

1:00:35

a really understandable human

1:00:39

access to what

1:00:42

I consider to be good information, which is it's sourced.

1:00:45

It's clear. It's clear what she

1:00:47

knows. It's clear what she doesn't know. I

1:00:49

think she's done a fantastic job. I'm

1:00:53

not at all surprised, Bob,

1:00:55

that Caitlin's gotten the

1:00:57

following that she has. She

1:01:00

seems to play it just right, not too hot,

1:01:02

not too cold. Yeah. I

1:01:05

mean, it's been interesting watching the

1:01:07

people that have emerged as leaders, communication

1:01:10

leaders, and we would never have discovered

1:01:12

them but for this pandemic. I

1:01:15

mean, Caitlin, I'm sure her

1:01:17

sensible approach and thoughtful approach

1:01:19

was what she's always taken and probably

1:01:22

five people followed her newsletter

1:01:24

and now thousands and thousands of people do. I

1:01:26

mean, you were very well known before in the

1:01:28

bubble, but in the same way, you were

1:01:31

in a household name and this elevated you

1:01:33

in a way that

1:01:34

is appropriate because

1:01:36

you brought incredible knowledge and

1:01:38

empathy and your ability. I mean,

1:01:40

you're such a far ranging thinker.

1:01:43

It sort of doesn't matter what the topic is. You've

1:01:45

got deep knowledge of it and deep understanding

1:01:47

and you're also a mentioned. And

1:01:50

so, you know, and I watching Ashish

1:01:52

on TV, it was like, boy, is

1:01:54

he good at this. So

1:01:57

these people kind of emerged and all

1:01:59

to kind of.

1:01:59

slightly different lanes, but it's

1:02:03

actually quite gratifying being on a show with all of them

1:02:05

because in many ways they were my sources

1:02:07

of information over the past several years and I think

1:02:10

they did immense good. Yeah, and of

1:02:12

course you as well. I

1:02:14

remember getting texts

1:02:17

from someone who would say they saw you in a

1:02:19

grocery store and that I think it was okay

1:02:21

to talk to you. I

1:02:24

have to tell you one last quick story.

1:02:27

Jake Silver, who's a very

1:02:30

prominent writer about politics

1:02:33

and statistics and called me

1:02:36

several months ago and said, can I take you out

1:02:38

to dinner in San Francisco? I'm writing a book about

1:02:40

the role of statistics and I want a chapter

1:02:42

on medicine. I'd love to interview you. So he interviews me. He's

1:02:45

wearing a baseball hat, which I assume is so he's

1:02:47

not going to get recognized. We're sitting at a restaurant

1:02:49

in San Francisco and a couple gets up to leave and they kind of

1:02:51

do a half look at our table and then they finally

1:02:53

come over and they say, are

1:02:56

you Bob Wachter? I'm sitting with

1:02:58

Nate Silver and Nate says, how

1:03:00

long does that happen? San Francisco

1:03:02

probably happens quite a bit to you. Around

1:03:06

here. Yeah, around here. Well, you know, I

1:03:08

think you personally, you

1:03:11

struck a chord with people

1:03:13

and how you communicated,

1:03:17

which was without panic

1:03:19

at a time when people were feeling panic. She may have felt

1:03:22

worried, but, and you were never afraid

1:03:24

to say this is a worrying thing, but

1:03:27

I think people for a long time, particularly the beginning,

1:03:30

wanted to know that there was an adult on the case,

1:03:33

you know, that while there was a lot of chaos

1:03:35

and I think you did that well.

1:03:37

Thank you. Look, there's a reason why when

1:03:39

I went to the White House, I asked you to guest

1:03:42

host the show and there's a reason why I

1:03:44

wanted to finish this episode

1:03:46

with just you and I to

1:03:48

reflect. You know, certainly as I

1:03:50

look back in the three and a half years, I'm

1:03:53

not feeling overly reflective because I

1:03:55

feel like, you know, the show did its

1:03:57

job as it needed to. But,

1:04:00

you know, I know that I

1:04:03

guess you're the only other person that I know

1:04:05

who, you know, sits, you know,

1:04:07

staring into this screen with

1:04:10

a giant microphone in front of you

1:04:12

and, you know, tens

1:04:14

and hundreds of thousands of people are going

1:04:17

to listen. And, you

1:04:20

know, knowing that the emotion that people are feeling

1:04:22

is equally powerful to the

1:04:26

information need that they have and, you know, trying

1:04:28

to fill both. And I appreciate

1:04:30

you, Bob. You did a hell of a job

1:04:33

and you came on this show for that period

1:04:35

of time. And I thank you for that. Well,

1:04:39

it was an amazing honor

1:04:41

to be given your baby and the

1:04:44

ass to make sure to take good

1:04:46

care of it. And

1:04:48

it was an amazingly gratifying period

1:04:50

because the chance to say what are the

1:04:52

important issues in

1:04:55

the most important issue of the world at the time and

1:04:57

who would be best to talk about them. And something

1:04:59

I learned from you is you can do it factually

1:05:01

and you can get the information out there, but

1:05:04

you have to do it with heart. And it

1:05:06

was always clear to me as every

1:05:08

step of the way that you were caring deeply about

1:05:10

everybody in your audience and you were focusing

1:05:13

on their needs. And you did a masterful

1:05:15

job and sad to see it go away. But I

1:05:17

think you're going away at the top

1:05:19

of your game and going away partly because

1:05:21

it did fill a need that doesn't exist anymore.

1:05:23

And that's a good thing. Well let's

1:05:26

go make the world a better place and

1:05:28

honor it, man. Let's

1:05:30

do it. We've

1:05:42

got one big show left. I

1:05:45

hope you'll tune into it. It's the next week. Going

1:05:48

to do a number of things. Going to have some of the people who brought you

1:05:50

to the show on this show. So

1:05:52

you did 99.9% of the work. And

1:05:56

I would love to talk to them with you. I'm

1:05:58

going to have...

1:06:00

Some of my family come on the show. My

1:06:02

mom will be on for a bit.

1:06:05

My wife Lana and our sons Caleb

1:06:08

and Zach are going to be on. Some

1:06:10

of you remember Zach. And

1:06:13

maybe even Tony Fauci, always not a family member.

1:06:16

But I think we'll have him on because it's the last episode.

1:06:20

Yeah, so thank you again for

1:06:22

listening up to this point. You only

1:06:24

got to make it through one more episode and I know

1:06:27

you can do it. And if it leaves

1:06:29

you wanting to say something, let me give you that voicemail

1:06:31

number again. It's 833-453-6662. Then

1:06:38

you can just punch 4 and

1:06:40

talk to your heart's content. Just

1:06:42

say what you want to say about the show. I

1:06:45

really want to thank Eric,

1:06:47

Ashish, Bob,

1:06:50

and Caitlin. We got them in the middle of

1:06:52

a bunch of stuff they were doing and they were all kind

1:06:54

enough to come on the show because they have a number of

1:06:56

times. And

1:06:58

all the other COVID related guests and other guests

1:07:01

that we've had coming on the show. Thanks

1:07:04

to them as well. All right, be good for the next week. Talk

1:07:07

to you again on Wednesday. Thank

1:07:14

you for listening in the bubble. If you like what

1:07:16

you heard, rate and review and

1:07:18

most importantly, tell a friend about

1:07:20

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1:07:23

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1:07:25

Shealy is the senior producer of our show. He's

1:07:27

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1:07:29

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1:07:31

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1:07:34

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1:07:36

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1:07:39

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1:07:41

ultimate big bosses are Jessica

1:07:43

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1:07:46

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1:07:49

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1:07:51

executive produced the show along with me. Our

1:07:53

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1:07:56

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1:07:58

by Ivan Karyev. You can find... Find out

1:08:00

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1:08:02

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1:08:05

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1:08:07

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1:08:10

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from our 20s and the many anxieties

1:10:02

we've experienced along the way. We're often

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joined by guests who range from celebrities

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to renowned health experts. And together

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we'll unpack big topics like deciding

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whether or not we want kids, building your dream

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career, strengthening self-trust, and

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much, much more.