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1:27

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1:30

current the and the current a game and of

1:32

current a for state one search

1:35

and current affairs and one one search

1:37

one search of state a affairs

1:39

search current one search of the

1:41

the huckabee be about i'm a crime in

1:43

what's known and understand that these podcasts are always

1:46

dated right to the date of the recording of this podcast

1:48

was monday december twenty seventh and

1:50

the time this podcast his outbursts already been weeks

1:53

three months from now we'll know things we don't think

1:55

that's just the nature things but nevertheless we talk about

1:57

what is known today about i'm a cron talk about

1:59

what the understand about vaccine

2:02

most benefits and risks focusing

2:04

on the mrm a vaccines your and specifically

2:07

looking at the differences between pfizer and

2:09

modern a especially in the subset

2:11

of young people and further

2:13

stratifying that by gender we

2:15

also talk about natural immunity something

2:17

that seems to be a very taboo subject matter

2:20

but very important thing to discuss

2:22

it wasn't a lot of time trying to explore the

2:25

what is the endgame hear what is it we're

2:29

hoping to achieve from a policy perspective

2:31

to get to living in a world that

2:33

looks more like it did in twenty nineteen

2:36

is that even going to be possible what is

2:38

the difference between a pandemic in an endemic

2:40

so this is a very conversational

2:43

interaction it's partly an interview but

2:45

really in the end it kind of is the discussion between

2:47

the the three of us despite briefly

2:49

a background marty is a johns hopkins professor and

2:51

public health researcher he's served on the

2:53

faculty of hopkins of the school public health of the past

2:56

sixteen years and servant leadership at the wh

2:58

oh he's a member the national academy of medicine and

3:00

serves as the editor in chief the

3:02

second largest trade publication medicine called

3:04

medpage today he also writes for the washington post the

3:06

new york times and a wall street journal the

3:09

dog is a use yes at stanford trained

3:11

internet and the founder of turntable health

3:13

he's also the house to be very popular podcast

3:16

z dog md podcast as well as

3:18

the cohost of an excellent podcast

3:20

called the vp z d show

3:22

and that's with been i proceed who by the

3:24

way has also been a guest on this podcast

3:26

and we reference been i hear in fact i would

3:28

have loved to have been eye on this podcast as well

3:31

other than the fact that it would have been pretty cumbersome have four

3:33

people on a podcast final thing to

3:35

know here is that because we recorded

3:38

this on december twenty seventh with the aspiration

3:40

of getting us out as quickly as possible our

3:42

video team was not in town

3:45

so we did not do this on video and

3:47

we don't really have the staff this week to

3:49

put out show notes so we're doing

3:51

this the be as quick as possible

3:53

in response was possible to some of the questions that

3:55

many of you i suspect you're asking so i hope you'll

3:58

accept your apology but this will be and the

4:00

only podcast and there won't be so

4:02

now it's beyond just a number of references so

4:04

without further delay i hope you enjoy my conversation

4:06

with marty macri answer

4:13

the dog marty so

4:15

awesome to be sitting here with both of you

4:18

as you know not a topic i have been spending

4:20

much time on certainly publicly

4:23

obviously anyone who think your patience has

4:25

to be paying attention to what's relevant to

4:28

them so that's permitted me

4:30

the luxury i think of being able to offer

4:32

my opinions to patients my interpretations

4:34

what i did feel a need to go a little

4:37

bit deeper in the in the past few weeks

4:39

and thought i'd reach out to you guys and we could

4:41

do this is a discussion because you guys have been spending a heck

4:43

of lot more time on this than i have and

4:45

in the last five days i've been drowning

4:48

in this substance luckily

4:50

i have wonderful analysts who have been able

4:52

to organize information for me but

4:55

anyway let's say let's just start with

4:58

helping me understand when the listeners

5:00

understand kind of what we know and don't know and and one

5:02

of the ideas that we had talked about the outset which

5:04

i think you guys agreed was it was at at a good

5:07

thing that we can try is the

5:09

listeners helping people differentiate

5:11

between what we believe is fact or

5:13

when know what is knowable and then what his opinion because

5:15

i think we're going to very easily

5:18

go back and forth between those two and i think people expect

5:20

that right on some level people wanna hear our opinions but

5:22

i think they also want to know when that separated from fact

5:25

so hopefully between the three of us we can

5:27

always kind of remember

5:29

which of those pillars where we're playing

5:31

and that's what i'd like to do is kind

5:33

of start with some basic

5:36

questions for you guys so we're

5:38

recording us on beer what

5:40

is it the twenty seventh right and obviously

5:42

a lot of what we're talking about is in flux

5:45

part of what's prompting this is omagh

5:47

cron being a new surge

5:49

would we know about this virus this

5:51

particular mutation and how it differs

5:53

from delta and

5:56

do we want to call the original one alpha are owed year

5:58

would what would you get what you call that

6:00

agreed to be with you peter and great to see again

6:02

here to been so i

6:05

think we can compare i'm a crime to

6:07

delta because delta represents are the worst

6:09

of the previous trains and now we've got

6:11

some pretty good laboratory data that

6:14

tells us that

6:15

i'm a cron is not infecting lung

6:17

cells neither long individual

6:19

cells or what we call organized

6:21

in the in a lab which the cluster of similar tissue

6:24

types the same efficiency

6:26

it's about ninety percent

6:28

less efficient in replicating

6:30

in those lung cells we've got laboratory

6:32

data now confirmed by three

6:35

independent labs that it's not in fact

6:37

he now says as well that's why we're not seeing the cost

6:39

of severe disease and the systemic

6:42

illness like beaver as frequently

6:44

with armor conversing more the upper respiratory

6:46

stuff since nerys the

6:48

broncos symptoms and five virtua

6:51

that you're gonna blow it off more maybe

6:53

that's one of the drivers have a be a be more contagious

6:55

but we gotta laboratory data get

6:58

epidemiological data

7:00

looking at south africa of looking at the numbers

7:02

down now over thirty five percent

7:04

off their peaks get shorter length

7:06

of stay there observed about two and a half days vs

7:09

eight days hospitals were not over

7:11

run in a country with you could argue

7:13

so my limited resources then we

7:15

got bedside observation so

7:17

we've got epidemiological data laboratory data

7:20

and bedside it at that all said that

7:22

it is in fact no longer an open

7:24

question this is a more mild virus

7:26

yeah i guess one of the questions that i have

7:28

a round the mildness of the virus because there is also

7:31

the i think it's that hong kong data that you're

7:33

pointing out that you have a lot

7:35

of upper airway replication enoch

7:37

some malt i fold over the

7:39

the oh gee strain and delta but

7:42

this idea that it's that milder clinical

7:45

syndrome is a little complicated

7:47

by the fact that in south africa you have africa lot of

7:49

a high sera prevalence of previous infection and

7:51

so the question is how much of this is we

7:53

have now or degree of natural

7:56

immunity and some vaccine immunity in

7:58

south africa and what you're the virus

8:00

that more replicate about maybe a little

8:02

less pathogenic maybe a little less

8:04

disease but in the setting of a much more

8:06

immune population because if you're

8:08

looking at the kind of the three precepts of a pandemic

8:11

it's a very transmittable

8:13

virus that causes a

8:15

lot of disease that we don't have

8:17

great immunity for those three things and it

8:19

looks like with am a cron we have a very transmittable

8:22

virus that may cause milder disease

8:24

that we have quite a bit of immunity to

8:26

already and and soaks all those things make

8:28

allude to make this less of a problem than delta

8:30

and terms of what we care about which are actual outcomes

8:33

of the risk of asking maybe i'm naive

8:35

question

8:36

it still reasonable to say that this is absolutely

8:39

a coveted variant or

8:42

at some point will mutations

8:44

of the oh gee strain allow

8:46

the delta lineage get

8:48

so far away from those strains

8:51

presumably in terms of virulence as one metric

8:54

that we really ought to be thinking of them

8:56

more as the amount of viruses

8:58

and not necessarily covered nineteen where

9:01

where that line be

9:04

the guy thing that is the ultimate question is

9:06

covered going to be assessed seasonal

9:08

corona virus as i know you

9:10

and

9:11

misa dodger had postulated early

9:13

in this pandemic their out you know i was reminded

9:15

of us listening for corona viruses that circulate

9:18

year to year that account for about

9:20

twenty five percent of cases the common cold this may

9:22

be the fifth and it may be in this version now the

9:25

russian flu which was eighteen eighty nine

9:27

done that eight eighty ninety one many

9:29

are now postulating that

9:31

that was a horrible pandemic

9:34

of a flu season proceeding the spanish

9:36

flu and that may very

9:38

well been a corona virus that turned into

9:41

one of those for seasonal current viruses

9:43

that we live with today we may have

9:45

essentially a fossil the previous

9:48

pandemics that mutated to a seasonal

9:50

mild current virus and it may be in fact

9:52

one of those for existing viruses

9:55

the i think this dividing line is interesting

9:57

ride because it really is at what

9:59

point of decide that's the case because

10:01

you know a seasonal cold can actually

10:04

kill somebody who's medically fragile

10:06

with come morbidities we see it every winter

10:09

as hospitalist we have we admit it's

10:11

impending sense of doom it's like winter is coming

10:13

every time in october

10:15

we know that just sanders

10:18

flu standard seasonal cold the krona

10:20

virus stuff that we already have the ad know viruses

10:22

or even are as v and adults can cause a very

10:25

nasty syndrome if you have a lot of

10:27

como abilities and it fills

10:29

up our hospice because a hospice operated capacity

10:31

so at what point is where we are now

10:34

considered very different from that and

10:36

that's a really operative question

10:39

another interesting question and again we're clearly

10:41

now in the editorial phase but rope they can move

10:43

will come back to some data later but if

10:45

you were thinking about this through the lens of evolution

10:49

micron would be by far

10:51

the best of the three

10:53

so far like if you're putting your virus

10:56

hat on and you're saying what's in the

10:58

virus his best interest you

11:00

have the perfect virus it

11:02

is highly communicative the

11:04

not lethal and in fact that

11:06

the worst viruses are the ones that are little harder

11:08

to spread in killed their hosts so

11:11

there any evolutionary argument

11:13

to suggest that it's we would

11:15

expect this to be the evolution

11:18

of the virus that it's as it

11:20

gets more evolutionarily fit should

11:23

be killing people last and it should

11:25

be spreading more

11:26

seems that that makes evolutionary sense

11:29

on many levels and actually few compared to sars

11:31

the oh gee this sars once sars

11:33

one seem to have a little higher case fatality

11:35

rates affected a different swatch of

11:37

people but it the way that it's spread

11:39

you could detect it's symptomatic

11:42

lee when it was contagious and when you are

11:44

asymptomatic you weren't contagious a we were able

11:46

actually to stop that virus through behavior

11:48

restrictions and testing of for people

11:50

with what we consider now to be hygiene theater

11:52

pointing a and this this

11:55

pointing out or temperature gonna somebody had

11:57

back then may actually have worked with that but

11:59

if you look at then the success of the virus that

12:01

wasn't a very successful evolutionary virus whereas

12:04

this one oh boy spreads when it's asymptomatic

12:06

causes severe disease just in typically

12:09

more vulnerable people but but there's so many

12:11

people that are vulnerable that you end up causing

12:13

a up a pandemic level of of dramas

12:16

but as you start to evolve it to arm

12:18

a cron were man it spreads so

12:20

fast that everybody pretty much

12:22

as a date with you know i'm a chronic some

12:24

points but he causes less severe

12:26

disease we sink based on the data

12:29

that marty citing and emerging information

12:31

well that's a very successful the virus

12:33

in that virus gets rewarded by being part of the pantheon

12:36

of are seasonal that affects

12:38

us every year and us i think it

12:40

would be very and surprising if that's the ammo

12:43

us evolution in this

12:45

like the temperature gun reference for some reason

12:47

those temperature guns scare me as much as

12:49

by

12:53

dams you know it may be

12:55

that i'm a crime is nature's

12:57

vaccine it is

12:59

far more mild and for the ninety three percent

13:01

of population living in poor countries in the world

13:04

they don't have access to a vaccine right now

13:06

and it's can be very difficult so the wanna

13:08

people out there are going to get vaccinated

13:11

and essentially i'm getting

13:13

i'm a cron and like it's ideal

13:15

to get the vaccine over getting the infection

13:18

but it may be sort of as

13:20

silver lining of this variant and

13:22

it may be how a pandemic ends we

13:24

do know from a johns hopkins study that's now

13:26

in the pre print server richard t

13:29

so immunity which is the

13:31

most under recognized third

13:33

of the immune system in the entire covered discussion

13:36

that is still solid against i'm a crime just

13:38

as was against delta that the crossover

13:41

is very high and

13:43

that if you get on a klein you've got to

13:45

sell immunity to delta and vice versa

13:48

that's now

13:50

jump in here on something because i'm glad

13:52

you brought this up marty and i suspect

13:54

both of you will have a lot to say on this everybody's

13:57

heard the expression what gets measured

13:59

gets manage what we can measure

14:01

we tend to fixate on and

14:04

unfortunately when it comes to

14:06

measuring immune strength

14:08

we really have one tool in the tool kit which

14:10

has to measure circulating antibodies

14:13

which you're not the same as neutralizing antibodies

14:16

twitter party you know be sell

14:18

immunity then you have it everything that you've

14:20

allude to marty called tcl immunity i

14:23

don't think we need to go into it in great detail i get a podcast

14:25

with the rosenberg that was cancer focus but

14:27

we had it totally index discussion

14:30

on be silver city so immunity so we'll we'll

14:32

we'll we'll send people there if they want a primer

14:34

on the upshot is we

14:37

don't have a laboratory tests

14:39

to measure t so immunity we we

14:41

don't even have a commonly available test measure

14:44

neutralizing antibodies we did measure circulating antibodies

14:46

so we can't really even measure what memory

14:49

be cells are doing you

14:51

think that's a little part of the problem

14:53

here in that we're kind of flying

14:56

blind and making a lot of assertions

14:58

about immunity based on arguably

15:01

the least important thing that you could measure

15:03

and again i'm editorializing in my question a

15:05

little bit but but what you guys think about a push back

15:07

on that if you think that were under

15:10

valuing circulating antibodies

15:13

i definitely think that we're undervaluing

15:16

circulating in advice and cellular nearly

15:19

as abroad group that is that memory be sells

15:21

more meaty south listen to our public health

15:23

officials from day one they talk

15:25

about the antibody levels

15:27

jump up and then we see them go down and

15:29

then initially there was a fear of reinspection

15:32

what we didn't see it clinically at the bedside than when

15:34

the vaccines came early on

15:36

they said you know you really have to get

15:38

that second dose because look at the antibody

15:40

levels just go up tenfold of

15:42

what they go up after the first dose well

15:45

that's good but it's good for activating your

15:47

memory be cells and memory t cells is good for

15:49

the cellular immunity antibodies come

15:51

and go that's in the textbooks right dates linger

15:54

for months in the system and then

15:56

they they wayne and by having

15:58

this in intense the station

16:00

on only one aspect of immune system that

16:02

is yeah nobody tigers what

16:05

we have don is what we create

16:07

a scenario where we're chasing our tail

16:10

keep those levels high because

16:12

when they're higher you're less likely to test

16:14

positive so what what we created

16:16

it was created this expectation vaccine is

16:18

somehow failing now when you test

16:20

positive even though that sell your immunity still

16:22

strong and preventing severe illness

16:25

the increase in almost a cascade of surrogate

16:27

markers that don't really measure what were directly

16:29

interested in right because if you have the surrogate

16:32

marker a fucking neutralizing antibodies then

16:34

stats trying to treat a surrogate

16:36

marker of cases pc

16:38

are positive cases but what do we

16:40

really care about we care about people in

16:42

the hospital filling up the hospital sick

16:44

dying maybe we can say long covert

16:46

isn't that question mark of things we

16:48

care about and so how

16:50

do we really look at i think what peters question

16:52

really points out as do we have good

16:55

measurement criteria to look at our we

16:57

actually immune against severe disease which

16:59

is that sort of innate memory

17:02

response that as anybody's wayne

17:04

you still are able to mount as which means which

17:06

you're still gonna get cold and flu symptoms

17:09

are still going to potentially be infectious during that

17:11

period but it's not going to settle

17:13

into cytokine storm a rds

17:15

and being prone dinner prone see

17:17

you ready to die and

17:19

that's what we care of and i agree i don't i know we talk

17:21

about things like things sell detect which detect which

17:24

don't know much about it's one of these come you know

17:26

commercially available tas i don't have marty knows more

17:28

about it but i really don't think

17:30

we have good the patient commercially

17:32

available test outside of research that

17:34

measure these things i mean in a study

17:37

that we're

17:38

and i'm not really that involved i mean i was

17:40

involved in some of the planning of it but there's a

17:42

study that going on at the receive indiana right now

17:45

it's specifically looking at long

17:48

term be so and he sell immunity and

17:50

in speaking with the investigators there

17:52

i mean the essays to measure that

17:54

degree of function or quite complicated i mean these

17:57

are not things that are amenable to commercial testing

18:00

any regular so i i do feel pretty confident

18:02

in saying that we don't really have

18:04

the tools to measure those things and and

18:06

and i forget who who i heard say this but i'm paraphrasing

18:09

somebody they said measuring

18:11

circulating antibodies saying

18:14

you know everything about a person's immunity

18:16

is sort of like looking in a person's bank

18:18

account and saying you know everything about their

18:20

net worth it's probably correlated

18:23

right especially

18:25

with a wealthy person like the they're checking

18:28

account is really not representative

18:30

of their net worth yeah they're checking account

18:32

probably doesn't have zero dollars another probably

18:34

not overdraft it the

18:37

unlikely that a billionaire is going to have hundreds

18:39

of millions of dollars sitting in a checking account

18:41

so i think that's

18:43

sort of to your point both of you

18:46

i think created a series of metrics

18:49

that are problematic especially

18:51

when i haven't heard a clear articulation of what

18:53

the endgame is right so there's now a macro

18:55

question right which is i

18:58

had to go out somewhere today and actually

19:00

pretty unusual for austin because austin really

19:02

doesn't care about masks or anything like that but

19:04

i was surprised i went in the woman

19:06

said the if she took my temperature and

19:08

so i got the temperature gun in the face and then she

19:10

said oh you know where it were were wearing masks

19:12

or she had to be a mask and in i don't

19:15

i don't argue with people over that kind of stuff because

19:17

i feel like it's it it is just that are pay grade

19:19

right that gets her job to tell me that final where i'm asking

19:22

whenever but i keep

19:24

thinking of a what's the endgame here it is the implication

19:26

because if you're making me wear a mask now there

19:28

may be imply that you're in to make me

19:30

wear a mask forever how

19:33

do you extract yourself or walk back from this position

19:36

of temperature gun mask

19:39

you know it's cetera so when

19:41

it comes to what is the endgame

19:43

what can we all agree is a reasonable

19:45

line in the sand beyond which

19:48

the world goes back to twenty nineteen

19:51

i'm having a hard time understanding that so so what

19:53

are you guys understand with respect to that you

19:55

know is from my and so much

19:57

of it peter him is an emergent property

20:00

how we're measuring stuff is actually the question that you

20:02

ask the beginning it's like if we care about cases

20:05

and a neutralizing antibody levels

20:07

and it's gonna be an infinite number of boosters

20:10

and masking into perpetuity and

20:12

even though the data as very questionable on all the stuff

20:14

we keep doing it this is a policy

20:16

question how do we want to be in the world

20:19

how do we wanna live our lives what's the difference

20:21

quantitatively and qualitatively

20:24

between twenty nineteen before we had

20:26

this pandemic but we would have severe flu

20:28

that would overwhelm hospitals in the fall

20:31

in certain places would go on divert and we've

20:33

all worked enough i've worked in those facilities

20:35

when that happens it sucks every

20:37

medical person grind cities and

20:40

nash's everything but we get through

20:42

it and we don't disrupt society we certainly don't

20:44

close schools we don't inflict masking

20:46

on the public because we would never

20:48

think to do that as a policy so

20:51

this is really a policy question how do we

20:53

want to be in the world i think that's worth all

20:55

the division that's been sewn on

20:58

social media through mainstream media alternative

21:00

media you know all this disinformation

21:03

misinformation i don't even know what that even means

21:05

anymore has created an environment

21:07

where we're so atomizer by tribe that

21:09

even the policy questions become tribal

21:11

identifiers so we need to kind

21:14

of really see that clearly from

21:16

a perspective of a more holistic

21:18

is integral perspective of go okay to

21:20

this what's happening or it's wealth what

21:22

do we really care about we care about people

21:24

not dying not filling up hospitals and

21:27

we care about our economy working because health

21:29

actually correlated the well which

21:32

is correlated to longevity emmy these these are things

21:34

that are clear such economic status education

21:36

matters for that so speak this is how

21:38

we have to look at policy not a reduction

21:40

is how many cases can we prevent and

21:42

i think there's political stuff here that happens

21:44

and and it's it's just becomes have a complicated

21:47

math

21:48

can you imagine guys if we

21:50

tested for influenza every influenza

21:52

season when say four years ago we have

21:54

forty one million flu cases a

21:57

matter of a couple months can you imagine if we

21:59

grasp on it daily basis the

22:01

number of newly diagnosed flu cases and

22:03

we'd create mass hysteria now

22:06

that doesn't mean we blow off flu or we don't take

22:08

it seriously or we don't tell people some reasonable

22:10

strategies like if you're around someone

22:12

vulnerable be careful what you think you've been exposed

22:16

wear a mask if you have symptoms stay home

22:18

i mean that that's kind of how we do

22:20

live with that respiratory pathogen

22:23

hundred twenty five percent of the population

22:26

will get infected with a respiratory pathogen

22:28

every year in perpetuity

22:31

because there's a whole bunch of right

22:33

virus and it kind of virus

22:35

and influenza and para influenza

22:38

ends the for corona viruses we talked

22:40

about if a parent brought

22:42

their kid and say for their newborn

22:44

evaluation the first pediatrics visit

22:47

and a pediatrician said your

22:49

child will develop five to seven

22:52

pediatric respiratory infections

22:54

during their child mm

22:57

you could do you could blow that up

22:59

into you know the

23:03

headline to but the risk the

23:05

risk is we're not going to eradicate

23:08

pathogens from planet earth were quite peter

23:10

you mentioned something about the time

23:12

at the antibody tigers and sort of chasing

23:14

our tail this just came out

23:16

day before christmas from ,

23:19

from the uk now this is from the uk security

23:22

agency they're pulling they're data

23:24

that they've got great data so the vaccines

23:27

they have had them with the primary

23:29

series or seventy percent effective

23:31

against symptomatic kobe ten

23:34

weeks after a booster it

23:37

goes down and thirty

23:39

five per cent for pfizer and forty five

23:41

percent from alternate so within ten

23:43

weeks you're seeing even the booster

23:46

where off against your ability

23:48

to positive or

23:50

have a symptomatic case those

23:53

memory be cells and t cells are still working

23:55

the sell your immunity is so protecting

23:58

against severe illness of we keep chase the

24:00

antibody tigers you might be

24:02

getting a booster every first monday

24:04

of every month when you shop at work and

24:07

it still won't work

24:08

the think about something this morning guys that i

24:10

thought could help us kind of anchor

24:13

a little bit into the

24:15

evolution that we've undoubtedly all experienced

24:18

so if i think back to march

24:20

of twenty twenty i actually

24:23

pulled my kids out

24:25

of school about two weeks before

24:27

the lockdown so before to be enough

24:29

two weeks before this guy kind of insane i was like know

24:31

what i don't know anything about this virus i

24:33

don't like what i'm seeing outside of united

24:35

states we're going to keep our kids

24:38

home our my daughter was furious

24:40

how could you do this to me bubble lot though

24:43

i look back about anything that was the

24:45

wrong thing to do because it didn't matter

24:48

i didn't know better then i think it

24:50

was a reasonable precautions in the

24:52

absence of any information right

24:54

like if this turned out to be as bad as

24:56

sars one meaning

24:58

it was as week our sars

25:00

one but as infectious has sars to would

25:03

have been a good thing to do turned up was overkill

25:06

i was thinking about like how many times

25:08

has my view of this problem

25:11

changed and the answer is many and

25:13

i think part of it comes down to the

25:16

framework around what

25:18

tools do we have it our exposure at our

25:20

disposal and what knowledge do we have about

25:23

how to reduce morbidity and mortality for

25:25

kovac and i was thinking about this because the first

25:27

time i delineated this in

25:29

the spring of twenty twenty the now

25:31

and i do it today so so tell me if you guys would add

25:33

to or subtract from this i break it into three

25:35

broad categories the first is preventing infection

25:39

the second is treating infections and

25:41

the third is providing supportive care

25:43

for people who end up in hospitals in

25:45

the preventing infections you have two

25:47

things basically vaccines and behaviors the

25:50

treating infections you would have existing drugs

25:52

vs new drugs and and sort of care so

25:55

in the spring a twenty twenty we had no vaccines

25:58

we had behaviors that we didn't know which ones were right versus

26:00

wrong being indoors being outdoors

26:02

wearing this type of mask that tiger mask weekly

26:05

been know anything stand sixty two parts and

26:07

sixteen feet apart i mean i'm just a whole bunch of

26:09

made up stuff the treating infection

26:11

side we're busy had no new

26:13

drugs but we had a whole bunch of existing drugs

26:15

and drug in there was a whole slew

26:17

of ideas around well with this

26:19

drug work what about remember him disappear we talked

26:22

about that so much and and of course you had

26:24

happy drugs became totally politicized etc

26:26

and then in the supportive care side

26:28

of things we didnt know anything right it was like is this

26:30

a r d s should you be oxygenating

26:32

the bejesus people steroids

26:35

must be horrible mean we really knew nothing

26:38

a whole bunch of empirical insights and when you

26:41

consider where we are today on that

26:43

front the i just kind of trotted

26:45

out a bunch of ideas it's kind

26:47

of amazing that

26:49

in less than two years we

26:51

have multiple vaccines the

26:53

pretty clear ideas about which behaviors

26:56

reduce the spread of infection and which them the

26:59

treatments side

27:01

pretty good sense of at least one existing drug that

27:03

works which is flu vaccine we can discuss

27:05

if there are others and we've got a boost

27:07

to new drugs that seem quite promising

27:10

i'm more familiar with the pfizer data than the merch data

27:14

you can probably speak much more to the

27:16

the therapy side right the supportive care side

27:18

but it seems to me the i cu

27:21

doctors and nurses have a way

27:23

better sense of what to do today than

27:25

they did a year ago let alone eighteen

27:27

months ago and even us

27:29

would add to that framework because i i think

27:31

it's important to differentiate between

27:34

what the world looks like in the spring of twenty

27:36

twenty with respect to those data

27:38

points are those those parameters

27:41

versus what it looks like today so would

27:43

you expand or subtract on

27:45

i can say a couple of things sure that's a really good framework

27:47

it's interesting because in the prevention framework

27:49

you could also throw in hey you know what about

27:51

things like vitamin d

27:54

treating metabolic syndrome diet exercise

27:56

those kinda things which are which are softer lifestyle

27:59

but no i like i like yeah like lifestyle

28:01

modification which i remember in the early

28:03

days you were talk about things that you did of things

28:05

i did too we're we're because

28:07

i said i have this is more like oh gee sars

28:10

then what because we didn't know what the i asked the infection

28:12

fatality rate was it was sitting

28:14

there exercising like a lunatic and

28:17

stop drinking alcohol as i spit

28:19

as hotly personal things to try to improve my

28:21

metabolic condition so

28:23

that that's that piece of it and then there's a question of chemo profile

28:25

access you know some i've been i've had these politicized

28:28

drugs they've been advocating that they're more prophylactic

28:30

is while you to take it you know i've or mac and once and week

28:33

and prevent is where is mean it's worth exploring worth

28:35

exploring think there's data that we have it's your your comment

28:38

that this has evolved so quickly is

28:40

absolutely it's a beautiful

28:42

vindication of the scientific process when

28:44

it's allowed to unfold people i

28:46

think people whose politicized this a lot on both

28:48

sides sale nothing's he of doctors aren't really

28:50

trying to do anything to treat this we haven't really learn

28:52

anything now the opposite is true multiple

28:55

good vaccines things like dexter

28:57

matheson in the hospital that if really

28:59

the improve mortality and we've

29:02

actually thrown out things that don't work

29:04

which is actually just as important because those things

29:06

can actually cause harm so the question

29:08

of hydroxy corkin for example you know in

29:10

in it he says us that analysis showing

29:12

the maybe we actually cost lives by giving

29:14

that much hydroxy cork once these

29:16

are things we need to actually really

29:19

dive into end the comes

29:21

down to this peter like let's say the

29:23

i have far this how i think about it is subsection fatality

29:25

rate let's say it's you know point two point three somewhere

29:27

in that range which seems reasonable

29:30

although we don't have exact date us how

29:33

many people in the us are roughly at risk

29:35

then of dying based on the population

29:37

of the u s and the i far as the disease and

29:39

so i did a lack of a napkin typically snow

29:41

few months ago that was roughly about one

29:43

point four million americans if

29:45

that thing was the actual i fr of the disease

29:48

if we didn't do anything that's at

29:50

the current state of the i fart and that's how

29:52

many people would die were at what

29:54

eight hundred thousand so the court

29:56

the question is will we get

29:58

to one point four or will

30:01

it not reach one point four and if it doesn't

30:03

what of those three buckets

30:05

were me what what did we do to actually

30:08

improve that nice suspect it's a mix of vaccines

30:11

therapeutics in hospital lowering i

30:13

afar by improving hospital care and

30:15

some behavioral stuff like maybe avoiding

30:17

big crowds when something surging something

30:19

like that but i but that that's kind of my current

30:22

thinking on as you know with a goal

30:24

is get that down from one point

30:26

four million as much as we can without destroying

30:28

the fabric of society which will actually push

30:30

it back up towards one point four three

30:33

ancillary damage in terms of substance abuse

30:35

overdoses mental health problems

30:37

suicide

30:39

yeah it's amazing what we have an aunt

30:41

toolbox how far we've come scientific

30:43

innovation the me was

30:45

almost equally amazing how

30:48

we've not incorporated many of

30:50

these new therapeutics

30:53

into

30:54

common practice and that is probably

30:56

a glimpse as to what's broken with our broader

30:58

health care system the average seventeen

31:01

year lag the new evidence

31:03

to get broadly adopted into practice and

31:05

we're seeing that play out now now maybe it's truncated

31:08

maybe it's a three year lag but

31:10

it's too slow for health emergency yes

31:13

it's amazing how how much we've learned

31:15

that is also amazing how we

31:17

still have daughters telling folks you

31:20

have covered tough it out stay at home

31:22

you know what we should be telling them

31:25

in order based on evidence

31:27

a list of things and a no specific

31:29

order flu vaccine reduces

31:31

mortality by ninety one percent pure

31:34

desk and i the steroids inhaler markedly

31:36

reduces hospitalization

31:39

vitamin d has been sound to be correlated

31:41

with severity of illness and a german study

31:43

and hospitalized patients hypertonic

31:46

saline is an age old treatment

31:48

has been used the sort of rinse

31:50

out the naval nasal cavity and has

31:52

been used by doctors flaunt how many viruses

31:55

then you've got all of these things that are

31:57

not being adopted broadly

32:00

and to me we are still suffering

32:02

from significant groupthink

32:05

we've been burned badly that

32:07

group think in madison throughout this pandemic

32:10

no failure to warn about it in

32:13

the surface transmission idea in

32:15

the draconian and barbaric practice

32:18

that doctors and hospitals were complicit

32:20

in to ban people from visiting

32:22

their loved ones to say goodbye closing

32:25

public schools will ironically with

32:27

a less contagious strain out there

32:30

ignoring natural immunity not

32:32

talking about flu vaccine i just saw another

32:34

white house briefing you've never

32:36

once heard of public health officials talk about

32:38

it the group think and not spacing

32:40

out the doses maybe we wouldn't be talking

32:43

about boosters as vigorously if we

32:45

would have spaced out the first two doses as we

32:47

shut up by the way i want to make a comment on that when

32:49

the vaccine started rolling out i

32:51

spoke with

32:53

the re immunologists

32:55

virologist so an easy i won't name

32:58

who they are just for the sake of protecting

33:00

their identity but i mean

33:02

i explicitly talk to them about this

33:04

and i said why they're four

33:06

weeks between first and second shot

33:09

that seems at odds with the little bit the

33:11

i know about the immune system they

33:13

said there's not a single reason

33:16

to do that other than they'd probably did the trial

33:18

that way for the sake of speed but

33:20

they said if you can

33:23

drag your feet as much as possible

33:25

between those doses do

33:27

so and i was like well you

33:29

think it's worth saying that and they're like no don't

33:31

fix that not gonna say that just

33:34

just you know drag your feet

33:36

as much as you can show up

33:38

three months later saying you forgot to get

33:40

your second shot kind of thing so

33:42

yeah there's a little bit of of this going on by the i want

33:45

to do want to go back to one thing you said marty

33:47

that that i have generally

33:49

found the evidence to not be favorable which

33:51

is vitamin d at least supplemental

33:53

vitamin d so get my patients

33:55

ask me about this all the time i'd said look don't confuse

33:58

your vitamin d level that you are there

34:00

are being in the sun

34:02

playing sports outside with the vitamin d

34:04

level that you can get by taking

34:06

four thousand five thousand i you a vitamin d

34:09

i don't think those are the same i think

34:11

vitamin d might be a surrogate for

34:13

health through other means did

34:16

this study that you're citing specifically

34:19

look at outcomes being improved with supplemental

34:21

vitamin d or did it simply associate or

34:23

note the association of higher levels of vitamin

34:25

d and better outcomes

34:27

the latter so out of all the things

34:29

i mentioned that has the weakest evidence that

34:31

was sort of a retrospective review of hospitalized

34:33

patients just looking at their levels may sound

34:36

some correlation but it doesn't

34:39

imply causation necessarily

34:41

all the other staff has randomized controlled trial

34:43

date up behind it vitamin d thing

34:45

was a retrospective review

34:47

that's my take on that has been in my practice

34:49

has been not to prescribe vitamin

34:52

d and instead to get

34:54

outside and exercise in the sun and get it that

34:56

way zoom and you have a a take on any

34:58

of those including the vitamin d thing yeah

35:01

that was my take on the vitamin d p's to his

35:03

there's a correlation causation situation

35:05

that there is definitely something going on

35:07

with naturally acquired vitamin d that seems

35:09

and least in a correlative way protective

35:12

one thing that i think is interesting social vox mean again

35:15

i think when you've been through the hydroxy

35:17

cork when i ever met in mills their

35:19

the group thinks starts to shift and go therapeutics

35:21

to simply don't work especially for their reapers drugs

35:23

there is a lot of groupthink in madison and people

35:26

are then on inclined to look at these

35:28

pieces the other interesting thing about this

35:30

particular pandemic that makes it tough marty is

35:32

that you know ninety nine point

35:34

six percent or whatever of people are

35:37

going to get better no matter what

35:39

in other words staying home and doing nothing they're

35:41

probably going to be just fine and so it

35:43

becomes a question of how do we

35:46

do we tell the whole world to take you

35:48

know be death knight and slovaks mean and

35:50

all of that the minute they get sick like autocrats it's

35:52

gonna suck everyone and i'm getting tons of emails

35:54

hey i have cold symptoms i'm at home psycho

35:57

get monoclonal antibodies should i do

35:59

notice peter has is defined patients

36:01

i have like millions of patients who email

36:04

me and i keep telling them i'm not sure doctors

36:06

but what at what i always say as

36:08

you know look you have to look at your risk factors

36:10

utility or age you have to look at where you

36:12

infected previously hired to do with that there's so

36:14

many intricacies whereas

36:16

it would be nice to say you know what if you're

36:18

if you're have these symptoms hear symptoms hear risk

36:21

high yield are things we can

36:23

do and i don't know marty do you think some

36:25

of those things on your list are applicable

36:27

to say anyone who gets covert or would you risk

36:29

stratify

36:31

we've got a risk stratify because

36:33

one it's it's just over kill somebody

36:35

who's young and healthy the german data

36:37

just came out that between the ages of five

36:40

and seventeen and a single healthy

36:42

person died three vaccine

36:44

so when you get someone vaccinated that's

36:47

probably a an indicator of over

36:49

use if were to using some

36:51

big guns in that population and

36:54

yet i made a comment about dockers

36:56

being slow to adopt some of the stuff and i

36:58

just want to be clear we

37:01

have put doctors in a terrible situation

37:04

in the united states we've put the money very

37:06

bad situation by putting

37:08

them on the front lines of this pandemic without

37:11

any good data for a long time when

37:13

this pandemic happened it

37:15

hit this country and every single person all

37:17

of our friends and everybody

37:19

everybody who emailed you zoom

37:21

in and by the way sorry for

37:23

knowing people who emailed me just to email

37:25

you maybe i'll thank selling them to the

37:27

, you know how if it just pay

37:29

me a nickel every time that happens and then

37:32

as peter says video feed your wallet

37:34

biopsy of my bank account i'll have like at least

37:36

a time and are great but

37:38

we were all getting the questions

37:40

how does it spread the masks

37:43

work how long are you contagious for

37:45

the news spread it priests symptomatic all the basic

37:48

questions of covert we did not

37:50

have answers because are gigantic

37:52

four point two trillion dollar healthcare system

37:55

could not do the basic bedside clinical research

37:57

i remember peter was even doing it video

38:00

about somebody please do this study we were

38:02

all saying the same thing labs were mostly

38:04

close because it was no pp the an early

38:06

age but was unable to

38:09

pivot their of forty two billion

38:11

dollars to answer these questions quickly

38:13

so what we did as we had as vacuum

38:16

of scientific research and all

38:18

the doctors run the front lines without

38:20

any data to really answer these questions

38:22

and that's when the group think began and guess what

38:24

ended up feeling that vacuums political

38:26

opinions the we

38:29

just did a study of and i it's research funding last

38:31

year lesson five percent

38:33

went to covert research three

38:35

months into the pandemic zero point zero five

38:38

percent of the nih his budget went to covered

38:40

research the average time for

38:42

them to give a grant was five months

38:44

the find a research team to then start

38:46

the research the hundred and fifty

38:49

seven grants on social

38:51

disparities with covered an

38:53

important topic the only for

38:55

on how it spreads and one on

38:57

masks which hasn't even read out yet the

39:00

most basic questions doctors needed

39:03

the evidence for that was not being

39:05

conducted i want to go back to something

39:07

that

39:08

you guys are both a now alluded to and

39:10

i talked about this a little bit on the podcast

39:12

with rogan and i think it's worth mentioning again

39:15

the a fundamental issue that i think we're going

39:18

to talk about many times this afternoon

39:21

it out know i had a discussion a couple

39:23

months ago and he put this very eloquently

39:25

and i something we all understand

39:27

by think i like the way he phrased it right which

39:29

was always know the difference

39:32

between science and advocacy and

39:35

as we explain these differences now i think people

39:37

will inherently understand it but then

39:39

again we're now talking in the were from of opinion

39:42

my opinion is perhaps

39:45

the greatest the service that has come out of this

39:47

has been that that line has been

39:50

so blurred the be nonexistent

39:52

soap science is messy

39:55

science is uncertain science

39:58

speaks in probabilities science

40:01

constantly changes in the face of

40:03

new information right so science

40:05

is a process not a thing rinse

40:08

science says what

40:10

we know today with this degree of certainty

40:13

as new information becomes available the

40:15

new truth will be there at such a truth

40:17

is not a constant within science i

40:19

truth we hopefully converges

40:22

on greater certainty

40:24

so when scientists speak it

40:26

doesn't really sound that reassuring

40:28

i mean is you know we know this because we

40:31

interact with scientists alot they

40:33

never give you a straight answer because if

40:35

they're doing their jobs honestly they rarely

40:37

know outside of really well

40:39

known phenomenon we we have to speak and uncertainty

40:44

for understandable reasons advocates

40:46

can't do that they don't have that luxury right

40:49

if you're if you're a public health advocate

40:52

your job is to communicate something

40:55

with complete certainty that

40:58

if you're observing this is a member of

41:00

the public and you don't know the difference

41:04

how do you know what to make of this so

41:07

it's safe to say that anthony fouch he is

41:09

an advocate in cohmad and not

41:11

a scientist

41:13

this is the central thing that's

41:15

going on here i think peter i think you're

41:17

absolutely right because , it is

41:19

as if you look at fancy say are you look at francis

41:21

collins so recently leaked emails

41:23

francis collins talking about the great

41:25

barrington declaration which was a bunch

41:27

of scientists including someone is been on my show j

41:29

bought a char yes saying hey as

41:32

a matter of policy we

41:34

think the following things should happen

41:36

that would improve outcomes in this pandemic

41:39

based on our interpretation

41:41

of what the best sciences right now there is no

41:43

za science this is our policy interpretation

41:46

rights and what francis collins

41:48

roughly wrote collins this email was

41:50

hey did you see these fringe epidemiologists

41:54

coming up with this great barrington declaration oh by the way

41:56

one of the friends guys was us is was nobel

41:58

prize winner at stanford mike leavitt and

42:00

i if you haven't seen it we need to do a

42:03

devastating and you know decisive

42:05

take down of this and i don't see it out there

42:07

yet and since basically saying ultimately

42:10

what i would turpin to says is hates i disagree

42:12

with this as a policy we

42:14

need to put out something that takes

42:17

down as a policy and there's not

42:19

a discussion of oh let's have let's discuss the underlying

42:21

science let's actually have a

42:23

discussion about policy like does it make sense

42:25

to treat healthy people are that are young the same

42:28

as elderly people at high risk these

42:30

are the conversations we ought to have instead they

42:33

acted as advocates well our position

42:35

is to the lockdowns make people

42:37

mask promote whatever it is we're promoting

42:39

and that's our policy so we need to advocate

42:41

for it in no uncertain terms which

42:44

means a devastating and immediate

42:46

take down of these quote on quote friends

42:48

epidemiologists and that that's that

42:51

is as lear and aspect of

42:53

the difference between policy politics and

42:55

science but this is a scientist

42:57

who represents our one of our largest

43:00

scientific public agencies south

43:02

and that was really concerning to be a terse marty

43:04

what what you think of that that was chilling

43:06

when i saw that email from census

43:08

collins to fallacy and he called for

43:10

a devastating take down of

43:14

another opinion basically

43:16

i mean they control the

43:18

currency the academic medicine

43:21

which is an i h funding when you

43:23

got the head of that talking about

43:25

taking down ideas and taking

43:27

down people this

43:30

is probably the greatest lesson

43:32

we should learn from the pandemic in addressing

43:35

how do we avoid group sank in

43:37

the way that it's burned us time

43:40

and time again we've got

43:42

to openly talk about

43:44

the corruption of science itself

43:46

how there has been a shut down of scientific

43:49

discussion how you cannot talk about certain

43:51

things that started with google suppressing

43:54

any search of woo on lab

43:56

leak and they admitted this openly you

43:58

said you know we we support the researchers

44:00

because we weren't sure we do my people to get the ideas

44:03

if they weren't shirts well as not their role

44:05

they did the same the great barrington declaration

44:07

took down doctor bad sorry i was skeptical

44:09

of the of the declaration early on

44:11

but look at what's happening in sweden now

44:13

and tell me if there wasn't some truth in what they

44:15

were talking about martin cold

44:18

or very well known

44:20

a vaccine i'll just from harvard

44:22

on the cdc a sip

44:25

committee basically dismissed

44:27

openly told me this and he said i could say

44:29

this publicly have written about in the wall street journal dismissed

44:32

from the committee for having a different idea

44:35

he was upset about the jnj pause been

44:37

to prolonged in creating vaccine hesitancy

44:40

asked to leave the committee ft

44:42

a bypass their own expert

44:45

advisors called for a pack on

44:47

the boosters for young people vote city

44:49

see with their expert advisors

44:51

on boosters for young people told

44:54

that committee specifically you're

44:56

voting on older folks we're

44:58

not holding a vote on boosters in young

45:00

people and then they go ahead and author

45:02

and and recommended for for young people

45:05

two senior ft a officials quit

45:07

including the head of the vaccine center at

45:09

the ft a academic

45:11

bullying how many people have reached out to

45:13

us and said thank you

45:16

for talking about natural immunity i see

45:18

it in my patients i can't talk about

45:20

it on told we have to keep one message

45:22

and that is to get everyone vaccinated and

45:25

you know thank you for speaking up speaking can't do

45:27

so why is the nih

45:29

not done a study on natural immunity they keep

45:32

saying we don't know ignoring

45:34

the hundred and forty one studies that have been

45:36

documented by the brownstone institute it's

45:39

not the hard coded new york where people

45:41

had the infection the interview them

45:44

tessler blood i mean why

45:46

is my research team doing this without and

45:48

i it's funny because the nih

45:50

as dunaway not funny if they're not doing it and they're

45:52

relying on to really fly studies

45:54

that cdc put out this is

45:56

the the distortion the

45:59

science south shutting down

46:01

scientific discussion and that should be our greatest

46:03

missing

46:04

come back to the museum of natural immunity because now i want to

46:06

gonna get into let's talk about

46:08

what we know so let's start with that

46:11

what do we know about

46:13

naturally acquired immunity

46:15

you know it's interesting because there are multiple studies

46:17

showing that natural immunity is actually a

46:19

real thing it's a real phenomenon it generates really

46:21

good protection against either ,

46:24

at a lower rate or severe disease at a much

46:26

higher rate and then there are

46:28

a couple of studies the

46:35

and a a

46:38

of the

46:41

the u s if

46:48

and a and the cannot

46:52

or for the

47:01

the that point the and

47:05

and or to

47:14

or a on and

47:19

the the or

47:27

i a

47:30

for

47:31

the repertory virus to not

47:33

generate natural immunity in other words like what

47:35

would be your prior yes

47:38

if you knew nothing little

47:41

again this is so outside of my wheelhouse guys

47:43

i am not an immunologist i'm not have

47:45

a more poorly amount of my rolla just run i think that's

47:47

the real question and and none of us are so

47:50

do we know if it's

47:52

actually the norm that once

47:54

you have a virus you tend to develop

47:56

natural immunity to i mean that was sort of my

47:58

understanding from medical cool but have things

48:01

changed significantly and what

48:03

would be our expectation here

48:05

yeah so just real quick strep throat

48:07

which is a bacteria that

48:09

can reinfected you and reinfected you see you cannot

48:11

have a viable vaccine respiratory

48:14

pathogens in general you

48:16

can get reinfected but your immunity

48:19

against severe disease tends to be quite strong

48:21

alternatively when they're just changing right of

48:24

the a

48:30

that's right and even then even the novel this

48:32

is a pathogen is actually not as

48:34

novel as a real phase shift

48:37

in the antigens you're presented with

48:39

like maybe would happen in h one n one swine

48:41

flu or a new bird flu so yes

48:43

it's a spectrum all the way up to measles where

48:46

it doesn't change that much even though it's and aren't a virus

48:48

and you can get through permanent sterilizing

48:51

immunity from natural infections for the rest

48:53

of your life and that's why we don't even vaccinate

48:55

people who were born before say ninety

48:57

six because we assume they all got measles and

48:59

they have immunity so maryam cursor

49:02

yeah i know right look as think one of the

49:04

yam little known secrets as we all

49:06

have our group of go to

49:08

people we've got our immunologist

49:11

are vast knowledge as our infectious

49:14

diseases experts then

49:16

we go to them frequently and we learn to trust

49:18

the judgment as many these and

49:21

i haven't heard paul offit on your podcast

49:23

as ubuntu about how

49:25

does that spectrum so let's look

49:27

at the hot corona viruses what i

49:29

call the hot run of our says the cold ones caught

49:32

caused the common cold and are

49:34

seasonal the ones that cause severe

49:36

illness or the hot corner viruses there's

49:38

only been three and history and that sars mers

49:41

and covered nineteen now

49:43

sars was studied seventeen years

49:45

out and the natural immunity was solid

49:48

mers was studied three years out and the natural

49:50

immunity was sought probably longer but that's just

49:52

of time points at which they study the viruses

49:55

no longer circulate why would you study

49:57

it much longer if it's no longer in circulation

50:00

the the starting hypothesis

50:02

in my opinion should have been natural

50:05

immunity appears reliable we

50:07

don't see people getting reinfected was severe

50:10

illness on a ventilator on the i cu

50:12

and once we start seeing man we can

50:15

chase the starting hypothesis but let's

50:17

use the starting hypothesis that natural immunity

50:20

works at least in the time that it's been around

50:23

and what you had was a series of studies

50:25

come out from early on two months into the

50:27

pandemic rhesus

50:29

monkeys were reach our honest with

50:31

the virus and they did not get re

50:34

insulted the cleveland clinic then

50:36

came out with their big study of hospital workers

50:38

who are around covert all the time and

50:40

found no re infections

50:42

and the vaccine did not add anything to their

50:44

immune protection then you had the washington

50:47

university study which actually did bone marrow

50:49

biopsy is a look at the these

50:51

are activated t cells in

50:53

the system the very difficult experiment we

50:56

talked about is not as simple as a blood draw and

50:58

they concluded that immunity

51:00

from coven is likely lifelong

51:02

its lasting study

51:05

after study kept coming out then we got the biggest

51:07

study ever done out of israel population

51:09

studies the we met in natural

51:12

immunity was twenty seven times more

51:14

protective adjusted for age then

51:16

vaccinated immunity

51:18

tell me a little bit more about that one marty that seems

51:21

difficult to quantify can you can you tell me

51:23

a little bit more about what that actually means

51:26

so what they did as just they have all

51:28

the positive testing data as

51:31

the cdc daz but they won't really sense

51:33

of people who test positive and then subsequently

51:35

testing positive again they also have all the vaccine

51:38

records so he tested positive

51:40

and did not get a vaccine they looked at the rate

51:42

of testing positive again and

51:44

it was there is something like us thirteen fall

51:46

difference but adjusted for age

51:49

because we know every age group is different it

51:51

ended up being an age adjusted twenty seven

51:53

fold difference now when

51:56

that came out it was a few weeks before the

51:58

data came out on boosters using hospitalizations

52:02

hi tenfold and people over sixty five

52:05

the temple reduction and hospitalizations

52:07

with a booster and older people doctor found she immediately

52:10

described it as quote unquote dramatic

52:12

data and wrote up a lot of policy around that

52:14

immediately data on

52:16

national merely being twenty seven times more protective

52:19

not mentioned once every by public

52:21

health officials there's a general fear

52:23

i i hear in my private conversations

52:26

with public health later if they talk

52:28

about natural immunity people might just go out there

52:30

and try to guess the infection and we don't

52:32

want them to do that and i agree we don't want them to

52:34

do that but we can be honest about

52:36

the data and encouraged vaccination

52:39

at the same time look how many careers we've

52:41

ruined the teachers nurses

52:45

soldiers getting dishonorably discharged

52:47

they have antibodies that

52:49

neutralize the virus but they are

52:51

antibodies that the government does not

52:53

recognize that has been a

52:56

tragic misstep and i think it's one of

52:58

the reasons why the government has lost credibility

53:00

the water want to talk about their but can you talk

53:02

about the two studies the

53:05

cdc that suggest

53:07

that natural immunity is not lasting these

53:11

studies would not qualify

53:13

for his seventh grade science fair

53:16

the methodology was so poor that factor

53:18

opinion marty

53:19

that is my last one hundred and of it's just that

53:22

i think any any honest

53:24

scientists will tell you that

53:26

the conclusions cannot be drive from the data the first

53:28

study was a study

53:30

looking get a narrow two month period in

53:32

the state of kentucky and they looked at reinspection

53:34

rates and they didn't say anything they're

53:37

not they had symptoms or were hospitalized

53:39

or anything the rates

53:41

in both the vaccinated and natural

53:43

i'm naturally me and group were exceedingly

53:45

lao they were zero point zero

53:47

one percent over that two months

53:49

interview and an interval but

53:51

because they were both so low and they weren't equal

53:53

one happened to be two point three times higher than

53:56

the other in than in the natural

53:58

immune groups are they concluded does the natural

54:00

merely were two point three times more likely

54:02

to get the infection again it's too

54:04

small a sample it's so what

54:06

happened was the cdc has date on

54:08

all fifty states for fifteen months

54:10

the pandemic at the time they

54:13

do something called fishing and anyone and

54:15

research knows this technique you find some

54:17

small sliver of data in some

54:19

locale in some narrow time

54:21

window that supports it at foregone

54:23

conclusion that you've made before resuming the day they

54:26

they found one state over a two month period

54:28

supported their hypothesis why don't

54:30

they release all of the nation state henri

54:32

infections they've never done that the

54:35

other study they surveyed people in the hospital

54:38

and ask them if they had the infection in the past

54:40

and they they make conclusions about population

54:43

level risk by serving people

54:45

in the hospital you you simply can't do

54:47

that how can you drive a population

54:50

level risk without knowing the denominator

54:52

so both were highly flawed no one

54:54

really defended them except for

54:56

a lot of politically appointed physicians for

54:58

just kind of mom about it and

55:00

yet these numbers get quoted all the time like

55:03

the maricopa mass study highly

55:05

flawed wouldn't make it's way into any

55:07

has been published in any journal it has

55:09

a review process just the

55:11

little mm wr rag that

55:14

cdc puts out there has there been a

55:16

metre analysis marty cause one way

55:18

to address the body of literature

55:20

this vasquez as you said is always gonna be

55:23

i mean your you're always going to find

55:25

a signal and you're always gonna find noise

55:28

good process met an analysis

55:31

could sift through that has someone done that

55:33

definitive met analysis on this question

55:36

the summer new colors who

55:38

as the harvard professor now is at brown

55:40

pounced on institute has summarize the hundred

55:42

and forty one studies on natural immunity

55:45

and so once out she gets on us tv

55:47

and says

55:48

we just don't know about national

55:50

music what do the study how hard is

55:52

it this is not the riddle of the sphinx

55:56

you can figure out how many

55:58

people have been reinfected from the rich these

56:00

new york and had severe illness and as this

56:03

issue was coming up i reached out to

56:05

zubin and i said hey are you hearing him out

56:07

reinspections after somebody

56:09

truly was sacked not just and asymptomatic

56:11

test they were truly

56:13

sick from covert have you heard of anyone coming

56:16

back to the hospital on

56:18

a ventilator or dying in

56:20

look i'm sure there's some rare case up there

56:23

but he said no i haven't heard about it

56:25

it's becoming like big for everyone

56:27

thinks they've heard about it but there's

56:29

no good documentation

56:31

anecdotally i think we see the opposite right a mean i

56:33

know many people who have been reinfected

56:35

with coven and i

56:38

can say without exception every one

56:40

of them had a much much milder course

56:42

the second time some of it founded

56:45

because some of those people also got vaccinated right

56:47

so they got the first way they got the first

56:50

illness prevent seen

56:52

that was pretty bad you know that was again

56:54

and in in a healthy young person i could still be

56:56

like a bad case of influenza

56:59

some of them just went on to get another covert a few months

57:01

later pre vaccine some got vaccinated

57:03

and got another coven i

57:05

think the point here is this is

57:07

no up there are some things that are not knowable

57:10

there are some things that are unknowable just falls

57:12

in the bucket of knowable therefore

57:14

it's frustrating when we don't have information on things

57:16

that are knowable or when we claim we don't have information

57:19

about things that are no

57:20

i think this point again and marti's acetate

57:23

things that are as a policy we

57:25

haven't chosen to does devote resources

57:27

to the senate is a central question and

57:29

of it i think our anecdotal experience against

57:31

speaks to the difficulty of preventing

57:34

re infection with a mucosal pathogens

57:37

like a corona virus and that's why

57:39

you need get a cold year after year but you don't

57:41

die that long term immunity

57:44

you know prevent severe disease and we see that anecdotally

57:46

that not speak of amateurs one thing i want to say about that

57:48

everybody has and anecdotes

57:51

of somebody who broke through vaccine

57:53

or did this or that and ended up getting sick and died

57:55

in hospital people are really good at this because

57:57

they see in and rich sample so they'll be like while

57:59

there was pregnant mother who was twenty you had no problems

58:02

died of covered in this and this and all that

58:04

that can happen but when we

58:06

now have an internet where these anecdotes

58:09

can be amplified in to larger level

58:12

distorting sort of datasets

58:15

i think it influences a level of fear

58:17

and policy decisions fence that

58:19

spring from that and that's something we have to kind of

58:21

tease out by actually doing science actually

58:24

studying the stuff directly in say nothing

58:26

of this is actually a well designed study that says

58:28

actually now it it can happen but it's a point

58:30

zero zero one percent risk and so do

58:33

we make policy to prevent that risk

58:35

and the answers probably not because it has cost

58:38

yeah did get back to a a r to keep harping

58:40

on this idea of science vs atrophy science

58:43

for saturday evening began on the other as out of

58:45

the spectrum you have you have you have gotten people who are saying

58:47

hey vaccines are horrible they should

58:49

never be use nobody should be vaccinated natural

58:51

immunity is the only way to go vaccines don't even prevent

58:54

illness because look at all these breakthrough cases

58:57

the and again i think a very

58:59

arrogant approach is to say

59:02

shut up vaccines

59:04

cure everybody put

59:07

your head in the sand you knuckle draggers that

59:09

would be an advocacy position right a scientific

59:12

position would be like know you're absolutely right

59:14

like seen it a probabilistic game

59:16

vaccines reduce the probability

59:19

of infection the severity of infection

59:21

but that's all probabilistic so if

59:23

you take a hundred vaccinated people

59:26

versus a hundred and vaccinated

59:28

people on an individual

59:30

basis you can't make any assertion that's

59:32

what science is and

59:35

i go back to this thing which is you look

59:38

at all the amazing things that have happened

59:40

in the last two years that really speak

59:42

to the scientific method so imagine

59:44

this pandemic took place

59:47

the sixteenth century before

59:50

we even had the scientific method

59:52

so let alone the capacity

59:54

to generate drugs and all these other things

59:57

totally different game right yeah into

1:00:00

think we have monoclonal antibodies

1:00:02

we have novel antiviral as we

1:00:04

have vaccines we've got all of this

1:00:06

stuff done in less than twenty four months

1:00:11

what bums me out and i've said it before opinion

1:00:13

not fact i think

1:00:16

that this is a iraq

1:00:18

victory for science i

1:00:20

think it has what's the expression

1:00:23

like we've we've won the battle

1:00:25

and lost the war from a scientific

1:00:27

perspective right which is yeah

1:00:30

you know what eight hundred thousand people died instead

1:00:32

a two million that's an awesome victory

1:00:35

that it came at such an erosion

1:00:37

of trust the next

1:00:39

time one of these things comes around when you

1:00:41

actually do need to take really draconian

1:00:44

measures good luck with that

1:00:48

this idea of the pyrrhic victory of science

1:00:50

i think is is really central her because one

1:00:52

thing you said about advocacy as advocacy

1:00:55

position maybe it's a good advocacy position to

1:00:57

say no vaccines your severe

1:00:59

dom if you don't take them they're they're absolutely

1:01:01

central to any the pandemic the on the way through as with

1:01:03

vaccines but even that as an advocacy

1:01:06

position the is ineffective because

1:01:08

how's that work degenerate psychological

1:01:11

react dense among people who are

1:01:13

have ideological and moral

1:01:15

reasons to be skeptical

1:01:18

of these vaccines whether they're politically

1:01:20

aligned with somebody skeptical whether they don't like

1:01:23

authority telling them what to do whether they distrust

1:01:25

science whatever this that approach to

1:01:27

advocacy only serves to shore

1:01:29

up people who are already agree with you and the crates

1:01:31

react and some others which is the problem with

1:01:34

mandates which is the problem with the

1:01:36

inflexibility of recognizing natural

1:01:38

immunity so even as a policy standpoint

1:01:40

will all we've done is served to do exactly

1:01:43

what you said peter which is a road our

1:01:45

trust and ability

1:01:47

to understand science and then the next

1:01:50

thing that happens is is potentially a huge disaster

1:01:52

if we had a supercomputer to calculate all

1:01:55

the downstream effects of what we've done

1:01:57

during this pandemic so let's say we saved

1:01:59

you know a million lives let's say

1:02:01

but how many did we cost in terms of

1:02:03

future distrust in terms of childhood

1:02:06

vaccines that now people are reluctant to get

1:02:08

because they're so burned by this whole thing

1:02:10

with the coven in terms of all the

1:02:12

whatever screening for cancer we didn't do

1:02:14

during the time that covered was going on substance

1:02:17

abuse the mental illness that

1:02:19

further fragile isation of for children

1:02:22

through this culture of safety as i'm

1:02:24

an overprotective nis and and teaching

1:02:27

them that you know words and people who disagree with

1:02:29

you are evil and violent and so on

1:02:31

so that's something that's something think we really

1:02:33

if we don't wake up to that then it doesn't

1:02:35

matter how good are sciences it it's not going

1:02:37

to actually affect anything in affect positive way

1:02:40

you may have seen a brown university study that

1:02:42

just came out of read the conclusion the

1:02:45

examined general cognitive

1:02:47

they had scores two thousand and twenty

1:02:50

the two thousand twenty one versus the preceding

1:02:52

decade we find that

1:02:54

children born during the pandemic has

1:02:56

significantly reduced verbal

1:02:59

motor an overall cognitive

1:03:01

performance compared to children

1:03:03

born pre pandemic we're

1:03:06

in uncharted territory we're playing

1:03:08

with fire we know going to have a generation

1:03:10

now living with this we've got

1:03:13

a mental health crisis declared by the

1:03:15

surgeon general in children you've got

1:03:17

a fifty one percent increase in self

1:03:19

harm admissions to a hospital among

1:03:22

young women we have

1:03:24

yet to comprehend how significant

1:03:26

many these restrictions have been on

1:03:29

most vulnerable members of our society

1:03:31

and and as children who don't vote have been

1:03:33

subject to so many these policies

1:03:37

things about this the odd to

1:03:39

me the is again

1:03:42

when you contrast eighteen

1:03:44

months ago with today is based

1:03:46

on what we know

1:03:48

these proposed policies

1:03:50

and mandates don't even make sense though

1:03:53

let's talk a little bit more let me let me

1:03:55

get a little more data so i can create

1:03:57

a thought experiment which you know i love what

1:04:00

is the best available evidence

1:04:02

we have for how much

1:04:04

a vaccinated vs on vaccinated

1:04:07

individual reduces

1:04:09

the ability to spread and infection

1:04:12

to some other person another it

1:04:14

how much do vaccines reduce

1:04:16

the ability to spread the infection

1:04:19

i think one of the great

1:04:22

the mistakes we made as

1:04:24

medical community was to suggest that

1:04:26

somehow being vaccinated was

1:04:28

going to eliminate that

1:04:30

risk of transmission and we set that expectation

1:04:33

and now people run around saying they don't work

1:04:35

when in fact the vaccines are very effective and

1:04:37

downgrading disparity of illness but

1:04:40

the transmission peace now it's pretty clear

1:04:42

is not significantly affected

1:04:45

by the vaccines because the virus

1:04:47

lances lands in than because

1:04:49

all the area of the nose

1:04:52

and upper airways replicating

1:04:54

you blow it off faster than the systemic

1:04:56

community can kick in now the

1:04:58

national nearly as is more based in

1:05:01

the local area of the mucosa

1:05:03

and so therefore that's why some think it's

1:05:05

more effective when you

1:05:07

look at this lances sorry that just came out

1:05:10

about a month ago pete viral

1:05:12

shedding was equal in those vaccinated

1:05:15

and and vaccinated the differences

1:05:17

the window of contagiousness was

1:05:20

more narrow among those vaccinated

1:05:23

the we're talking one day vs about three

1:05:25

days on average though we

1:05:27

could

1:05:28

again this is a very crude assessment by

1:05:30

we could say there's a sixty

1:05:32

six percent reduction in transmission

1:05:35

if you believe all things that are otherwise

1:05:37

equal

1:05:38

you could but if you show up to the same day

1:05:40

care center same workplace every day

1:05:43

you're still going on on one of those days

1:05:45

be setting virus at at a high

1:05:48

level

1:05:49

zoom and anything to sharpen

1:05:51

that analysis cause that's against me that's

1:05:53

a very juggler question when i think about

1:05:56

policy decision yeah

1:05:59

i think it's it's because there's

1:06:01

two ways that i think

1:06:03

we can see a reduction in transmission

1:06:05

one is a narrowing of the window which marty talked

1:06:07

about the other is that there is

1:06:10

including and current data and i can't cite

1:06:12

the specific studies that have to dig them up but there

1:06:15

is a reduction in reduction in

1:06:17

infection overall

1:06:19

which means that operative question becomes

1:06:22

when a vaccinated

1:06:24

individual is asymptomatic

1:06:27

i'm not i'm a priest symptomatic like there eventually

1:06:29

gonna develop symptoms and offer we

1:06:31

found precinct about people are quite contagious

1:06:34

but the asymptomatic but they would test positive

1:06:36

by pcr sex or the infectious

1:06:39

and , is in the realm of speculative now

1:06:41

right but that the answer is probably not

1:06:44

not the more people that are vaccinate

1:06:46

around them probably even the lesson sexist

1:06:48

they'll be because those people have an innate resistance

1:06:51

even to infection unless the innocuous

1:06:54

quite high which is why delta was kind of us

1:06:56

are real drag if you look at vaccine numbers

1:06:58

with alpha vaccine very effective

1:07:01

but then very effective of waning neutralizing

1:07:03

antibodies plus a very high

1:07:05

are not virus in the form

1:07:07

of delta made it more likely to break

1:07:10

through in terms of infection mucosal

1:07:12

replication so i

1:07:15

think there's those two main mechanisms

1:07:17

by which but then you have the emergent

1:07:20

phenomenon of a community

1:07:22

the faq and i'm not using even the term

1:07:25

for to meet of anymore because it's it's just it's

1:07:27

gone by the wayside it's more that there's this

1:07:29

community cocooning a fact and you see

1:07:31

it in a place like say the bay area where the vaccination

1:07:33

rates are ninety plus per cent there

1:07:36

really aren't that many cases and if i talked to my friends

1:07:38

here they're like yeah yeah there's a few really morbidly

1:07:40

obese elderly people that are in i see but in

1:07:42

general it's not happening and kids are doing just

1:07:45

fine even prior to being vaccinated and

1:07:47

schools are you know opened up and stuff is

1:07:49

happening that there is this kind of effect so

1:07:51

i think it's more complicated than has

1:07:53

currently been measured easily

1:07:55

but that doesn't mean we can't if

1:07:58

you say it look at let's just take the most

1:08:00

dream like let's say it's reducing transmission by

1:08:02

two thirds and it's clearly

1:08:04

reducing severity of infection

1:08:06

by at least ninety percent i

1:08:09

think that would be fair assessment

1:08:12

some demographics probably more than that that

1:08:15

it's a good log reduction

1:08:18

the severity though

1:08:21

the new you take another that do we have

1:08:23

effective agents to treat

1:08:26

it the answer is we have once

1:08:29

so now imagine a different world imagine

1:08:32

a world where you had a vaccine that

1:08:36

didn't reduce severity

1:08:38

of illness by more than fifty percent

1:08:42

the reduce transmission by ninety nine

1:08:44

percent would we

1:08:46

want to at least discuss whether

1:08:48

there be a different policy view

1:08:50

yeah that makes perfect sense because if you're

1:08:53

so if the main goal is dropping transmission

1:08:55

but it's not the for the people who do get sick they still

1:08:57

get very sick then your policy

1:08:59

changes to hey you know as many people as

1:09:01

we can get vaccinated the better it is

1:09:03

that's a true herd immunity kind of cool their

1:09:06

we can do that measles etc but

1:09:08

if it's the opposite

1:09:10

they're in your calculation of

1:09:12

policy changes dramatically and here's why

1:09:15

i think it it does at this point

1:09:17

like you said we have treatments we

1:09:19

have prophylactics and the former vaccine

1:09:21

we have prophylactics in the form of and and

1:09:23

ninety five or ten ninety five mask

1:09:25

we have prophylactics in the form of you don't go

1:09:28

to that concert or go out to eat if you

1:09:30

really are that paranoid right so at

1:09:32

this point we've shifted from a community

1:09:34

level decision risks to an individual

1:09:37

level decision i can get vaccinated

1:09:39

as i want to prevent severe disease and myself

1:09:41

i might have a little cocooning effect on my family

1:09:44

that finds we don't want to minimize it but it's with want

1:09:46

to maximize it either because it may not be troops at

1:09:48

in a maximal sense if it's true it's on some

1:09:51

continuum and then if then if want

1:09:53

to get sick and i'm high risk i don't have to go to

1:09:55

that saying or i could wear it can ninety

1:09:57

five or and and the ninety five and then if i

1:09:59

do get sick i'm in a demand yeah the

1:10:01

right monoclonal that is on a cron

1:10:04

you know sensitive and we've

1:10:06

actually mean and all the other stuff like so

1:10:09

if this point we've turned something from

1:10:11

your out of your control entirely to something

1:10:13

that becomes a much more individual decision

1:10:15

which is why it's policies that use

1:10:18

the mechanism of the state to actually

1:10:21

the influence your behavior may be less effective

1:10:23

less relevant and backfire and a bigger

1:10:26

sense and it goes with causes to when you're

1:10:28

mandating kids be double vaccinated

1:10:30

and boost it's quarantine for ten

1:10:32

days in their rooms getting toward asked

1:10:35

if they test positive well why

1:10:38

who exactly are they harming their

1:10:40

own risk is low their professors are

1:10:42

vaccinated and can wear masks

1:10:44

so it's kind of like at this point what are we really

1:10:46

doing so is the underlying

1:10:48

situation matters to what policy one

1:10:50

actually and still yeah

1:10:52

i think what what i'm struggling with his

1:10:56

you could paint too extreme cases so again

1:10:58

you imagine a a scenario where the

1:11:00

vaccine does not really reduce transmission

1:11:03

but really reduces severity of illness

1:11:05

vs a vaccine that really reduces

1:11:07

transmission but not so much on safari be

1:11:10

almost wealth again the any

1:11:12

person with commonsense could say you

1:11:14

have a totally different set of

1:11:16

recommendations if you're gonna

1:11:18

wave a policy hammer you're

1:11:20

going to do it totally different in their situations

1:11:23

it seems to me that were using the wrong

1:11:26

policy to again opinion not fact

1:11:28

we're using the wrong policy tool for

1:11:30

the tools on the ground

1:11:31

even when you talk about kids which what i'm sure you'll

1:11:33

talk about the policy tools we have our are

1:11:36

not concurrent with the situation

1:11:38

on the ground in terms of these rumors that peter

1:11:41

discuss

1:11:42

i think that's a very reasonable opinion

1:11:44

but here's a fact that is the

1:11:47

therapeutics we have today have

1:11:50

had covered deaths to zero in

1:11:52

the clinical trials once they get

1:11:55

distributed member they would just f t a approved

1:11:57

once they get distributed in out there are no

1:11:59

one should be dying code right now with rare

1:12:01

exceptions with all the state

1:12:04

of the art care with the randomized controlled trial

1:12:06

data behind and and paxil

1:12:08

that and

1:12:09

one of you bear no one has died from

1:12:11

covered in as clinical trials period

1:12:14

now in in in fairness marty still

1:12:16

relatively small right divisor

1:12:18

study only had about a thousand and each arm

1:12:20

is that correct he a little over six hundred

1:12:22

and the charm okay so we just have a joke

1:12:24

when i was at the and i hated the and sea ice

1:12:26

whenever a small trial would come out and a phase

1:12:29

two that showed an amazing result this

1:12:31

the patients would say i get that drug

1:12:34

before the results change this

1:12:36

you know my the larger trial comes

1:12:38

out but so so just a set expectations

1:12:40

right mean people are going to die even

1:12:43

still three these drugs but i think the point

1:12:45

is when you look

1:12:47

at this protease inhibitor which is the new pfizer

1:12:49

drug this or any replicating

1:12:52

blockade it's the merc drug

1:12:54

the kind of remarkable and presumably

1:12:57

we will come out with another

1:12:59

set of monoclonal

1:13:01

antibodies that will be reactive to

1:13:03

whatever strain is relevant just

1:13:06

as regeneron was very effective against

1:13:08

the o g reasonably effective

1:13:10

against delta i think we can talk about how

1:13:12

effective it is against ah micron that

1:13:14

yeah i think your point is what

1:13:17

we've been saying like oh my god we have

1:13:20

tools today we couldn't fathom

1:13:22

twelve months ago so good point

1:13:24

now twenty three

1:13:27

people died in the placebo arms collectively

1:13:29

of the mana pv or and paxil that

1:13:31

trials zero that of covered

1:13:34

in the treatment arms now it may not end up being

1:13:37

you know that dramatic in era in a real population

1:13:40

but whatever it is it's is it's it's impressive

1:13:43

it is very impressive then you add to that the gsk

1:13:45

veer monoclonal problem

1:13:47

is we're we've got the monoclonal 's out for the

1:13:49

delta variant we just can't sequence quick

1:13:51

enough to know what to give people that's the dilemma

1:13:53

but well especially by the way marty sorry interrupt

1:13:56

when you start stacking these things

1:13:58

right this is where it starts to get very

1:14:00

beige

1:14:01

your vaccinated you have access

1:14:03

to monoclonal antibodies you have access

1:14:06

to a new therapeutic you have access

1:14:08

to existing therapeutics is

1:14:11

and fluvoxamine in

1:14:13

you have i see use that are

1:14:15

ninjas compared to what they

1:14:17

were two years ago that's right

1:14:20

that's five pieces of swiss cheese you can

1:14:22

put on top of each other and you still have

1:14:24

to try to get a piece of you know a pencil through there is pretty

1:14:26

tough that's right and

1:14:28

you add fluvoxamine your destination

1:14:31

i mean it's i'm a south lit and were on

1:14:33

agreements the therapeutics now or have matured

1:14:36

once they're actively available everywhere

1:14:39

the changes the calculus so

1:14:41

if people were jumping out of an airplane in

1:14:44

some people chose to use a parachute

1:14:47

and other people chose not to you

1:14:49

would say you know people

1:14:51

not using a parachute are making a very

1:14:53

poor decision you might even

1:14:55

mandate parachutes of any one jumping

1:14:57

out of the plane it the

1:15:00

plane is flying at a very

1:15:03

low speed only fifteen

1:15:06

feet above an inflatable

1:15:08

matt that changes

1:15:11

calculus on the entire

1:15:13

necessity of institute martial

1:15:15

law to require parachutes or whatever the mitigation

1:15:18

is right now

1:15:20

is is if there is

1:15:23

mild illness the people with immunity can

1:15:25

develop and we're bringing all of heaven

1:15:27

and earth down to lock

1:15:29

up these college students in solitary

1:15:31

confinement for ten days requiring

1:15:34

them to get a booster just so they can go to class

1:15:37

despite no evidence the boosters

1:15:39

right now help young

1:15:41

people maybe some evidence that there's harm

1:15:44

that could change but that's the evidence to date

1:15:46

and look a what we're doing to ourselves

1:15:49

the i'm a we've moved to a second

1:15:51

pandemic after covered nineteenth which

1:15:53

is a pandemic of lunacy which

1:15:56

is this over reaction to

1:15:58

mild ill

1:16:01

what become so frustrating marty

1:16:03

is when we talk about the stuff and you and i are

1:16:05

pretty a line on the cynicism is assist of

1:16:07

opinion based on the best evidence

1:16:09

we have so it's a mix of sort of editorializing

1:16:12

and i will get emails

1:16:14

from say and i see

1:16:16

your doctor who will say but i'm still seeing

1:16:18

sick people in the icy you and to

1:16:21

which which reply okay

1:16:23

so what in our societal

1:16:25

policies would actually prevent that short

1:16:27

of locking everybody up in their house and

1:16:30

if forcing vaccinations on them and then

1:16:32

telling them they can't do anything that they normally

1:16:34

do and what's the cost of that and

1:16:36

the same i see your doctor will told me when my son's

1:16:38

actually having a lot of anxiety in high school right

1:16:40

now has to see the counselor because he was kept

1:16:42

home and away from a social network and

1:16:45

then the pressure of using zoom and he's an

1:16:47

introvert and it didn't really work out and so i

1:16:49

i i'm sympathetic to that it's like well it can now multiply

1:16:51

that by how many millions of kids we've

1:16:53

done this to for something that eventually

1:16:56

it seems to me and i'm editorializing

1:16:58

is going to be fully endemic in

1:17:01

the sense that you have a respiratory pathogens

1:17:03

to to which initially we had no immunity

1:17:05

or limited immunity we now have much

1:17:07

better immunity against severe disease we get reinfected

1:17:10

every year like the common cold but

1:17:12

people who get very sick have a series of therapeutics

1:17:14

at their disposal to prevent them from dying some

1:17:17

old and frail and co-morbid people

1:17:19

will die like they do from a common

1:17:21

cold but we don't have to really

1:17:24

changed society over it because it's another common

1:17:26

pathogen that we have next do

1:17:28

we really need to vaccinate every single child

1:17:30

for this when every single child every

1:17:33

single season after they're born is

1:17:35

going to be infected naturally they're not

1:17:37

going to get severe disease because their parents pass along

1:17:39

some degree of immunity him and in breast milk and

1:17:42

as it is we're blessed that the kids don't get

1:17:44

very sick typically from this

1:17:46

unless they're very sick otherwise and

1:17:48

so they're going to develop immunity and so

1:17:50

it insert in in less than a few

1:17:52

years we won't even need to vaccinate anybody

1:17:55

because all adults will be exposed are vaccinated

1:17:57

all children will be exposed and we'll have another

1:17:59

car and circulating endemic corona bars

1:18:02

so that's what i think is

1:18:04

where we're headed and yet so why are we destroying

1:18:06

our society seats in the process and

1:18:08

generating so much division were squandering

1:18:11

our community to for this

1:18:13

thing that just doesn't make sense to me now that's

1:18:15

editorialize

1:18:17

well i am gonna keep editorializing for a minute and

1:18:19

then i want to come back to something you said marty

1:18:21

which is let's now look at the data

1:18:23

around the risks of vaccine

1:18:26

because again i think one of it challenges

1:18:28

of the scientists

1:18:32

the and conflated with the advocates is

1:18:34

that no one's allowed to ask that question

1:18:36

right as though somehow that

1:18:40

was like let's take a drug that i

1:18:43

mean just demonstrably

1:18:45

reduce the risk of cardiovascular disease

1:18:47

like eujust you know

1:18:49

you gotta look far and wide to figure

1:18:51

out over the right time her as if he stands

1:18:54

for a year you might not see a benefit the

1:18:56

monster billy the biggest sea

1:18:58

change we've had in the reduction of risk

1:19:00

for the most prevalent chronic condition

1:19:03

in the developed world anybody

1:19:05

with a straight face say that there are risks

1:19:07

of stands

1:19:09

nobody with a straight face could tell

1:19:11

you that's that and don't

1:19:13

harm some people there's nothing bizarre

1:19:16

about that right there's nothing odd to say

1:19:18

that i mean like we talk about this every

1:19:21

time we give patients

1:19:23

a drug you give somebody a prescription for something

1:19:25

eighth let us know see develop a rash

1:19:27

if you do it could be really severe you know you

1:19:30

please call us right away and let's stop it you might be

1:19:32

one of the four point nine percent of people that is susceptible

1:19:34

to the side effect right so

1:19:38

somehow the become

1:19:40

impossible to have the discussion

1:19:43

if you're coming at it from the the sort of that

1:19:45

the advocacy point of view that there might

1:19:47

be a risk associate with a vaccine until

1:19:50

you know something like to change a thing came along then

1:19:53

the response seem the exact opposite

1:19:55

which is so this is the thing i'm struggling with okay so

1:19:58

so there's a long rambling question could i don't stan

1:20:00

something i don't understand how

1:20:04

when the first jnj data came out

1:20:06

and said

1:20:07

i believe it was six cases

1:20:10

of vaccine a in seven million

1:20:12

doses about one in a million

1:20:14

incidents the drug was pulled

1:20:16

the vaccine was pulled

1:20:19

and in a moment we're gonna talk about my a card titus

1:20:21

with madonna nobody

1:20:24

wants to talk about that why

1:20:27

the difference i'm happy

1:20:29

for opinion because i mean we can talk about what the facts

1:20:31

are which will get you bet

1:20:32

the broader question is help me

1:20:34

understand the difference because i'm getting questions

1:20:37

from patients of mine saying

1:20:40

i don't want my eighteen

1:20:42

year old son getting a third

1:20:44

m are in a booster which is being

1:20:46

mandated by his university

1:20:49

do you think i'm crazy to which i say no you're not

1:20:51

here's the data that set tells me you're not crazy

1:20:54

and how i'll let marty answer this but i just want to say this

1:20:56

i think it comes down to the difference

1:20:58

between peace time in wartime vaccine

1:21:00

communication and again this is advocacy versus

1:21:03

science so in peacetime vaccine

1:21:05

communications you have children

1:21:07

who need to get the series us vaccinations

1:21:10

in order to present common

1:21:12

what would we become common diseases

1:21:15

like measles mumps etc us if

1:21:17

we didn't get a certain degree of herd immunity that

1:21:19

happens which is above ninety odd percent

1:21:22

and south of the messaging is always

1:21:24

been hey listen they're very rare

1:21:26

side effects of these things and by the way they

1:21:28

can be quite serious but they're very rare but

1:21:30

as a community benefits pretty much

1:21:33

is at risk your child is so small and

1:21:35

the risk of the communal communicable

1:21:37

diseases small right in in an absolute

1:21:39

sense absolutely small but if we don't do this as

1:21:41

a community we're gonna have gonna problem

1:21:44

and you see it when vaccine rates drop below ninety

1:21:46

percent you see measles outbreaks in that's or think so

1:21:48

the public health messaging is always been hayes zero

1:21:50

tolerance for anti vaccine discussions

1:21:54

we don't talk much about the rest of them because

1:21:56

we just need to do this in their mandated for schools

1:21:58

and so on stuff griffin

1:22:00

there's their merits and demerits to that approach

1:22:02

but that is the peace time approach to vaccines

1:22:05

the wartime approach where you have

1:22:08

so on uncertainty you have

1:22:10

changing data and you have risks and

1:22:12

benefits that are stratified by

1:22:14

age and co morbidities were

1:22:16

applying the same peacetime approach

1:22:18

which is vaccine absolutism

1:22:21

with no quarter and anything

1:22:23

you say against the vaccines is taboo

1:22:26

so it becomes almost an

1:22:28

unspeakable curse like in harry potter

1:22:30

you can't use them are your excommunicated

1:22:33

from the tribe of medicine and it has become

1:22:35

has tribal things will now will think

1:22:37

it's become this kind of absolute of things they've

1:22:39

applied in war times to something

1:22:42

that it just doesn't apply to which is this vaccine

1:22:44

which as you mentioned has risks

1:22:46

that actually are worse

1:22:48

for younger people and benefits

1:22:51

that are much less for younger people

1:22:53

so we ought to be looking at it clear eyed

1:22:55

i'm sorry marty over to you

1:22:57

that's just my rant

1:23:00

now i like yours spot on here

1:23:02

because what we now see in

1:23:04

this tribalism of medicine seated

1:23:07

in the group think of so many aspects

1:23:09

of covered that the establishment got wrong

1:23:11

and the reality is we've got a few people

1:23:14

making all the decisions uncovered

1:23:16

a very small group the

1:23:19

non age diverse non

1:23:22

ethnically diverse political

1:23:24

appointees with political allegiances

1:23:26

making all the decisions on

1:23:29

covered for the country and quite frankly

1:23:31

i think they're detached the

1:23:33

life of a young person in baltimore

1:23:35

city

1:23:36

who was barely hanging into in

1:23:38

school pre cove it okay

1:23:40

it's not as easy to hand that person

1:23:42

and ipad and say we're going , promote

1:23:45

learning as it is in the hamptons

1:23:47

or in santa barbara county so

1:23:50

what we developed was the sort of tribalism

1:23:53

whereby you would question

1:23:56

the anything that might

1:23:58

result in an answer albeit

1:24:00

scientific that could threaten

1:24:02

the vaccinate every human being with

1:24:05

to feed message that

1:24:07

needed to be suppressed

1:24:09

her squashed or ridiculed are labeled

1:24:11

of anti vax or it could it could

1:24:13

be natural immunity in i

1:24:15

think that's maybe how i initially

1:24:17

get they have seen as

1:24:19

he is he one of us what the vaccine community

1:24:22

in alaska was point for lockdowns

1:24:24

beforehand warning of this thing

1:24:26

wrote the first piece called for universal masking

1:24:29

to keep society semi open and

1:24:31

then then rollout came along

1:24:34

and i said hey wait a minute the nice to be

1:24:36

simply age based and those

1:24:38

who have natural miri need to step aside

1:24:40

and of as the line so we can save more

1:24:42

lives and let's just focus on the first

1:24:44

doses because the minute he is pretty good

1:24:46

for three months we can save more lives

1:24:49

tens of thousands of people could have been saved

1:24:51

if we adopted as passes and some people

1:24:53

would suggest a wait a minute if

1:24:55

you're saying hold off on the second dose you're

1:24:58

kind of anti vaccine and a few

1:25:00

telling people not so many they can wait a little bit

1:25:03

from the data that kind of anti vaccine

1:25:05

and if you're asking about the my card ideas complications

1:25:09

trying to understand the rate of them that

1:25:11

could scare some people often therefore you

1:25:13

might be putting an anti vaccine message

1:25:16

out there the bears data

1:25:18

system which is the self reported

1:25:20

system the fk said there's

1:25:22

such a shoddy poor way

1:25:25

to track complications that

1:25:27

would it's basically unreliable

1:25:29

it's overloaded and yet at the

1:25:31

same time it's very cumbersome to report

1:25:33

into that most doctors that tell me about a complication

1:25:36

they they haven't reported it devours you

1:25:39

really get almost no follow up there's been

1:25:41

deaths and children in the united states

1:25:43

immediately after the second dose from my card

1:25:45

either the and the cdc

1:25:47

says they are gonna investigate one of em

1:25:50

that was several months ago we never heard anything

1:25:53

such you ask questions it's

1:25:55

almost as if you know how dare you

1:25:58

note look the vaccine so make sense and

1:26:00

certain context and certain way in young

1:26:02

people its a often to present

1:26:05

and a a certain hospitalization more it

1:26:07

is to prevent death and children but it's nuanced

1:26:10

it's not a one size fits all strategy

1:26:12

especially with those of natural

1:26:14

immunity so let's talk a little bit about

1:26:16

that the dog when i did a great

1:26:19

video on this just the other day

1:26:21

let's talk a little bit about what we know

1:26:23

and now let's just talk in fact for a moment right

1:26:26

let's not editorialize anything what

1:26:28

do the data suggest with respect

1:26:30

to the pfizer vaccine in

1:26:32

the madonna vaccine with respect

1:26:35

to the incidence of my car died as

1:26:38

in males and females below

1:26:40

the age of forty and stratify

1:26:43

that as much as you'd see fit

1:26:44

the argued the high level and marty can dive into the details

1:26:47

because he's a vastly bigger nerd

1:26:49

than i'm capable of being but else

1:26:51

i'll say this the party line

1:26:53

has been that

1:26:55

then you'll hear pediatricians around the country

1:26:58

calling their patients this when

1:27:00

asked about vaccine they're kind of reiterating what

1:27:03

cdc says which is the

1:27:05

, of mio card titus in

1:27:07

young people is

1:27:09

exceeded from a vaccine

1:27:12

is exceeded by the risk of natural

1:27:14

covert infection causing myocarditis in

1:27:16

other words if they were to go out and get natural infection

1:27:19

their ex fold more likely

1:27:21

to get mile car data's than

1:27:24

any risk of myocarditis from either

1:27:26

of the vaccines pfizer or madonna

1:27:29

now , isn't the setting off

1:27:31

not knowing the denominator

1:27:34

of how many people are actually infected

1:27:36

with cove with out in the community they're just looking

1:27:38

at kind of hospitalized patients and so on and of

1:27:40

course those patients are sicker of course

1:27:42

they have more cardiac side effects and so on

1:27:45

when they're infected with covert there's two

1:27:47

counting issues there just to clarify right zubin

1:27:49

the first is your have a negative selection

1:27:51

for patients then you have a

1:27:54

the underestimation of a denominator

1:27:57

that's rights to another as we don't know how many people got

1:27:59

infected with

1:28:00

covert out in the community that did just fine we're

1:28:02

, at that are using incomplete tools

1:28:05

and so that's part of the problem in the calculations

1:28:07

whereas with vaccines we can say oh these guys got

1:28:09

vaccinated and there were this many cases of

1:28:11

my occurred artist and they were hospitalized for this many days

1:28:13

and they had this kind of cardiac function that discharge

1:28:16

and these with a complications and so on so you can

1:28:18

you can actually look at that data now looking at all

1:28:20

that same data that was available the

1:28:22

european authorities said you know what actually

1:28:24

we see a bigger risk with madonna for

1:28:26

mile card itis that is especially

1:28:28

when we have pfizer which seems to have less microdata

1:28:31

so we're just not going to recommend moderno

1:28:33

for men are people under

1:28:35

thirty now the that's a huge difference

1:28:37

between us and european policy based

1:28:39

on datasets now this is where the newer

1:28:41

data comes out that marty can talk about

1:28:43

saying hey you know this may not be true that

1:28:45

actually natural infection is more

1:28:48

mio cardiogenic than

1:28:51

the vaccines so we

1:28:53

generally recognized this rate

1:28:56

early on to be somewhere in

1:28:58

the range of one in seven thousand

1:29:01

and that is young boys

1:29:03

and young men so in the age group fifteen

1:29:05

to twenty five that was about

1:29:07

one in seven thousand six hundred

1:29:09

according to a new england journal study

1:29:12

after the second douse the cop cases

1:29:14

ninety percent of them were clustered around

1:29:16

the second dose and my card itis

1:29:18

cases the vast majority

1:29:20

of which were mild the to were

1:29:22

severe in new england journal

1:29:24

analysis out of israel and one

1:29:27

person died that is that twenty two year

1:29:29

old died old died it's you know you can barely

1:29:31

say that because you

1:29:33

know of the sort of trigger that it creates

1:29:36

but like by enlarge this is a safe vaccine

1:29:39

that for parents asking these questions

1:29:42

about that's when their kids to

1:29:44

get a guest and illness that

1:29:46

has in ultra rare rate

1:29:48

of death in healthy children

1:29:51

this is a reasonable conversation have maybe

1:29:54

the rate of death from the vaccine parallels

1:29:56

the rate of death from hold it

1:29:58

in a healthy wild now

1:30:01

the cdc reports their six hundred and

1:30:03

sixty eight deaths over two years

1:30:05

so let's say probably three hundred

1:30:07

some deaths a year from covered

1:30:09

in everyone under age eighteen

1:30:12

all children who are those

1:30:14

kids we believe

1:30:16

many of us believe that they are

1:30:18

nearly all in children with

1:30:21

a coma or bid medical condition

1:30:23

now they're still important members of our society

1:30:25

we needed during weekend at protect

1:30:28

them what it does change the

1:30:30

calculus now for healthy

1:30:32

kids when we recognize that the vaccine

1:30:34

is not halting transmission so

1:30:37

the subject all healthy children

1:30:39

to a vaccine when

1:30:41

the risk of my car died as

1:30:44

could be as high as one in seven thousand

1:30:46

young males and boys then

1:30:50

all the soldiers i'm not a very nuanced

1:30:52

decision there's some pediatricians

1:30:55

might say you know what about we do one

1:30:57

dose there was a study of

1:31:00

kids five through seventeen in

1:31:02

germany the just went on the pre print server

1:31:06

all the desk in germany over the fifteen

1:31:09

months the pandemic right up until

1:31:11

around march march

1:31:13

april there were zero

1:31:15

deaths in healthy children no healthy

1:31:17

child est one hundred percent of the deaths were

1:31:19

clustered in kids with a coma bit condition

1:31:22

hundred percent so that change

1:31:24

calculus now too apparent that says

1:31:26

hey my kids healthy i'm a little

1:31:28

concerned about the rare side

1:31:30

effects i'd like

1:31:33

to talk about the data this

1:31:35

is a conversation it is not a one size

1:31:37

fits all strategy as we're being told

1:31:40

specially when you get boosters i

1:31:43

mean the here's new

1:31:45

year's and you ain't here said new england journal paper

1:31:47

from december a looking at boosters

1:31:50

and know boosters in kids well

1:31:52

i can't kids cause i'm on a college campus

1:31:55

in people under age thirty okay

1:31:58

the in people under age thirty you are

1:32:00

vaccinated with the primary series

1:32:03

there were zero guess this is population

1:32:05

data from israel zero deaths after

1:32:08

the regular primary vaccine series you

1:32:10

cannot lower that any further you cannot

1:32:12

lower the number zero for there with a booster well

1:32:15

they looked at those with boosters and as you

1:32:17

would expect zero deaths in that group

1:32:20

then in germany they ought to people really essentially

1:32:22

of a period when the when there was no vaccines

1:32:26

the rate was also zero for

1:32:28

healthy kids that tells me the kid as

1:32:30

a comrade condition if the vaccine

1:32:33

otherwise for healthy kids it's a nuanced

1:32:35

discussion

1:32:36

if you look at the circulation paper that came out in july

1:32:39

of this year the knock on this is

1:32:41

it doesn't distinguish between

1:32:43

pfizer and madonna so

1:32:45

we'll talk about that in that second but i think

1:32:47

to me the most interesting table interesting

1:32:49

there is there one that stratified by age

1:32:53

then it does rifkin benefit mail for female

1:32:55

which again seems to me a very

1:32:57

reasonable way to think about this right so when

1:33:00

you looked at twelve to seventeen year old

1:33:02

males and females then

1:33:04

again this is all am irony

1:33:07

vaccines we know now

1:33:09

i think can we say that unequivocally

1:33:12

the modern a vaccine is three

1:33:14

to four times more likely to be associated

1:33:17

with my occurred itis or a mile

1:33:19

pericarditis at least at least yeah

1:33:21

okay the supplemental data that came out

1:33:24

literally two days ago looks like

1:33:26

it's five times worse but let's

1:33:28

be conservatives a three females

1:33:36

eight to ten cases of my car died as per

1:33:38

million doses

1:33:40

males fifty six to sixty nine

1:33:42

cases they did benefits

1:33:46

saves thirty eight i see you admissions

1:33:49

saves one death so

1:33:52

here's where i'm struggling right

1:33:54

now if you look at this then you say

1:33:56

look you're gonna give seventy cases of

1:33:58

my car died as to say but damn what's

1:34:00

the natural history of those

1:34:02

seventy cases of my card i guess so

1:34:05

zubin how many those kids make

1:34:07

and the remarkable recovery

1:34:10

how many of those kids are going to have

1:34:13

chronic issue with their heart they're going to have

1:34:15

a reduced iaf for some point of their life when

1:34:19

you know kids die this is a thing we

1:34:21

don't have

1:34:22

the enough data to be able to actually answer some

1:34:24

of that i think there's a degree of uncertainty

1:34:27

and when you're talking about the quality life your saved

1:34:29

in a kid if you if you're gonna in

1:34:31

any way impinge on their ejection fraction

1:34:34

of their heart in the future cause any

1:34:36

scarring or cause what

1:34:38

we may even be under diagnosing whether there's

1:34:40

a revere happening it ,

1:34:43

a really open question that this ah to be looked at very

1:34:45

carefully now marty may have his hands on some of the

1:34:47

more specific data on the outcomes

1:34:49

you mentioned the twenty two year old the died in itself

1:34:52

is also little difficult him pegged causation

1:34:54

sometimes because some of these kids

1:34:56

had also pre existing existing

1:34:59

abnormalities we always think about

1:35:01

sudden cardiac death in athletes

1:35:03

and children and end whether the screen

1:35:05

or not in those kind of things are asking questions

1:35:08

but even if this works from

1:35:10

fuck that to happen say they were to get

1:35:13

my apartheid as you're impacting

1:35:15

a child and and tons of live

1:35:17

life years that are affected adipose

1:35:20

and ninety year old who maybe the vaccine gave

1:35:22

them gave fever that push them into cardiac arrest

1:35:24

the i'm just speculating right it's a very different

1:35:26

quality of life years saved kind of calculation

1:35:29

so kind don't have the specific

1:35:31

data like how many these kids go on to have

1:35:33

chronic problems or even

1:35:36

the hospitalization risk right a

1:35:39

certain percentage of these eighty six percent in one

1:35:41

study that i saw get hospitalized for

1:35:43

our average of about three days when

1:35:46

you hospitalized anybody

1:35:48

you put their life at risk because

1:35:51

there risk there and it's the most dangerous place

1:35:53

on the planet because medical errors

1:35:55

happens infections in the hospital

1:35:57

happen complications happen that's why

1:35:59

saying the articles a good idea if you can do it sucks

1:36:01

you give to look at that as well and

1:36:04

i just don't i haven't seen the data that compellingly

1:36:06

says oh this is the answer to that

1:36:09

the argument i hear by the way because i

1:36:11

you know few days ago the

1:36:14

something that was

1:36:15

ranking colleges or something like that and i made

1:36:17

some snarky comment on twitter like can

1:36:19

we start ranting the dumbest colleges

1:36:22

you know when i was gonna put my alma mater

1:36:24

you know going up at stanford and hopkins their which

1:36:26

are two of the idiotic colleges

1:36:28

in my view that and by the way this is her opinion

1:36:30

not fact who are mandating

1:36:33

you know boosters for kids and not letting them back

1:36:36

to campus without them and

1:36:38

i couldn't believe

1:36:41

the people that were just furious

1:36:44

with me how could you possibly suggest

1:36:46

this

1:36:47

of course those kids need to have their

1:36:50

third shot and

1:36:52

the argument was they're putting

1:36:54

so many other people's lives at risk by

1:36:58

not having booster shots i'm

1:37:00

thinking explain

1:37:02

that to me like again this is i've every

1:37:05

six months i do something stupid which is

1:37:07

i guess on twitter and ah i need

1:37:09

to i need to create sort

1:37:11

of like a testicular teasing device

1:37:14

that is hooked up to the twitter app

1:37:16

were any time i look at twitter i

1:37:18

get like a one hundred and twenty volt hayes

1:37:20

to my testes and it just says like don't

1:37:22

ever do that again like don't ever don't

1:37:25

ever go on twitter like nothing

1:37:27

good comes of it

1:37:29

it's a de c device guys are direct

1:37:31

epididymal current and when you

1:37:33

apply at least seventy three

1:37:36

jewels to your jewels it it

1:37:38

will dissuade you from ever clicking on that stupid

1:37:40

app no no i i actually just real quick on

1:37:42

this because this is the thing this

1:37:44

is the tribal as asian so what you did his you

1:37:47

behaved as an outgroup to

1:37:49

the in-group off whatever

1:37:51

public health dr e types that are on there

1:37:53

and this idea that that these if

1:37:55

vaccinating triple vaccinating these kids

1:37:57

at stanford and by the way closing campus for the

1:38:00

weeks because of ah microns which

1:38:02

is what they've done how have we got this far

1:38:04

in the podcast without marty you

1:38:06

referring it to omagh cold cause this

1:38:08

is your turn right so so

1:38:11

so for we're going to close the campus for

1:38:13

two weeks because of omagh cold continues

1:38:15

him obama called rips through

1:38:18

marty is you know cashing in his royalty

1:38:20

money from every time someone says omagh called and

1:38:23

at this point the argument is

1:38:25

over there protecting professors to protecting other

1:38:27

people in the community and this is my taken

1:38:29

i'm editorializing we have no data as it that's actually

1:38:32

it's at scale true we talked

1:38:34

earlier in this part just about the transmission

1:38:37

have sex with younger people to offer

1:38:40

, who are they exposing most professors and family

1:38:42

and community okay those professors

1:38:44

and family and community can make the decision to

1:38:46

triple vaccinate to wear a mask to

1:38:48