In this must-watch interview, we talk about EVERYTHING, including the true infection fatality rate, comparisons to influenza, drama around his Santa Clara antibody trial, reinfections, vaccine development, economic and social impacts, why we MUST reopen schools NOW, the horrors of censorship of scientists and opposing dialog, how Stanford is contributing to the problem of stifling dissenting opinions, Dr. Scott Atlas and his advisory role to the president, empathy vs. compassion with regards to COVID, and MUCH MORE.
This is a must-listen interview with a really smart and thoughtful scientist who has been too-often maligned and mischaracterized by the media.
[Dr. Z] Hey, everyone Dr. Z, welcome to The ZDoggMD Show. Today I have a special guest look, I moved back to the Bay Area, so I could talk to smart people at places like UCSF and Stanford and in the Bay area. And I was all excited and then COVID hit and it was Zoom, Zoom, Zoom, and I hate Zoom. So today I have someone I’ve been wanting to talk to since this pandemic started, Dr. Jay Bhattacharya is a Stanford Professor of Medicine and he has training and specialty in economics. Actually tell me Jay, who are you man?
[Dr. Jay] Well, okay.
[Dr. Z] Not in a metaphysical sense.
[Dr. Jay] Exactly, so I am a Professor of Medicine as you said at Stanford university, I’ve been at Stanford on the faculty for about 20 years. I’ve an MD and a PhD in Economics. And I studied health policy and health economics. I’ve been working on infectious disease, economics and epidemiology for 20 some years now.
[Dr. Z] So the reason I wanted to have you on the show was what you just said. You have the MD Stanford training and PhD in economics, which means you can see in a way that many frontline healthcare people, including public health people, aren’t able to see the bigger picture. Now you came to prominence during the pandemic as one of the coauthors of the Stanford Seroprevalence Study, which raised all kinds of interesting. I mean, tell me about that experience because I was talking about your piece early on saying, hey, if this is true, the actual infection fatality rate of this disease is actually much lower than we thought it’s still higher than flu, but it’s not as high as they’ve been saying in China. What was that experience like?
[Dr. Jay] I mean, that was incredible. Just an amazing, in some ways, dispiriting, but also exciting experience. Let me kind of go back just a little bit?
[Dr. Z] Absolutely.
[Dr. Jay] So what got me into it was I had done some work during the H1N1 Flu epidemic in 2009.
[Dr. Z] I remember that one.
[Dr. Jay] I mean, it was a big deal at the time, right? But luckily it didn’t turn out to be as bad as COVID, but especially at the beginning, people were really, really panicked over the high fatality rates that were the case fatality rates that were coming up out of all around the world.
[Dr. Z] I remember I was a practicing hospitalist at Stanford and everybody was like, we’re all going to die. It was a kind of a catastrophization.
[Dr. Jay] Yeah, it’s actually an in the early days, there was good reason. There were these case fatality rates that looked like Ebola. It just did look terrible. In the months that followed what happened was people did zero prevalence studies and found that there were many times more cases of infections than there had been cases in H1N1 and the infection fatality rate, which turned out to be about a hundred times less than the initial case fatality rates in the H1N1 case.
[Dr. Z] So let me reiterate that for people who don’t understand some of the terminology. So case fatality rate is when someone is actually tested for disease, presents to care and is diagnosed with the disease, and then how many people die out of that group.
[Dr. Jay] Correct.
[Dr. Z] Infection fatality rate is, well, of all the infections that exist, including ones that we weren’t able to openly diagnose. What’s the rate of fatality in that group. And it was 100X different in H1N1.
[Dr. Jay] In H1N1 that’s right.
[Dr. Z] And so this got you interested then when COVID came around, I imagine.
[Dr. Jay] It looked like a repeat to me, right? So looked like the people were finding enormously high case fatality rates. I think World Health Organization said 3.4%. There was a piece published in JAMA in February Journal of American Medical Association, that said 2.2%. And these are terrible numbers.
[Dr. Z] These are horrifying numbers. These are the kind of numbers that would cause you to lock down the entire planet instantly, because you’re gonna lose that percentage of your population if everybody gets infected.
[Dr. Jay] Millions and millions of people dead, right if that’s the number in the United States alone.
[Dr. Z] Alone.
[Dr. Jay] If the numbers are right. But that was what happened at H1N1. And I said okay, well, do we really know how many people actually have it? And at the same time we’re worried about how much testing resources we had. Remember there was a shortage of tests. So we’re just holding onto the test to look at people who actually have serious disease, which is what you ought to do from a clinical perspective. But then from an epidemiologic perspective, can you extrapolate that to say, okay the population at large 3% of us are all gonna die if we get it. And we don’t have the answer to that. So that’s what led to the Stanford Seroprevalence Study.
[Dr. Z] Yeah.
[Dr. Jay] And the other share problem studies I’ve worked on. So it was this hypothesis. Like how many people actually have it? How deadly actually is it?
[Dr. Z] And so how did you do this study? Because there was a ton of controversy around the methods and the actual sensitivity specificity of the assay that you use and all that.
[Dr. Jay] Yeah, so that was a lot of confusion around that. So we wanted to do a study that could be done very, very quickly, put it in the field very, very quickly. At the time of the study the FDA had approved for use some, the lateral flow assays, they looked like pregnancy tests, like little pregnancy kits. The one we used had pretty good error properties. You know every medical test has errors. I mean, there’s just not a, and you can’t avoid that. That’s just the nature of, we don’t have a tri-corder that can automatically tell me exactly what’s wrong with you, right? We need to look at the numbers and interpret them. At the time the FDA had approved for use these little lateral assayed tests, including the one we use, for sale but they hadn’t approved them for general use in the population. We could use them for research purposes, but not for clinical purposes. So we use one of those, the reason it was very simple. There are two kinds of tests to do antibody testing, there’s these ELISA tests, which are pretty accurate and then these lateral flow assay tests. For the ELISA’s, you have to draw venous blood. It’s really hard in the middle of a pandemic to go out and find, you know, can I draw venous blood from you? A big vial of it, or I can just do a little finger stick. The nice thing about epidemiologic work is that you can correct for the errors, which is what we did. Actually I’ve run three Seroprevalence Studies, one in Santa Clara County, one in LA County, and one in with Major League Baseball.
[Dr. Z] Did you get to meet a lot of baseball players?
[Dr. Jay] I got to meet a lot of, not baseball players, I mean it was surreal, I got to be in a meeting with all the owners. It was just–
[Dr. Z] Oh, wow, that’s nice.
[Dr. Jay] It was fantastic. I had to contain myself when I met the Yankee’s owner, but, you know, that’s another thing. So I ran three different studies and the interesting thing about the studies was we use very different methods to try to disseminate them. So the Santa Clara Study was the first one. It was a big study, 2000 some people in the Bay area in Santa Clara County.
[Dr. Z] Right.
[Dr. Jay] We wrote the study very quickly and we released it through an open science process,
[Dr. Z] Like a pre print,
[Dr. Jay] A pre print, right, exactly. So now the traditional path involves sending it to a journal. The journal then sends it to three anonymous reviewers. No one will hear it about it, except me. And that’s how I spend my life dealing with this three anonymous reviews, all of them always hate me.
[Dr. Z] So you’re not used to the whole planet hating you at once.
[Dr. Jay] Yeah, that was interesting. So we sent it and I got 10,000 peer reviews in one day.
[Dr. Z] Oh my gosh.
[Dr. Jay] And it was kind of interesting, exciting. I learned a lot. So we made, what I would characterize a relatively minor error in standard error calculation, which we corrected within a week.
[Dr. Z] Right.
[Dr. Jay] And the number that we got was absolutely stunning. What we found was that the disease was 50 times more prevalent than people thought based on just the case number. So people thought in Santa Clara County, there were a 1000 cases as of April 3rd, I think it was. But in fact based on the study, you could tell 50,000 people had, had some antibody evidence of it the same time.
[Dr. Z] Right, which would correspond to an infection fatality rate at that time of what?
[Dr. Jay] About two in 1,000.
[Dr. Z] two in a 1,000
[Dr. Jay] So that means out of the 1,000 people who got the infection, 998 survived.
[Dr. Z] So 0.2%.
[Dr. Jay] 0.2%.
[Dr. Z] So double what we think the mortality is for flu.
[Dr. Jay] Well I am not 100% sure I know what the flu mortality, I know the evidence, it’s unclear in flu no one’s done the same kind of infection fatality rate numbers that they’ve done with for COVID that they’ve dealt with the flu.
[Dr. Z] So in many ways we’re comparing apples to oranges when we’re comparing flu–
[Dr. Jay] So let’s come back to that flu comparison. ‘Cause it is interesting and important, but I think the key thing is how much would you change your life’ for two in a 1,000 risk? And there’s a couple other things we learned. So one is that if you’re older, it’s much higher. It’s probably much worse than the flu actually.
[Dr. Z] Yeah.
[Dr. Jay] For older
[Dr. Z] Order of magnitude.
[Dr. Jay] So if you’re over 70 versus if you’re let’s say you’re under 15 or under 10. It’s on the order of a 1000 to one difference in mortality probability. So the flu is much more deadly if you’re older, if you’re over let’s say 65 or 70. And if you’re under–
[Dr. Z] The flu or COVID we are talking about?
[Dr. Jay] I’m sorry COVID I apologize. It’s COVID is much more deadly if you’re over 65 or 70, and if you’re under say 40, the flu is worse. That’s what seroprevalence studies shows.
[Dr. Z] And that was the sense that I was getting early on too. And seroprevalence study was supporting that. And you said something which we’re gonna get back to. I think that’s a theme of this, how much would you change your life for a two in a 1000 chance, right?
[Dr. Jay] Yeah and I think that age difference is important. The absolute number is also important well, let’s get back to that theme.
[Dr. Z] Yeah, absolute versus relative risk, yeah.
[Dr. Jay] So the interesting thing about that, so we released the LA County Study. It was immediately accepted in JAMA and published.
[Dr. Z] Just instant.
[Dr. Jay] It’s the same number
[Dr. Z] Peer reviewed.
[Dr. Jay] Peer reviewed, yeah. I’ve never had such an easy time with a review it was a very strange. Whereas the Santa Clara Study, it exploded Twitter. I’m not on Twitter myself.
[Dr. Z] Thank God for you.
[Dr. Jay] It was actually probably good for my sanity.
[Dr. Z] It really is.
[Dr. Jay] And everyone on earth was paying attention to it all at once, one study, right.
[Dr. Z] Right, pre print.
[Dr. Jay] And everyone was convinced that I was absolutely wrong.
[Dr. Z] Yeah.
[Dr. Jay] 100% wrong because people had fixed in their mind, New York City where the death rate was higher. Actually we know from seroprevalence studies that it was higher, the actual infection fatality rate was higher in New York City. So now since then 50 some studies from around the world have been done. And there’s a consistent theme that the infection fatality rates somewhere between two and three in 1,000, just like what we found in Santa Clara, just like what we found in LA County and the places that have higher density where you think did worse, you know, Bergamot, New York City, they did worse. Their infection fatality rate is worse five in a 1,000, six in a 1,000 in some Spain, maybe 10 in a 1,000.
[Dr. Z] So, okay, there’s a lot here. And again, this gets me fired up because I’ve been talking about this myself, why would an infection fatality rate be different in say New York versus at Santa Clara? Walk me through that.
[Dr. Jay] Yeah, sure so we think about infection fatality rate as if it were just a–
[Dr. Z] Static.
[Dr. Jay] Well, as if it’s the virus itself, it’s a feature of the virus. Here’s the virus. Here’s the infection fatality rate. That’s wrong thinking. It’s a function of the virus obviously, the biology of the virus, but also the host and also of the healthcare system taking care of the patient.
[Dr. Z] Do they survive or do they get care
[Dr. Jay] All three of those things matter a ton.
[Dr. Z] Ah.
[Dr. Jay] So for instance, if you look at the case fatality rate for this disease, just case fatality forget about infection fatality, right? This is the number of people who have the disease who actually died from it. It’s declined very sharply since March and April.
[Dr. Z] Sure has, cases up deaths down.
[Dr. Jay] Has the virus changed? Maybe a little, I mean, there’s some mutation, but not enough to think that it’s had any appreciable change. What it is, is a few things. One is the set of people that are getting infected are less vulnerable to it. They tend to be younger. And so they just don’t die at higher rates from it. The second we were better at managing it, better treating it.
[Dr. Z] Right, dexamethasone.
[Dr. Jay] Exactly.
[Dr. Z] Not intubating everyone.
[Dr. Jay] Not killing people with ventilators right. I mean that would seem like a really good idea.
[Dr. Z] Yeah which by the way, wasn’t clear in the beginning at all. So not to disparage people who are intubating everyone, but we just didn’t know.
[Dr. Jay] Yeah, I know, look, I have a lot of sympathy and people were really brave going in when we didn’t have the numbers. I honor that, absolutely. But it is absolutely the case, we’ve learned a lot about how to treat the disease and we’re much better at managing than we once were. I think that kind of news ought to get out more. That seems like an important fact, our understanding of disease shouldn’t be frozen in Amber, in March.
[Dr. Z] No, so you’re preaching to the choir because I just did a video on this, on the cases up deaths down. I actually think that there is a lot of catastrophization and misunderstanding, and there’s been a polarity that I’ve not seen in science ever. And the thing is folks like you, this is the thing I criticized your trial as well, but also put it out there and said, hey, this is what’s going on. This is the critique, et cetera.
[Dr. Jay] Well, science, that’s how it works.
[Dr. Z] That’s what you do in science.
[Dr. Jay] I mean, I didn’t mind the science. Of course we talk, we look at the data, we try to interpret it. That’s the fun part of science.
[Dr. Z] But the vitriol and the censorship too, like Ioannidis is your partner in that one of the most respected scientists actually has done papers and papers and papers on how we get science wrong with our own biases, right. Was accused of severe bias and censored.
[Dr. Jay] Yeah, it was absolutely shocking. So, like Buzzfeed attacked my family, Buzzfeed.
[Dr. Z] Can I say, so anytime I see anything in Buzzfeed, if it isn’t 10 reasons celebrities have done something that make you go, what I’m shook! I don’t listen to it because it’s so clearly biased.
[Dr. Jay] Yeah, it was really kind of
[Dr. Z] Buzzfeed attacked your family?
[Dr. Jay] Yeah they said my wife was involved in like she volunteered, my daughter actually volunteered as a, it was lot of community involvement with the feeling around the study in Santa Clara was a lot of volunteers a lot of people, it was a really good feeling. And my wife was super excited about the study. She’s an oncologist. She wrote a email and to her friends, encouraging them to sign up and somebody leaked the email, which had some information that was not quite right. And then Buzzfeed made her international news.
[Dr. Z] Oh my God.
[Dr. Jay] That’s the hardest part of this. It was just getting my family involved with it in a way that I didn’t expect.
[Dr. Z] What’s the agenda for that, that you’re somehow minimizing the pandemic and gonna cost lives, is that right?
[Dr. Jay] I think so, that’s part of it. The same Buzzfeed author then wrote an accusation that somehow, because people gave money, including like, I guess a JetBlue executive
[Dr. Z] Right, I saw that.
[Dr. Jay] To Stanford
[Dr. Jay] Right, right 5,000 bucks.
[Dr. Jay] 5,000,
[Dr. Jay] So 5,000 which is a rounding error on the cost of a trial.
Well, in this case, the study was we ran a really cheap, it was less than a $100,000 for the study.
[Dr. Z] Nice.
[Dr. Jay] But they give the money to Stanford and somehow I’m gonna change the results for the, it’s just ridiculous.
[Dr. Z] You know what, Jay, when you’re in big JetBlue’s pocket anything goes bro
[Dr. Jay] It was really kind of him to give money for the study was like, I’m grateful.
[Dr. Z] And that’s fine that he had his own agenda, which was probably, hey, yeah.
[Dr. Jay] Everyone has an agenda
[Dr. Z] Everyone has an agenda.
[Dr. Jay] So my agenda was to learn what that number was. I think we now know it.
[Dr. Z] So your feeling now is that somewhere between 0.2 and 0.3% infection fatality rates.
[Dr. Jay] That’s the median around the world
[Dr. Z] Median, around the world, It may be higher in places like a New York.
[Dr. Jay] [Dr. Jay] Yeah.
[Dr. Z] Why was it higher in New York, do you think?
[Dr. Jay] I think there’s lots of reasons. I think potential one is I think the set of people that were infected in New York were older. And the institutions where they are infected was less capable of dealing with it in the early days of the epidemic. So there’s something to this and the fact that it was older people in nursing home settings that weren’t sort of equipped to manage it. I think that played a big role in why it was higher in New York. The other thing is I think there’s a, and this is a theory I’ve seen, I think, I mean, there’s something to it, when viral load is higher, when you’re exposed to it multiple times over and over again, you just get a worse outcome.
[Dr. Z] So I talked about this with Monica Gandhi yesterday on the show UCSF ID doc, and her theory of viral inoculum correlating to severity.
[Dr. Jay] I saw that.
[Dr. Z] Yeah, yeah and she actually posited the same exact thing in, it’s a theory like it’s was hypothesis in New York was that people are in the built environment or on top of each other, especially minority communities, which were hardest hit. And so, as a result, if you’re out in Queens or somewhere, and you’re just living in this multifamily home, told to stay indoors, right. What are you doing? You get a high viral inoculum. And again, it’s a hypothesis, but it’s interesting because that would affect your infection fatality ratio if that is a component of how severely ill you get.
[Dr. Jay] Correct and that is what explains why nosocomial spreads like hospital’s spread it’s so important.
[Dr. Z] Exactly. We talked Dr. Li, the guy, the ophthalmologist in Wuhan who first sort of broke this news and he died and he was 33 and the thought was, he’s an ophthalmologist. So he’s seeing patients this close to their face, getting viral inoculum right in the face. And now we’ve learned a lot from that. that’s why we N95 and face shield in the hospital and paper and all that. If we can yeah. So do you think the infection fatality ratio, if you just looked at one community, like say Latinos, Latinas, would you think it’d be higher there from what we’re seeing?
[Dr. Jay] From what I’ve seen, I think that minorities are harder hit with this epidemic. That’s absolutely true. So black communities, Latino communities are been harder, especially in California, Latino communities make up the bulk of the–
[Dr. Z] Disease yeah, 45% yeah.
[Dr. Jay] It’s incredible, I don’t think the infection fatality rates,
[Dr. Z] Sorry 60%, 60% of cases in California
[Dr. Jay] But I don’t think that the infection fatality rate is much higher conditional on getting it. It’s just they’re more likely to get it.
[Dr. Z] I see.
[Dr. Jay] It may be a little higher. I mean, you know, it’s hard to.
[Dr. Z] See because is there preexisting disease more in that community, chronic disease, diabetes, hypertension disease.
[Dr. Jay] Yeah, that’s the question. So if you have these underlying conditions, of course, you’re more likely to die from, if you’re older you’re more likely to die from it, things like that we know for a fact. Once you control for that, if you’re Hispanic, are you more likely to die? My guess is probably not.
[Dr. Z] Interesting.
[Dr. Jay] It’s mostly those preexisting conditions and the fact that you’re more likely get it in the first place.
[Dr. Z] Now, one counter proposal I might say as well, if viral inoculum does matter, if that hypothesis is true and Hispanic families are more likely to congregate together under one roof, you might see actually a higher infection fatality rate in that.
[Dr. Jay] It could be yeah. There’s a study that was done in Mumbai, in the Dharavi Slums in Mumbai.
[Dr. Z] Yes, I saw that, explain it.
[Dr. Jay] First, the, the prevalence was enormous. I mean, I think it was like–
[Dr. Z] It was 80%, 60 or 80.
[Dr. Jay] I actually talked to some of those study authors, the studies who ran the thing. Essentially the idea they have is that the lockdown put people, this is a slum where like 10 people live in the same house and there’s police walking around, making sure that if you walk out of the house, you’re gonna be arrested. So they put 10 people in the house, they probably spread the disease with the lockdown, enormous viral load. You can see with the 80% antibody number right.
[Dr. Z] Right
[Dr. Jay] But the infection fatality rate was really low.
[Dr. Z] Minuscule.
[Dr. Jay] Yeah.
[Dr. Z] Like I think it might be an under reporting to some degree, but like 200, 300 deaths out of all these.
[Dr. Jay] Yeah it was really, really low. So part of that is they don’t have the diabetes, they don’t have the obesity, they don’t have those kinds of predisposing conditions.
[Dr. Z] ‘Cause they’re thin.
[Dr. Jay] And they’re younger.
[Dr. Z] They’re younger.
[Dr. Jay] So, I think we’re still learning and at least I’m still learning quite a lot about this disease.
[Dr. Z] Well, and you know the other thought that I had, and again, this is just pure mental masturbation is the idea that that group may be exposed to so many pathogens on a daily basis, including Corona Viruses, et cetera, that they have some innate T-cell immunity or mucosal immune something that we don’t have.
[Dr. Jay] Yeah, I think there’s some evidence of that even in the United States right.
[Dr. Z] Yeah, exactly.
[Dr. Jay] I saw this really interesting study where it looked at, it was a small study so I don’t know if it generalizes it will hold up when it’s done larger, but people who have young kids, you know if you have young kids, I have three kids and when they were little I had colds all the time. People with young kids are less likely to die from it.
[Dr. Z] And that really tells you something like, I remember I had a severe cold actually just in January before it was really widely prevalent and I never had antibody testing or anything. So I don’t know if it was COVID, but I doubt it. No one else in the family was sick. I caught it from a friend who was in Las Vegas. And I wonder whether getting those really jazzes your T-cell immunity kind of like getting a BCG vaccination or something like that.
[Dr. Jay] There seems to be increasing evidence that T cell mediated immunity does matter quite a bit.
[Dr. Z] But even talking about that people are like, “stop minimizing the catastrophe.”
[Dr. Jay] I don’t understand this, like this is not politics to me. This is a really important epidemiologic phenomenon that we absolutely have to get our hands around. We need the best science possible. I don’t understand the politicization of you’re on team apocalypse or you’re on team doom, right, team–
[Dr. Z] Team denial.
[Dr. Jay] Yeah, exactly.
[Dr. Z] I liked that team apocalypse versus team denial go! That’s really what it is. And we say that we don’t understand it, but we do understand it’s an election year all that, but as scientists, we don’t condone it is what we’re trying to say. You got sucked into it, right? Because by definition now you’re on team denial because you did science that doesn’t support the press’ narrative of X, Y, and Z.
[Dr. Jay] Yeah, what I was taught in public health circles, we actually give people the right information, the true information. We don’t unduly stoke panic just in order to get the result we want, which is essentially you’re gonna comply with this order or that order. We don’t do that. We tell people, okay, here are the risks. We have to trust people to react to that appropriately. Not many times, they won’t some but many times they will, but on net if you wanna maintain trust in the public health community, the absolute first thing we have to do is tell them the absolute truth about what we know and we don’t know.
[Dr. Z] So what you’ve nailed here again, is something I talked with Vinay Prasad on the show about which is authenticity. We suck at it in medicine, we prevaricate, we think we don’t trust the public to do the right thing. We are paternalistic to a fault. So when Monica was on the show yesterday, she said, you know, I’m an HIV researcher. I believe in harm reduction. How dare us preach at people wear mask you dummy, you stupid person. And do you wanna kill grandmothers? And this and this and this, that’s not the way to communicate public health. You communicate the uncertainty, but you communicate what we know and her whole thing as well, if mass reduce inoculum, and it’s a low risk intervention, then maybe you guys should do that. But it’s your decision. I don’t wanna mandate it. And if we get 80% compliance according to our data, maybe that’s a tipping point, but you know, again, it’s a hypothesis.
[Dr. Jay] I’d amend that a little bit. I agree with that actually, but the only thing I’d amend is it’s related to the harm you really, really are seeing. So if we really are seeing it’s a 3% mortality disease, yeah then I’m okay with more aggressive. But if on the other hand we’re really uncertain about that 3%, which we were. If we really don’t know, we should tell people, look, it’s looking like 3% we don’t know, let’s see, here’s what we’re doing to try to figure it out. We should just be honest about what we don’t know. I think to me has been the most shocking thing that the public health people and doctors have dawn this mantle of absolute knowledge in a place where I’ve read a lot of this literature there’s a lot I don’t know even though I’ve been reading the literature scientifically. So we just don’t know. We should say that. Why is it bad to say that when we just don’t know.
[Dr. Z] You know, and what it does there’s a side effect of that, that we’re seeing now, which is when doctors and public health officials say, “don’t wear a mask.” and then yeah in the next breath, “wear a mask of any kind. “I don’t care “if it’s just the lace panties over your face wear that” we look like idiots. And on top of that, the public then, which isn’t as dumb as they’re portrayed by the intellectual elite, goes, “now wait a minute.”
[Dr. Jay] And they should.
[Dr. Z] And they should. And then what happens is, and you see it in the comments to my own videos, right? If I do a video kind of leaning in one direction, a billion people comment the other direction. If I lean in, in that other direction, a billion people comment, the public is trying to find truth.
[Dr. Jay] Right.
[Dr. Z] And it’s tough.
[Dr. Jay] I mean, you know, that’s okay. We’re having a conversation, there’s stuff I’m learning from you. I hope there’s some stuff you’re learning from me. And basically that’s what science is. It’s a conversation that leads to more data that leads to more conversation. That’s what it is.
[Dr. Z] So what you just said is absolutely reasonable and rational and Buzzfeed attacks your family.
[Dr. Jay] Yeah, so, I mean, that was tough, I have to say. That was probably the hardest parts of the whole work on this was just feeling like I’ve dragged my family into something. There’s one thing to go after me. It’s another thing. Like, but in any case, let’s leave me aside. So we put this paper out, we find this number 0.2 to 0.3, and then a whole series of studies started coming out from around the world to find the same number. Many of them published, the peer reviewed literature I think now has established it.
[Dr. Z] So let me ask you a question though. So what, two to three times a flu is still catastrophic, man. Well, how do you respond to that?
[Dr. Jay] I’d amend that, there’s also no vaccine.
[Dr. Z] Right no vaccine and we didn’t have treatments.
[Dr. Jay] Absolutely it is worse than the flu for those reasons.
[Dr. Z] Thank you ’cause I think that the denial, I think a lot of people perceive a denial. This comparison with flu is very charged and the truth is–
[Dr. Jay] It’s worse than the flu. And I think for older people, it is absolutely we should treat it like it’s much worse than the flu, because it is worse than the flu. So for instance, nursing homes, right? So I just looked at a paper that said that nursing homes often share staff workers. So like one staff worker works in nursing A may also works in nursing on B. We should be using our testing resources to make sure that when shared staff workers move back and forth, they don’t bring the virus back and forth with them across these nursing homes. That seems like a completely reasonable outcome of the fact that older people are much more vulnerable, especially people with comorbid conditions.
[Dr. Z] And you’ve been a big advocate of protecting vulnerable groups.
[Dr. Jay] That’s the whole point of this is to learn who really should we be using our relatively limited resources to protect. And when we raise alarm, who should we be doing it for. There’s cost to raising alarm, right? So like, if I panic you, you may take actions. That’s the whole point of the raising the panic and the alarm. But those actions will have very little effect or much less effect on the spread than the costs that you pay and the society pays for those acts.
[Dr. Z] And the problem with those costs are they’re often in tangibles, like I have had fans, who’ve become fans of my show since we started the COVID adventure. And the reason they became fans is they have generalized anxiety disorder, or they have some level of anxiety. They have been jumping out of their skin, watching the press catastrophize about this in generating the fear that I think was the medical establishment was complicit with because they are seeing it on the front lines in a very biased way. Oh my God, my ICU is full of people who are dying, including some young people. And therefore anything we can do to get the public to behave is gonna be important, right. And then what ends up happening is these poor individuals who have a tendency to anxiety are losing their minds. So they tell me, I watch your show because you seem rational and you have opposing viewpoints, and you’re not just saying we’re all gonna die. And I think why should I be the one who’s doing that?
[Dr. Jay] Well, you have a good audience.
[Dr. Z] I think that ought to be the general.
[Dr. Jay] I agree with that. I don’t really understand it, but it seems like people want, especially the press seems to want to create this panic. So every time there’s a study that comes out, that a child has died, which has happened absolutely for this disease. You’re gonna get this panic headline from the press. Now, one of the things I’ve learned from the seroprevalence studies, again from around the world now, not just mine, is that there’s a very wide range of clinical presentations from this disease. It ranges from, somewhere between 30 to 40% of the people that get it have no symptoms whatsoever. They can’t remember. They have the antibodies, but they have no symptoms that they can remember from it maybe even a larger part have relatively mild symptoms. It’s like a cold. And a small fraction have this horrible viral pneumonia that kills them. We focus all our attention on the viral pneumonia and none on the fact that 998 people are gonna recover from it.
[Dr. Z] Yeah, that’s a feel good hit of the summer, right there. Like that’s a positive story and they’re going to develop immunity and this whole panic about, well, no, we’re never immune. That’s another press thing.
[Dr. Jay] Yeah.
[Dr. Z] It’s insane
[Dr. Jay] It’s like no other virus does that, right.
[Dr. Z] Exactly well, what do we all, and the related piece to that, like you said, one story about a child.
[Dr. Jay] HIV, I guess
[Dr. Z] MISC, HIV I guess, strep throat. You can’t have a vaccine.
[Dr. Jay] So actually it’s a legitimate scientific question, but one we now have an answer to. You do develop immunity, this virus.
[Dr. Z] And the thing is because we have now millions of cases and we can look and there’s been like, I think two documented cases of actual re-infection.
[Dr. Jay] Yeah.
[Dr. Jay] One was like, it was totally mild. The other was more severe. And so you could think in a population there’s variants, right.
[Dr. Z] But two out of millions right? So, and as you said, the first case, that was the reinfection, it looked like the guy was protected.
[Dr. Jay] Mild, which is what you would expect, even with a cold, like, you get a cold one year, you may get it again the next year, but it’s gonna be minor.
[Dr. Jay] Yeah, if you have the same virus, even if the antibodies fade, you may have T-cells or other mechanisms immunity that make it so that, it’s not that you won’t get sick, but you’ll get sick much less and it won’t create severe illness.
[Dr. Z] Now, one thing that’s gonna come up, and this comes up a lot again, in the catastrophization camp, but what about the long haulers and the terrible damage to the lungs and the cardiac damage and the brain damage and all the other things.
[Dr. Jay] You know, those happened with influenza.
[Dr. Z] Exactly, right.
[Dr. Jay] So my son, my young son, 13 year old now a couple years ago, got the flu and he’d had the flu vaccine and he still got the flu.
[Dr. Z] Which happens.
[Dr. Jay] Yeah, it happens I mean it was fine. Like, it was a little worse than I thought it would when you normally would get, and he was getting better and he woke up one morning and he couldn’t walk.
[Dr. Z] Oh my gosh.
[Dr. Jay] I was going through all the panic things when you go through medical school, you always have to.
[Dr. Z] Like Guillain-Barre.
[Dr. Jay] That’s exactly
[Dr. Z] Transverse myelitis.
[Dr. Jay] And I’m like, Oh God. So it turned out it was benign myositis. Thank God and within a week he was walking again. Flu has all kinds of strange side effects. It has neurologic side effects. It can have cardiac side effects. We put these in context, right? These are things that happen. Absolutely can happen. but we have a lot of information about how frequent they are. Are they likely? How long lasting they are? If it was Guillain-Barre would have been terrible, but if it’s benign myositis it’d last week and he’s okay.
[Dr. Z] So that’s funny because my daughter had a viral syndrome when she was three and couldn’t walk and again benign myositis. But again, you go through the panic, but the point being these things happen with viral infection, this is a new viral infection that we don’t have a vaccine for. That is novel to the degree that it’s novel. Although we seem to have some innate immunity from cross-reactivity to Corona Virus, and yet we are spinning it as if the world is ending. And the thing is that would be fine if we thought it was actually going to cause less harm to spin it that way than not, but it’s actually causing a lot of harm in terms of the response. So whether it’s suicide rate going up, substance abuse, economic catastrophe, mortgaging our children’s future, creating intergenerational divides now.
[Dr. Jay] Yeah, I was hoping we get to talk about that. ‘Cause that’s something I think has been vastly underemphasized and it’s breaking my heart. So let’s talk about suicide. The CDC released a report, I think in July that it was a report where they ask about suicidal ideation. Like how many suicidal thoughts, have you have you had any serious suicidal thoughts. One in four 18 to 24 year olds, one in four 18 to 24 year olds in June had serious thoughts of suicide.
[Dr. Z] You know, so my assistant is in her early twenties and she only just recently told me during the early lockdown stuff, we didn’t have her in our house. And, kind of kept her on a, not a furlough we were paying her, but she isolated. Now this is a hyper social person in the prime of her life who is now told, don’t leave your house sit there with your dog. And she told me now that it was so awful for her, you know?
[Dr. Jay] Yeah, for a disease for her 20 early twenties, probably one in 10,000 death rate. We’re basically imposing asking young people who are meant to live in community. Not me I was a hermit, but everyone,
[Dr. Z] Me too, I really enjoy this.
[Dr. Jay] But we’re not meant to live alone in our house hold up, it’s going to have consequences. It’s gonna have severe negative consequences, psychologically, and we are already seeing it. That is just the beginning of the cost of the lockdown. Worldwide, they’re reports of hundreds, of millions, of additional people starving as a result because you said you’re talking about economics. So one of the themes I’ve heard argued against me when I make this point is, well, look, you’re talking about the lockdowns and there’s some economic costs, but what are they relative to the lives we save. But it’s not lives on one side the economy on the other. The economy is really important to the lives of the people who are in the midst of it. And hundreds of millions of people around the world that are on the edge of economic disaster. And you push them over you, you destroy the world economy. It’s not just dollars. It’s hundreds of millions of people starving. And that’s what the UN has said. Then you go, and it’s fine.
[Dr. Z] I said this, like in the first month of this pandemic, I said, you guys seem to have this false dichotomy between economy and lives. Blood is treasure it’s there it’s a transitive property. When you start having unemployment, the suicide rate goes up in the world when you shut the economy down, people starved to death. And this idea, and I’m gonna rant for one second and you may or may not agree with me. I feel like my own tribe of people, the healthcare professionals, have held the rest of our country hostage with their catastrophizing around this, which was done with good intent. These are good smart people. And they’re right. We’ve had deaths and terrible outcomes, but they fail to see the bigger picture. And Monica Gandhi on the show yesterday said, as doctors it’s our responsibility to see this.
[Dr. Jay] Our job is to show people that picture, I’d say even more than just, I mean, I call us the Zoomocracy and I mean it. So like, I’m fine I can be on Zoom and I’m not going to lose my well, maybe who knows the Sanford could keep me.
[Dr. Z] We gotta talk about that.
[Dr. Jay] But I think I’m fine, right? So like, why should I care about, well, my job is to tell people what’s happening in the rest of the world, I think. There’s this program called Gavi, which is a program for vaccinations International Program for Vaccinations. They’ve halted their operations because of the lockdown.
[Dr. Z] So polio comes back, measles comes back. measles never gone, measles is still here.
[Dr. Jay] Yeah we’re gonna see research we may even see resurgence in polio in the United States because people stopped taking their kids for the OPV vaccine.
[Dr. Z] Yeah absolutely cancer screening, their mental–
[Dr. Jay] So we’ve had good news from cancer for the past few years. We’ve actually had decreases in cancer related mortality for the first time in my memory anyways, for three or four years in a row that will reverse, we’re gonna start seeing later stage breast cancers, later stage prostate cancers, people stopped getting screening. People actually even stopped getting treatment for cancer, active cancer. During the epidemic.
[Dr. Z] Yeah I’ve seen that. HIV, patients are losing their viral suppression. Monica was talking about that because they’re not coming in.
[Dr. Jay] Tuberculosis millions of extra tuberculosis cases ’cause you have tuberculosis, you have to treat over a long period of time with regular antibiotics. People come in around the world because they’re–
[Dr. Z] Directly observed therapy, all this other stuff.
[Dr. Jay] Exactly and that stopped were gonna see a resurgence of tuberculosis deaths.
[Dr. Z] Well, so let me ask a question because this is very gloomy stuff. Like, honestly, when you said earlier, you were heartbroken. This is what keeps me up at night because you know here we have this platform we can get to see, like you said, we’re part of the Zoomocracy. Like we can do this, we can get this information out, but it doesn’t sink in. And what it does is, I worry that it even contributes more to this polarization because there are camps that get so emotional about the damage we’ve done from our response and camps that gets so emotional from The United States’ perceived failure relative to other countries in terms of mortality per million.
[Dr. Jay] I’m heartbroken at both. I mean, I think we in public health need to balance COVID is not the only threat to public health. We need to understand that there’s all kinds of public health problems.
[Dr. Z] So what do you think you would say The United States should do? And then I wanna talk about Sweden and Europe and Asia too, but what do you think the United States should do? So here’s the problem, all this disaster from our response and then the danger of the virus, which is worse for the elders and people with comorbidities. And it’s blessed than we thought initially. And we have a little better treatment now. So what do you think?
[Dr. Jay] If I had to characterize the American response. It’s exactly backwards.
[Dr. Z] Yes.
[Dr. Jay] We have quarantined the healthy and we’ve exposed the vulnerable to the disease.
[Dr. Z] That’s it and Monica said yesterday.
[Dr. Jay] Flip that around.
[Dr. Z] Monica said yesterday, we were exactly backwards as well. We’ve favored the rich people who can survive this, the Zoomocracy like you and I, and we’ve punished the poor. So we’ve actually told them, stay inside, lose your jobs, get $1,200 a month.
[Dr. Jay] Yeah, or you go out and expose yourself, deliver the groceries to
[Dr. Z] Essential worker.
[Dr. Jay] Yeah, I don’t understand it. I could understand three in a 100 deaths.
[Dr. Z] Different story
[Dr. Jay] You imagine it, but even there you’d wanna focus response and figure out who really is
[Dr. Z] In that 3%.
[Dr. Jay] Right, exactly and there may be people who are less vulnerable. You tailor your strategy around the numbers you’re seeing, but we haven’t done that yet. We’ve gone the opposite route since in many ways, I think New York is an absolute disaster, New York, I mean, the highest death rates in the world happened in the Northeast early map of the United States.
[Dr. Z] Yeah and multiple reasons for that probably that will become clear also more in retrospect and our retrospectoscope is is gonna be highly, highly indicting. I think of a lot of behavior that we had early on.
[Dr. Jay] Yeah, can we return to, you were asking me earlier about like the scientific discussion around this.
[Dr. Z] Yeah, I would love to,
[Dr. Jay] So I’ve been really concerned about censorship in science around this epidemic.
[Dr. Z] As have I.
[Dr. Jay] Yeah and so like you mentioned, John Ioannidis is one of the foremost physicians in the world, researchers in the world studying. I had the honor to be able to work with him. He did an interview early on in the epidemic that was suppressed by YouTube.
[Dr. Z] How do you suppress John Ioannidis?
[Dr. Jay] I don’t know, I don’t understand it. My view of science is that it’s a conversation. We have to have the ability to express views that are not popular or else we can’t have a science. We can’t have science.
[Dr. Z] I mean.
[Dr. Jay] So the idea is that somehow if somebody is expressing a view that is contrary to somebody’s interpretation of some public health organization, World Health Organization or whatever, it’s ipso facto dangerous to say those views, that is a form of population control. That’s what it is, right.
[Dr. Z] It really is, yeah.
[Dr. Jay] It’s fine if you know, with 100% scientific certainty, that some fact–
[Dr. Z] Is wrong.
[Dr. Jay] Yes.
[Dr. Z] Yeah, like vaccines cause autism, right?
[Dr. Jay] So what’s the your response. You say, look, the vaccines don’t cause autism, right? That’s the right response.
[Dr. Z] That’s right.
[Dr. Jay] And here’s the evidence.
[Dr. Z] That’s right.
[Dr. Jay] If you have a situation of a new virus where the science is emerging rapidly and we’re learning new things, I’ve changed my mind about 15 things about this virus as I’ve read new papers
[Dr. Z] Me too.
[Dr. Jay] over the course, how could you not?
[Dr. Z] Yeah but you know what, read the comments in my videos. You flip-flopped on this five times.
[Dr. Jay] Got me with this new evidence coming up right.
[Dr. Z] Yeah.
[Dr. Jay] So in that context, scientific censorship is criminal.
[Dr. Z] Yeah. I agree.
[Dr. Jay] And so I think, and we’ve seen this over and over again, there’s a set of papers by this scientist, Gabriella Gomez on the Herd Immunity threshold.
[Dr. Z] I love her work, yeah.
[Dr. Jay] And what I’ve seen her write is that she sent her paper to scientific journals the editors won’t even send it out for review because they’re saying that it’s too dangerous her findings suggest a lower Herd Immunity threshold. Now I don’t know if it’s right or wrong, I don’t–
[Dr. Z] Does it matter?
[Dr. Jay] Well, let’s just have a scientific conversation about it. Why is that so dangerous to talk about that you wouldn’t even send it out for review?
[Dr. Z] I mean, the last time we did stuff like this, it was the inquisition in Galileo.
[Dr. Jay] I felt a little like that Stanford. I think the,
[Dr. Z] Tell me about it
[Dr. Jay] well, we’ll talk about that in just a bit. But I think the knee jerk reaction to censor people that you disagree with inside the scientific community has been absolutely terrible. One of my Stanford colleagues actually wrote a New York Times article arguing for essentially a censorship board for our articles in Nova Science.
[Dr. Z] Hey, look, I kind of am an expert in misinformation management. I have always, look, remember those Bakersfield Docs, they were proposing some similar ideas to what you were saying, but their, their data was a little and you know, they were clearly a little.
[Dr. Jay] I’ve talked to them, look, there’s stuff I agree with it, but there’s stuff, I don’t necessarily agree with them, but why should they not be part of the conversation?
[Dr. Z] Exactly, so when that video came out, a million people sent it to me, what do you think of this? And I said, well, let me do a show on what I think. I agree with them that lockdowns are harmful. I agree with them we’re overreacting creating fear. I disagree with their use of the data on this and this and this. And I disagree that YouTube pulled their clip.
[Dr. Jay] Yeah it’s ridiculous.
[Dr. Z] Why would you do that? All you’re gonna do is also solidify this idea that there’s a conspiracy.
[Dr. Jay] I think the idea that media organizations or Stanford has some obligation to censor opposing views is absolutely anathema to science.
[Dr. Z] And you know, my wife is on a Listserv at Stanford. So a bunch of people that I know at Stanford got on a Listserv on the Stanford listserv email and said, “we hear by disavow Scott Atlas.”
[Dr. Jay] Oh, that’s disgusting.
[Dr. Z] Yeah so can you tell me a little about that?
[Dr. Jay] Sure, so again one of my colleagues sign that letter too. You know people I respect.
[Dr. Z] People I respect and know are on that.
[Dr. Jay] People I love are on that list. I mean like friends, I mean, I disagree with them about some of the things.
[Dr. Z] Right, but we can love people and disagree without shutting them up.
[Dr. Jay] So think Dr. Atlas Scott is the Special Advisor to the President on COVID. He has certain views about the nature of the epidemic. They’re actually closer to my views than by colleagues. So among those views are things like the disease is less dangerous for kids, less dangerous than the flu for kids. That seems like there’s solid scientific evidence. And yet the letter it seems to like paint this picture about the danger to kids. I think my colleagues are just wrong on this. The way they disagree with Scott on this,
[Dr. Z] I agree when I read the letter, I’m like, these guys are just wrong. They haven’t read what Scott is saying. Now, look, I don’t agree with Scott on everything.
[Dr. Jay] So now I think they’ve also mischaracterized what Scott has said. So for instance, Scott has repeatedly said that he’s not in favor of a Herd Immunity strategy. Actually, we should talk a little bit about Herd Immunity
[Dr. Z] Herd Immunity Strategy.
[Dr. Jay] What does that actually mean? Herd Immunity means that, so when we think about Herd Immunity, if we think about it as a single number, but it’s again, just like infection fatality is not a single number. What Herd Immunity means is that when a new person gets the disease, how many people are they gonna spread it to? If it’s less than one, then you reached Herd Immunity.
[Dr. Z] It’s gonna be squashed.
[Dr. Jay] Exactly, if there’s more than one, then you get more sort of this exponential growth right.
[Dr. Z] Right.
[Dr. Jay] That happens with every disease where immunity actually happens, that’s just normal. The number is a function of how people interact in society. So if I interact with a lot of people and I get it, I will spread it. If I’m sort of more fearful about the disease and I spreading it, then then social distancing happens then Herd Immunity, could get lower to meet the thresholds. ‘Cause one person getting it, doesn’t spread to a lot of people. So it’s a function of the behavior of people, as well as again, the virus itself, it’s not a single number where you say, okay, here’s, we’ve reached it. And ironically, you can reach it cases are declining and people stop taking those precautions. and it goes back up again. We can go in and out of Herd Immunity.
[Dr. Z] Right, autoregulation homeostasis of the population’s behavior.
[Dr. Jay] Yeah, exactly so that’s actually, it’s more complicated than that. Personally Scott has told me, I’ve never told the president that he’s in favor of Herd Immunity strategy. He is not. He specifically said that the letter my colleagues wrote accused him of that, just falsely. It’s just, if you set up the straw, man, I mean, I just, I don’t understand it. It’s like they weren’t listening and partly it’s the press’s fault. Like the press has mischaracterized him as well.
[Dr. Z] For sure, this is what I think happened. And honestly, and you can correct me. They read the press, they read some CNN, MSNBC Scott, Atlas doesn’t knows nothing about science. And he’s got president’s ear.
[Dr. Jay] He was the Chair of Neuroradiology at Stanford for years. I mean, I just don’t,
[Dr. Z] My wife worked with him right. And the thing is, if you hear him talk again, he’s reiterating some of the concerns that we have. He’s never said, let it rip through the population and develop.
[Dr. Jay] That’s that’s the exact opposite strategy. I know he’s been telling the president.
[Dr. Z] Right, right and the thing is, you’ve talked to him, have these colleagues talk to him, no. And this is what happens. You have in-group. This is his tribe of people. Now excommunicating him and which hunting him because that’s what’s happening on social media. That’s what’s happening in the halls of academia. Is this how you met him? Okay just play with this for a second. What if your right and Neeraj is right. And in retrospect we realize you guys were actually banging the right drum and these people who censored, you were wrong. Okay, that is gonna be a criminal act that they did. That costs lives.
[Dr. Jay] Yeah, I think there was an attempt to cancel me right.
[Dr. Z] Oh, for sure.
[Dr. Jay] I don’t actually care I get canceled. What I really want is the data to drive the policy. That’s what I really want. And I think Scott would say the same thing. I mean, it’s just not personal for him. It’s like, let’s let the data drive the policy. Cause the cost on lies are high on both sides of this decision. There’s no riskless option here.
[Dr. Z] Right.
[Dr. Jay] So whether you lock down or don’t lock down is not a, okay, let’s just stay safe on one side so my colleagues started the letter with the principle of do no harm. How do you do no harm in this situation?
[Dr. Z] There’s plenty of ways to do harm sensor a colleague.
[Dr. Jay] For instance.
[Dr. Z] On insufficient information. Now, I imagine, okay, so let’s dig into that a little more, and you can refuse to answer this if you like. Your own paper was attacked internally in a almost politicized way. It wasn’t so much about the science. And I was reading these things about the internecine drama at Stanford. And I’m like, I know these people, what are they doing?
[Dr. Jay] It was absolutely shocking to me. I feel like my academic freedom was attacked and I’ve been at the university for 30 plus years actually the motto of the university is “Let The Winds of Freedom Blow.” I don’t think that they acted, the leaders of the university have acted in that way toward my study. And it’s been absolutely shocking to me.
[Dr. Z] Are you tenured?
[Dr. Jay] I am.
[Dr. Z] Okay, so you can say this kind of thing.
[Dr. Jay] Well, I don’t care if I lose my job.
[Dr. Z] You know what I’ll hire you. We could be like , you know, we could have one of these like Sunday mornings
[Dr. Jay] It’s been really enjoyable talking to you
[Dr. Z] that would be really fun. So to this thing, I was shocked when I saw how this thing was played out. And I knew that what the press was reporting, wasn’t the full story. It was still concerning. I was like, well, is there a lot of bias here is this thing, you know? And so I was waiting to talk to you about this. And you know, at some point I’ll have one of the colleagues that’s attacking you guys on the show and see what they think. ‘Cause it’d be interesting, right.
[Dr. Jay] Yeah.
[Dr. Z] But I would love to see that play out in a way that isn’t just politicized. Cause it’s this.
[Dr. Jay] Yeah I got to do a debate with Stan Vermund.
[Dr. Z] Oh yeah I know Stan. I know of Stan.
[Dr. Jay] Yeah, so it was really interesting. Like he’s a Yale, the Head of the Public Health Department at Yale.
[Dr. Z] Yeah.
[Dr. Jay] Really sweet guy.
[Dr. Z] Talked really slow I was listening to debate going , oh my God I got to put it up to three X. Except when you talk, then I had to slow it down.
[Dr. Jay] I’m sorry.
[Dr. Z] No, no I love fast talkers.
[Dr. Jay] I bet but I think is that he’s open. He wants to talk. He wants to have a conversation. I wish we had that spirit of Stanford.
[Dr. Z] Yeah.
[Dr. Jay] I think in some ways we have lost that and it’s been dispiriting for me.
[Dr. Z] Yeah. I agree. Well, you know, the two folks that I interviewed from UCSF, Monica and Vinay are deeply embodied that spirit of open discourse. They may politically disagree. It doesn’t matter. They only wanna have the conversation in a polite and civil way.
[Dr. Jay] Yeah, I mean, I that’s the thing, Internally I don’t think, I don’t know what joining these politics are. I have literally no idea. I don’t and I’m pretty sure if I were to talk with Eran that we would disagree about politics. It doesn’t matter, we’re doing science,
[Dr. Z] Right.
[Dr. Jay] Like we move to what the data tell us.
[Dr. Z] Eran Bendavid who was also a resident when I was an attending there. I’m gonna try to have him on the show later.
[Dr. Jay] Yeah he was the lead author on the Santa Clara Study.
[Dr. Z] Yeah so I can dig in a little more with him, yeah. It’s great to be next to all these smart people, you know. But so it’s been just a mess. It’s been hard I imagine. Forget, it’s been hard on you clearly, you and your family, but secondary thing that has been hard on our scientific advancement and understanding this virus because when you suppress these ideas, what happens? They pop up on Twitter in a weaponized form. So now you have frank anti maskers that are taking masks and ripping out the lining so that they can do the hygiene theater without the actual filter. You know, I mean this crazy stuff, none of that would have happened if we’d just been open and honest.
[Dr. Jay] Yeah, I think it’s the same thing with the anti-vaxxers right. So like
[Dr. Z] Same thing.
[Dr. Jay] Actually, the funny thing is like we should talk about the vaccines.
[Dr. Z] Let’s just say that, yeah.
[Dr. Jay] But I think if a vaccine does come out and it’s effective. The fact that the scientific community is acting this way will create doubt around the vaccine.
[Dr. Z] Who’s gonna get it? 40% of Americans don’t want to get it now.
[Dr. Jay] Yeah and because the scientific community is very, very clearly seems politicized around this.
[Dr. Z] 1000% and remember in the early days of fear, when we were in the Imperial college sphere of influence, and we thought 3 million Americans were gonna die, there was not an anti-vaxx voice to be heard. They were terrified. They wouldn’t open their mouth. They saw, oh, ’cause when push comes to shove, if there’s a vaccine, they’re gonna be first in line to get it when you’re afraid for your life. But then as this thing spun out now, they’ve actually been empowered in a way that we haven’t remembered in recent.
[Dr. Jay] It’s because the scientific community is screwed up.
[Dr. Z] They’ve made idiots of themselves.
[Dr. Jay] Yeah.
[Dr. Z] Does it make you want to hit stuff and throw stuff. ’cause I get emotional about it.
[Dr. Jay] I’m not built that way.
[Dr. Z] I forget sometimes that I’m talking to scientific introverts who have like Spock like controls, whereas I’m the opposite. I’m just like throw the table over and kill everybody.
[Dr. Jay] Well, when, when they were talking to my wife, you know that means–
[Dr. Z] That’s too much.
[Dr. Jay] But other than that I still just want to know what the right thing to do is.
[Dr. Z] Right, there’ve been things where I’ve gone back and forth because I’m not convinced one way or the other. And I will literally sit up at night going I put out a video today saying this and is it really a 100% right? No, it can’t be a 100% right ’cause we don’t know yet. So am I doing more harm than good saying it, what’s the harm reduction.
[Dr. Jay] You have to say what you currently believe. And then when you find new evidence you change your mind you say it.
[Dr. Z] That’s the thing. So that’s what it is. But, but it’s hard. For me it’s emotionally difficult because I tend to involute this emotionally. Whereas again, that’s why I’m not a researcher. So a researcher I could have a little more equanimity.
[Dr. Jay] I mean,
[Dr. Z] It’s meditation,
[Dr. Jay] it’s hard to admit that you’re wrong right. That’s just, but look, you can’t do science without that, ’cause new data come out and you change your mind.
[Dr. Z] So let me ask you a question, speaking of data. So, and I’ve been meaning to ask this of you. So you read an Atlantic article, all right. And it says, here’s all the cognitive distortions that we’ve shown in this thing. And it was the actually the opposite version of what I’ve been saying, which is here are the cognitive distortions that we’ve are showing that cause us to catastrophize and misunderstand the science on this. They were saying, well, here’s all the reasons that America screwed it up and not taking it seriously and so on. And we have this terrible mortality rate and the high case rate and all that. And they would say things in there just throw away things like, and then they’re Sweden’s policy, which is folly and they put a link and they wished they hadn’t done. How do you respond to that?
[Dr. Jay] I mean, U.S has higher death rate than Sweden right now.
[Dr. Z] Yeah.
[Dr. Jay] More cases per million in the United States than Sweden. To characterize Sweden as a failure seems like, I mean they’ve made mistakes. It’s in the early days, I think
[Dr. Z] Not protecting the elderly.
[Dr. Jay] Yeah, they wait until early April to essentially protect the nursing homes in a serious way. And I think that led to some of their higher deaths, but that’s the same way U.S made the same mistake.
[Dr. Z] We did the same thing. 45% of deaths were nursing home patients 0.6% of the population. So Sweden actually took a very different approach.
[Dr. Jay] I think it’s more consistent with what a democracy does in the context of these kinds of things, right? So the idea of the lockdown we were copying, what Japan, oh, sorry not Japan, what China did.
[Dr. Z] Right.
[Dr. Jay] I like this idea but the idea that we could do this militarized lockdown, I don’t think is consistent with a constitutional democracy.
[Dr. Z] I agree.
[Dr. Jay] And you’re seeing this play out in places like Australia or Victoria, where they have essentially a very draconian lockdown. You can only go out for an hour. If you’re gonna go to a park, you have to walk alone. You know, I don’t think that’s consistent. I mean, people will play with that for a while if it’s a 3% mortality rate.
[Dr. Z] Sure.
[Dr. Jay] But they won’t put up with it forever. And that’s a constraint on public health in a democracy. You have to take that into account. You can’t pretend like, oh, it’s really unfortunate that people won’t put up with this forever.
[Dr. Z] I said that in February. I said, what we’re seeing in Wuhan is absolutely never going to be feasible in this democracy. It’s just not. And you could just say, well, then people will die because of that. Then that’s the cost of living in a constitutional democracy that you will not have that kind of control. And one thing I would say to that is life is to be lived we don’t live in fear of death or dismemberment every single second we’re awake. And that’s an ethos that I think is worth supporting. And again, that’s a personal thing I mandatory.
[Dr. Jay] Yeah, but I think that’s completely right. I think one of the unfortunate outcomes of this pandemic has been to train people, to think of other human beings as just bags of germs to be avoided.
[Dr. Z] You’re right.
[Dr. Jay] It’s going to take a long time to repair the damage from that
[Dr. Z] It’s a social dissolution. And then what happens now we have, you know, unrest on a massive level. I’m not saying they’re directly correlated, but I’m saying they’re directly correlated.
[Dr. Jay] It wouldn’t surprise me. I think that people are psychologically frayed.
[Dr. Z] Yeah, I am. Monica, when she came yesterday, like I said, you don’t know me. The reason she came was she wanted to talk to another human being face to face about things she cares about. And she has been able to do that. Zoom is, listen, Zoom is great from a technological level, what a wonderful tool, right. I hate it, it makes me wanna die. And the reason is I’m an extrovert and being in the room with someone, like you and I right now could not have the same conversation. I’m reading your body language in real time. It’s a 2000 frame per second refresh rate. You know we’re able to talk over each other. It’s a beautiful thing that humans do.
[Dr. Jay] Yeah and we’re built for this kind of community we’re built for this kind of communication. And we’re not built to be alone, which is essentially what this epidemic has done. And the public health community said, look, that’s what you need to do.
[Dr. Z] That’s what you need to They’re telling you be inhuman.
[Dr. Jay] Yeah.
[Dr. Jay] And also now we changed our mind being human in this way, instead of out there. Let me ask you something. So you look at the Asian countries cause you can look okay, okay U.S, Sweden, U.K, deaths, deaths.
[Dr. Jay] Yeah.
[Dr. Z] Then you get to European Union deaths and then you get to New Zealand, Singapore, Hong Kong, whoa, actual viral suppression.
[Dr. Jay] I think there’s a few lessons to be learned for this. So New Zealand let’s come back to New Zealand. New Zealand is really, it’s super interesting on this front. I think that some of the Asian nations that suppressed the virus, they caught it very early on when contact tracing the kinds of things that we say are like the mantra of like test trace and quarantine actually can be effective.
[Dr. Z] Early
[Dr. Jay] Early, but by early April, 50,000 cases in Santa Clara alone,
[Dr. Jay] [Dr. Z] It’s out of the bag.
[Dr. Jay] I don’t understand why people thought that that was go work.
[Dr. Z] And how do you contact trace asymptomatic cases. You’d have to test everyone hope there aren’t a bunch of false positives yeah.
[Dr. Jay] Yeah so I think that was a thinking mistake that the virus wasn’t so widespread, we could use this strategy that seems like it was working in Asian countries, but even in the Asian countries, I think there’s some evidence that the, we talk about cross-reactive immunity. Like there were other Corona Virus like infections that they’ve had, they may have had some more extensive cross-reactive immunity more prevalent cross-reactive immunity than European countries and the U.S had.
[Dr. Z] Right.
[Dr. Jay] So I mean, I don’t know.
[Dr. Jay] SARS-ish, yeah.
[Dr. Jay] Who knows?
[Dr. Z] Who knows right?
[Dr. Jay] So I think we don’t know fully why it didn’t hit the Asian countries as hard I think it’s important to think about New Zealand is a really super interesting example. They famously suppressed the disease at zero cases for 120 days. And then out of nowhere, the cases start rising again. Okay, well, what did they do? They locked down again. The problem is like that lockdown is now repeated forever. They have to keep repeating the lockdown over and over again.
[Dr. Z] Or they’ll just go through what we went through.
[Dr. Jay] And they’re an Island nation that depends on tourism. I mean fully, I think just like 10% of, very large fraction of GDP. Don’t quote me on the number, but that large fraction of GDP is gone basically permanently because who wants to sit on 14 day quarantine to visit someplace. And people leaving the Island are also gone already, so there’s just the traffic in and out of the islands out So what you have is a continuous, and they’ve had like a seven to 10% decrease in their GDP rate just this year. You don’t keep that. If you wanna isolate yourself from the rest of the world, you can do it, but it’s gonna take you enormous. It’s gonna be enormous cost. And that is not an option available in the United States.
[Dr. Z] Yeah absolutely, so the New Zealand experience is interesting because they are relying on something that may or may not happen, which is a safe and effective vaccine as their savior, because what else could they be waiting for? It’s always gonna exist in the community at some level otherwise we have to learn to live with it. And their way of living with it is shutting down their entire Island forever. But they’re probably waiting for this finish line, right.
[Dr. Jay] They’re waiting for the vaccine.
[Dr. Z] Now what’s the risk of that?
[Dr. Jay] Well, so the vaccine is, I have to say that more progress and rapid progress has been made on the vaccine than I anticipated. If you’d asked me in April, that we’d be be here with Phase 3 trials, actually ongoing for several vaccine candidates. I would have said there’s no chance. I mean, there aren’t any human Corona Virus vaccines.
[Dr. Z] Yeah, often said that Paul Offit had the same thing on my show vaccine expert. So at that time.
[Dr. Jay] Okay, but now here’s the situation we have these vaccine camps that many and look promising in the Phase 2 trials. The Phase 3 trials need to be on large populations of people. Why? Partly because the cases and deaths are declining, ironically, that makes it more difficult to show that the vaccine is efficacious because you just, let’s say you had the COVID vaccine before Corona Virus came along at all. Well, you’d never find it efficacious in preventing death because there was no risk of Corona Virus.
[Dr. Z] Exactly, right, we’re making it harder now.
[Dr. Jay] So the decline of the cases and the decline in deaths makes it harder to show the vaccine works.
[Dr. Z] Yeah, yeah and that’s gonna make it more difficult to show efficacy. Safety we could still study.
[Dr. Jay] Yeah safety we could study. And there’ve been some good news and bad news. Like many of the vaccine candidates have been safe. In Phase 1 and phase, but they’re reports now there’s a Transverse Myelitis.
[Dr. Z] Transverse Myelitis case in the UK, Astra Zeneca, now that’s a different a viral model, right. Adenovirus, yeah. So it’s a different than the mRNA vehicle.
[Dr. Jay] The mRNA vehicle hasn’t really been used in human vaccines before
[Dr. Z] Ever, exactly, so it’s totally novel.
[Dr. Jay] So I mean, it could work. It could still work, I think I’m waiting. I mean, if the data show that it’s safe and effective, I’ll be first.
[Dr. Z] I’ll first in line I have to look at that data. People have asked me, what will you and your kids get this thing? Well, I’ll tell you what, as soon as I am convinced that the data looks good, I’ll go do it because I would like to get on a plane and go do things without thinking, well, I’m 47 so my risk profile is X. I have genetic clotting disorders and so endothelial dysfunction. So my risk is somewhere in the X. That’s how I calculate my own risk. So I take reasonable precautions, but I’m not crazy because I desperately seek human connection and I’m willing to die rather than.
[Dr. Jay] It’s probably two to three in 1,000 for me. Yeah I would rather live my life with that two to three in 1,000 risks. If I happen to get it than not.
[Dr. Z] But you’re going to kill grandma by asymptomatically spreading it to her.
[Dr. Jay] When I visited my 80 year old mom, I wore a mask.
[Dr. Z] There you go. And that’s what I would do with my parents. So let me think here. What you just said is be rational. Take risk personally and decide based on open data. Don’t sensor people, let’s have actual scientific discourse instead of name calling and politicization. And let’s look at this thing with clear, open eyes and listen to all viewpoints. Is that about right?
[Dr. Jay] I mean, I’ve tried to be controversial.
[Dr. Z] Well, you’ve done a good job by proxy in person and I haven’t heard anything that you’ve said that makes me go, oh my gosh, that’s so controversial. It’s called being rational. Now the thing is, I’ll get criticism even on during this interview that, oh, did you really pound them on this and pound him on that? That’s not my job. My job is to say, here is a guy who has a certain experience set that’s very valuable. Let him talk about what he thinks and you guys can then debate it in the comments openly. That’s called scientific discourse. It’s actually just discourse. And sometimes I wonder, because anything I post, you know, if I look at Facebook, for example, which is our biggest platform, 2 million people follow us there. If I put something there and you start reading the comments, sometimes you wanna die a little because it’s like the movie “Idiocracy” actually came true and you just go, oh, and it’s on all sides. It’s all sides.
[Dr. Jay] I get referee reports all the time for my papers. So I’m used to that.
[Dr. Z] You’re used to it right. You’re used to it. So, we talked about Sweden a bit. We talked about New Zealand and we talked about Asian countries and why they were different than us. We talked about the U.S. We talked about what we might wanna do moving forward. So do you think cases are just gonna continue to decline and deaths are going to continue to decline here.
[Dr. Jay] I mean, there’s two points of view, right? So one is that there’s gonna be a second wave. That seems to be the Fowchee point of view right now. I don’t see much evidence of that. Like we haven’t started, in the United States for instance, we talk about if we had a second wave, in New York and then the second wave, we hadn’t had a second wave, we had is a regional epidemic. Each place has had a first wave. That’s what it looks like everywhere. Now, it’s possible I mean, we don’t know the thing has only been around a few months that there could be one, but it’s looking increasingly unlikely to me, but we will see.
[Dr. Z] I’m with you. Based on current information, I can be proven wrong and I’ve said this to my supporters, who there are people who subscribe to the show and we do private live shows there’s like 7,000 number out of them. And I’ll tell them things that I’m not comfortable, fully vetted out for the public. So I go this is my feeling right now based on data is that there is not a second wave in this classic sense, there may be a second wave casedemic where we start testing a lot. And we see a lot of asymptomatic, positive PCR fragments. The second thing is what people don’t seem to understand is that the first wave, like you said, was a geographic thing where in a cooler climates like the Northeast, you saw massive rise and then a fall. In more Southern temperate climates is what you see what kind of with influenza, which is a slower delayed rise and a low, long hump. And they’re calling that second wave. That’s still all part of the infectious pattern. And I think in the winter, it’ll be interesting to see also schools. Tell me your thoughts on school.
[Dr. Jay] I think it’s criminal not to open schools.
[Dr. Z] I agree with you.
[Dr. Jay] Yeah, we talk about safety. It is more unsafe to not let kids go back to school than to open up for schools.
[Dr. Z] Absolutely.
[Dr. Jay] We are harming kids in a way that is irreparable and immoral.
[Dr. Z] You’re gonna get a horse’s head in your bed from the teacher’s union on that one.
[Dr. Jay] I think a lot of teachers want to be that’s their vocation is to teach and they wanna teach in person. How do you teach a first grader to read over Zoom?
[Dr. Z] No, it’s a crime.
[Dr. Jay] Yeah.
[Dr. Z] And the thing is they’re doing the best they can. It’s very, very hard, but this is one of the things that just gets me so upset because it’s a regressive tax on the poor. So you’re saying basically that a person who depends on school for their meals, for their social interaction for behavior control mom is a single mom and can’t it’s and how is she gonna work we can hire nannies and assistants they can’t.
[Dr. Jay] I saw a picture, I think it was in San Jose, Mercury News of two kids, Hispanic kids, sitting outside of a 7-Eleven with their little Google Chromebooks.
[Dr. Z] I saw that Using the 7-Eleven, the taco bell wifi.
[Dr. Jay] To wifi ’cause they don’t have wifi at home.
[Dr. Z] That is disgusting.
[Dr. Jay] It’s terrible.
[Dr. Z] It’s heartbreaking.
[Dr. Jay] And you know schools are not just simply places for teaching, although that is incredibly important.
[Dr. Z] you are Indian I knew it. It’s for teaching only nothing else.
[Dr. Jay] But there are also places where kids get their nutrition. Somewhere I think on the order of a third of kids in the country have subsidized school meals of some sort or another, like a lot of their calories get come from there. It’s places where they learn to socialize. The long run consequences of shutting that down are absolutely enormous. Even the short run, I suspect we’ll start to see suicides jump up among adolescents School is good for their mental health as well.
[Dr. Z] I have a close friend who’s a physician whose daughter was 12, 13. And during the lockdown started to exhibit just the worst anxiety. Like he would describe this to me. And it was heartbreaking. This kid was beside herself and to the point where it was medications and psychotherapy and all that, and he affluent guy, so he can afford all this. And then school started some little bit in person, some little bit by Zoom and the anxiety started to evaporate and we forget that we’re the social animals. And especially kids. I used to look forward as much as I love summer, you look forward to school starting. ‘Cause I’m gonna see Joey and Chad and we’re going to hang out and cause some crime, man. I mean, that was what it was like.
[Dr. Jay] Yeah. I agree. I mean, I think for kids, especially that playtime is incredibly psychologically important. To deny them that seems… Okay it’s one thing if they’re really we’re facing high risk.
[Dr. Z] So tell me about that because the teachers will push back and say, but there’s teachers with chronic disease who are elderly, who.
[Dr. Jay] I think we should that into account. I think like different school districts should creatively manage that. So if you’re a 62 year old teacher and you have diabetes, your school district to make some accommodation for you. So you don’t have teaching.
[Dr. Z] Agree.
[Dr. Jay] Absolutely.
[Dr. Z] Do you think we should be paying teachers more too in general.
[Dr. Jay] Yeah.
[Dr. Z] As an economist.
[Dr. Jay] I think there’s some debate in economics about how much extra pay correlates to outcomes. But as a whole teacher, I mean, I honor my teachers, I think they did incredible things for me.
[Dr. Z] Me too.
[Dr. Jay] And also for the kids. So I’m not against that. I’m fine with that, But I think we should use the resources, different school districts use the resources they have to creatively manage so that kids can actually come in person.
[Dr. Z] Yeah.
[Dr. Jay] In some places, maybe you can’t social distance, you need more masks in places where you can social distance, you can figure it out. I mean, you have to creatively manage that. Young teachers who face very little risk, let them come in. The older teachers who are at risk, they can maybe they can help the younger teachers by helping them grade, create curriculum, teach online. I mean, I think there’s some mix, but the absolute must is you have to have the kids in person.
[Dr. Z] Yeah, yeah.
[Dr. Jay] With each other or else you can’t actually have school.
[Dr. Z] Now, you know what I think is happening too. And it’s related to this is this safety creep. So in the early days of this thing, when they talked right here in the Bay about shutting down schools, we were thinking it’ll be two, three weeks. And then they said, it’s gonna be till the end of the year, the school year There was absolute horror and panic on the part of parents and kids like what, you’re doing what. Now, when school’s supposed to reopen it doesn’t and people have just accepted it as well. All right we’re keeping people safe now. It’s the norm. Our kids are slowly dying a little we’re destroying poor families. We’re creating a cycle of poverty, violence, substance abuse, but you know what? Safety safety first.
[Dr. Jay] It’s not safe.
[Dr. Z] It’s not safe it’s the opposite of safe.
[Dr. Jay] Yeah and if you think about what the scientific evidence is saying, the teachers and staff pose more of a risk to each other than the kids pose to them. There’s a study done by this group in Iceland. It was published in New England Journal. It’s absolutely fascinating. So what they did is they took 12% of random sample of the Icelandic population. And they did PCR testing on every single one of them. And they identified the virus from every single one that was positive. And they sequenced the genome of every virus. Why is that important? Because the virus has these mutations there, give it like a fingerprint. And they did this detailed contact tracing study where they, and because they did the genetic analysis, like let’s say, I have virus A with mutation and you have virus A and B.
[Dr. Z] Yeah.
[Dr. Jay] With mutation A and B. Well, it’s possible that I passed it to you because you added on mutation B, but it’s unlikely you pass it to me.
[Dr. Z] Right.
[Dr. Jay] And if I have just a mutation A and you have just mutation B, then we didn’t pass it to each other.
[Dr. Z] Right separate sources yeah.
[Dr. Jay] Okay, what they found was that there was not one single case of a child passing into an adult.
[Dr. Z] Not one case.
[Dr. Jay] Many, many cases of parents passing it to their kids.
[Dr. Z] Yeah.
[Dr. Jay] But not one the other way.
[Dr. Z] So why are we ignoring this data?
[Dr. Jay] I don’t know.
[Dr. Z] And so here’s the counter that the mainstream media will say, well, look at what’s happening at Notre-Dame or wherever there’s thousands of cases and, oh, my God.
[Dr. Jay] Not one hospitalization, by the way.
[Dr. Z] Not a single one.
[Dr. Jay] Yeah and I mean, talking about college kids right. So there’s not one hospitalization.
[Dr. Z] Now, but what about these it’s just these horrible vectors of disease for the elderly.
[Dr. Jay] I mean, asymptomatic spread happens. That’s what the evidence says, but it’s much less common than symptomatic spread. So the diseases spread by mostly by droplets, you can have these aerosolization events it seems like, but they’re relatively rare compared to the droplet spread,
[Dr. Z] Right.
[Dr. Jay] Asymptomatic spread happens, but it’s much more rare. Just to give you some sense, Sweden kept its schools open 15 and under including daycare all the way through the epidemic. Even when cases were rising, even deaths were rising. And they did this detailed study compared to Finland. Opening and closing the schools does not have any appreciable effect on the spread of the epidemic.
[Dr. Z] The what the hell are we doing?
[Dr. Jay] I don’t know, I don’t know. I think the evidence on this is so strong. And you read it and you just weep because you’re saying, okay, we’re making a scientifically uninformed decision.
[Dr. Z] You know what it is. It is also coming to this thing of what I call empathy versus compassion. So empathy is feeling another person’s pain as your own and acting from that feeling. They ask us to do this in medicine all the time, more empathy. But what they don’t realize is empathy is a poison when it comes to things like this, because here’s what happens, I read an in some mainstream media piece about a 28 year old teacher who died of COVID after school was open and you go, oh, my God, the young teacher died we should never have opened the school. I feel for her and her family and she’s young and we should just stop everything. Whereas when you look at the case, okay, what were the comorbidities? They were there. What’s going on? And that’s one person. Did she get it from school? We don’t know, could have gotten it somewhere else, but we’re going to now fail to do what we ought to have done, which is compassion, which is cognitive empathy. Understand the suffering. Look at the bigger picture. What’s the most wise thing we can do for the most people to relieve the suffering and detach a little bit. Well, if you do that, you go, actually that’s true. But we could have provided masks to the teachers and given schools an opening so that these children who are dying of diseases of despair or are going to, get a chance. But we don’t do that.
[Dr. Jay] I mean, you’re arguing for it. I mean, that’s a really nice way to put it. You’re arguing for empathy for everybody. Not just for like the select few.
[Dr. Z] And the trick about empathy is it doesn’t work on everybody. So Paul Bloom has written about this, psychologist. It is a narrow spotlight, not just on individual, but on tribe. So empathy evolved for as an in-group way. So for your kids, empathy is absolutely appropriate. My God, you better feel their pain ’cause they are you, but for a population you don’t empathize with them. And the charities have known this for years. They don’t show you a population of starving people. They show your help can help this child, you know, Sally in Sub Saharan Africa, look at her and then you go, absolutely. ‘Cause that’s how we’re wired.
[Dr. Jay] Interesting.
[Dr. Z] It’s really interesting.
[Dr. Jay] I think that’s really right. But I think compassion in the sense that you mean it exactly the right thing here. So we have to understand. So like the scientific evidence says that the teachers face about as much risk as other professions doing their work, not from the kids again, from other staff members. But you act on that. You said, okay, well, given that that’s the case, so let’s structure the workplace to reduce that risk as much as we can. What they’re doing is a vital function for the kids, for society at large, they are absolutely essential. So they’re, they’re taking a risk. We should honor them for taking that risk. Just like we honor the doctors that have come in or the nurses that have come in to come to care for their patients. They’re not doing something as less vital than that.
[Dr. Z] It’s funny ’cause you’ll see memes where it was like, teachers will say, we didn’t sign up for this. And the nurses will say, neither did we. We didn’t sign up to put ourselves at risk, but we do our essential job. Someone wrote a nurse wrote an Op-ed and it shouldn’t, it’s not a real contest between who’s the bigger martyr it’s the idea is that they’re both honored as absolutely essential. And it’s tough because you do feel for people too, who are at risk and that’s why it’s nuanced. And it’s something you even opened the show with where you said you’re heartbroken about the suicide statistics. That’s because what you’re showing is love in the face of suffering. Love and concern in the face of suffering will lead you to feel that way, right. Because you go, I can’t, this is terrible. So let’s have the discourse from a place of compassion and the way that you’ve been treated, I think is just abhorrent because that’s not a compassionate response. It’s let’s talk if we disagree, that’s fine. And then we can have the argument, but why are we vilifying people?
[Dr. Jay] Yeah, I don’t have much to complain. I actually have been fortunate in many ways. And actually it’s been interesting from a professional point of view to be able to contribute at all to this. In many ways gratifying that I’ve had something to say, but I completely agree with the spirit of it. Let’s look at the data. Let’s make decisions that understand that we’re making decisions that affect the lives of everybody, not just the people with COVID and COVID is not the only public health danger that we face. And that there are trade offs, there’s risks on all sides. There’s not a safe option where we can say, and so I think like cheap rhetorical tricks, like, oh, you only care about the economy. You don’t care about lives. I think for the most part it’s aimed at shutting down just conversation as opposed to having serious conversation.
[Dr. Z] Yeah, I agree, I agree. Man, was there anything else you wanna talk about?
[Dr. Jay] I think we covered it, thank you.
[Dr. Z] Oh my gosh, this was such a enjoyable conversation for me because it allows an airing of this kind of side of the conversation that I just don’t think we’re getting in a clear eyed way. So if mainstream media does it, it’s politicized by Fox. If the left does it, it’s politicized by the media, I’m trying to create a space here and hopefully we can have more conversations where we just get out some interesting information in a clear way.
[Dr. Jay] Well, I’m really honored to be able to talk with you. And actually it’s been really interesting to be able to have this conversation as open. I think there’s stuff we probably disagree on a little, I don’t know what time.
[Dr. Z] Sure.
[Dr. Jay] But I think having a space where you can actually do that, I think all of science should be like that.
[Dr. Z] I 100% agree. So we’re gonna try increasingly to use the space for that kind of good. Guys like, I mean, this was a conversation you can disagree I want you to, I want you to leave comments. I want you to leave ad hominem attacks out of it, if you can, let’s try to use our critical thinking. Do me a favor Just share this thing. It’ll be on a podcast. It’ll be on my website zdoggmd.com. It’ll be on YouTube. It’ll be on Facebook. Ultimately what we do is we make a little square out of it and caption it and put it on Facebook too so you can read along. The transcript will be out in a couple of days. I love you guys. Please stay well. Please let stop stifling discussion and having it. Dr. Bhattacharya I mean, what a real thrill, please come back.
[Dr. Jay] I’d love to.
[Dr. Z] Awesome, awesome and we out peace.