Our COVID science should be much better than it is. Here’s a breakdown on spacing doses, natural immunity, gain of function research, therapeutics, healthcare worker burnout & much more.

Dr. Marty Makary is a Johns Hopkins physician and editor-in-chief of MedPage Today. Here are all our past shows!
Here’s some of Marty’s referenced articles:
Topic List:
0:00 Intro
2:35 NIH spending & COVID research
7:53 Herd Immunity, was Marty wrong, clickbait headlines
11:02 Menstrual changes and vaccines
13:08 Boosters and booster mandates
16:45 Rabies Diffr’ent Strokes rant
18:54 VAERS surveillance
21:44 Tinnitus
23:32 Spacing second vaccine dose, Johnson & Johnson booster
29:34 Natural immunity and a failure of messaging
32:40 Silencing debate and heterodox voices
36:49 Bullying and shaming in healthcare and nursing shortages
44:29 Treatments for COVID at home
49:15 Understanding risk
51:43 NIH gain of function virus research
54:26 Moderna, BARDA, and profit motives in vaccines
57:36 Marty’s thoughts on cloth masks and kids
1:06:04 Nikki Minaj & Marty
1:11:36 9-11 commission for COVID
Transcript Below

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– [Zubin] Hey guys, I have Dr. Marty Makary back on the show. He’s a Johns Hopkins physician, editor and chief of MedPage Today, generalized superstar during the pandemic and beyond. What’s up, Marty?

– [Marty] Good to be with ya, Zubin.

– [Zubin] 1.21 gigawatts! I always want to say that when I see Marty. Dude, so we’re gonna, dude, we’re gonna talk about so many things today. In fact, I actually wrote them down because, I never do this, there’s that much stuff. This is what we’re gonna talk about. We’re gonna talk about NIH spending on COVID research and the resulting disaster, boosters.

– [Marty] Boosters. I, by the way, I took a couple extra boosters just before I came here just to prepare.

– [Zubin] Just to kind of top off the tank ’cause your antibodies were already unmeasurably high.

– [Marty] Yeah, they were suboptimal. They were only 15 times normal.

– [Zubin] But you know, we, that incremental 0.0005 percentage point protection against infection, you already protect against severe disease, but that’s not what we care about. We care about infection.

– [Marty] Every antibody counts.

– [Zubin] No antibody left behind.

– [Marty] No, I’m gonna take Regeneron too if I need to.

– [Zubin] Just to get those monoclonals bumping, which we’re gonna talk about. We’re gonna talk about spacing the Pfizer vaccine and the mRNA vaccines longer than they have been spaced. We’re gonna talk about therapeutics, including nasal sprays, molnupiravir. We’re gonna talk about the backlash against ivermectin because that’s a whole controversy in and of itself. Monoclonals. How people think about monoclonal antibodies. We’re gonna talk about gain of function research. Oh dear.

– [Marty] Oh boy, oh my gosh.

– [Zubin] Here we go! BitChute. Are you ready? Rumble? Who’s gonna post this video?

– [Marty] You have security outside?

– [Zubin] Yeah, as it is the, you know, the NSA is monitoring this signal, so we’re gonna be called in front of the tribunal.

– [Marty] You know, when you emailed me about this, I lost the email, so I just contacted the NSA and got their copy.

– [Zubin] Oh, that’s good. They have all my aliases too. Zed Dog, apparently as I’m known in Canada. We’re gonna talk about masking kids and your Wall Street Journal piece on that. By the way, you write for both the Wall Street Journal and The Washington Post, so you’re like playing all the political spectrum, man, against the middle here. This is great.

– [Marty] Alt center.

– [Zubin] That’s what it is, baby. Alt metal, alt center. Healthcare burnout is what we’re gonna wrap up with and how mandates might affect that. Now, one thing for the audience, you’re gonna hear a lot of drilling and sawing and stuff. It’s because the idiots upstairs are remodeling their condo right when we’re doing an interview.

– [Marty] Is that what they told you? They’re not coming after us?

– [Zubin] I have no idea. I’m just assuming, plus I’ve drilled already a peep hole up there ’cause I’m a creeper. NSA aren’t the only people who can creep. All right, Marty, so let’s get into it. Tell me about this NIH spending issue with COVID.

– [Marty] Ah, yeah, so we did a study at Johns Hopkins because when COVID hit us, there was very little solid research. And so what you had was everybody contacting us. They contacted you, me, basically every single person watching this right now. We were asked through texts and calls and emails. How does it spread? When are you most contagious? Well, can you get it a second time? All of these questions.

– [Zubin] Asymptomatic people, can they spread it?

– [Marty] Can they spread it? How long should you quarantine for? Where do you get it? How do you get it? Do masks work? So, we were getting bombarded with all these questions, and we did not have good data to answer those questions. We had almost no data. The NIH last year spent twice as much money on aging research than they did on COVID research. They spent less than 5% of their budget on COVID research. So, we didn’t have the answers to these questions. And so there was a vacuum of data, and what filled that vacuum was political opinions.

– [Zubin] So it was actually, the polarization was partially due to the lack of actual science. So, people are like “Follow the science,” like it’s some dogma, but there actually, there wasn’t even science in general being done at a scale that we needed.

– [Marty] Yeah, it was as if what was the truth was just an opinion. And a lot of us are making opinions, you know, based on the little information we had extrapolating to SARS, which interestingly spread by aerosolized virus. And so we were making these connections, but the good studies were getting done a year later. I mean, we were learning like a year later, “Hey, you know, 85% of people report having been “to a restaurant within a few days of getting COVID.” Well, an indoor restaurant, outdoor, a pub, a cafe? Like, and how are we having such little data at a time when we needed it and we spent $42 billion at the NIH? Here’s what they spent their money on by the way. The money that did go to COVID was not even for the stuff you would think. 57 grants on health disparities in COVID, an important topic, but none on how it spreads with young people, four on transmission, and 1.9% of all funding went to clinical research. A lot of it was laboratory stuff. So, the basic things we needed to know we did not get answered. And by the way, this problem is still the case. The funding cycle was like five months when COVID hit us. So, we’re using peace time protocols in war time. That doesn’t work.

– [Zubin] Yeah, and you know, who’s filling in the gaps here? The Israelis, the Icelanders, if that’s a thing. Like, these guys are actually science the crap out of this as much as they could.

– [Marty] Bangladesh is the only cluster randomized trial on masks. You know, kudos to them, but we’re the United States of America. We have 50 times the healthcare spending on research, 20 times the data of Israel. I mean, thank you, Israel for the data, but where is the United States CDC?

– [Zubin] You know what we’re really good at though? We have three times the per capita mortality from COVID so. I made that number up, but we do have a high per capita mortality of COVID. So despite all these resources that we have, we don’t deploy them properly. This has always been the problem in the US.

– [Marty] But we’re very good at Botox.

– [Zubin] Oh my God. My goal, Marty, by the end of my career as ZDoggMD, whatever that is, I’ve not had any work done, except I had some moles and stuff burned off live by a dermatologist on a show that I did. He’s like, “Oh, I don’t like this.” You know. I want to look like this. Like, I want to look like Dr. Oz.

– [Marty] Speed racer.

– [Zubin] Yeah, exactly.

– [Marty] You know, it’s the funny part about traveling, we meet so many doctors. And I’ll get to know dermatologists, and then at some point they’ll often say, you know, “You know, if you want to take care of that spot “or that crease or that, you know, “I’d be happy to do it for you.” And I always tell them, “Leave me alone.” I am gonna wear this ugly nose and these wrinkles. People want to Botox me all the time.

– [Zubin] I had a female doctor who was stalking me to Botox me. She was like, “You are a mess. “You’re hideous.” Like, she would shame me. She got my cell and she was texting me like, Listen, “You’re just horrible. “Like, all you need is this, and you’ll live longer “because your internal impression will be one of youth.” I’m like, “Listen, woman. “I felt like a 90 year old codger when I was 10. “Nothing is gonna fix that.”

– [Marty] Nice gesture.

– [Zubin] And it was a good gesture. So NIH, you know, again, it’s really kind of embarrassing that we haven’t scienced up, like, do masks work on kids?

– [Marty] We’re still having these debates, and we can have good informed debates with good research. But right now it’s, like, there’s almost no data to really support a lot of the stuff that we’ve been recommending. And so that’s how we got behind, right? Not recommending masks early. How long would it have taken to do that mask study that FAU did where they blew green grass, sorry, green-

– [Zubin] Oh, I see where your mind is. We’re in California.

– [Marty] That just slipped. By the way, 5% of everything I say is wrong.

– [Zubin] Just 5%. By the way, which we should say this real quick before we talk about that mask study. So people are gonna say, “You’re having,” and I’ve seen this on Twitter. They try to cancel me preemptively. “If you ever platform Marty Makary again, “you are part of the problem.”

– [Marty] I love it.

– [Zubin] I love it. And I’m like, “Why?” “Because he said herd immunity was gonna happen “at the end of April.” And I’m like, “Did he? “Well, hold on, let’s talk about that.” ‘Cause we came on, we talked about this. What happened with that? What’s going on?

– [Marty] Yeah, so the opinion articles said that at the current trajectory, you know, forget about the headlines that the people who want clickbait, you know, throw in stuff.

– [Zubin] You don’t write those headlines. Just so people know.

– [Marty] In medical journals, you do. In newspapers, you absolutely do not. And they won’t even run it by you or let you see it because they know sometimes you’ll protest it. That’s the standard convention, unfortunately. But you do have the reach of The Washington Post or the Wall Street Journal. So, in the actual article I said, “at the current trajectory I expect.” Now Delta was a game changer. And by the way, we were at very good levels of population immunity by the end of the spring. But Delta was a game changer. And the dynamics of the virus is such that I don’t know if it even applies. I mean, everybody will probably either get the virus or the vaccine.

– [Zubin] Yeah, I’ve said everyone’s kind of had a date with this thing. Didn’t Fauci actually early on say like he thought in the spring of this year?

– [Marty] March. He said March of… So, I suggested April at the current trajectory.

– [Zubin] You are more conservative than Fauci.

– [Marty] Well, he changed, he changed a lot. And the thing is when something gets cemented in a title and then it goes viral, like people ask you your opinion on things. You don’t know that everyone in the United States is gonna read something, right? You’re just talking openly. And we need that open honest discourse.

– [Zubin] Yeah, you know, I did a piece on Delta surge and when Delta surge is gonna end, and it was based on David Wallace-Wells’ piece in the New York magazine Intelligencer about how natural human dynamics change in the face of something like Delta. So, it’s not so much mandates and all the other stuff. It’s like, oh, people decide they’re gonna maybe put a mask on or distance a bit. They go get vaccinated more. You end up with a combination of natural immunity and vaccine immunity that then causes a collapse like it happened in Great Britain. Like, it happened in the Netherlands. And I said, you know, I bet if that’s the case, we’re gonna start seeing Delta turn the corner in early September and believe it or not, it started turning the corner, but doesn’t happen everywhere because America is a really heterogeneous kind of place. So, you know, we have to say when we’re wrong or when we got it wrong. And so-

– [Marty] People are hungry for that humility out there. I was talking to a group of infectious diseases doctors recently, and they sort of concluded that the only thing we know for sure about COVID is that we’ve all been consistently wrong on different aspects of it and we need to be humble. And I thought that’s the right approach.

– [Zubin] It is, and actually respecting and understanding uncertainty would be nice. Like, “Hey, you know what? “We don’t know.” I get a lot of emails. I’m like, “You know, we don’t know the answer to this.” “How far should we do this? “Should we space this out?” Which we’re gonna talk about. “What about boosters?” You know.

– [Marty] How much do patients appreciate it when you say, “I don’t know, I’ll try to find out.” Or, “I don’t know if it is known, “but I don’t know right now.” I mean, I think people appreciate, they’re hungry for honesty right now.

– [Zubin] Authenticity is in short supply in healthcare and beyond let’s be honest. That’s why, you know, that’s why Twitter is such an interesting thing. You know, we talked about the polarization because you, when NIH doesn’t do research, there’s a void. By the way, they’re just now giving like $1.7 million to study menstrual irregularities that may be vaccine induced. And it’s kind of like, wow, there’s a whole 50% of the population that’s really interested in that. Like, that seems like something we probably should expedite. It’s probably fine. Like, it probably does affect maybe that first period after you get the thing. But like guys are just like, “Wait, what’s a period?” Well, that’s something that’s probably, it’s nice to be able to tell women, “You know, your first menstrual cycle “after the vaccine may be a little unusual for you.”

– [Marty] Yeah, I mean, look at the pace at which they did the study in pregnancy of the vaccine. Why not do that early on?

– [Zubin] Up front.

– [Marty] Yeah, I’m sure there’s volunteers out there. And the mask study where they had the fluoro labeled green gas that came out of the mannequins. Why is that being done after the epidemic in the spring of last year? These are things we can pivot quickly to do. And it’s not just the NIH, by the way, IRBs were meeting monthly, journals were taking months to turn things around. Some were a little quicker, but still, you know, if you look at say JAMA, why do they insist on only three original research papers every Tuesday? What if, is that the pace of scientific discovery? What if there’s four really important COVID articles that week?

– [Zubin] That’s more than three, Marty, so…

– [Marty] And how about publishing it, maybe if they get this amazing article on a Friday, how about publishing it on Friday? You know? And it’s this old guard, rigid. The rigidity has really hurt us badly.

– [Zubin] And then I think it opens up the opportunity for these predatory medical journals that you can pay to publish and these kinds of things. And then the whole pre-print thing. And it just becomes like a mess. Like, these guys are not flexible, they’re not adaptable. They need to be. In war time, you called it. You said there’s a peace time way of doing science and there’s a war time way of doing it, right? And it’s the same with, you know, talking about anything. Like, let’s look at boosters now. So, the latest right now is really interesting ’cause Rochelle Walensky overrode the advisory committee to the CDC that said, you know, “I don’t think you need to recommend this for healthy people “under 65,” or whatever. And they said, “No, actually let’s give it “to healthcare workers and so on as a booster.” And what’s your thinking on this whole thing?

– [Marty] Yeah, this is the second time in recent history where the CDC director has basically overruled the advisory group. And I think the last one was like in 2003, it was something about smallpox. So, what she did is use language that was broad enough where basically anybody can get a booster for Pfizer because one of the criteria is that you’re in a setting or workplace where you might be at increased risk of getting COVID. Well, that’s everything.

– [Zubin] That’s everything, yeah.

– [Marty] That’s the whole society right now. And you know, the thing is there’s so many layers with this booster thing. One is how about the answer “we don’t know,” instead of, everyone wants to say yes or no on the booster. How about, you know, “I haven’t seen the data on younger people, “people under 60, to really make a convincing case.” How about the idea that maybe it may be different for teens and adolescents than it is in somebody who’s 50 years of age. One dose of the Pfizer vaccine was 100% effective in kids 12 through 15 in an Israeli study. Now we need followup data. But how about, you know, there’s a lot we don’t know. And I think some people feel like she jumped the gun a little bit. There’s enough hatred out there. I just want to say, look, it’s well-intended what she did. But there’s also a global equity issue. Does it make sense? Half the world doesn’t have any doses and what are we doing right now?

– [Zubin] Yeah, yeah. And on top of that, I mean, she’s kind of following what the FDA advisory committee said which was, hey, you know, or you’re a frontline, you know, essential worker. So again, at the end of it, it’s like a backdoor way of saying “anyone can get a booster.” You know, like, Oprah. You get a booster and you. But again, the question is, what people want to know is, okay, first of all, do I get more side effects from a third dose? What’s the rate of myocarditis in young people with a third dose? Is this actually going to prevent what I care about, which is being hospitalized and being sick, or am I already protected? And then the third, what I love is like, what I love in an ironic, sarcastic way, is what this may do is open the idea then that now people are gonna mandate a booster shot for healthcare professionals. And we’re gonna talk about healthcare burnout and mandates. But, that to me is a real slippery slope of bad science.

– [Marty] Oh, they’re already talking about it. Bryn Mawr College or University-

– [Zubin] Bunch of hippies.

– [Marty] I don’t, I’ve never been there. I don’t know anybody there. But they have on their website that basically they will require a booster if in fact that’s what the CDC recommends. Now, I don’t know if they’ve updated that, but we’re talking about young people.

– [Zubin] This is crazy, this is crazy.

– [Marty] And where is the data on myocarditis after the second dose or the booster?

– [Zubin] You’re gonna give a booster to young people in college? Like, this is, if you just even look at the risk data for this group. “Oh, but they’re gonna go home “and give it to their parents.” Their parents are vaccinated and boosted.

– [Marty] What about flu shot? Are you…

– [Zubin] Are you gonna mandate a flu shot for every kid in college? ‘Cause flu actually knocks those kids on their ass.

– [Marty] Anthrax?

– [Zubin] Now anthrax I’m down with just because it sounds so scary. I’m purely emotional about anthrax.

– [Marty] I think it’s like five doses, five boosters with anthrax.

– [Zubin] Is it?

– [Marty] That’s what the military did in the Persian Gulf.

– [Zubin] That’s like that old school rabies vaccine. There was a “Diff’rent Strokes” episode where Arnold got bitten by a dog that may or may not have had rabies, and they had to find the dog in order to determine whether Arnold needed to get like 25 shots in the stomach.

– [Marty] 25, I remember hearing about that, yeah.

– [Zubin] Yeah, remember that? Used to be a ton of shots.

– [Marty] Oh, I remember I was just, you know, scared out of my whits of any raccoons because the idea of 25 shots, that was the biggest deterrent in the world.

– [Zubin] Okay, so we’re both children of the 70s. We’re the same age. I’m gonna make a confession here. When I was, I must’ve been eight. I lived in New Jersey. There was a squirrel, and I was a real big, like I love nature. I was always into bugs, picking out bugs, opening up rocks, all that. I was fascinated by life. I would grow plants in my house. Eventually those plants became marijuana plants, but no, that’s another subject. But the point being, this squirrel was trying to climb this tree and it couldn’t make it up. And I’m like, what the heck? So I go up and I go, “Hey, Mr. Squirrel, let me help you.” And I pick the squirrel up. I remember this vividly, I was eight. It turns around and just goes, with its squirrel tooth, which is a big ass tooth. So I’m bleeding, and I’m like, “Oh, I got bit.” I got bit by so many things when I was a kid. I just didn’t, I picked up a centipede once. It bit me right on the wrist. I’m like, “Oh, I got bitten by a centipede.” I didn’t realize they were poisonous. So anyways, I go in the house and I tell my mom. I’m like, “Yeah, a squirrel bit me.’ She’s like, “What? “You had a squirrel bite you? “This thing has got rabies. “Now you’re going to have to get 25 shots. “Wait, ’til your father comes home.” Panicked. And I’m like, “Wait, 25 shots? “What the heck?” So I was like, “Actually, it wasn’t a squirrel. “No, I was just making this up. “It was something else.” I forget what the story, but I changed my story. I went to bed that night terrified of two things that I was gonna die of rabies, that I lied to my mom, and that I was gonna be punished by God for lying about it. You know, ’cause magical thinking. And that, if I wasn’t wrong, I was gonna get 20, if I fessed up, I was gonna get 25 shots. But that’s how the human mind works, right? And I could have died of rabies, but I would rather have died of rabies than get the shots.

– [Marty] 25 shots.

– [Zubin] And now we’re mandating vaccine for people, right, and they’re scared. They’ve had natural COVID, we’re gonna talk about that so.

– [Marty] And, you know, the data on myocarditis after the second dose or the booster, which is really scant right now, is using this self-reported database called VAERs, which nobody really heard about until COVID.

– [Zubin] Except for the anti-vaxxers. They loved VAERS.

– [Marty] Yeah, they’ve been surfing that for a long time. But now we got people reporting into VAERS, and in Sweden, they found that a lot of the reports in their self-reporting system were somebody died in a nursing home, which normally happens at a high rate, and it turns out that’s not attributable to the vaccine. So, it’s very messy data. Now we had been studying the device database, self reported database called MAUDE. FDA has a database for device-related complications. Same clunky, broken system. Self-reported, hardly any doctor even knows how to do it. I didn’t know how to do it.

– [Zubin] And they even named it after one of the Golden Girls.

– [Marty] Oh, MAUDE. I don’t know, stands for something. I don’t know. But why are we relying on these rickety, old, clunky, self-reported, hard to use databases to get really important data that we need right now as a country to make informed decisions. The reason we believe these self-reported databases have been so shoddy is that the pharma and device industry doesn’t want a good post-approval surveillance system. If you’re big pharma, do you want us to closely follow and accurately capture complications after your drug has been green-lighted by the FDA? Probably not. And so that’s why it’s so bad.

– [Zubin] So, you’re saying they’ve kind of been hobbled from the beginning. But I will say this, it’s been impressive. They picked up VITT with Johnson and Johnson. They picked up myocarditis. Of course the Israelis picked it up first because they actually probably have better data collection. A unified EHR would go a long way, right?

– [Marty] The CDC claims that they can surf EHRs and do these rapid analysis, but it’s a lot of talk. And even if you look at the way they detect influenza in the United States, they sample like a dozen hospitals. They’re not even geographically representative. And then they make these broad extrapolations. That’s why they’ll tell you like four years ago, somewhere between 60 and 100,000 people died of flu or 120,000 people died of flu. How do you have such a broad range? It’s such a bad post surveillance system.

– [Zubin] Yeah, our data collection sucks. Now we have to be careful because this is a speaking point for anti-vaccine people.

– [Marty] That’s right.

– [Zubin] That VAERS is not trustworthy. We’re not seeing what’s really happening out in the world, and so on and so forth. But I’d say that, you know, everybody’s skin in the game on finding complications for this one. Like, we may miss something, but I think in general, I’ve been impressed that they’ve been able to pick out these things that are unusual. Now, the menstrual irregularity thing, you hear a lot of people talking about it. Another thing you hear people talk about is tinnitus. Now, tinnitus is interesting. This ear ringing. Tinnitus is interesting because tinnitus requires a mental focus on your ears, on your auditory sensorium in order to notice it. And a lot of people, what I’m seeing is they probably had tinnitus before and they’re starting to pay attention after they’ve been vaccinated, looking for complications. It’s like a nocebo effect. And they’re noticing it. But how do you even begin to study that, right? It’s tough.

– [Marty] I can recommend some placebo for that.

– [Zubin] Oh, it’s great. It’s called obecalp, it’s just placebo spelled backwards. I write prescriptions for it all the time. Obecalp, one pound TID.

– [Marty] It’s called relief factor.

– [Zubin] Yes, a relief factor, that’s good. Pain away. Yeah. You apply it directly to the scrotum because of the high absorbability of that skin. It’s very thin. And guys, anything you make them put down there, they think it works. So, spacing of vaccines.

– [Marty] Yeah, spacing. So we probably got the spacing wrong.

– [Zubin] On Pfizer or on Moderna or on both?

– [Marty] Both. And the reason I say that is, and by the way, it’s with good intentions that they picked that interval of three and four weeks. And they’re not bad people. They picked a narrow interval really for the purpose of getting the trial done quickly.

– [Zubin] Expediting it, yeah.

– [Marty] But we know in general, no vaccine is given at that brief interval except maybe the rabies vaccine. I’m not-

– [Zubin] It’s given every five minutes. Another shot.

– [Marty] For some reason, I picture all at once. All 25.

– [Zubin] I just gotta say this. What you talking about, Willis? If they try to come at me with that vaccine. Anyways, go on.

– [Marty] That’s a deterrent for anything. Just tell somebody if that happens, you might need 25 doses of a rabies vaccine.

– [Zubin] Right. You know what? You keep smoking, 25 doses of a rabies, the smoking rate will go to zero.

– [Marty] That’s right. So, they picked these intervals of three and four weeks. Guess what? It turns out that the four week interval vaccine, Moderna, is holding up better over time. And we know in general, and I know Paul Offit and others have talked about this with you, is that the longer you space out the intervals with any vaccine dosing regimen, the better the immunity. And it’s been studied now. 3.5 times better with Pfizer if you space out the two intervals at three months apart.

– [Zubin] Three months?

– [Marty] Three months. And so that’s what I recommend, and that’s what I’ve done for myself. I went for my first Pfizer dose I think in mid spring. I wanted to let other people, vulnerable Americans get it first in principle. Went for the first dose, they basically held a gun to my head saying, “You’re coming back in three weeks, right? “We need to schedule it now.” And I said, “I’m not coming in three weeks. “I’m not coming in four weeks. “I’m coming in three months.” And you know, the schedule, they’re just flustered. And, “We can’t, and the system doesn’t go out that far. “And I have to put in a schedule date, “so give me a date in three weeks or three and a half “that I can put in the system.” And I kept saying, “I’m not coming.”

– [Zubin] Oh wow.

– [Marty] “I’m telling you right now I’m not coming.” And it turns out that the immune protection’s stronger. And if we did that more broadly, we probably would not be talking about boosters.

– [Zubin] Boosters. So, okay, let me dig into this a little bit because people ask me this question a lot and I tell them, look, I think anything longer than the scheduled dose is probably good. So four to eight weeks is what I’ve been kind of, it’s a continuum. Now the thing is, what’s the risk in that period if you’ve just had one dose and you’re unboosted for three months, what’s the efficacy during that time?

– [Marty] Yeah, so UK, did this. They postponed the second does.

– [Zubin] 12 weeks.

– [Marty] To 12 weeks as a rationing strategy.

– [Zubin] Right.

– [Marty] And they had Delta during that time period. And they did not see a significant influx of severe illness.

– [Zubin] So there’s a real world example via the Brits.

– [Marty] That’s right. And the J and J trial just came out on the second dose of the J and J.

– [Zubin] Yeah.

– [Marty] And it turns out that when it was studied for six months out, it was like twice as effective as given two months out. So again, it’s all showing the same thing. Why are we not changing that guidance right now? The reason is the FDA is so rigid. They have this system of voting on an application and that’s the law of the land to stay. And they are not reviewing data in real time and updating the guidance. And if they did, as we should, then we wouldn’t be talking about boosters as frequently as we are.

– [Zubin] It’s interesting. The Johnson and Johnson piece is interesting because at two months, you might actually still have antibodies against the adenovirus vector. And so spacing to six months with the Johnson and Johnson may actually be almost a requirement if you’re gonna boost because you might wane some of those anti adenovirus vector antibodies. So, you allow that vector to actually come and do its thing. But yeah, interesting. Really interesting stuff. But again, like, even talking about spacing somehow brands you as some kind of like right-wing lunatic.

– [Marty] You know, the frustrating thing, Zubin, is that if we would have spaced out that second dose to three months, as a group of us were saying and writing about with multiple articles, talking ’til we’re blue in the face in every media outlet that would let us talk about it, we would have saved tens of thousands of more American lives because what we were doing

– [Zubin] COVID.

– [Marty] Excuse me.

– [Zubin] 100% COVID. It’s ’cause you spaced it out, dude.

– [Marty] Well, remember I took four boosters last week in preparation for this.

– [Zubin] Just to make sure you had enough antibody levels to deal with the Zeta variant.

– [Marty] Yeah. And I tested myself this morning using a swab from another person, but it was negative.

– [Zubin] And it was a rectal swab.

– [Marty] COVID in the rectum. Have you heard kids are getting more GI symptoms with COVID?

– [Zubin] I’ve heard this actually.

– [Marty] Yeah, I’ve heard that from pediatricians. Again, this is the data we’d love to see. Like, feed it to us in real time, right? Doctors and nurses love data. Like, just feed it. And instead it’s like, the retrospective MMWR from the CDC from four months ago.

– [Zubin] Wait, so you were saying we would have saved lives if we had just spaced them out. Is that because more people would have gotten a first dose, like in Great Britain?

– [Marty] If we would have recognized natural immunity and had those people step aside when we were rationing a scarce vaccine supply and focused on first doses, giving the second dose three months out, not only would we have increased our vaccine supply to save many more, tens of thousands of more lives, and actually a paper, I believe in the Annals of Medicine, put a number around it. They said it was like 45,000 lives would have been saved if we would have spaced out that second dose. And now we’re learning that it would have been better immunity and could obviate the need for a booster. And yet so many experts said, “Absolutely not. “You cannot veer from this.” And many people were saying, “Look at other vaccines, “look at the new data that’s coming in. “Use rationing science.” That’s its own science. And by the way, in laboratory science and virology and vaccines, they’re not accustomed to thinking in terms of rationing science. It is its own field in the academic area of design. And the Europeans are good at rationing ’cause they’ve done it with renal failure and everything else, and that’s why they did that. Delay the three months. We would have saved tens of thousands of more lives. And that’s why it’s so painful to look at our COVID policy over the last year and a half. So many mistakes. I mean, look, everyone’s gotten some things wrong. Closing schools last year, ignoring natural immunity, not spacing out the doses. These are things, some of these things are still happening. We’re not recognizing the value of spacing that dose out.

– [Zubin] So many of the emails I’ve gotten have been people who’ve been naturally infected, have been through the COVID mill, and then are now mandated to get two doses of an mRNA. And you’re just like, dude, can we call it an immunity pass? Where like Monica has been saying that they do in Europe where it’s like, oh, you’re either naturally immune or you get the vaccine. And then, you know, you get to do your thing, but you can do your thing anyways. You just take higher risks. I don’t understand why, you’re the natural immunity. You’ve been pounding the drum of natural immunity from the beginning. You’ve been branded again, some kind of like, you know, alt-right lunatic for talking about the science of natural immunity. Like, didn’t they, like, ban one of your Wall Street Journal articles?

– [Marty] It’s a badge of honor. I think I’ve, I think I’ve been banned two or three times. I can’t remember.

– [Zubin] You’ve got me beat. I’ve only been banned once on TikTok for Monica Gandhi and I talking about boosters, saying we were advocating what the FDA ultimately decided. And the Chinese government that runs TikTok banned that clip.

– [Marty] I saw that.

– [Zubin] So you got banned like three, four times?

– [Marty] I was banned once on Facebook. That was awesome. Because Facebook is doing terrible things to society, polarizing us.

– [Zubin] Great to be banned by them. That’s a definite badge.

– [Marty] And it was a tag, it wasn’t a ban.

– [Zubin] I see. It was like, “This may be misinformation.”

– [Marty] Yeah.

– [Zubin] Yeah, oh, that’s the best.

– [Marty] Once on Twitter, a tag. And once in China I was tagged.

– [Zubin] Yeah, but you expect the Chinese to tag you,

– [Marty] The scary thing is why are they not tagging more of my stuff?

– [Zubin] Right, right. Your piece that’s like, “The Chinese invented this virus.” And they don’t tag that.

– [Marty] Yeah, the lab leak stuff.

– [Zubin] Which we’re gonna talk about too. Man, that’s great, so-

– [Marty] But yeah, natural immune. So, we’ve disenfranchised this massive group of people now that are losing trust in the medical profession and public health because they’ve got a very legitimate, scientific rationale that they have circulating antibodies. There’s data that they are reading through the lay press in Israel that natural immunity may be stronger. 27 times more effective than vaccinated immunity in the largest study in the world coming out of Israel in preventing symptomatic infection. You cannot ignore that data. You can’t cherry pick. Now maybe the study has a design flaw, but it’s consistent with 15 other studies that say natural immunity is at least as effective. And that’s why many of us early on, Monica Gandhi and I, many others were saying, let’s talk about the immune and the non-immune rather than the vaccinated and unvaccinated. Let’s be more precise and let’s focus our efforts because the people dying right now at a very high rate are adults with no natural immunity and no vaccinated immunity with some very rare exceptions. And that’s the group where we really need to get the message out to and tell them, look, get vaccinated and do it today because Delta is burning through the population.

– [Zubin] Yeah, that’s what I love about this whole booster distraction. It’s, like, can we just spend all that money on getting people over 65 to get vaccinated? Like, every single one that can be vaccinated, go and get vaccinated. You’d save more lives. You know, it’s like what Jay Bhattacharya talks about and gets vilified for. Targeted protection. That’s a rationing science, isn’t it?

– [Marty] It is.

– [Zubin] It is.

– [Marty] Yeah, you don’t hear about Sweden much anymore ’cause they’ve been doing very well. I’m not a, let it rip kind of guy. Although I-

– [Zubin] Neither was Jay.

– [Marty] He was actually mis-characterized.

– [Zubin] Yeah, very much so.

– [Marty] When I look back on what he was putting out there, I think it was a very legitimate, reasonable hypothesis. And we were all flying blind. And looking back, it was actually very reasonable.

– [Zubin] And he still gets crapped on by Stanford. I mean, they do not treat him well, dude. It’s like if you violate the dogma of “the science.” You know, Vani Persaud did a great piece recently about how “the science” is just the worst possible phrase you could ever use.

– [Marty] I saw his piece on tribalism.

– [Zubin] Oh, it’s great.

– [Marty] And we published it at MedPage and it was excellent. I mean, there are doctors not speaking to each other.

– [Zubin] Yep.

– [Marty] There are family members who are infuriated with each other and it strained their entire family dynamics. I’m ready for COVID to be over.

– [Zubin] Me too. It’s because we don’t listen to each other anymore. We vilify people as evil. Like I said, there are people on Twitter who, they’re like, “I have followed ZDogg since I was a pre-med “and I just can’t abide what he’s doing now. “Platforming people like Vinay Prasad and Marty Makary,” who are trying to point out the times when rational people behave irrationally.

– [Marty] And you got pretty tough skin. I know, you know, you got a lot of-

– [Zubin] Oh, I love it.

– [Marty] Yeah.

– [Zubin] I enjoy it. I thrive on it. I’m like, I’m like the emperor. Oh yes, unleash your anger and join me! You know like, oh no, no, no. And it’s funny, Marty, because I work hard on, like, meditative practice and mindfulness and all this stuff and trying to generate equanimity. And most of the day I’m good. But sometimes I just let the mindfulness barrier down and I let pure raw rage circulate through me. And I’ll reply to an angry email from some doc that’s like, “You being against forced mandates for X, Y, and Z “because natural immunity is gonna cost lives.” And I’m like, and I will literally reply with every curse word in the book and say, okay, tell me how many people you’ve actually convinced to be vaccinated. Okay. Now multiply that by 100. Those are the emails I get from people who are convinced because I listened to them. I actually agree with their concerns. I give them reasonable data and I tell them whatever decision they ultimately make is the correct decision for them. And then they get vaccinated because they’ve decided that’s the right decision for them. That’s what we need instead of all this polarization. I’m guilty sometimes of generating polarity because it does pay off in views.

– [Marty] Yeah, and we have forms of communication that are basically shouting. You know, social media is basically a shouting platform. It’s not a listening platform. Brings out the worst in people because of the anonymity of it, you can throw a grenade in there. And it’s tempting, right? It’s tempting to fight back and punch back. And I often have to remind myself cool down, don’t reply, move on. And you know, I’ve got listening posts. I’ve got about a dozen folks that I really respect around the country who I check in with frequently. And I’ll check in with them before writing something and afterwards. And you should be learning from feedback, but not from that extreme peanut gallery.

– [Zubin] That’s a great, actually that’s great advice for anyone doing social media who’s in medicine. It’s great advice. Don’t listen to the peanut gallery, but do listen to people that you trust that also may have heterodox views compared to you, that may be somebody that would challenge your views, but do it in a respectful way.

– [Marty] ‘Cause some people get so bent out of shape of criticism. And how often have doctors say called us and said, “You know, my university, my hospital’s giving me “such a hard time because I suggested “that we have a carve-out in our vaccine mandate “for those with circulating antibodies on their blood test.” And it’s, like, to watch them be afraid to speak up or intimidated or bullied, it’s not healthy for science.

– [Zubin] Dude, and it’s not healthy for the mental health of the people being bullied. So those are the emails I get. It’s like, “let me tell you my life story,” right. Which by the way is an honor. It’s really an honor. And I hate it to the degree that I can’t read anymore. I’ve had to buy Costco readers because I can’t read these stories ’cause they’re so tiny and long and I’m on the phone. But my God dude, like it’s like, “I suffer with anxiety. “I’m a frontline nurse. “I’ve been doing this since the beginning of the pandemic. “I got COVID from a patient ’cause we didn’t have PPE. “Now they’re telling me I have to take two doses “of something. “When I get a flu shot, I get this big reaction. “I’m terrified, ZDogg, what do I do?” And I’m like, this is what we’ve done to people. And then there’s gonna be a shortage of nurses. There is a shortage of nurses.

– [Marty] Yeah. Yeah. And you know, it’s interesting some places where they cannot afford that shortage of nurses, they’re saying, “Look, we’ve got to be flexible “with the mandate because we’re just not gonna have anybody “to deliver babies.” And a lot of these nurses have very good reasons for not getting the vaccine. They have immunity, and it may not be the type that’s been sanctioned by the government, but it is officially valid in the immune system. And so this is not a failure of science. This is a failure of government.

– [Zubin] It’s a failure of policy absolutely. And a failure of compassion. Really honestly. Like, if you read these emails, you’re like, you’re really gonna force this poor person? And, you know, the other thing is like, sometimes it’ll be like, “Look, I’m a pregnant nurse. “We did four rounds of fertility. “It costs this much to get this baby. “I’m just uncomfortable “in the first trimester taking the shot.” And the truth is the data says, you’ll be fine. I recommend it. But I also understand where you’re coming from. You’re wearing an N95 mask. You have this concern. Why can’t we respect that? It’s not like you’re gonna kill someone, you know? It’s really, it’s very frustrating, and people feel this and they go, “Well, now I don’t trust.” Like, you know, look, I understand mandates. They actually make a lot of sense, right? We have them for kids vaccines. We have them for seatbelts. But for this, it’s like, well, there is a adverse consequence of these mandates and we have to at least talk about it.

– [Marty] That’s right. Look, we can have immunity requirements for essential workers in the United States. I actually support that. But we’ve got to recognize there’s multiple forms of immunity. It’s not just that you got injected with the vaccine. And we’ve also gotta respect carve-out situations. And there are some carve-out situations out there. I’ve talked to people with clotting disorders that run in their family. And they’re young and healthy, so the risk of COVID itself is minimal. And maybe they had COVID in the past. So, we’ve got to customize and tailor guidance. We’ve always done that as physicians. But when it comes to the students, that’s when it really becomes really heartbreaking. Los Angeles County just had this blanket indiscriminate vaccine mandate policy just announced for kids all the way down to age 12.

– [Zubin] I saw that!

– [Marty] Yeah. There’s gonna be unintended harm there because UC Davis came out with a study showing that the rate of myocarditis and pericarditis is 162 per million after the second dose. Well, the rate of hospitalization for COVID is 40-

– [Zubin] Yeah, 40. And the death is like five per million.

– [Marty] Yeah, something like that.

– [Zubin] In kids, yeah.

– [Marty] So you’re creating, you know, potentially more harm. Now, again, that’s VAERS data, but they did try to filter it. They try to not just use the raw data.

– [Zubin] Yeah, and, you know, Vani talked about John Mandrola and other studies looking at VAERS data and the criticism of that is well, VAERS is garbage data. And it’s like, well, but that’s one of the major, so the same pro-vaccine absolutists. And this is what I used to be one of these people, Marty. Because it was kids vaccines, and I felt very strongly about it. And now I’m just like, well, the same absolutism that says, you know, “VAERS is garbage. “You can’t look at that data for safety.” It’s like, well, then why does it exist? Okay, second, why do you keep saying we should trust it then? People can see, like, that’s just, this paradox there. So be clear, be nuanced, understand what we know and don’t know.

– [Marty] Can I say the word Fauci?

– [Zubin] Please. It’s a bad word.

– [Marty] I’m afraid to. I love the man. He’s so kind.

– [Zubin] He’s such a nice guy.

– [Marty] He’s such a gentleman. And in my interactions with him, he’s been incredible. And I have a lot of respect for him.

– [Zubin] Of course secretly he’s telling the NSA to murder you.

– [Marty] I don’t think so. I think he’s, he actually welcomes different opinions, but he has so much influence that when he has an opinion that may not be one I agree with, it becomes the law of the land. And I wish he would speak up, for example, last year, that schools need to be opened last year. But he doesn’t. He stays very much in line. So, it’s a unified message. And there’s a value to a unified message, but there’s also a value to a smart doctor speaking their mind, giving their true opinion. And I really believe that well, Fauci, is they knew school should have been open last year. But there was influence. But anyway, separate from that. Separate from that… There was this idea that natural immunity is unreliable. Why was that the hypothesis and not natural immunity appears to be durable to date. That’s the baseline hypothesis. Prove that it’s not long lasting. So, it’s the hypothesis generation with the pretest probability that you program into the hypothesis that allows you to generate other good or bad hypothesis, and you can have good and bad hypotheses. The hypothesis that natural immunity is unreliable until proven otherwise was a bad hypothesis. The hypothesis should have been, we’re seeing it’s durable. The other coronaviruses that cause severe illness in humans have long-lasting immunity. We have good observational data at the bedside. Let’s wait for the data to show it’s not lasting. And until then our working hypothesis is that it’s effective. And so it was just a different way of looking at things.

– [Zubin] Yeah, yeah, yeah. So, let’s switch gears a bit and talk about something that I think also generates a lot of mistrust, and it is very politicized. So vaccine seems to be the providence of the left. “Oh, you know, mask up, vax up, lockdown,” all that. Lefty left. Why? Because Trump just happened to say the opposite early on. So, it’s purely like, this is what I love. Like, people who really don’t like Donald Trump have let him totally play them into politicizing around whatever the opposite of whatever he says. So, now you have that tribe. Then you have now what’s happened is it’s pushed the kind of righty tribe to be like “therapeutics.” You know, whether it’s ivermectin, monoclonals, Regeneron, you know, whatever. I mean, how do you think about this?

– [Marty] So unfortunately, I do see people out there who have this blind faith that therapeutics are gonna rescue them if they get COVID, therefore they don’t need to get vaccinated.

– [Zubin] Right.

– [Marty] And that’s one side that I think has misrepresented the benefits of some of these things. On the flip side, you have the sort of counter reaction, and this is the politicalization of COVID where it’s like, you guys think these therapeutics are gonna help you. They absolutely should not be given. There’s no evidence to support them. Don’t talk about them. We can’t let anyone talk or write about them, and if they do that’s misinformation. And the reality is there’s some stuff you can do if you have COVID that will help, that you can do at home. And we’ve not been talking about it. I mean, things like a saline nasal spray. I mean, in the past it was, “Oh, you have COVID? “You have to sit at home and just ride it out.” That was our only guidance. We’ve got a lot of data now that’s coming out on the use of saline and hypertonic saline sprays. I mean, there’s a study out of Augusta University found that it reduces the risk of subsequent hospitalization by 19 fold that just came out on the preprint. There’s some other studies, there’s a ClinicalTrials.gov study that’s reading out right now. There are some things, right, there’s vitamin D, there’s aspirin has been shown to reduce the risk of severe illness. So, there are a bunch of things. And ivermectin, and I think that data is mixed. I don’t have a strong feeling on it yet. I’d like to see more data. I mean, I think it’s conclusive with hydroxy chloroquine that there’s no activity against this virus. It just doesn’t have activity.

– [Zubin] Does hammering upstairs from remodeling actually affect coronavirus survivability?

– [Marty] It creates tenesmus.

– [Zubin] Tenesmus. For people who don’t know what that is, that’s rectal urgency. Yeah, I have tenesmus right now when I hear them pounding upstairs.

– [Marty] It’s a colorectal.

– [Zubin] It is, it’s a spasmodic. So, back to ivermectin. Ivermectin, we’ve done, Vani and I have done shows. We’ve beaten this into the ground. We need to see better data that it does anything. It’s not gonna have the treatment effects that its advocates are really pushing, that these miracle drugs stuff. But if it works, great, we add it to the armamentarium. Like, fluvoxamine. There’s data.

– [Marty] Really suggestive,

– [Zubin] Really suggestive. 30% reduction in hospitalizations, something like that. Really good stuff. But what’s happened is now the press has said, “Oh, ivermectin, right-wingy stuff. “Let’s go the opposite direction. “Oh, ivermectin is, “if you even talk about it, you’re a bad person,” you know?

– [Marty] You know, we’re gonna get data that’s gonna read out any day now on molnupiravir which is the oral antiviral. And the phase two trial was really, really exciting and-

– [Zubin] This is Merck, right?

– [Marty] Merck, yeah. Through I think Ridgeway Pharmaceutical was the company that developed it.

– [Zubin] Got it.

– [Marty] I always like mentioning the actual developer company because they get acquired by the giants.

– [Zubin] That’s true.

– [Marty] You know, even the Pfizer, the quote unquote Pfizer vaccine-

– [Zubin] You mean BioNTech?

– [Marty] BioNTech.

– [Zubin] How many Germans have messaged me, they’re like, “Why are you saying Pfizer? “It’s the BioNTech. “And why are you talking with this accent? “It’s not us.”

– [Marty] And actually I talked to somebody at BioNTech once. It’s an amazing company. I mean, it’s like a family owned business.

– [Zubin] What?

– [Marty] Yeah, the head of it is like an amazing guy.

– [Zubin] Wow.

– [Marty] And it’s-

– [Zubin] But instead we have to listen to Borla. “I think we should have 27 boosters.”

– [Marty] Booster every Monday morning when you show up at work. Sure that’ll keep the shareholders happy.

– [Zubin] Exactly. Bobby BioNTech sitting in Germany is like, “I don’t know, get a booster, don’t. “But there’s bratwurst. “That’s all. “It’s Oktoberfest. “Why are we talking about boosters?”

– [Marty] Stay at home and gain 50 pounds, increase your COVID risk of severe illness.

– [Zubin] How dare you, Marty Makary. That’s exactly my plan. Well, Johnson and Johnson too now. Did J and J invent that vaccine, develop it? Or was it John Yonson? I don’t know. I don’t know the answer to this.

– [Marty] I developed it. In my garage.

– [Zubin] I knew it.

– [Marty] And I gave it to J and J for free. ‘Cause that’s the kind of guy I am like Jonas Salk.

– [Zubin] You are basically Salky. You know, I get tenesmus just thinking about Jonas Salk.

– [Marty] How about the Olympics. We get the lowest risk human beings on planet Earth.

– [Zubin] The healthiest I’m sorry, I’ll bleep that out. In the world.

– [Marty] And then they get two doses. They’re already basically have the physiologic benefit of being fully vax, just because they’re young and healthy. In other words, there’s more risk of COVID death in fully vaxxed seniors than there is in unvaxxed 20 year olds. It’s almost as if they have their natural, strong immunity.

– [Zubin] That’s right.

– [Marty] So then we take them and give them two vaccine doses. Great. God bless them. I love it. I recommend it. They’re all God’s children. And then they get an asymptomatic positive test and we tell them, you cannot compete with other young ultra healthy people who are fully vaxxed in an outdoor setting.

– [Zubin] It’s insane.

– [Marty] We’ve ruined lives.

– [Zubin] And we’re still doing it. We’re still doing.

– [Marty] College kids.

– [Zubin] ‘Cause nobody can understand risk. And there’s an absolutism about “the science.”

– [Marty] Is a lot of this you think the idea that we’ve never explained that the risk is not equally distributed in the population? I feel like that is still not understood.

– [Zubin] Dude, I’ve been doing videos about this from day one. We don’t understand risk, we don’t understand risk. Your likelihood of dying in a car accident as a young person is 30x what it is of dying of COVID. And that inverts 2x more likely to die of COVID than a car accident as a somebody over 65. So if we understood that, heaven forbid that Jay Bhattacharya is targeted protection. Now there’s some logistical challenges. How do you protect old people while allowing young people to run amuck and so on? And young people can get sick, but they can get sick from flu. We don’t shut down the entire world for that. Did I just compare flu to COVID? Oh my God, I’m gonna get canceled, Marty Makary.

– [Marty] You know what I like about Jay, by the way?

– [Zubin] Yeah. He’s handsome.

– [Marty] I don’t notice those things.

– [Zubin] Okay. It was top of my list.

– [Marty] He’s willing to say he’s wrong and be persuaded. That’s what we need, that attitude to say, “Look, I can be convinced. “Let’s have this conversation.” And I love it how you bring in different points of view. That’s the healthy, scientific dialogue we’ve always had in the profession until this virus.

– [Zubin] You know, what’s interesting is when I bring someone on who’s a little more absolutest on certain things, like say Paul Offit, right, my audience will watch it. And they’ve been conditioned to think in an alt middle kind of, you know, more holistic way, and they’ll go, “Oh, there were some things that Paul said “that I disagreed with. “There were some things that I really like. “So this was very helpful.” I’m like what?

– [Marty] Civility.

– [Zubin] Right, civility. Otherwise like, well, “Paul was a fan of vaccine mandates? ” Kill him!” “Murder!”

– [Marty] He gave I think a pretty good rationale for it when he came on here. You know, I wish he would have supported the delay the second dose early on. His hypothesis was that people may never come back for their second dose. But you know, that’s how we should be listening to people. You know, that makes sense to me, this one, I may want to see more data on this topic. And that civility is being replaced by tribalism. But I think people are seeing through, people are sick of the tribalism.

– [Zubin] They’re tired of it.

– [Marty] They’re so tired of it. And they’re so tired of the emails they get from everybody about what should I do? And they’re just ready for COVID to be over.

– [Zubin] It’s done, it’s done. And we’re gonna talk about that right after we talk about gain of function research. What’s the deal with that?

– [Marty] So there was an amazing thing that happened in 2012. The NIH funded a researcher in Wisconsin to basically do gain of function research to juice up an influenza virus. And, what they did is an experiment where they showed that it was more deadly and more contagious in ferrets, which is a well-known respiratory model. And they published this article, “Hey, we juiced up this virus, more contagious, “and here’s the data.” And people basically read this article in the scientific community worldwide. And I’m gonna paraphrase the response. “Holy you did what? This should never be done.

– [Zubin] Right.

– [Marty] So they started organizing and lobbying, and they eventually convinced the Obama administration to put a ban on all gain of function research. And part of that moratorium was a committee that was to be set up at the NIH called, which got nicknamed the ferret committee. And they were supposed to screen any research to see if it qualified, if it was gain of function. And if so, they had the ability to block it. And so this was about 2015. And what happened over a couple of years is Dr. Fauci and Dr. Collins, head of the NIH, dismantled the power of that committee as is well-documented in a Washington Post investigative piece that came out called Science in the Shadows. Changed it kind of to an advisory committee level and went ahead and made their own conditions to enable gain of function research and continue to fund it. Now, whether or not that money that went to the Wu Han lab was specific for gain of function research, I don’t think so. The official grant was to characterize coronaviruses. Again, I think that Dr. Fauci and Dr. Collins are well-intended. They thought, “Well, let’s study this in the area “where it came from and that will help us in general.” But the old school mentality was, you know, and this is the world Dr. Collins comes from, you take a decade to sequence something like the human genome. Now you can do it in 45 minutes in a lab. Do we really need to create viruses that might mutate or once they mutate, we get the code in 45 minutes and then develop the vaccine, which Moderna was designed in two weeks after the sequence was posted on the internet. Of COVID.

– [Zubin] By the way, I just have a question about, so yeah, gain of function of course, even talking about that was taboo, right? And we talked about this on our last show, so we won’t dive back into it. Moderna, dude, are they cool or not cool, man? I don’t know those guys. NIH funding?

– [Marty] So, they took money from BARDA. Pfizer never did. They never took government money. Which is interesting when people talk about the power of Operation Warp Speed. It’s a good idea. It’s actually supposedly Peter Marks’s idea at the FDA.

– [Zubin] Right, interesting.

– [Marty] I’ve been hammering the FDA, so hopefully Peter Marks is listening and will know that I said something nice about him. Supposedly he’s a Star Wars guy and so the warp speed came out of that.

– [Zubin] Oh, but you know, that’s Star Trek. ‘Cause Darth Vader would say, wait, but warp speed? You know, it’s hyperspace in Star Wars. So he should have called it Project Hyperspace. What kind of Star Wars fan is this Marks? Bring him before me.

– [Marty] Yeah, I’d be happy to, we don’t, I don’t think, we don’t talk Peter Marks and I. So…

– [Zubin] Would he talk to this guy? Mini Vader?

– [Marty] Yeah, I’m sure.

– [Zubin] Just want to make sure.

– [Marty] I’m sure. So anyways, so Pfizer never took government, so people talk about, you know, Operation Warp Speed delivered us the vaccine. BioNTech in Germany gave us the vaccine that Pfizer acquired that never took government Operation Warp Speed money, but it was still an important project, Warp Speed. It helped accelerate Moderna, and it created prepayment for risk.

– [Zubin] Right, that’s right.

– [Marty] Which is a strategy we need to use for HIV and for cancer drugs, and other things.

– [Zubin] Prepayment for risk, meaning, they would say, “Okay, we’re gonna guarantee, we’re gonna buy this thing “whether it works or not.” Take that financial risk off.

– [Marty] That’s right. You don’t have to worry about the liability of the vaccine, and you don’t have to worry about whether or not you’re gonna make money. You design, let the scientists come up with an amazing invention. And they did so… But yeah, Moderna, you know, I would have loved to see a more charitable organization. We’ve created so many billionaires. How about, remember Jonas Salk said that this vaccine will be a gift to humanity. It’s the property of mankind. So, that as many kids in the world can get a polio vaccine as possible. That is our great medical heritage. And it has been gone with a lot of the actions we’ve seen.

– [Zubin] Yeah. Yeah, yeah, yeah. You’re a communist, Marty Makary. That’s what they don’t know about when you go on Fox. You tell them. Go, “I’m a card carrying member of the communist party.” Let’s talk about kids and masking, the data and your Wall Street journal.

– [Marty] Oh yes. So, you know, one of my regrets in COVID is not being able to communicate the nuance of some of these issues in a country where they don’t really do nuance. And sometimes the newspaper editors will just create extreme and inflammatory titles, and that’s what they did on that piece. So, they invited me to co-author a piece on the issues around masks and kids. And I was pretty clear that, you know, I’m pro mask. I wrote the first piece during the pandemic in a major paper calling for universal masking in the New York Times in spring of 2020. I believe in masks. Nobody wants me to operate without a mask as a surgeon. But with kids, there are some important nuances. When the background rate of infection of the community is low, which we had a lot of communities and counties with very low COVID at the time. And we will in a few months, again. That to me, it doesn’t make sense for them to wear a mask because we’ve assumed there’s no harm. In other words, we’ve got to have some criteria, some number threshold. Maybe it’s 10 cases per 100,000 in the community daily. I think that’s a reasonable threshold. Dr. Fauci actually put that number out there also a while back. I think he said 10 to 20. So, let’s create criteria. But when we had this assumption that there’s no downside to the masks, that may be true for the kids who tolerate the mask very well and that is probably most kids. But there are kids with disabilities; cognitive, learning, physical. Some kids wear glasses. 25% of school-aged children wear glasses. Some of them-

– [Zubin] I was one of them.

– [Marty] Yeah, and some of them do fine with the mask and others really struggle. They can’t see when they’re trying to learn. And with anxiety, there’s a connection that is well-described where the resistance with breathing that, can increase the rate of breathing. And we know that long-term, we’ve not studied what a mask does over two years in a developing kid. That’s the truth. We don’t have the data and people have strong opinions. We do know that with something called severe adenoids of the nose, there is something called an adenoid face where the face will elongate in its development because the kid is chronically mouth breathing. Now it’s rare, but it is a well-known thing in the books. It’s called basically nicknamed an adenoid face, and it’s from chronic mouth breathing. And there are speech pathologists who have told me, as I did the research for this, this is not my area, development of the jaw. But I’m basically-

– [Zubin] It’s penile development. That’s your kind of thing.

– [Marty] That’s not it actually. So, you know, I’m basically a journalist. I interview people and I talk to them all the time. And for the hundreds of people out there that I’ve interviewed, you know, thank you for letting me talk with you. And so the speech pathologists were saying, you know, we’re seeing kids not visualize the verbalization of words for a year or two. We’re concerned. We’re noticing it’s affecting development. We’re seeing a loss of the human connection. So, all these things are not to say don’t wear a mask if there’s an outbreak, By all means, do wear a mask during an active outbreak. By the way, we’re not even certain that it’s that effective when it’s a cloth mask. You see Palm Beach County announced… Basically almost every kid got COVID in school with the masks. And what’s safer, being in school or not being in school? ‘Cause you’re not living in the international space station when you’re not in the classroom. You’re around the virus in other ways. And so, you know, the cluster randomized trial shows the cloth mask was almost ineffective. And others have basically hinted that. Even Fauci said that last year.

– [Zubin] Cloth.

– [Marty] What are we doing? I mean, this is what I’ll say when people say, you know, they absolutely, you know, there’s such a culture war over these cloth masks and three-year-olds. That’s now what we should be fighting over right now. Let the school districts make their decision. So anyway, when that title came out, basically an anti mask in children title, my heart just sank.

– [Zubin] Yeah, what was the title? They titled your piece-

– [Marty] “A Case Against Masks for Children.”

– [Zubin] Oh my gosh. But that’s what sells the clicks. That’s why, because social media, this kind of thing, I’ve been railing about this. That’s the culture that we’ve designed is one that polarizes, gets the money. So, you know, and I’m not taking a crap on Wall Street Journal. I’m taking a crap on the whole media model, you know? That’s why, you know, and I’ve said this before, like my creator monetization model. Yeah, we do ads and stuff because if it’s public video, like you get to sit through an ad. Sorry. But if you don’t want to sit through that or you want to actually support the creator, you subscribe to our thing because then what happens is I’m in your pocket. Like, I just have to make content that’s authentic and true to what our general ethos is. Very different, right? It’s like what the newspapers used to be. They would actually get subscriptions.

– [Marty] Yeah.

– [Zubin] Now it’s very different.

– [Marty] Well, the irony was that article was pay walled. So, people just see the title and my name. And then, you know-

– [Zubin] Get pissed.

– [Marty] Yeah, understandably. I mean, they didn’t, I disagree with that and I tell them, I am with you. I also disagree with it! This is the title I didn’t write. Then a lot of people say, “You know, I read the piece “and it was not represented in that title. “I think you give a balanced perspective.” And in there, I even said like, we’ve been pro mask. My coauthor is a pediatric infectious diseases doctor who’s on the FDA advisory committee on vaccines. But you know, the country does not do nuance and it’s hurting us and it’s dividing us. And it’s hard. You know, it’s actually at the point where you say, do I not write this article say in a newspaper like The Washington Post because they’re going to ignite a forest fire by a misrepresentative title. You know, by the way, the same thing happened with child vaccines. I coauthored a piece way back, gosh, four, five months ago, trying to explain, at that time we didn’t have good data on child vaccines. And I tried to say, here’s the, you know, what we know in favor of child vaccination. You know, COVID illness is a vaccine preventable illness at this point in children. And, you know, it’s not just death we want to prevent. It’s this serious illness. It’s the MIS-C. And then here’s where I’m cautious of the second dose, and so I presented those issues and they put a title on it, “The Case for Child Vaccinations.” And I thought-

– [Zubin] For or against?

– [Marty] For!

– [Zubin] For?

– [Marty] Yeah, and I thought, okay, I guess it’s four, but it’s really-

– [Zubin] It’s more nuanced.

– [Marty] It’s nuanced. So-

– [Zubin] It should’ve been “How to Think About Child Vaccination.”

– [Marty] That’s right. This is the media culture we live in.

– [Zubin] It really is. I tell you if I title my thing something clickbaity, like this thing, I’ll go, you know, “Hopkins Doctor Swears Chinese Invented Virus.” If I did that, oh man, YouTube would blow up, I’d be paid in ad revenue. I’d be just showering in cash. I’d be like, “I’m rich!” ‘Cause that’s what’s rewarded.

– [Marty] Well, if that happens, if you could share some of that with me.

– [Zubin] I’ll take you to dinner. Mickey D’s. Possibly, there’s a fried chicken place in the San Mateo Hillsdale Mall called Winner Winner, short for chicken dinner, and it’s delicious fried chicken. I’ll take you there.

– [Marty] Do they accept Bitcoin?

– [Zubin] No, only light coin. They only accept the like sub-cryptocurrency.

– [Marty] Somebody just told me about that the other day.

– [Zubin] Well, you know, as a Bitcoin minor, and by minor, I mean I’m under 18. Yeah, I have no idea. So, speaking of Speaking of Bitcoin, as an escape. Healthcare burnout. Yeah, let’s wrap up with that because this is something that, you know, we talked about the mandates effects on frontline healthcare workers who’ve been suffering from the beginning. But you have a more nuanced take on healthcare worker burnout as a healthcare worker who’s burned out. You and I both are burned out creators. We’re burned out communicators to the extent that, you know, everybody wants a little piece of us every single day, and the million emails and you want to help. But at the same time, there’s only so much of you.

– [Marty] And I think everybody in healthcare feels that way. I know nurses in the ICU and people on my staff that say they get bombarded with text messages and emails all the time. I have a friend who’s a respiratory therapist, and he says he gets it nonstop. Like, every COVID question you can imagine. And you know, your phone blows up, my phone blows up every day with COVID questions from friends, from people that are hard to blow off sometimes.

– [Zubin] Right, right. Yeah, like, the Pope emails me. He’s like, “Broseph,” which is interesting because he’s Italian. He didn’t go for Brosepi, he went for Broseph, which I thought was a little, anyways, back to you.

– [Marty] I know exactly how you feel ’cause Nicki Minaj emails me and texts me frequently. And I just can’t get back to her on the quick turnaround time that she wants.

– [Zubin] Did you try to convince her that her song WAP should have been VAP for ventilator associated pneumonia?

– [Marty] No, but I did actually, I did meet her when I was on the Today Show years ago. She was performing and I met her in the, you know-

– [Zubin] Green room.

– [Marty] The green room. And we had, I’ve never had zero in common with somebody. We had nothing in common. I mean, I think she asked me, I think I told her, at the time I didn’t really know who she was, but I recognized her and then it kind of clicked. And I checked my phone real quick when I saw her performing. And I was like, oh yeah, I’ve heard of her. And she said, I said, you know, I don’t follow, you know, pop, rap culture that closely, but I know you’re a very successful artist and it’s a pleasure to meet you. My name is Marty Makary. And she kinda like looked me over, you know, like, why am I talking to this guy? And then she said like, what do I do? And I don’t know why I got into this detail in the brief answer I gave her, but I told her that I do chronic pancreatitis minimally invasive surgery.

– [Zubin] You went for the full specificity. Wow.

– [Marty] She kind of lost interest quickly. And that was the brief interaction.

– [Zubin] That’s unbelievable. See, God, I don’t know how I would’ve handled that, but I would have been like, “Nicki Minaj, you’re so much better than Cardi B. “I’m just saying.” I would’ve tried to like butter her up. And then I would’ve said, “Oh, I’m a,” if I were you, I would’ve said, “This is what I do. “I do the surgeries that no other surgeons will do, man. “They say, don’t with the pancreas. “I with the pancreas on the real.” I’m gonna have to bleep all that out.

– [Marty] If I could’ve just had like another minute to explain that I use 4-0 Vicryl stitches, not 2-0 like a lot of people do. And I do it differently, but-

– [Zubin] It’s not a running, you know, you’re doing interrupted, which nobody does. And it’s just, it was, she would’ve then understood.

– [Marty] I’m so misunderstood.

– [Zubin] You’re a craftsman.

– [Marty] That’s story of my life. Misunderstood.

– [Zubin] Yeah. That’s the title of my sex tape.

– [Marty] Now that will not be canceled. That definitely-

– [Zubin] No, that won’t. That’s gonna make it go viral.

– [Marty] Actually the tape itself would not be canceled.

– [Zubin] You haven’t seen it.

– [Marty] Saying that you’d like to see more data on ivermectin probably will cancel this.

– [Zubin] That will get you canceled.

– [Marty] People are getting bombarded with text messages and questions. We all get it. And I think, it takes a piece out of you, you know? It’s like everyone is trying to take, take, you know, wants your opinion. People you haven’t heard from in 15 years, 20 years, you know, somebody from high school or college. “Hi! “Zubin, hope you are well.”

– [Zubin] Oh, it’s the best, here it comes.

– [Marty] Haven’t talked to them since high school or college, starts with hope you are well. Long description of their cousin’s COVID situation. And you know, it’s like you can’t, and it’s hard. And it’s like, at what point can we just… I don’t know.

– [Zubin] Can we design a sustainable healthcare system that focuses on prevention and relationships and actually compensates us to do that instead of just put band-aids on things and treat stuff with stuff. You know, this is a longer-term issue.

– [Marty] I just recommend surgery. And then people stop asking questions.

– [Zubin] There it is. Is that what you told Nikki Minaj? Maybe she mistook you for a plastic surgeon. You know, maybe she heard, you said pancreas minimally invasive. And she heard minimally invasive like boob technician or something. Then you would have had a longer conversation. I don’t know if that’s what you wanted, but.

– [Marty] I admit, every time the phone rang for the next two weeks, I thought maybe she’s reaching out to me.

– [Zubin] You know. And I just realized that I did just confuse her with Cardi B when I talked about ventilator associated pneumonia. But I have to say it doesn’t matter because whether it’s Cardi B, whether it’s Nicki Minaj, both of y’all, you have my number. Slide into my DMs. Is that what the kids are saying?

– [Marty] Yeah, stop promoting sex without consequences and violence and foul language in their music. But otherwise we invite a healthy, civil dialogue.

– [Zubin] Okay, you are canceled by all of hip hop right now, Marty Makary. The whole point of hip hop is to promote exactly those things in excess plus drug use. So, if you’re not down with that. I know you’re a Christian, Marty, okay, and I have to say this it’s very un-Christian of you to be unaccepting of other people’s lifestyles, when they’re full of sin.

– [Marty] They’re all God’s children. I believe in love.

– [Zubin] I believe we have something in common. Anything else Marty, that we didn’t hit?

– [Marty] So… What’s interesting is that there is basically a healthcare system that failed us during COVID for the last year and a half. Too slow, unable to pivot, overly bureaucratic, relying on group think that shut out a lot of important views that could have saved more lives. And we’ve never done a formal assessment of it like we did with the 9/11 commission report. And you’ve got all these agencies now begging for some kind of increase in funding or change in the, just they want more money. It’s like a cash infusion. Give us more money. CDC. They’ve got 21,000 employees. FDA’s got 18,000 employees. How about we do a formal assessment? And I read a book just recently by Scott Gottlieb called “Uncontrolled Spread” that was probably the best assessment of what went wrong structurally. To say, hey look, peace time systems didn’t work in war time. Here’s how we need to reevaluate things. We need to change the whole retrospective report mindset of the CDC just collecting some data and then spitting it back out in pieces and a MMWR report a few months later. We need real time systems. And one thing he mentioned in the book, but I got a chance to speak to him recently, and he was saying that after hurricane Maria in Puerto Rico, he went down there because there’s a lot of pharmaceutical manufacturing. And there’s a company that makes Neupogen, and they had incredible backup generators and a security system and they were resilient and they were going strong right through there.

– [Zubin] Wow.

– [Marty] And the reason is that Neupogen is necessary. And if there’s a bioterrorism attack with a nuclear-

– [Zubin] Oh, right.

– [Marty] Because it regenerates.

– [Zubin] Anemic.

– [Marty] That’s right. They get anemic, and it regenerates the blood cells.

– [Zubin] Is Neupogen the white blood cell regenerator? Sorry, not anemia. They get neutropenic.

– [Marty] Right, for neutropenia which you can get from radiation injury. So if we get a nuclear, you know, attack, that’s a key, that’s important for vital national security.

– [Zubin] So it seems like we have other things that are vital.

– [Marty] Right. So we were not able to do that with basic-

– [Zubin] IV fluid even and saline.

– [Marty] Ventilators, PPE.

– [Zubin] VAP, VAP, VAP.

– [Marty] That’s right. And the things that went, that killed our whole supply chain were the cheapest things like it wasn’t the actual PCR machines. We had tons of those. It was the pipettes and the vials and the swabs for testing. And so we’ve got to start thinking about, and this is the thesis that he’s been putting out there. We’ve got to start thinking about healthcare as a national security issue and not rely on the CDC and their staff to tell us when something’s brewing over there in some gain of function bat lab in Wu Han.

– [Zubin] The bat lab.

– [Marty] You know, this is, we need like clandestine services.

– [Zubin] That’s actually right. ‘Cause what he’s talking about is creating an antifragile healthcare system that actually you get adversity like this and it gets actually stronger, you know, like the Neupogen dudes, they were resilient, but also they design their systems with anti-fragility in mind. Man, I like that. We got to get Scotty G on the show.

– [Marty] He’s a really good guy. And also I think has the humility and the right approach. You know, we’ve all made some predictions that were off, but in general, I think Scott has been more spot on than almost anybody out there. And I really value his input. I listen to him frequently.

– [Zubin] And he’s on the board of directors of Pfizer.

– [Marty] That’s right, he’s on the board of directors at Pfizer. So, you sort of have to factor that in, you know, and he’s, you know, when he’s talking about something involves Pfizer, he probably needs to be a little careful with what he says.

– [Zubin] Right, right, right. He should say BioNTech instead. Somewhere there’s a German guy eating bratwurst, Bobby BioNTech, who’s, you know, who’s just, he’s just really loving the show right now.

– [Marty] But in terms of just brain power, super impressive guy I think. Very sort of nonpolitical, nonpartisan type of person. The sort of voice we’ve needed. He’s really done a lot for this country to contribute. And my guess is based on his brain power, he probably knows every intermediate molecule in the Krebs cycle.

– [Zubin] Oh my God.

– [Marty] That I have personally forgotten.

– [Zubin] Pyruvate, dehydrogenase. How many NAD pH does that throw off, Marty?

– [Marty] One or two?

– [Zubin] I was gonna say, I was gonna go with PI.

– [Marty] It’s like in Sunday school growing up, you know, I’d be zonked out. You know, every Sunday be there sleeping. You know, it’s like some crazy early hour of the morning. And they would just ask me a question and I have no idea what the story was or what the context is, and they would say, “What’s your answer?” And I would just say, “God?” Like in “Zoolander.” God? And then if that was like, “No, no.” “Jesus?” “Yes, in a way.”

– [Zubin] By the communitive property of God, Jesus equals God.

– [Marty] The Holy Spirit.

– [Zubin] Right, exactly. By the transitive property of the Holy Spirit. That’s what I, ’cause I never did Sunday school ’cause I wasn’t, you know, Christian, religious growing up. And I’d always, it always struck me as, well, there’s gotta be a science to this God thing. So, there’s probably like, there’s a mole of Holy Spirit. You know, 6.02 x 10 to the 23rd Spirit molecules. According to stochastic probability, you can do some stoichiometry and come up with one mole of God. You know, it’s…

– [Marty] That’s how the scientific journals I’m sure want to reduce it. It’s like all medical journals, the first sentence of the result section, didn’t matter what the science, it doesn’t matter if you’re introducing the cure for breast cancer, “48.2% of study subjects were male.”

– [Zubin] I want to know the results.

– [Marty] Give me the results. This cured breast cancer, you know. It’s like every… It’s like so rigid. It’s unbelievable how rigid. And so what you’re seeing is that’s being replaced now through a lot of new forms of medical communication, including what you do, right? Summarizing findings in a way, like when you summarize the new data, the data that say just came out on the Pfizer vaccine after that phase three clinical trial was done, and you share that with people through this forum, you’re not saying, “Hey guys, “you’re gonna talk about the Pfizer vaccine. “First of all, 52.6% of subjects “in the phase three clinical trial were women.” And so these new forms of communication are streamlining how we learn.

– [Zubin] Yeah, and how we teach, and how we actually get the lay public to understand nuanced concepts. Marty Makary! 3.21 gigawatts of Marty. This was so much fun, man. Guys, just share the thing. Listen to those guys banging upstairs, dude. It’s, like, talk about God angry with us.

– [Marty] They want in.

– [Zubin] They want at least half a mole, they want Avogadro’s number of Holy Spirit in this place right now. Marty Makary, I’m glad that you are with us. And I’m glad that you guys are with us, so share the video. That’s it. Become a supporter. ZDoggMD.com/supporters and check out all of Marty’s works in the links that I will be putting here. All right, guys, I love you. We’re out, peace!

– [Marty] Great to see you brother.

– [Zubin] Always great.

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