The end is near, but if we had focused on what we CAN do instead of what we CAN’T, we just might have saved lives and sanity.
Here’s that Atlantic article. And here’s my recent interview with Dr. Monica Gandhi.
Full Transcript Below.
Hey guys, this pandemic is pretty much over. I’m saying that. It’s pretty much over. I’ll tell you why, but the main thing I wanna do today is I wanna go through all the ways we screw up in public health in messaging about this pandemic. Why we’ve led to this reactivity where people are like, the whole thing’s a hoax. I’ve failed, I don’t even care anymore. I just, whatever. The vaccine rollout. We ought to be messaging that this is one of the greatest accomplishments in history.
In the history of science. And instead we’re like, well, if you get vaccinated you still have to mask up and you really can’t do anything else. We focus on talking about what you can’t do. All these arbitrary rules that seem arbitrary instead of teaching people simply, this is what the virus does. This is how it spreads. This is how you can improve your safety. There’s no absolutism. It’s all about harm reduction for the most possible people knowing that some people are gonna behave like ding-dongs. That’s okay, it’s expected, we’re human beings. Socialization is not an option. It’s not something you can just turn on and off. So instead of saying, don’t socialize, we oughta be saying, here’s how you socialize safely.
And we’ve totally screwed it up. But the good news is, the pandemic is going to be over, like, ASAP. As we start vaccinating, these vaccines you guys, they’re not telling you. They’re scared to tell you how good these vaccines are. Because they’re risk averse. They have this idea. Let’s go through. Let’s go through it. Why have public health officials screwed up the response to this pandemic so royally that we should hold them accountable, actually. At the end of this. We should go, you know what, you’re losing your job. You know what, you think you’re so smart, you’re a terrible communicator and you got this wrong because you think you’re so smart. So, let’s go through it, okay.
The first thing that the public health officials screw up is this idea they have of risk compensation. And there’s a great article in the Atlantic about this that I’ll link to. So risk compensation says, oh if you tell people, hey the vaccines work really good, then the concern that these public health officials have is well then, people are gonna go out and be reckless. They’re gonna get in people’s faces. You know, the vaccines aren’t perfect. They’re only 95% efficacious against symptomatic disease. And 100% practically against severe disease and death. Well, yeah but what if people go out and stop wearing masks and stop distancing and go talk to their friends without masks and hug their parents who are also vaccinated? What if there’s a .000000000001% chance that someone gets sick? Guys, shut up, really?
Wake up. You want people to get vaccinated with these amazing vaccines. Which by the way, I started skepticism… I started skeptical. I have been convinced by the data that these are amazing, right? And so this idea that you’re gonna cause recklessness by telling people the truth. That the vaccines are a way out of this. That if you get them you can start to open up. Especially with other vaccinated people. That this is the answer. That you could do indoor restaurant dining with a room full of vaccinated people with no problems. .000000001% someone’s gonna have a cough. Come on, right? Now I was actually guilty of this early in the pandemic because I thought, you know what, masks, we don’t have great data that they work in public settings because we haven’t studied it. But if we tell people to start masking they’re gonna not distance.
They’re not gonna wash their hands. They’re gonna touch their faces. That’s the same mistake. It was a mistake. I was wrong. No, give people mechanisms for why, how the disease spreads. And it turns out, we were all obsessed with like surfaces and fomites and disinfecting and all of that. That we missed the idea that actually respiratory viruses are typically spread in the air. So, if you do things that reduce your ability to catch in the air, like, wear a mask. Keep a relative distance. Don’t crowd together too much. Avoid indoor, closed, poorly ventilated spaces. Then we could have, instead of telling people what not to do, we could have said, hey, how about this? Go outside. Open the parks. Have kids socialize with each other outside. You don’t even need to wear masks. There’s no… We coulda told people, you know how this thing is spread?
It’s spread by something called over-dispersion. Meaning a very small number of people are super spreaders. A very large number of people don’t even transmit the virus. Even when they’re symptomatic or asymptomatic. So, and where does those super spread events happen? Indoors, in poorly ventilated spaces. Indoor restaurants, gyms. We kept those open but we closed schools, we closed parks, we closed beaches. It makes no sense. And on top of that we did another terrible thing. We inflicted this idea of, well let’s give people what they can’t do. Here are the rules. Six feet apart, made that up. And um, 15 minutes. So CDC’s like, six feet apart for 15 minutes.
Well, there’s some data on some of that. But what we shoulda been saying is well, okay, well now people are just going to game this arbitrary rule. So now you have people working indoors with plexiglass shields keeping them six feet apart with all the windows closed. You can’t open the windows. Crappy ventilation and they’re supposed to wear masks unless they’re more than six feet apart from each other, but they’re indoors. So, again it’s spreading everywhere. Teach people the principles. You wanna avoid poor ventilation. It’s a respiratory virus, so masks can help. And then you could figure out what are the best things to do to decrease the chances of spread. And so, what we do instead is we give all these edicts. We give these rules. We say, stay home. Stay home. It’s the most paternalistic crap I’ve ever heard. Stay home. Um. Okay, what does that mean? Well it means the people who can’t stay home, the essential workers who work in. Oh, you can’t go indoor dining, fine. That makes sense, it’s a poorly ventilate space. But what happens?
The line cook in that restaurant, according to a study, is more likely to get COVID than practically anybody. And instead of focusing on what will keep the actual people who are at risk safe, like that line cook, that essential worker with a high degree of filtration mask with good ventilation, with paid sick leave, with access to rapid testing. We don’t do any of that. They get sick. This is a poor and minority disease. Because we’ve made it that. Because rich people can sit at home in their Zoomocracy tsk-tsking. Everybody saying stay home. Closing parks. Mandating stupid stuff like, you have to wear a mask outdoors on a trail. And then shaming people.
Because it’s easy to do, right? So, things that are visible. Not wearing a mask, throwing a fit in a store because you don’t wanna wear a mask. Throwing a fit on a plane, okay. It’s a handful of people that do that and yet we blow it up into this big shame fest. So what happens when you shame that kind of public behavior? People take it indoors. They’re afraid to disclose it and there’s this feeling of absoluteism. Like, well okay, we have to do all these things. Well, I screwed up. I screwed one thing up. Well, then I’m just gonna give up. That happens. That’s normal human psychology. We shouldn’t be doing that. We should be practicing harm reduction.
Like Monica Gandhi, like Vinay Prasad said on my show. They said, well no, no, no. We wanna reduce harm by empowering people to be safe within the parameters of what they feel their risk is. Telling people to wear a condom or you’re gonna die is not gonna work. Telling people abstinence is the only answer is not gonna work. What you have to do is give them education, give them resources, give them access to the condoms, teach them, well, you know abstinence is actually the way to prevent all STDs but we know you’re probably not gonna wanna do it. But here’s why it might be a good thing. You give people all the tools. And then let them decide.
And so, that’s what we should have done here. Okay, here’s how the things spread. Here’s who at highest risk. So you have to think about your risk. Here’s how you might actually injure others. So, you can make a decision about where your altruism lies and where your selfishness lies and make the decision, right? But instead we said, nope! You gotta wear a mask on a trail and then you shame people. So like, I was walking on my trail, 10 feet wide thing. Outdoors, sun, UV destroys the virus. Heat destroys the virus. Infinite air circulation means you’re not gonna get it large enough inoculum to get sick. There have been no document overdispersion cases outdoors. Meaning massive super spreader cases outdoors. And yet, and yet, and yet. We shut down beaches. We shame people for going to the beaches. We force people to go indoors where the risk is the highest. We hurt poor people and essential workers by closing the schools. Even though we know how to open schools safely because you can improve some ventilation.
You can mask. You can do these simple things that don’t reduce risk to zero. You can never have zero risk. That’s a culture of safety-ism. That’s absolutism. That’s gonna fail. What will succeed is giving people the tools, the power, and the resources to do this. If restaurants are dangerous places and gyms are dangerous places, pay them to stay closed. Problem solved in the short run until you get control of the pandemic when you get to a vaccine.
Okay, now we’re at a vaccine. What does that mean? Instead of messaging people, hey, we have the answer now, okay. You can throw your masks off. You can go back to loving other human beings and being connected because socialization is not an option, it is an essential necessity. School in person is not an option it’s an essential necessity for most children. And again, we’re regressively hurting the poor when we do these edicts. Get vaccinated. Instead we’re like, well, you know, okay yeah these vaccines are pretty effective, we think. But you know, we’re a little nervous about saying that because you know, there’s always some doubt.
But also, we don’t want people to be reckless and we still want them to behave with their masks and their social distancing because you know, there’s the .0001% chance that maybe we, you know, we don’t have good data that it doesn’t transmit when you’re vaccinated. And yet we have every piece of circumstantial evidence and first principles to believe that transmission plummets with vaccines. All the other vaccines tend to do this, right. No vaccine’s perfect. You’re never gonna be perfectly safe. But if we’re messaging, oh, you know, get your vaccine because you should. But also, continue to have draconian measures on your life. Rule based, not logic or intuition based. Or principle based. Who’s gonna get vaccinated? No one. And then what happens is the anti-vax ding-dongs come in and go, yeah, well, you know. These things are dangerous.
And then people are finding every excuse not to get the vaccine because it’s another rule. Instead of trying to find every excuse to get a vaccine because it’s a way out. It’s the most brilliant. I mean, this is amazing. The pandemic will be ended because of a mix of natural infection, vaccination, and a change in the weather. People going outside. That’s it. When we do a post mortem on this, we need to go back and look at what we did wrong. We closed parks. We took out every other swing. We closed schools. We mismessaged on vaccines. I got masks wrong in the beginning. Hey, just throw a mask on. The precautionary principles. It’s not that big of a deal. It’s an airborne disease. Just do it, don’t worry about what the public’s gonna mishear and not hear. Just tell them the truth. Don’t be paternalistic. Don’t be absolutist.
Think about harm reduction. And understand that humans are social creatures. If you tell them not to get together, they will take that underground. And that’s what we saw on Thanksgiving. That’s what we saw on Christmas. Why do you think we have this huge surge that’s now done winding up. Which by the way, the press and the media, and the CDC are finding plenty of excuses to bring it back. Oh, but it’s plateaued now. Oh, but the variants are coming. And oh, but not all the vaccines are equally effective. Dude, they’re all amazing. The variants still are, if you get vaccinated you still have protection from severe disease. Even with the variants that we have.
All the more reason to get vaccinated now. But they’re still gonna find ways to drag this out because to be honest, between you and me, public health people are empowered by this thing. And when it goes away they’re just gonna be like, well now what? I mean, let’s be really. I mean this is a little conspiratorial of me, I’ve gotta admit, but there’s a piece of that. You know, it’s a lot of Twitter juice to be what’s his name out there saying the sky is falling. And putting in doom bait titles, right? It doesn’t help people. It’s been a long 12 months. The winter is here. We’re trying to get through it but instead we’re like, but variants.
But only 70% effective against mild to moderate disease but 100% or 95% effective against severe disease. 100% against mortality. We’re not saying that. Because that’s not as sexy a headline. Hope doesn’t seem to sell as well. We just need to stop thinking about what sells and what saves lives and sanity and our economy and our way of life. And that’s truth. So, hopefully we will get back to open schools, open parks. Very soon with vaccination, open restaurants indoors. Parties and friends and family and ask Monica Gandhi said on my show, society will fly open. And this holiday disaster where we told people your social bubble is burst.
Don’t hang out with your loved ones. We should have said, here’s how you hang out with your loved ones safely. Stupid, stupid. The smarty pants public health. It’s starting to get me angry because these people should know better. We’ve had the HIV epidemic. We’ve kind of learned a lot about harm reduction from that. We know harm reduction harm reduction with intravenous drug use. We know, where did those principles go when tested with the big one here? Which isn’t even the big one. This is pandemic light compared to what eventually could come. All right, guys. Here’s the good news. We’re done with this thing. It’s ending soon. If we don’t screw up, the end zone here.
All right, get vaccinated. If you have access to any of the vaccines, get them. All right? Then go hug your loved ones. That’s it. It’s gonna be a beautiful thing. All right, I love you guys. Share this video. Become a supporter. All the usual calls to action. If you wanna just do a little tip jar thing, it’s Paypal.me/ZDoggMD and I’ll send you personal thank you email. I love you guys. We out.
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