The boys are back in town πŸ˜‚ and we talk COVID policy failures, fact-checking fallacies, criminalizing nurse Radonda Vaught’s fatal med error, Twitter “experts,” safetyism, fixing healthcare efficacy and costs, and MUCH more.

Here’s all our shows with Marty Makary. Here’s The VPZD Podcast. Full transcript in transcript tab below.
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00:00 Fact-checking the facts, COVID policy failures, RCT’s & parachute studies
08:11 Masking, vaccinating and boosting kids
22:28 Nurse RaDonda Vaught facing criminal conviction after a fatal med error
31:55 4th dose, Twitter giving rise to questionably qualified leaders, virtue signaling
45:30 Adolescent mental health, extreme safetyism, antifragility, mandates
1:25:42 Getting back to fixing healthcare, the burden of medical debt, healthcare’s hidden costs
1:33:01 Solutions like eliminating middlemen, price transparency & direct primary care
1:40:00 Long COVID further inflating cost, reductionism, NIH funding, finding the synthesis position
1:52:27 USA vs. European COVID strategies, mandatory boosters to keep medical license
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– [Zubin] Dave Marty. Welcome back, man.

– [Vinay] It’s good to see you, Marty.

– [Marty] Good to see you, Zubin and Vinay.

– [Zubin] We just walked right into it, VP, ZD, MM.

– [Marty] Double M.

– [Vinay] Double M.

– [Zubin] Double M.

– [Marty] Great to see you guys.

– [Zubin] With the three horseman are back to cause harm in the universe.

– [Marty] I had so much fun last time. So many people came up to me and said, you know, it was just fun to watch the interaction and banter.

– [Vinay] People like the show, people like the show.

– [Zubin] People come up to me with like a white glove and slap me across the face challenge me to a dual, dude. Who are these people that are talking to you?

– [Marty] They’re racist if they’re using a white glove.

– [Zubin] Exactly, thank you. There’s an equity issue here.

– [Marty] But they’re, I think people learned something last time. They may have decreased in knowledge. But I think.

– [Vinay] No, they learned you were dropping facts on their head, Marty. They weren’t ready to hear them.

– [Marty] Hey, I’m a fact guy.

– [Vinay] You’re a fact guy. We’re all in the news business. I know, right? We’re in the news business.

– [Zubin] I’ve had fact’s dropped on my head, that’s the difference. You know, it’s funny, you know, knowledge can neither be created nor destroyed according to the first law of thermodynamics and yet we managed to destroy knowledge in the last episode we did, I mean.

– [Marty] You know, how you can add these arbitrary titles to what you are? You know, like most people decided to add epidemiologist to their credentials?

– [Zubin] Right.

– [Vinay] Of course.

– [Zubin] I’m a eucronologist now.

– [Vinay] Trust me, I’m an epidemiologist.

– [Zubin] Yeah, exactly.

– [Vinay] Right, eucronologist.

– [Marty] So I–

– [Vinay] That’s a new specialty that’s emerging on Twitter. Yeah, I see them.

– [Marty] So my latest is, I’m adding fact checker.

– [Zubin] Oh!

– [Vinay] Facts checker, of course.

– [Zubin] Mme!

– [Marty] You guys can be fact checkers too.

– [Zubin] I’mma,

– [Vinay] Well, you have to already have a strong point of view and be unwilling to reconsider it. That’s the key.

– [Zubin] That’s the key thing.

– [Vinay] That’s a key thing.

– [Marty] See, you have to have strong opinions in order to be a fact checker.

– [Vinay] That’s right.

– [Zubin] Actually, this is important. So a friend of mine, Daniel Schmachtenberger wrote a piece on his concillienceproject.org website about the dangers of fact checking and seriously.

– [Marty] What a fact.

– [Zubin] We know, we’re in an information ecology that’s so fractured, you don’t even know what’s true anymore. Like I don’t know, are the Ukrainians winning? Are they losing? Am I bald? Do I have hair? It’s not clear. So there are three things that you can do with fact checking that can mislead people, even with real facts. And one is the failure to contextualize the fact, right? So we see this all the time. Like here’s a study, the study shows without a doubt that masking a two-year old prevents apocalypse.

– [Marty] Facts.

– [Vinay] It’s a parachute, you know, what I mean?

– [Zubin] It’s a parachute.

– [Vinay] A parachute.

– [Zubin] You don’t study a parachute, you just know it works. You select, you selectively did choose things you don’t want to study. You call them parachute,

– [Vinay] Of course.

– [Marty] Issues, right?

– [Zubin] That’s right.

– [Vinay] It’s a hallmark of medicine. You know, we’ve published a couple papers on this, where we looked at people who claim their medical practice is like a parachute. And it’s almost always something that could easily be assessed and 50% of the time, it has already been studied in a randomized study, proving it ain’t no parachute.

– [Marty] So people listening may not know. The parachute argument is when you say, Well, we don’t do a randomized control trial with parachutes it’s just so obvious that they’re effective so people selectively use that to say–

– [Vinay] Analogy, yes.

– [Marty] Look, I believe in this medical dogma, and there’s no need to study it because it’s like a parachute.

– [Zubin] Exactly, exactly, and so the parachute of masks, for two-year olds.

– [Marty] Cloth mask.

– [Zubin] The way you-

– [Vinay] Of course, the cloth mask, the good one.

– [Marty] The one that everyone’s wearing. The cloth mask.

– [Vinay] You’re right. No, but the truth is the majority of people in this country who wear masks to this day, it’s still cloth.

– [Marty] You know, the last people in America forced to wear cloth masks.

– [Vinay] Right, who’re those?

– [Marty] kids two-through-five.

– [Vinay] Yeah.

– [Zubin] Yeah.

– [Vinay] In New York city and other places-

– [Marty] Servers, waiters, staff.

– [Vinay] They have.

– [Zubin] So, my

– [Vinay] The least powerful people.

– [Marty] Yeah, the defenseless.

– [Zubin] Oh, speaking of least-powerful defenseless people, so my daughter, a middle schooler, age 14, they just got rid of the mask mandate, public schools here yet every single child in her school wears a mask.

– [Marty] They don’t wanna piss off the teachers.

– [Zubin] Well, so this is what happened. So my kid’s in class.

– [Marty] Teachers grade them.

– [Zubin] Teachers grade them. And they also form unions where they say. You know what? It’s okay if school is closed for a year. If they don’t get catch up with their timetables that’s okay. But what they did learn was what was important like the words “Coup” and “Insurrection” which it’s really, school is not about accomplishing knowledge, it’s about understanding your social purpose, diversity and inclusion and social justice.

– [Vinay] The greatest domestic policy failure of this pandemic in the U.S. there are many failures we’ll have to have a contest for which is the best, but I’d say the greatest is school closure one year.

– [Marty] Yeah, I would say that’s number one. The school closures, forced cloth masks on kids, ignoring natural immunity, surface transmission instead of aesolized virus, the interval between the two doses.

– [Vinay] Oh, that’s another one–

– [Zubin] That’s a good one.

– [Marty] I would say those–

– [Vinay] But that’s it.

– [Marty] I mean, those are, that’s a partial a list.

– [Vinay] That’s a partial list, that’s an opening salvo. Okay, I see it, oh boy.

– [Marty] Yeah, draconian hospital visitation policies.

– [Vinay] Oh, and that was bad too, yeah, we talked about that.

– [Zubin] Boosters for children.

– [Marty] Boosters in young people with no data to support.

– [Vinay] Oh, that’s true. And demand and you wanna boost in the most young people and not boost the elderly that was apparently the new strategy.

– [Marty] Basically, the one size fits all thirst.

– [Vinay] Yeah, that wasn’t good.

– [Zubin] Right.

– [Marty] Public health officials want where a single message to apply to everybody.

– [Vinay] But you see that’s, you know, what they say as their justification for why they have this, you know, backwards protocol. But the truth is, there’s so much complexity already. For instance, if you got Pfizer, you got 30 micrograms, two doses, 21 days apart, that’s what they wanted. But if you got Moderna, it was 100, 28 days apart and then initially the Moderna EUA for booster was after six months, Pfizer was five. But then they homogenized that using Pfizer data for Moderna. You know, so my point is just, and then J&J was initially one dose then of course they wanted an MRNA booster after the one dose. My point is just that we have always tolerated complexity. The problem is, for the complexity they don’t want to acknowledge, natural immunity complexity or the fact that younger people have lower risk than older people. The complexity they don’t wanna acknowledge then they say. You can’t handle that complexity. You can handle all the complexity we want you to handle, but not the complexity that we don’t.

– [Zubin] And this again is how you lie with facts.

– [Vinay] Yeah.

– [Zubin] So the idea that you de-contextualize a fact, you take it out of the context of, well, what were the limitations of the study? What are the limitations of the data set? What is the actual context of the civilization you’re putting this data into? All of that, you take it out and you go, “Hey, did you know the study showed that masking a two-year old means less COVID?” “It’s like, ba, ba, ba, ba.” So that’s one way to lie with facts. And if we’ve been lied to with facts, I think for a lot of this, don’t you think?

– [Marty] You guys are used.

– [Zubin] And also after this, for being at obedient side.

– [Marty] You guys are used. They’re using data now and facts and.

– [Vinay] It’s a taboo.

– [Marty] You really shouldn’t be doing that. You should just come up with, you should meet with the marketing department and come up with an easy message that everyone will be able to follow without asking any questions. You know, I heard this interesting analysis–

– [Zubin] Burger King, “Have it your way.”

– [Vinay] Oh, brilliant.

– [Marty] Yes. Learn from the king.

– [Vinay] Yes.

– [Zubin] Yes. That guy had it right. He was a little dysmorphic, a little shady looking, a little frightening to children, but–

– [Vinay] There’s a Burger King advert? Oh, I remember now.

– [Zubin] There is a guy I remember, yeah. it’s a weird dude.

– [Vinay] Weird looking dude.

– [Zubin] Dude, just grill the burgers and shut up.

– [Vinay] Man, I’ll go with Grimace any day or whatever.

– [Zubin] Dude Grimace?

– [Vinay] Grimace.

– [Zubin] Okay, let me tell you about Grimace real quick. He’s purple,

– [Marty] That’s McDonald’s, isn’t it?

– [Vinay] Purple, yes. That’s McDees.

– [Zubin] McDonald’s.

– [Marty] There’s shift in here.

– [Zubin] Grimace also has central obesity, purple strait, he was a little psychotic. Grimace.

– [Marty] Type two diabetes.

– [Zubin] He had type two diabetes.

– [Vinay] And he’s cushingoid.

– [Zubin] He’s cushingoid.

– [Vinay] You think so.

– [Zubin] He had adrenal storm.

– [Vinay] Can you?

– [Marty] Some kind of storm.

– [Vinay] Can you reset Marty?

– [Marty] Lots of storms going on in there.

– [Vinay] Can you reset that Marty too?

– [Marty] Yeah, we can do a sleeve or a gastric bypass on Grimace.

– [Vinay] Oh no, why don’t you get to the source? Take away the adrenal?

– [Marty] No, we don’t wanna deal with the underlying issues that bring people to care

– [Zubin] Listen, ever since the arm burglar had his whipple, it’s been downhill since then.

– [Vinay] The arm burglar.

– [Marty] Don’t talk about food as medicine and school lunch programs. We only talk about surgical outcomes after bariatric surgery.

– [Zubin] Yeah.

– [Vinay] That’s a good point that in many ways, like the fact that as a culture, you know, we’ve never really dealt with the obesity epidemic at the root level of, you know, the kinds of processed foods we feed kids and the terrible school lunch programs we offer. And we wanna deal with it, with this kind of last-ditch solution. A lot of ways is kind of similar to COVID-19, not getting to the root causes of these problems.

– [Marty] That’s right. And that’s the exciting thing right now. People, doctors I find are dying to reach out into the community, get out of the bounds of the walls of the hospital where they treat things at the end, you know, last stages of illness. And start to talk about cooking classes for people with diabetes and stress management and sleep medicine applied to high blood pressure management. You know, stuff beyond just sort of the whack-a-mole once they come in with the problem. So that’s an exciting trend and it does apply to COVID. The interesting thing I heard about COVID recently from an HIV scientist, was that we all bring our biases to any problem in medicine, right? We all have of our approach. I mean, basically, you know, the people in charge of COVID policy, the people making all the decisions.

– [Zubin] Of course.

– [Marty] Are basically HIV doctors.

– [Vinay] Okay.

– [Marty] And so with HIV, there was no natural immunity. With HIV the risk was equally distributed in the population, in their mind. That’s at least direct quote from Dr. Fauci, during the AIDS epidemic was that everybody is at risk.

– [Vinay] Yeah, I remember him saying that.

– [Marty] So, you know, here you have an infection where there is natural immunity, it’s effective, it’s real. Here you have an infection where there’s a 10,000-fold difference in the risk between an older person with comorbidity and a young healthy teenager. And yet so that natural bias, it’s not I’m suggesting people weren’t well intended, but they’re bringing maybe the biases from that HIV perspective in managing that epidemic to COVID.

– [Zubin] And what it’s interesting is when you see the exception to that where she took her HIV bias and actually applied it correctly, which was Monica Gandhi. So Monica, says, you know what? We learned this in HIV. You don’t shame people, you don’t mandate things. You teach people, you give them the tools, resources, and autonomy to make these decisions and then they do it. We never forced condoms on gay-men. We never forced abstinence on you. We had conversations with them as grownups. And we haven’t really done that very well in COVID. In fact, we understand risk so badly, to cycle back to my daughter’s story in the classroom.

– [Vinay] Oh, yeah, finish that one.

– [Zubin] So nobody is wearing, everybody’s wearing masks, my daughter says now she feels pressured to do it so she’s fine, she’s not fine.

– [Marty] Even though, there’s no requirement?

– [Zubin] There’s no requirement. Everybody.

– [Vinay] It’s the polite thing to do, Marty.

– [Zubin] Everybody is double and triple vaccinated.

– [Marty] Do they know what life is like without a mask? I mean.

– [Zubin] Oh, no.

– [Marty] Some kids that are four or even five years old.

– [Zubin] My daughter entered middle school as a teenager in COVID and has never, I mean, had a year of, a year of remote class. And then so the teacher’s tell, so one student has the audacity to take their mask off in the class.

– [Vinay] Wow.

– [Marty] Oh, my God.

– [Zubin] The teacher said, “Billy, Bob, or whatever your name is, if you’re gonna take your mask off, I’m not comfortable with that because I’m high risk.” She’s my age, triple vaccinated, or she or he.

– [Zubin] Triple-VAX, yeah.

– [Marty] High is a relative term.

– [Zubin] And I’m gonna put you next to the door.

– [Vinay] Very high. So I’m gonna move you. She says this to the whole class. “Move you of the door, for.”

– [Marty] If you do it don’t work.

– [Vinay] Why the door, not the window?

– [Marty] Open the window, you’ve to–

– [Zubin] You know, good question. And by the way, all the windows are open in the classroom.

– [Vinay] They’re open?

– [Zubin] In the winter.

– [Vinay] Really?

– [Zubin] They’re all open.

– [Marty] You have to exhale through the open window. Because they’re high risk. The risks, my gosh.

– [Vinay] Okay, wait, hold on, so they put him by the door.

– [Zubin] They put him by the door.

– [Vinay] Where the air is stagnant.

– [Zubin] Where the air is stagnant. And all this,

– [Vinay] Okay, I see that.

– [Zubin] And my daughter comes home and tells me this story and she’s like, “Yeah, I feel really bad for this kid. Like he didn’t do anything wrong.” I’m like, “You’re a smart girl.”

– [Vinay] He dare to show his face

– [Zubin] But you know who did is the person who doesn’t understand risk.

– [Vinay] Well.

– [Zubin] And that’s what we’re getting at here is like risk.

– [Vinay] But, don’t you feel like, you know, we’ve conditioned.

– [Zubin] Of course we have.

– [Vinay] I mean, we’ve conditioned the teacher into believing this in a few ways? Number one–

– [Zubin] It’s not their fault.

– [Vinay] Yeah, I don’t think it’s a teacher’s fault.

– [Zubin] Yeah.

– [Vinay] I mean, it’s a cultural thing. Like where would I trace the root to? I mean, obviously anxiety was through the roof in March and April 2020, people wanted to do something. And even though the entire preexisting body of evidence was quite critical of cloth masking, which is why the WHO and CDC didn’t recommend it initially, people wanted to do something and there was a strong advocacy movement. There’s been a great article about this called, “The Masked Debacle” in Tablet Magazine.

– [Marty] Yeah.

– [Vinay] And it really unpacks some of the history here and so then people jump the board, but of course to jump aboard and make a switch this big, you kind of gotta be a propagandist, kind of really sell it. And then quickly by the summer, you know, masks were a symbol of virtue, Trump didn’t wear his and of course, he’s the bad guy. He’s the horrible person. So we wanted do the opposite of him. So in the liberal place, like where we are located.

– [Zubin] Anything Trump does, we’ll do the opposite.

– [Vinay] We’ll do the opposite.

– [Zubin] Yeah.

– [Vinay] And really hard to prove how much better we are than him. Obviously, that’s the philosophy and so then this person digs in more they’re in a culture where everyone they’re talking to talks about how important the mask is and then the next thing they know, they’re behaving the way, you know, if you really stand back and think about it, it’s quite cruel that a teacher would, to single out a child to make them feel, you know, I can imagine this. I feel bad for this kid too.

– [Zubin] Yeah, yeah.

– [Marty] Here’s the thing.

– [Vinay] And the kid’s right.

– [Zubin] The kid’s right.

– [Vinay] Doesn’t hurt the kids. They’re all vaccinating in that school, right? Is it mandatory?

– [Zubin] They’re like, oh, they’re all boosted. Except for my daughter.

– [Vinay] But of course.

– [Vinay] We got it. Don’t tell the museums. Oh, my God. Don’t tell the museums.

– [Vinay] They’ll come after.

– [Zubin] I know they’d come after me.

– [Marty] It’s first topic.

– [Zubin] First, they came for the zoo. Then they came for the museums. Then there was no one to back me up for my unboosted child.

– [Vinay] I think the museums are having their own panel to discuss the Moderna data that dropped today. Because you want the museum, the museum should be the first person to decide on the new vaccine data and then let’s go to the other thing later.

– [Zubin] Tell me about this data. What’s going on with Moderna?

– [Vinay] You wanna talk about that?

– [Zubin] Oh, wait, wait.

– [Marty] I was gonna say you know, the distorted perception of risk out there. So did you see the study of a journalist who studied bicyclers in Palo Alto? And he found that 46% were wearing a mask while riding their bike, but only.

– [Zubin] On Stanford campus.

– [Marty] Yeah, right by Stanford campus. He was at an intersection.

– [Zubin] I assume. He measured them. And only 17% were wearing a helmet. Right, so there’s this completely distorted perception of risk. And, you know, you’re being, I think appropriately kind and saying people have a distorted perception of risk because of the messaging that’s being sent out.

– [Vinay] Of course I do.

– [Marty] Sonia Sotomayor probably truly believed

– [Vinay] 100, 000 kids. there were 100,000 kids in the hospital at the time.

– [Vinay] Are you saying that number was a little off, Marty?

– [Marty] Well, I think it was 1,300 at the time.

– [Vinay] I see. And no one’s distinguished.

– [Vinay] It’s still a little lower than 100,000.

– [Marty] The thing is the CDC still can’t tell us how many were for COVID versus with COVID.

– [Vinay] They just acknowledged they were wrong about the number of children who’ve passed away with this virus. Did you see that?

– [Marty] Oh yeah, they cut it by 24%. The total COVID death tally in the United States, the CDC just cut by 24% and they still can’t tell us how many were for COVID.

– [Vinay] We’re not talking about something no fancy math, we’re talking about counting.

– [Zubin] Right.

– [Marty] And here’s the thing

– [Zubin] No, I’ll just say this, I’m gonna play the devil’s advocate. No children should die.

– [Marty] Of course.

– [Vinay] Yes.

– [Zubin] Children don’t die.

– [Marty] Right, and children die from more than COVID. They die from profound isolation and mental illness and homicide and suicide.

– [Zubin] I would argue they die from not knowing their times table. In other words, poor education is correlate.

– [Vinay] Of course not,

– [Zubin] I mean still

– [Vinay] Its been proven.

– [Vinay] Many studies show that failure to attain sort of these traditional educational outcomes like mathematics and reading, are profoundly tied to life expectancy and upward mobility in these things. That’s health. Learning your timetable is health. It’s a type of health, isn’t? To get around this world.

– [Zubin] Yeah, I agree.

– [Vinay] But Marty, back to your.

– [Zubin] Especially if you’re Asian or Indian.

– [Vinay] We were born on it.

– [Zubin] Because Dave you’ll I’ll kill you if you don’t learn your times table. I mean, its a health, it’s a existential risk.

– [Vinay] My dad would always kind of make special equations for us to study at home and he is like, “Why they only teaching you one variable? You know, let’s get another variable in there. Come on, let’s make it a little harder.” But, you know, it’s your point, Marty. No helmet, wearing a mask, you know, maybe there’s no reason to protect a brain that’s not working when it’s riding.

– [Zubin and Marty] Oh, oh!

– [Zubin] Well, Marty, but the bottom line is those helmets have big holes in them. They’re gonna let virus right through. Why would you waste your time wearing that?

– [Marty] But I just gave this talk you know, at the Society of Gynecologic Oncology, SGO.

– [Zubin] That must have been fun.

– [Marty] It was good, I mean–

– [Zubin] I bet actually that it was loved.

– [Marty] I learned a ton. When I’m at these meetings and specialties outside of my own, I learned a ton. I love learning and so they were telling me about some of the new chemotherapy pathways. I was talking to some folks about the uterus transplant operation. Evidently they’ve done 20 of these at Baylor.

– [Zubin] Oh wow.

– [Marty] And they transplant the uterus, the individual gets pregnant and then they remove the uterus afterwards. So they’re not all,

– [Zubin] Oh, so don’t get rejection and all that.

– [Marty] Yeah, you don’t have to deal with immunosuppress. I mean, just it’s amazing. We have a protocol at Johns Hopkins to start this.

– [Zubin] Yeah, so could a male get a uterine transplant?

– [Marty] Cool.

– [Zubin] I mean a genetically male.

– [Marty] How dare you ask that question? Actually, I asked the same question when I heard this and-

– [Zubin] Yeah, of course you did. ‘Cause I’m thinking, “It’s time for ZDoggMD to give birth.”

– [Marty] We need more of these–

– [Vinay] There’s gotta be some vetting process.

– [Zubin] Yeah, exactly, its psychological.

– [Marty] We need more of these in the world.

– [Zubin] Yes we do.

– [Marty] We definitely.

– [Vinay] So what’s the answer to that question?

– [Marty] So there’s discussion about it, but it’s not part of any current protocol.

– [Vinay] But I guess,

– [Zubin] Look, I’m holding

– [Vinay] Even if they did that, they’d have to do a lot of hormone regulation too.

– [Marty] Yeah, there’d be.

– [Zubin] You think, yeah.

– [Vinay] Wasn’t this covered in an Arnold Schwarzenegger movie?

– [Zubin] Oh yeah, it was called “Twins.”

– [Vinay] Was it?

– [Zubin] No, it wasn’t “Twins” it was, I forget but it was awesome.

– [Vinay] I thought it was a Schwarzenegger.

– [Zubin] You know, anything the Schwarzenegger does is scientifically perfect, like “Terminator.”

– [Vinay] And by the way. Did you see his talk thing on Russia?

– [Zubin] Oh, it was crazy awesome.

– [Vinay] It was really good.

– [Zubin] Yeah. He’s like, “Listen to my friends in Russia. Hear me now and believe me later. They are lying to you. Putin is bad man.”

– [Vinay] But it’s a good, that was a great story about that. Inspirational story, yeah.

– [Marty] Does he wear a helmet when he bike? I don’t know if there’s helmets that large.

– [Zubin] For Arnold?

– [Marty] If you wear a lot of masks, it functions as a helmet.

– [Vinay] I mean, if you put a… an outdoor masks.

– [Marty] KN-95, yeah.

– [Vinay] In the Palo Alto breeze, what are we doing?

– [Zubin] What are we doing?

– [Marty] KN-95 it’s gotta be. I a wear KN-95 and my nose hangs out, but I can’t. I wear a KN-95 below my nose,

– [Vinay] That’s because you have seasonal allergies, it’s for the pollen.

– [Marty] Yes.

– [Zubin] What I love is that people are wearing these things but they’re not fitted like we have in the hospital.

– [Vinay] No, they’d like to have the nice big gaps around here by the nose. So it’s easy that.

– [Zubin] Oh, I just see. It makes it so much easier to breathe, if I just open it.

– [Marty] There’s a KN-95 below the nose function better than a cloth mask below the nose.

– [Vinay] Oh, great question. That’s a good question.

– [Zubin] No one studied them.

– [Marty] Needs a study. It’s a parachute. Don’t study it.

– [Zubin] Yes.

– [Vinay] Well, it needs a mannequin study in a chamber, you know?

– [Zubin] Oh, yeah.

– [Vinay] In other words what the CDC calls the gold standard for public health.

– [Zubin] Yes. Speaking of which, I’m sorry, that’s the second, I’m gonna keep weaving these in, the second way to lie with facts is cherry picking, cherry picking data.

– [Marty] Oh!

– [Zubin] And just pulling particular data sets and saying, “Well, see the studies show this.”

– [Marty] Classic.

– [Zubin] You know, ignoring all the other studies that shows the obvious.

– [Marty] The Kentucky study by the CDC on natural immunity. They spent two month,

– [Vinay] Hey, they fixed it’s MMWR it’s the Lord’s truth.

– [Zubin] It is the Lord’s truth.

– [Vinay] It’s the Lord’s. MMWR, I’ve heard some people even say that it’s the best were the greatest journal. Would you call it the best or the greatest journal?

– [Marty] It’s the number one best journal that the CDC publishes.

– [Zubin] There’s only one peer reviewer and his name is Lord Zero-COVID, to whom we all hail.

– [Vinay] Lord Zero-COVID.

– [Marty] Lord Zero-COVID.

– [Zubin] So, I’m…

– [Vinay] They published some bad ones lately. I have to point out one. There was one about the efficacy. Oh no, I’m sorry, that was pediatrics. We’ll have to, I’ll come to it later.

– [Marty] Oh yeah, I saw that, I saw that, well, thanks.

– [Vinay] Okay, I’ll leave you alone for now?

– [Marty] This meeting was really great. The SGO meeting.

– [Vinay] Oh yes.

– [Marty] And Vinay gave me some slides to use. I told him, I’m like, “Look, I’m talking a big oncology meeting.”

– [Vinay] I sent him my slide deck. I sent him my full, dude I gave you my access to my whole slide, cancer slide.

– [Zubin] Dude, you guys like, blood brother, now?

– [Marty] I went through, a hundreds of slides that he had in his Google drive?

– [Vinay] Gosh.

– [Marty] Hundreds, and out of all the slides, and first of all it was very difficult to interpret the slides without.

– [Vinay] I was like, I hope he understands coefficients of determination ’cause it gets into the we, it gets into the weeds.

– [Marty] Oh my God, I don’t. It’s like,

– [Zubin] Why is this just a slide of big bird? Where did this come from? Why is that even there?

– [Marty] The spices? I saw the spice.

– [Vinay] You saw the spices? That’s what, yeah.

– [Zubin] Oh, nice.

– [Marty] It was like, trying to–

– [Zubin] Dude, he did look at your slides.

– [Vinay] So.

– [Marty] It was like trying to read the freaking Rosetta Stone into that sort of a thing. So I found, there are a couple facts that I pulled. One was that 8% of all cancer patients are eligible for genome’s specific treatment.

– [Vinay] Yeah, that was that, that’s a paper that was published in JAMA Oncology.

– [Zubin] That’s a lot.

– [Vinay] Mark Careldo and…

– [Marty] This still around 8% you think?

– [Vinay] We updated in the ounce of oncology. I think it’s up to like 10%. But I think the point is that, you know, the way they talk about it on the news, you might think the majority of cancer patients would be eligible for a genome targeted drug, but it’s still, you know, one in 10, still quite modest.

– [Zubin] I’m actually surprised is that high.

– [Vinay] I guess it’s because you’re a realist. No, you are.

– [Marty] The other fact, the other sound bite I pulled out of here. Hundreds of slides that I sifted through with my Rosetta Stone, was that if you do a hundred trials, about five are gonna give you a false positive.

– [Vinay] Yes, if you use a one tail P value 0.05, you use a two tail P value, it’ll be 2.5, but yeah, your points is well taken, yeah.

– [Marty] You wanted to use a P value, that’s gonna give you the most likely chance left

– [Vinay] Correct, I mean.

– [Marty] To FDA approval.

– [Vinay] That’s what they, they wanna do.

– [Marty] So one tail one, One tail worse.

– [Vinay] And they’ve done it. Yeah, go on.

– [Marty] So it costs about 2.2 million to do a trial.

– [Vinay] And you like this, I told you.

– [Marty] And so, if you wanna do a hundred trials it costs 2.2 billion, as stuff sloshing around Wall Street all over the place and San Francisco. And so if you do a hundred trials for 2.2 billion, you’re gonna get at least five false positives and they will pay out, how much? One did 50 billion each.

– [Vinay] Yes.

– [Marty] Of those false negatives and then of those that are positive on the response rate as the endpoint, you know, the tumor response rate, something like five to 19%, actually correlate with an improved survival most don’t.

– [Vinay] Oh wow, I’m impressed that you’ve gotten all these from these slides with very little text on it. So like I’ll say about this so.

– [Zubin] Wow.

– [Vinay] We published this paper a few years ago and actually the New York Times did an editorial on this paper and the paper was just sort of a thought experiment and the thought experiment exactly as Marty says, which is that, we know when you run all these randomized control trials, you tolerate some alpha error or some chance, that by chance alone, if the drug was totally inert, you would see this result or a more extreme result. That’s the P value. And we basically hypothesized. Let’s say we actually ran a portfolio of like inert drugs, drugs that just didn’t work. But we just ran many, many of those. There’s gonna be some false positive rate. We’re gonna find some of them work when they really don’t work. That’s just the vagaries of statistics. And then we started to do the math on how and whether or not, could you actually run a profitable company, just testing inert substances. And I use the visual of like spices from a spice cabinet, like things that I don’t really think help metastatic cancer patients and the answer is, you know, with a number of plausible assumptions, you could turn a profit because the amount of money we give for every approved cancer drug is so much, I think we’re talking about lifecycle earnings, 10 to 12 billion.

– [Marty] And it’s not just cancer, right? It’s the Alzheimer’s drug, it’s, I mean, they’re rolling the dice.

– [Vinay] Yes, and so.

– [Marty] They’re financial rolling of the dice.

– [Vinay] I think you’re hitting, you know, I think it’s such a profound point, which is that we have lowered the bar, so low for drug products in this country. And we have set the revenue post-approval so high that we are incentivizing very, very marginal programs and I actually don’t believe they’re testing inert substances. I think they’re better than that. They’re testing things that actually do work, but you don’t have to be that much better and totally worthless to generate huge portfolio revenue. And that was the theme of this paper in this drug discovery.

– [Zubin] And again, that gets to this, the systematic biases that lead us to bad outcomes in science.

– [Vinay] Yes.

– [Zubin] Which of course, our entire healthcare system is one big systematic bias against good outcomes in this country fee for service medicine, all the money we spend, disjointed siloed, crappy EHR, the whole nine yards, right? And then what we do, is we throw the frontline healthcare professionals under the bus when shit goes south, right? So you’ve heard, have you heard about this story about RaDonda Voit? RaDonda Vaught.

– [Marty] Oh, the nurse at Vanderbilt.

– [Zubin] Nurse at Vanderbilt.

– [Marty] Yeah.

– [Zubin] So she’s an ICU nurse at Vanderbilt.

– [Marty] Amazing story.

– [Zubin] Really nutty story because I talked about this a few years ago when this first came out when she was charged criminally, okay? So she’s an ICU nurse by all accounts of her colleagues wonderful competent amazing nurse, is one day she’s working, 75 year old patient, needs to go down to the scanner, CT Scanner, needs to be sedated because she’s claustrophobic, all right? Now she’s got a trainee with her. It’s they just, Vanderbilt just did some Epic nonsense, their big EHR. And it was a total cluster F, where their Pyxis is the machine that dispenses medicines, wasn’t communicating with Epic, and so you had to enter these overrides in order to get dispense the right medication.

– [Marty] Vanderbilt’s the only place where it’s been a cluster by the way, in the country.

– [Zubin] Totally, everywhere.

– [Vinay] Everywhere had a swimming rollout, Epic rollout has been swimming.

– [Marty] Oh, yeah, a billion dollar transition.

– [Zubin] Anybody else who spent a billion dollars on Epic got what they paid for, a billion dollars worth of amazing quality improvement.

– [Vinay] And what you buy Epic.

– [Zubin] Yes. Judy Faulkner, president of Epic says, all right so,

– [Marty] Yap.

– [Zubin] So, yeah. So, long story short, she’s down in the scanner they need to sedate this woman with Versed, which was ordered.

– [Marty] Yeah.

– [Zubin] She tries to pull Versed it doesn’t come out because of the mix giggling of the thing of magic, Epic, probably something related to that. She hits override, and then types in the first two letters of Versed VE, it pulls out Vecuronium.

– [Marty] Oh, paralytic.

– [Zubin] Which is a paralytic agent, serpent in the rainbow level stuff, will paralyze all your muscles but you’re wide awake. She then dispenses it, she’s talking to the trainee about how to do overrides. And then there are several different failure points here where because Vecuronium is a powder, Versed is a liquid. You have to reconstitute the powder. On the bottle it says warning, paralytic agent. So she blows through those warnings, for whatever reason.

– [Marty] I can’t tell you how many warnings I blow through, by the way.

– [Zubin] Yeah.

– [Vinay] Because it’s called alarm fatigue.

– [Vinay] Alarm fatigue.

– [Marty] Alarm fatigue.

– [Vinay] But the whole epic is nothing but a warning.

– [Zubin] Yeah, probably.

– [Marty] Yeah, 16 alert warnings before you prescribe aspirin.

– [Zubin] Are you sure you wanna give Tylenol with a bandaid? They can interact, you know, it’s stuff like that.

– [Marty] It’s a bad tit.

– [Zubin] It is, it’s like these ridiculous,

– [Vinay] It’s ridiculous.

– [Zubin] Ridiculous things. I mean, a rapid about this.

– [Marty] It can be prepared,

– [Zubin] EHR state of mind, talking about exactly.

– [Vinay] It’s nothing but alarm fatigue and, okay, anyway go on.

– [Zubin] And fatigue, fatigue

– [Marty] So anyway I relate to this as you talk here, I relate to making mistakes.

– [Zubin] And exactly so in fact, not only do you relate, but I’ve gotten,

– [Vinay] Wait, wait. You’ve never made a mistake?

– [Zubin] No, Marty does make mistakes.

– [Vinay] To be fair, never.

– [Zubin] No, he doesn’t make mistakes.

– [Vinay] I mean, you could have reviewed.

– [Zubin] He causes mistake.

– [Marty] I made a mistake once.

– [Zubin] And it was a mistake.

– [Marty] Yeah, I thought I was the second most humble person in the world.

– [Vinay] I thought he was about to say, I made a mistake about 30 minutes ago when I joined you guys on this.

– [Zubin] Yeah, exactly.

– [Vinay] I made a mistake, 30 minutes ago.

– [Zubin] I made a mistake and the mistake was thinking I’d made a mistake.

– [Vinay] No, wait. But I think, you’re right.

– [Marty] Very humble.

– [Zubin] I mean.

– [Marty] I’m the most humble person that I know of but go ahead, I’m sorry.

– [Zubin] I forgot what I’m saying.

– [Zubin] So humble I say. But.

– [Vinay] You’ve a reason for it.

– [Zubin] So much. So she reconstitutes the Vecuronium, gives the Vecuronium, pushes this lady into the scanner. She dies in the scanner awake, suffocates. I mean, horrible. The worst thing you could ever imagine.

– [Marty] Mm, terrible.

– [Zubin] And she, it was immediately, okay, this is what it happened. And she was fired instantly. Which by the way is not the standard.

– [Marty] It’s not how we deal with patient safety.

– [Zubin] Not how we deal with, well talk,

– [Marty] She feels horrible and she’s fired and shunned.

– [Zubin] And there’s a thing called second victim scenario, right?

– [Vinay] Oh, yeah.

– [Zubin] Where that happens to a person, who’s a good person who made a terrible mistake and maybe there was negligence even, but it wasn’t intentional and the next thing, you know, they’re suicidal or something worse, right?

– [Marty] It feel terrible.

– [Zubin] And so she then loses, she’s charged with criminal negligence.

– [Marty] Come on.

– [Zubin] Homicide. And on top of that, of course she loses her nursing license. I don’t know what their process was. They went for the board or whatever. And she admitted, she said, “I was complacent, I made mistakes, there were systematic problems, but it was my fault.

– [Vinay] Yeah, it isn’t.

– [Marty] Yeah.

– [Zubin] I feel terrible. There’s not a day that goes by, I don’t think about it.” About a billion nurses reached out to me when I first did the story on this a couple years ago and said, dude, but by the grace of God, right?

– [Vinay] Go on.

– [Zubin] So many times.

– [Marty] Could have been me.

– [Zubin] Have I come to that last point, and something happened and oh, paralytic, I’m like, “Oh my God, that was a close one.” Because the systems are set up in many ways for us to fail, or it’s just a Swiss cheese model, where all the holes lie.

– [Vinay] Yes, it’s a Swiss cheese model. They changed the system, the machine wasn’t working as well. They got comfortable with overriding because there were structural flaws in the system, they overrode, they will had a trainee to supervise. So their attention is distracted, you know, all these.

– [Marty] Moral hazard of relying on safe systems so you tend not to be as vigilant.

– [Zubin] You’re more complacent.

– [Marty] And that’s a natural human behavior phenomena.

– [Vinay] Absolutely.

– [Marty] It’s been studied in radiology when they have AI Eye check than they’re-

– [Zubin] Oh really?

– [Marty] Yeah, there’s more mistakes the Eye AI picks up. So I mean, but the moral hazard is a real thing. These often happens everyday.

– [Vinay] And the marketing of the products is that it’s going to make it safer. That’s the part of the marketing of some of these products of these machines that dispense these products.

– [Zubin] Right. Epic will make medicine safer, you know, by alert fatiguing us and, you know.

– [Vinay] And this computer that like in the old days when you could just access any medicine by pulling on the drawer,

– [Zubin] Right.

– [Vinay] It’s different now, it’s all locked up and it digitally unlocks just the drawer. I mean, I’m not an expert on this because I don’t handle medicines that much myself, but.

– [Zubin] And what RaDonda said was that, that day they had to do like 30 different nurses had to do 30 overrides on the Pyxis system because of the whole Epic miscommunication disconnect thing. So this was already happening. There was this other thing. And so now, she’s being criminally charging and she’s going to trial.

– [Vinay] Why are they charging her criminally?

– [Zubin] I don’t know?

– [Marty] Posturing, this is political posturing. You know, it’s.

– [Zubin] It’s Nashville. So I don’t know what’s going on. But I’ll say this, like, you’ve gone through COVID, you’ve thrown all the nurses and doctors under the bus. You give them a crappy system, crappy technology and people get rich off your backs and then they do this. Who’s gonna wanna be a nurse?

– [Vinay] Great, no.

– [Marty] After nurses jumped on the grenade.

– [Zubin] Yes.

– [Marty] When we didn’t know what the case fatality rate was.

– [Zubin] Yes.

– [Marty] In, you know, a population of healthcare workers.

– [Vinay] Correct.

– [Zubin] And they were shunned in grocery stores because they wore scrubs, coming from a hospital and people were panicked and they’re treating them like crap.

– [Marty] And they couldn’t interact with anybody when they came home, because people were still believing in the fomite and surface transmission theory.

– [Zubin] People attained full body shit, like showers out in their yard and crazy stuff like that. And so, we respond them by criminalizing, what is an error, a major error.

– [Vinay] But an inevitable like when you talk about a denominator of hundreds of thousands of nurses, this thing it’s inevitable and your point is well taken, that it could have been anybody, you know, who happened to have this series of events lined up. She’s not a malicious actor.

– [Zubin] No, no.

– [Vinay] And she’s not intentionally doing this.

– [Marty] It could have been me.

– [Vinay] She’s trying to do her best.

– [Zubin] And the thing is in a just culture model, how you would process this is you would first try to assume intention like, okay, are they a psychopath? Are they crazy? Are they criminal? Is there active neglect? Like are they refusing to follow protocol, et cetera. And I don’t think any of that matter or to did that here and so she would be a candidate for serious education and rehabilitation, not for going to jail, even losing license. Now this was bad, and I don’t know all the subtle details as to why the prosecutor decided to do this, make an example of this. But I’ll say, you know, just on the surface.

– [Vinay] But I mean, I guess I’d say that like, yes, there are some parts of this equation, it sounds like to me that are under her control, but you can’t just punish the person who that lined up with a series of systematic errors. You need to have some policy that addresses all of the people who make those errors and rehabilitates them.

– [Zubin] Yeah.

– [Vinay] Rather than–

– [Zubin] Or the system?

– [Vinay] Or yeah. And of course, this, yes,

– [Zubin] Or both.

– [Vinay] Both, right. The system needs to be rehabilitated. There’s no excuse for a system where override is the default. If override is the default, then what the hell is the machine doing?

– [Zubin] What’s the machine doing?

– [Vinay] It’s wasting my time. You know, it’s really a problem. It’s an impedance to doing proper work so override should not be the default and then the things that she did wrong, people should be, you know, better rested and have less stress and be under less pressure.

– [Zubin] Better support for teaching. Better staffing.

– [Vinay] Better staffing.

– [Zubin] All the other things that you do. And then there’s another system, my question was, why was Vecuronium on a crash cart in radiology?

– [Vinay] Yeah, do they mean. Seems a little funny.

– [Vinay] Paralyze, that hurts

– [Zubin] Paralyze somebody, I guess you might, but seems a little further.

– [Marty] There’s a system solution there, right?

– [Zubin] Yeah.

– [Marty] ‘Cause if you say.

– [Vinay] Take away paralytics.

– [Marty] They should be part of a crash cart, but not part of the Pyxis where somebody’s drawing up Versed.

– [Zubin] Right.

– [Marty] It’s just, if they, if we start firing people and prosecuting them for near misses or things that, you know, we’ve all, we all relate to something like that in our medical. If you-

– [Zubin] Absolutely.

– [Marty] If you haven’t been in medicine long enough.

– [Vinay] Of course.

– [Marty] I mean, I certainly relate to having made very close near missed sort of mistakes.

– [Zubin] Yeah.

– [Marty] And if we start firing people for that, we’re not gonna have anybody left.

– [Zubin] Right.

– [Vinay] Yeah.

– [Zubin] And we do it when we drive. You know, we’ve done things when we drive sometimes where attention is distracted and you go through a red light or you do something stupid and you just go. I got lucky, yeah.

– [Zubin] Oh my God, I got lucky. But there’s times when you’re not lucky. And then what are you.

– [Vinay] And if we fire people for near misses, who are we gonna have left to fire for having natural immunity and don’t wanna get the fourth booster, who will we have left, to be fired for the fourth booster? What, no one left.

– [Zubin] Tell me about this fourth booster myth. What is going on here?

– [Vinay] I don’t know, I mean you know, like they say, I’ve always said it’s a four dose vaccines, you know?

– [Marty] Exactly. It’s just up to date.

– [Zubin] It’s up to date.

– [Marty] Now’s, it’s not fourth, because that will be-

– [Vinay] Oh yeah, right. You have to be up to date.

– [Marty] Yeah, every Monday morning.

– [Vinay] Okay, I get one thing to say right off the bat, which is that, I was told that the virtue of the mRNA scaffold, the mRNA product, is that mRNA is so great ’cause you can so easily swap out the part in the middle. Why are we even entertaining the idea of boosting with an ancestral strain that hadn’t been around in one and a half years is no longer the dominant strain and for which we know the vaccine effectiveness with time is in the toilet.

– [Marty] Yeah, 13% in young people against Omicron.

– [Vinay] For, all right. You’re talking about symptomatic disease or hospitalization? I mean with-

– [Marty] Symptomatic analysis.

– [Zubin] Yeah.

– [Vinay] And with enough time you’re talking about maybe 16 weeks or 20 weeks post boost.

– [Marty] Yeah.

– [Vinay] I mean, I think I believe that very much because I’ve looked at so many of these studies with that point estimate. I mean, I don’t know what we’re talking about. I mean, look, I know why Moderna wants to do it, and by the way, Moderna, is pursuing a fourth dose in 18 and up. And Pfizer is pursuing a fourth dose in 65 and up. So Moderna, they’re going for the goal. They wanna get all that market share.

– [Marty] There’s not even good clinical outcomes data to support the boosts Zero-third dose.

– [Zubin] Well, of-

– [Marty] Or even maybe, I don’t wanna go there but–

– [Vinay] There’s some, there’s some confounded observational data for a fourth dose. Do you like your data confounded or heavily confounded?

– [Marty] I only wanna say titles, I don’t wanna see hospitalizations.

– [Vinay] Yes.

– [Zubin] No, you survive in the end by titles.

– [Marty] Or severe illness,

– [Vinay] That’s all I care.

– [Marty] Or gas. Only wanna see titles.

– [Vinay] Of course. That’s the whole-

– [Marty] That’s also perfect.

– [Vinay] Whole standard of medicine, where you know,

– [Zubin] It’s sort of marked-

– [Vinay] You tell someone they’re read, you draw a test and the patient doesn’t feel anything and then you tell them they’re better off because you administrative therapy, yeah.

– [Zubin] No, but then the museum needs to require that forth dose.

– [Vinay] Well!

– [Zubin] For a child or they have to get anally tested, for the anal swap.

– [Vinay] Well, first of all, the museum should have designed the study ’cause they’re the experts.

– [Marty] The Museum Of Science. This is a science–

– [Zubin] It’s a science museum. It’s, uh.

– [Vinay] They have an eagle, my friend, what more do, do they have an eagle?

– [Zubin] Oh, I don’t know?

– [Marty] And the great problem is…

– [Zubin] I couldn’t go. I was planning to go. I had a gift certificate. Someone bought me.

– [Marty] So I, look, I believe in mammograms, but I don’t recommend them for men. Right, because the data that does not show .

– [Zubin] Some men, you know what?

– [Marty] There’s no convincing data that it is.

– [Zubin] This is where you’re off the equity and inclusion train a 100%.

– [Marty] Well, I’m sure you could make an argument that we could save one life of a man with breast cancer, which we never could mammogram.

– [Zubin] For a 100,000 screenings?

– [Marty] Yeah, but, you know, there’s maybe a cost of the radiation exposure.

– [Zubin] Right.

– [Marty] So in children.

– [Vinay] Sounds like you’re thinking about trade offs, Marty. That’s a forbidden word these days.

– [Marty] Well here, here.

– [Zubin] Did you study policy per chance?

– [Vinay] Are you professor of policies?

– [Marty] I’m not, I consider benign evidencezologist. I mean basically from his hematology oncology, you know, analysis of the literature. He’s basically a studyologist.

– [Zubin] That’s great.

– [Zubin] That’s what I consider as a meta-researcher. That’s true.

– [Marty] That’s first file of Wien Gastache.

– [Zubin] I wanted to be a foreskin expert.

– [Marty] Foreskin.

– [Zubin] And call myself a preppy dentist. But anyways, back to you.

– [Vinay] But they never fully accept him in the tribes.

– [Zubin] That’s true, the urologists feel like I’m encroaching on their.

– [Marty] So here’s the thing. We’re applying policy

– [Zubin] Preppies. to all children healthy with a comorbid condition. When we’ve never gotten the data on the subgroup analysis of each of the two groups. In the healthy children, we don’t know if any healthy child has ever died. Now it, there may be a couple, there may be 10 or 20.

– [Vinay] Well, we do have some nice data from Germany where they tracked.

– [Marty] Yap.

– [Vinay] And they found that between five and 11, they were zero.

– [Marty] Zero. No deaths in healthy.

– [Vinay] In healthy kids in Germany.

– [Zubin] So what was this data that I heard recently? They’re saying like a third of the kids that died, that they looked at a set in the U.S. were healthy kids with no comorbid.

– [Marty] No, it’s hospitalizations, I think.

– [Zubin] Okay.

– [Marty] There’s a hospitalization report. I think it was more like a quarter or 27% or something.

– [Zubin] Okay.

– [Marty] But that’s hospitalizations and they’re picking up incidental Omicrons.

– [Vinay] I wanna say, also say that is this, like I guess, you know, the first thing I think about when I hear about hospitalization is are you talking about hospitalizations for COVID or with COVID.

– [Marty] No one will tell you.

– [Vinay] And no one will tell and maybe you know possibly they don’t have them.

– [Zubin] They don’t know.

– [Vinay] They don’t have the methodology to know. I mean, they…

– [Marty] They don’t wanna know.

– [Vinay] Well, I mean, they have difficulty giving an accurate count. I mean, you know, no child should die of COVID, but at least we should be able to know the number. The fact that they’re off by 20%, isn’t this, I mean, look, isn’t this so real? They they’re off by 20% of a number in the a hundred to a thousand range. I mean, this is the ballpark of the number. They cannot count this statistic. What are they doing?

– [Marty] Look, I think vaccinating children probably makes sense but the studies don’t account for natural immunity.

– [Vinay] Correct?

– [Marty] For which it’s hard. How do you have the certainty, to tell somebody with natural immunity, you must get vaccinated. Even though there’s no studies on vaccinating kids who already have natural immunity. And there’s no studies, there’s no data on the risk of dying in a healthy child and the only data we have from Germany says, “No healthy child five through 17 died.” And by the way, that was over a 15 month period when they were not vaccinated, with rare exception.

– [Vinay] Yes, you’re right. They were unvaccinated.

– [Marty] They’re unvaccinated

– [Vinay] And also the prevalent strain at the time was Delta. But I guess to your point, I mean, there’s a broad point about natural immunity, which is that whether you’re young or old, if you’ve had COVID, first of all, you wanted to get vaccinated at first. I mean, if you could have in-

– [Marty] Yes.

– [Vinay] If you wanted to get vaccinated first as an adult, then get COVID, of course. But unfortunately, 140 million plus Americans have had COVID at least, at least 140 million. That’s a CDCs estimate. Probably a lot higher ’cause that’s a Pre-Omicron estimate. Okay, so if you’ve had COVID and recovered from COVID and then the question is, do you have an additional benefit by being vaccinated? And the answer is, the perfect study would’ve been a randomized control trial just in that population. And Pfizer or Moderna have tons of cash. They can easily afford such a study. We don’t have that study.

– [Marty] Why would they do a study to shrink their market size?

– [Vinay] Correct, but yeah, no, you’re right. It will only erode their market share.

– [Marty] And the study that we have from the CDC was, a pretty good study, it was data from New York and California.

– [Vinay] Okay, I like this study.

– [Marty] Remember this?

– [Vinay] Yes.

– [Marty] And it showed that if you look at what really matters, which is hospitalization,

– [Zubin] Okay.

– [Marty] The rate of hospitalization in those who had hybrid immunity, that is combined natural immunity from convalescent disease, plus vaccination, was 0.3 per thousand.

– [Vinay] I remember this.

– [Marty] The rates, the rate of hospitalization in those with natural immunity alone was 0.3 per thousand.

– [Vinay] Yes.

– [Marty] So you capped out, you sealing,

– [Vinay] And now the vaccine only arm. Vaccine without natural immunity was good, but much higher. So natural immunity and that’s done higher.

– [Marty] Hospitalization.

– [Vinay] Higher hospitalization, you’re right.

– [Marty] Yes.

– [Vinay] So the point is, I think the point you’re making Marty, which is a brilliant point, which is this, in this New York-California study, which somehow was published in MNMWR, the first good thing they published in that journal.

– [Marty] That was very strange.

– [Vinay] It’s very strange–

– [Zubin] Got through they call it Zero-COVID period review. And they still, they still denied it. They still

– [Vinay] Of course.

– [Marty] Their own conclusion in their own article was nothing to do with data.

– [Zubin] Kind of lie with facts, the context.

– [Vinay] It says that it re emphasizes the importance of vaccination after natural immunity but if anything, it shows you that natural immunity is so profoundly good.

– [Marty] Yes.

– [Vinay] In preventing you from subsequent infection and re-hospitalization. So profoundly good that you probably, from a policy standpoint, if policy maker, those are the people you leave alone. ‘Cause you don’t need to bother. They’re not the policy problem. The policy problem is the old unvaccinated and non-immune person. And there’s still those people out there.

– [Marty] That’s where we should be putting our energy.

– [Vinay] And they’re taking time. They’re the people who Hong Kong is, you know, this is the Hong Kong in fact.

– [Zubin] Yes, exactly right.

– [Marty] If this is the situation.

– [Zubin] No, this is exactly right. Is that look, look, the three of us have been criticized unfairly, I think. For somehow being anti–

– [Vinay] I’ve never received criticism in my life.

– [Zubin] You know what, I’m, I’m…

– [Vinay] I’m criticism.

– [Zubin] I’ve finally made a mistake myself.

– [Marty] He doesn’t read you.

– [Zubin] You’re right, I haven’t either. I misspoke. For somehow being anti-children by raising the question about natural immunity and kids and death and kids and with COVID without COVID, et cetera. But the truth is, what we care about is the area under the curve of people surviving, right? So why are we spending,

– [Vinay] And having a minimal complications, you’re correct.

– [Zubin] Minimal complications.

– [Marty] And vaccine related complications where’s that data? We don’t know.

– [Zubin] Micro-dialysis, et cetera. And let’s say it’s zero. Let’s say it’s zero. Would you still compel children? You know, you could argue, well, no children should die. So then there’s zero complications from vaccine. Let’s give it to everybody. But there isn’t. Not only are there some rare complications, but there is the cost and there’s the distraction of resources.

– [Vinay] Yes, and to that point, we have seen in recent statistics, a huge drop in routine childhood immunizations, including MMWR.

– [Zubin] Exactly.

– [Vinay] And then the next point to your point is that we are all advocates for vaccinating children safely, the optimum risk health balance. And so I think to Marty’s point, if you are, if a four year-old has hadn’t recovered from COVID, are they gonna need to leap with this Moderna data for 25 micrograms times two? I’d say question that’s, I don’t know, question mark. I hope.

– [Marty] But, it’s the absolutism that is hurting.

– [Zubin] Yeah, that’s what I think.

– [Marty] It’s the absolutism and the certainty of masks.

– [Vinay] But I’ll tell you why there’s absolutism. Okay, here’s my, okay. All right good, this is not good. I think it’s a few forces. One.

– [Zubin] Am I gonna have to edit this?

– [Marty] For a separate show?

– [Zubin] Yeah, exactly.

– [Vinay] Make a note of the time so we have to delete it.

– [Zubin] Make a note. Time stamp.

– [Vinay] Okay, so. Here’s the absolutism,

– [Marty] Time is there, oh fuck.

– [Vinay] Absolutism. And it’s gonna hurt a little bit but I think. One, the White House is running the policy on COVID, they’ve run it, they’ve run it so hard that they resignations from FDA, ’cause they’ve taken control. A politician should never be running public health policy because politicians horizons and goals are very different than public health goals. Politicians goal is on this November election and politicians need these cases to be low. And if that means boosting 12 year olds, just to get the numbers down, you might have to do it. You know what I mean? Their incentive is not optimal public health. It’s on making sure their political fortunes are good going into election. That’s one problem. I mean, I’m not saying that they’re terrible. They’re not terrible. They’re they’re also not, it could be worse. You know, you could have totally incompetent people. Then they’ve hired people at these agencies who are nice people, good people. I’m sure they’ve done good work, but they have not been steeped in a policy culture. You have a head of a CDC who is an academic ID doctor. Who’s very smart.

– [Marty] HIV doctor,

– [Vinay] Exactly.

– [Marty] who’s taking orders from the White House probably.

– [Vinay] And I’m sure under the thumb of the White House, if they do the wrong, if she does the wrong thing, the White House can push her out and they got close, you know, they started leaking to news outlets, all this kind of trash about her, trying to get, you know, getting ready to show her that they could push her out if they wanted. And so, and also she’s not a policy person, no offense to her. She has expertise in her field, but she’s not played in the sandbox of public policy, which is a very complex dead game. You and I have spent a lot more time in this space and we understand that there are real trade offs. And if you only have so much political capital, you can’t blow it on, on trying to boost a 12 year old when you need to spend it on boosting 85 year old and then the than the last piece of the puzzle, okay, I gotta tell it.

– [Zubin] Oh, we’re getting sweaty.

– [Vinay] They’re picking people, including their News are, because they’re on social media.

– [Zubin] Yeah, go on.

– [Vinay] And look, I have nothing against Ashish, but let’s just say this, if Ashish who his background is not ID, epidemiology, his background is different, but the reason he is picked, whether we like it or not, he tweeted a lot, in the early part of the pandemic. Those tweets got the attention of reporters. They put him on TV a lot, he’s good on TV, he’s neutral, he’s, you know, balanced. He’s always a middle of the road guy. He blows whichever way the wind is blowing. And that got him the attention to the White House. He praised every one of their policies, even their boneheaded policy to use vaccine passports for airplane, domestic airline travel, which even they walked back, ’cause they realized it was so boneheaded. He praised it, he praised every decision they never made.

– [Marty] Ignoring natural immunity.

– [Vinay] He ignored, yep. He and he was for school closure. Thank God. He’s better than others, ’cause he apologized for it.

– [Marty] He apologized. I respect that.

– [Vinay] He apologize, I respect that, ’cause some of these other people they still haven’t apologized and I will get that apology from them in the next few years, they will give it. I know they will, they will wanna give it. So, but the CDC is the problem. You got people who aren’t policy experts. They’re under the thumb of a politician, not a public health expert. And you got some people who are self-made media stars, good for them, you know, hats off to them. But that’s not the people who you gotta go to in the time for crisis.

– [Zubin] And to be politically fair, that’s how Scott Atlas got his job. He was on Fox news and Trump saw him on Fox news. So I mean, it seems like we’re picking, when politicians science experts, it’s not always for the science.

– [Marty] You know, the thing to me though is you’ve got a medical establishment that is basically in lockstep. And they have locked arms and walked off the cliff together on so many issues, right? On so many issues, surface transmission, school closures, the interval.

– [Vinay] Masking toddlers. Masking toddler, ignoring natural immunity hospital visitation. You go down the list, right? And where’s the humility. Where is the, you know, we don’t have great data on healthy children and the vaccine complications. So we think there may be a benefit to vaccinating healthy children. But when they have natural immunity–

– [Vinay] We don’t know for sure?

– [Marty] We don’t know for sure.

– [Vinay] And we’re not gonna mandate it, but it can still be a choice. And totally that’s the right answer.

– [Zubin] That’s the way to do it.

– [Vinay] Should be like, we’re not gonna say advocate against it. We’re not gonna advocate for, we’re not gonna mandate. We’re just gonna offer it. Well, here are the data. Here’s what we’re learning. Here’s the real time data. By the way, our website’s up to date. Which they could work on that. But to your point, Marty, I gotta say this, that those people of locking arms in arm, they’re not as many of them as they would like. They have taken control over some institutions like AAP and CDC, they’re very vocal on social media. But they are not the majority of actual practicing infectious disease doctors. You and I talked data all the time.

– [Zubin] And I do too.

– [Vinay] You do too, sorry.

– [Zubin] That’s why I always say,

– [Marty] Express yourselves.

– [Zubin] I always say, it’s a silent majority of people who are sane here.

– [Vinay] Yes, who are sane.

– [Zubin] Who are not ideologues, who are looking at okay, what are the ins and outs of this? But they’re scared to say anything. So it’s funny. They’ll message us. “Oh, I heard you guys are doing a show. Can you say this and this, and this.”

– [Marty] All right, yeah.

– [Zubin] The things that we all believe. But like if I say it, I get fired or I don’t get promoted or I get somehow blackballed and it’s absolutely true.

– [Vinay] I’ve had like pediatric infectious disease experts. They like email me and they’re like, people say there are zero downsides to masking a two year-old. Can you point out that, that is obviously on the face of it ludicrous?

– [Marty] Oh yes it’s true.

– [Vinay] Of course, it’s obviously on the face of it a ludicrous proposition. There must be some downside.

– [Marty] Listen to these doctors and speech pathologists and high school guidance counselors, I mean, there’s a private school in this area where my friend was saying that the majority of kids in that school is, I think about 11 year old aged students, majority engaged in so-called cutting.

– [Zubin] Yeah, self-harm.

– [Marty] Self-harm.

– [zubin] Yeah.

– [Marty] Majority of students, that is a major flag.

– [Zubin] I’m not, I’m surprised, not a 100% in this area. Like when I moved back here, I felt it. You feel it energetically like there is a kind of insanity of how we’re treating kids in school and their expectations and then, and I think the COVID thing has made it even worse. So my kid was gonna have a play day. Right, my youngest.

– [Marty] At the museum?

– [Zubin] Yeah, at the museum. having this tears, daddy, what do you mean.

– [Vinay] Daddy they have a poster of you there now.

– [Zubin] Do not allow entrance to him or.

– [Vinay] They’re throwing dust at it Daddy.

– [Marty] I’ll send them tweet so they change their policy on their website before she gets there.

– [Vinay] She says, no Damania.

– [Zubin] This no Damania is allowed, of any kind. I’m like, there’s like at least three more Damania’s in the world, but they’re gonna have a play day. Three kids wanted to come to our house. One kid’s parents said, every person in the house and every child must be masked at all times and my wife, who’s not normally like this, was like, “Well, then that child can burn and hell.” And then, basically, no one comes to our house and tells us what, but the thing is, but what conditioning have we made that the safetism is such that at a point.

– [Vinay] I mean, this cannot.

– [Zubin] Where the school doesn’t require masks.

– [Vinay] I mean, this is the prob, I mean, kids have suffered so much holds on.

– [Zubin] Oh, it’s true.

– [Vinay] I mean, and it’s adult anxiety. It’s an adult, I mean, I hate, it’s almost a mental illness in adults, the risk, they have blown out of proportion, the risk to children. They don’t realize that there are risks for depriving, an adolescent, particularly of these ages, really incredibly important development to ages for relationships with the opposite sex for people with romantic interests, perhaps even the same sex for maturing in terms of your sexuality, your growths.

– [Marty] Spouse are these ages.

– [Vinay] Your social, your friends, all these things are so vital in this age group. And we’ve deprived them of all this for risk that is orders of magnitude lower than risks of.

– [Marty] We don’t even know.

– [Vinay] Utmost real fatality.

– [Marty] If any healthy child has ever died of COVID. Right, I mean, it may be.

– [Vinay] I mean, I think.

– [Marty] A couple, or 10, or 20, or 50.

– [Vinay] Global IFFR data would probably put it at four, three to four per 100,000. I’m talking about the Lancet people that came out. And look, I know there’s some limitations to that. So that’s not your point, because it really doesn’t separate comorbidity from like the healthy.

– [Marty] That’s key. That’s the key.

– [Vinay] No, that’s survey.

– [Zubin] With COVID or without COVID.

– [Vinay] But let’s just say that the raw number, I mean that they’re giving five to 11, I read it. I think it’s about four, three to four per 100,000 global IFFR. That’s low, you know, I mean, kids take risks when they like ride on a motorcycle, ride on a bicycle-

– [Marty] Swim in a pool.

– [Vinay] Swim in a pool-

– [Marty] Much higher risk than COVID.

– [Vinay] Much higher risk. Go on long travel, ride with a 16 year-old driver, late at night, you know, particularly male 16 year-old driver. When they’re, you know, that’s a very high risk. I mean, that’s a high risk situation. You cannot bubble wrap someone growing up in this world. You’re not doing them any favors. You’re actually weakening them for the challenges of life, which are often.

– [Zubin] Extensive.

– [Vinay] Extensive.

– [Zubin] And require a certain anti-fragility which is not good for children.

– [Vinay] Yes, an anti-fragility, yeah. A certain resilience.

– [Zubin] Of course, yeah.

– [Vinay] I mean, what about, this is as kind of off this, but we, I know we all agree on this which is like, I am always impressed when I meet someone these days who tell me that they like, that their goal is to like, make themselves better at something to really master something. They’re willing to work hard to do it. Those were like important traits and that to overcome adversity. These are really important traits.

– [Zubin] So, again just cycle.

– [Vinay] Not to throw your hands up.

– [Zubin] Just like Daniel Schmachtenberger, we talked on our show about this concept of hormesis.

– [Vinay] Hormesis.

– [Zubin] Which is stressing a system and the system becomes stronger from the stress. That’s anti-fragility hormesis. So exercises like that. It sucks when you’re doing it. You’re punishing yourself through it and you come out better for it or some kinds of, even spiritual type ordeals, like the old sweat lodges and stuff where you suffer through this like, it’s 120 degree heat. And you come out just like awake.

– [Vinay] Yeah.

– [Zubin] Like that kind of thing where you don’t break somebody it’s within the tolerances, that’s children need that. Adults could use a little of that, but we’ve generated this like very fragile generation and I think the masking thing is another nail in that coffin.

– [Vinay] Yes, and it’s a V, a constant visual reminder-

– [Zubin] Yeah, of course.

– [Zubin] Of one very low probability risk for the child.

– [Marty] Yes.

– [Vinay] At ignoring all the other higher probability risks.

– [Marty] Right.

– [Vinay] I feel bad for this poor kid whose parents say, “You can only go over to that house, if you all mask.” And by the way, are they not allowed to drink water? What are they gonna do, if they drink water?

– [Zubin] So the heart break,

– [Marty] Or take nap.

– [Zubin] The heart break, part about this is then. So we tell our daughter, we’re like, well, you’re gonna have to tell her that, there’s gonna be people in the house, like the parents and stuff. And the sister that’s not masked. If the kids wanna mask, that’s fine, but there’s gonna be unmasked people. My little daughter has to tell this girl that and she’s gotta go to her parents. The parents are gonna be like, “Well, then you can’t go.” And there’s gonna be all this drama. Over what?

– [Vinay] Over what?

– [Zubin] Over a total misapprehension in the first.

– [Vinay] And they’re all vaccinated?

– [Zubin] Triple vaccinated. No, not the kids. And they’re double vaccinated.

– [Vinay] At least double that

– [Zubin] Double vaccinated. Yeah.

– [Marty] Yeah.

– [Vinay] I mean, who thought we would be having this conversation one year after a mass vaccination campaign?

– [Zubin] Yeah.

– [Vinay] Will we be having it five years from now?

– [Marty] It actually go away.

– [Vinay] 10 years from now.

– [Marty] We’re not gonna have it in the fall for sure. ‘Cause we gonna see-

– [Vinay] The cases are gonna, I know.

– [Marty] Cases are down…

– [Zubin] Already the sewers are blowing up with COVID.

– [Marty] I mean, at this point.

– [Vinay] That’s where I look, every morning I’m in there with the effluent.

– [Zubin] You know what? It’s a log fold increase in the logs. You know what I’m saying?

– [Marty] In the logs.

– [Zubin] What’s the P value.

– [Vinay] But you know I did-

– [Zubin] You see what I did that. Me did it.

– [Vinay] Basically, P value. It’s significant.

– [Vinay] I saw somebody tweet a thread about how you can wear an N-95 and actually drink a full bottle of water and the thread, the thread involved deep breaths through the N-95, holding your glottis in place, pulling the N-95 and drinking, then putting the mask on, and exhaling briskly, to get the air out and then to repeat this and with three or four good draws through an N-95 you’re capable of drinking a bottle of water. I’ve got, I’ve got that bit, I just gotta drink.

– [Marty] I gotta drink I was like-

– [Vinay] I had a jeans-

– [Marty] Causative.

– [Zubin] I like causative, and now I’m totally safe. Like, nothing can hurt me except for opportunistic infection and stoma breakdown.

– [Marty] It’s just like the Palo Alto, Stanford students. These are smart individuals. 47% wearing masks.

– [Vinay] But you know, you saw this David Leonhart article where he looked at like attitudes to COVID by political party.

– [Marty] Mm.

– [Zubin] Yeah.

– [Vinay] And the reason I think we forced the colleges, like, you know, I’ve always wondered like, you know, I was like, I always wondered about these college students in a number of ways. One, this is a tangential, but one, I do wonder when, at these days I always see that there’s like some controversial speaker on a campus. And it’s usually, you know, different ranges of controversy from non-controversial to actually controversial. And the students are always up in arms. And I think back when I was a college student, I was like, Marty, maybe I was just like a bad student. But I don’t know a single person who spoke on, like I barely, I don’t know anyone came on that campus.

– [Zubin] I was like, “People spoke at Berkeley when I was?”

– [Vinay] I was like, I was just thinking about the next weekend and then, you know, the basketball game. I was like, all right, I didn’t have time to be protesting. So that’s what.

– [Zubin] I had test a study for it.

– [Vinay] They lean extremely politically left-

– [Zubin] They called me nut.

– [Vinay] And politicly left-

– [Marty] I was studying.

– [Vinay] People have disproportionate, disproportionate fear of COVID even after three vaccines. And I think the reality that people have to accept, I don’t know it’s gonna hurt, is that no matter how many boosters you get in your arm, you will get COVID eventually, you have a breakthrough. You’re gonna be okay.

– [Zubin] You’re gonna be okay.

– [Vinay] You’re gonna be okay. You’re healthy, you’re young, you’re gonna be okay.

– [Marty] Yeah, you’re healthy. It’s not zero, yeah.

– [Vinay] It’s not zero. But if you’re older had comorbidities, then you know, there’s a risk. But the choice is, what’d you gonna do, hide out forever?

– [Marty] And just to clarify, I wasn’t suggesting that the total death count in healthy children worldwide is zero. I’m trying to suggest that we don’t even have this data.

– [Zubin] We don’t have the data, right, yeah.

– [Vinay] We don’t even know this.

– [Marty] And so how can we be so sure, if we actually should know this.

– [Vinay] Well, they have counting problems.

– [Marty] They have significant, there’s a significant math problem.

– [Zubin] You know what? I know who the new COVID zero is, the count from Sesame street. Could you imagine.

– [Marty] The count.

– [Zubin] How much COVID is in the sewer, one long filled with COVID.

– [Marty] I saw that, they misrepresented the wastewater data. Did you see that report?

– [Zubin] Did they?

– [Marty] Yeah. They misrepresented the wastewater data on the CDC website.

– [Vinay] Accidentally?

– [Marty] It was probably, you know, a lot of this stuff is just.

– [Zubin] It’s new to the wastewater data, they’re still to figure it out.

– [Vinay] I mean, to be fair, it was shitty data.

– [Marty] Hey, it may be shitty to you, but it’s bread and butter to me. And we say that in colorectal surgery.

– [Zubin] Of course.

– [Vinay] They also withheld data. Remember there’s the New York Times story by Apoorva Mandavilli about how the CDC.

– [Marty] Shocking, she wrote it. I saw that.

– [Vinay] Yes I know that.

– [Marty] They’re not showing the hospitalization data in people under 50 who are boosted.

– [Vinay] Yes, of course. But here’s the thing, why are, is the data, it’s the agency that’s proven themselves incompetent to data analysis not sharing the data for others competent people, they don’t wanna share.

– [Marty] They don’t want, ’cause obviously it’s doesn’t support the narrative, right? Because other data is telling us.

– [Vinay] And she’s the New York Times reporter, of Lord Zero-COVID.

– [Zubin] Yes, you’re right.

– [Vinay] She’s been on that Lord Zero-COVID beat for a long time.

– [Marty] She’s been driving me crazy.

– [Vinay] She might as well padlock the doors of the schools herself with the way she wrote those news stories in the spring.

– [Marty] Dangling fear and sourcing the same doctors and taking whatever government.

– [Vinay] The same doctors from Twitter.

– [Marty] Same Twitter and,

– [Vinay] Yeah, of course. That’s what you gotta find the fear of the fear for.

– [Marty] Yeah, it was like weapons of mass destruction in Iraq.

– [Vinay] It is, it’s kind of look like that.

– [Marty] The government fed them stuff and they were like, “Oh, thank you so much.” And they just parroted whenever the government said.

– [Vinay] And he’s sell right with that analogy. ’cause I think like it’s gonna age like weapons of mass destruction, people are gonna go back and pull those New York Times stories where they like cover some family scared of going to school and like the huge amount of societal damage that story did. It’s gonna look like the WMD stories, I think.

– [Zubin] And again, it goes back to this like, how to lie with facts.

– [Vinay] Yeah, how to lie with facts. Miss that part.

– [Zubin] So shit, you can cherry pick-

– [Vinay] Cherry picks.

– [Zubin] Your own data.

– [Vinay] Yeah.

– [Marty] Yes.

– [Zubin] Like if CDC is well you know what? That data we did that but.

– [Marty] Yeah, they did not list hospitalization rates and boosted Americans under 50, but they listed it for people over 50. Did they only collect data in people over 50, no. All that data gets channeled into them for all age groups. So something fishy is happening. Now, in the group of 50 to 65, the difference in hospitalizations among those boosted and unboosted, that is just all the primary vaccine series, was the difference between four and one per million. Who were those three people? Probably immunosuppressed. We know immunosuppression is roughly 3% of the population of adults. And so that’s probably accounts for that tiny difference. And that was in people 50 to 65. And yet the emphatic nature by which we have this absolutism, right? That even if you’ve had COVID, you have to get a booster, that’s dishonesty. People are seeing through it.

– [Vinay] Yes.

– [Marty] People feel that they’ve been lied to for two years, and in some cases they’re right. Did you hear that the elites, the people that are making all the decisions, Collins and Fauci, they had basically like a straw poll of a couple of their friends that they summoned.

– [Vinay] You heard that on his show. That was from his show. He had offered to his.

– [Zubin] His office.

– [Marty] Oh I actually, I knew about it before.

– [Zubin] Oh yeah.

– [Vinay] You knew about it before?

– [Marty] Yeah, but I was,

– [Vinay] You just spilled the beans Marty.

– [Zubin] Marty is a political scientist.

– [Marty] Well, I had swore that I wouldn’t tell anyone ’cause the source.

– [Zubin] Yeah.

– [Marty] And so now it’s basically out there.

– [Vinay] Yeah, it’s out there, I discovered that.

– [Marty] They did the straw poll. You see putting a massive decision like that in front of…

– [Vinay] Like five people.

– [Marty] Five people who are lets to be honest. They’re politically loyal.

– [Vinay] Of course.

– [Marty] Scientists.

– [Vinay] Otherwise they wouldn’t be on the committee.

– [Marty] Otherwise they wouldn’t be on the committee.

– [Vinay] But that’s a huge problem because like I got.

– [Marty] Did they invite you to be on the committee?

– [Vinay] I’m a politically loyal because I’m a data first person. But you know, Marty,

– [Marty] You don’t just sign up for the program? A 100% of whatever one party believes?

– [Vinay] No. ‘Cause I’m not.

– [Marty] You think for yourself?

– [Vinay] Yeah, I’m not-

– [Marty] Oh my gosh!

– [Vinay] Crazy person.

– [Zubin] Who are you?

– [Marty] I don’t know what to do with you. Are you one us

– [Zubin] Hey man, get off my damn show. or one of them?

– [Vinay] But you know, Marty,

– [Marty] Come join me-

– [Vinay] I think I’m, they’re like,

– [Marty] Off middle party.

– [Zubin] Yeah, I’m sure, he should do that.

– [Vinay] If you were really running the show, they should wanna have like a red team, a team that opposes them. They should have a bunch of scientists who disagree with them, come to these meetings and be look, if we’re so confident that our proclamations are right, let’s get Marty, let’s get VP, let’s get ZD. Let’s get all these people who are like disagree, that push us.

– [Marty] Yeah.

– [Vinay] And that’s what good companies do. Good companies always have red teams pushing back.

– [Marty] That was Obama’s team.

– [Zubin] And they’re still manning those arguments right now.

– [Marty] Remember Obama’s team of rivals concept.

– [Zubin] Yeah.

– [Marty] Remember that was, there’s value to that, right? And especially when it comes to science, I mean.

– [Vinay] It’s now, it’s team of people who praise me on Twitter. That’s it’s team of people who praise me.

– [Zubin] Yeah, you could hear, you know, the third way to lie with data on fact checking stuff is.

– [Marty] Facts checking?

– [Zubin] Emotional framing. So if you take a study and you’re like this is def, like you frame it up front like, groundbreaking data out of, you know, New York the vaccine is crushing it in little kids and then it’s like 13% efficacy after all.

– [Vinay] Yeah.

– [Marty] I’m gonna fact check that by asking my friend on Twitter.

– [Vinay] By friend and the friend praised him so hard on Twitter they were one day ahead of the Wastewater data. They’re one day ahead of their Wastewater, they even better than the Wastewater data.

– [Marty] Did I tell you ever.

– [Vinay] Oh, they praise themselves good.

– [Marty] Did I ever tell you about this thing that was going around in some DC cycles of federal contractors, I have a friend who’s close to this, around aircraft carriers? So how many aircraft carriers does the United States have?

– [Vinay] I think 50.

– [Zubin] Around 6.

– [Marty] 11. And the country that.

– [Zubin] If there was a price he’s right, I would’ve won.

– [Vinay] Wisdom of cash.

– [Zubin] You have a debt.

– [Marty] The country that has the next most? There’s two, that have two.

– [Zubin] Oh.

– [Marty] And that’s the UK and China.

– [Zubin] China, yeah.

– [Marty] So we have 11 and it’s always a subject of debate on Capitol Hill when it comes to the federal appropriations for the military is, do we need all 11, right? That’s a topic that gets kicked around a lot.

– [Zubin] Right.

– [Marty] And so we have have 11. One is always in repair or being serviced, and one is always under construction and it takes about like 10 years to build.

– [Zubin] Oh, wow.

– [Marty] One of these aircraft carriers, they’re all nuclear powered.

– [Zubin] Oh.

– [Vinay] I see.

– [Marty] So the company that makes this, there’s one company that makes it. Okay, and the name is Huntington Ingalls. And they’re publicly traded and they’re big company and they’re probably gonna, you know, their media relations is gonna have a heart attack when they see this. But they basically have all these welders and yard workers that are working on the aircraft carrier. And their vaccination rates were low and they encouraged vaccination, but if they had to fire as a federal contractor, people are not vaccinated, you would fire half the workforce or something like that.

– [Vinay] Wow, they had.

– [Marty] So they basically said, told the federal government, when the White House called, you want us to fire workers who are not vaccinated, go pound sand, we’re not gonna do it.

– [Vinay] Wow.

– [Marty] If you find yourself another company to build your and service aircraft carriers-

– [Zubin] Oh, monopoly powered.

– [Marty] Go ahead.

– [Vinay] Wow.

– [Marty] But you know, it’s halfway built in the bay, you know?

– [Zubin] Wow.

– [Marty] So the White House couldn’t do anything. But then all the other federal workers and I’m not, you know, endorsing, I’m just describing what happened. I’m not supporting what Huntington Ingalls did, but they said, “You know, go pound sand. We’re not gonna do this.” All the other federal contractors started losing workers. ’cause when they announced or heard about the federal vaccine mandate, the workers said, we’re gonna go to Huntington Ingalls, who basically are pretty openly saying, “We’re not going to enforce this.” And so then all the other federal contractors were like, “We’re not gonna enforce this either, but we have to say that we’re gonna do this.” So basically the whole thing was a hoax, right?

– [Zubin] Oh, Wow.

– [Marty] Really nobody enforced this, the few places,

– [Vinay] But these mandates, this is another thing that.

– [Marty] It hardened people.

– [Vinay] She got, she and Joe got wrong. Which was, I think, if you look at, sometimes they will judge the mandate. Like if you look at vaccination over time, it’s going up, up, up. Then they drop the mandate and it goes up, up, up. And then they say anybody who got vaccinated after the mandate was because of the mandate.

– [Marty] Yeah.

– [Vinay] Post hot air, go propter hawk, which is a fallacy, because a lot of those people are gonna get vaccinated, anyway. It’s what happened to the change. And if you really look at it, I mean, I think it’s hard to believe it did more than a very few percentage point change. It targeted 18 to 40, 18 to 50, 18 to 60, not 65 and up where you needed to focus.

– [Marty] You’re right, that’s right.

– [Vinay] And then the political anger, backlash from this mandate, it’s not worth it.

– [Marty] It created never VAXes.

– [Zubin] Never VAXes.

– [Vinay] It created never VAX It created them.

– [Marty] It created never VAX.

– [Zubin] And it empowered idiots like Malone McCullough who are out there spouting insane talk and it empowered them. They’re like the nasal they’re like, because the government is idiotic.

– [Vinay] You always empower people who are wrong when you have a credibility vacuum and when you overplay your hand and there’s only so much political capital you have and it was misused, I think.

– [Zubin] You know, just one last,

– [Vinay] Marty got some to say.

– [Zubin] Marty got something.

– [Marty] I got juicy.

– [Vinay] Go ahead.

– [Zubin] Oh, I’ll give you something on juicy, just to go back to Hong Kong.

– [Vinay] Oh yes.

– [Zubin] Hong Kong has the highest death rate in the world from Omicron and BA.2 the squeal. And the reason is their 70 and overs are vaccine hesitant.

– [Vinay] Yeah, true.

– [Zubin] Beyond vaccine hesitant only 37% of them are vaccinated. They had Lord Zero-COVID. They were worshiping for however long, two years. They kept the cases low. But then when the shit hit the fan, the most vulnerable people were not vaccinated. That is a great caution, a terrible cautionary tale. Of who you should focus your resources on.

– [Vinay] Yeah, who you should focus on.

– [Zubin] And how you can get it wrong. And they did it. And now they have bodies pulling up and the morgues overflowing and their healthcare system overwhelmed, because they did the wrong thing. Well, we just got lucky that that didn’t happen to us with all the misappropriated resources to boosting a 12 year old, say go to a museum.

– [Vinay] And Boosting a 20 year old, so that they can attend Princeton University.

– [Zubin] Princeton University.

– [Vinay] A place where, of knowledge.

– [Marty] And all of these, sort of education, health disparities experts, who are shutting this one out, they’re just shutting out the pandemic. They can watch Princeton University, which I think 1% of their graduate students, are African-American, in a community where there’s a significant African-American population. And Princeton during the testing shortage where it was, remember a few months ago, very hard to get testing. The students are getting tested routinely twice a week and.

– [Vinay] They’re sucking up all the tests.

– [Marty] Sucking up all the tests from people in the population. Many of whom are vulnerable and disproportionately represented you know, in the you know, the majority individuals getting tested in the Princeton community are, they’re not representative of the United States or the local community, so they’re sucking up all the tests. This is a massive disparity-

– [Vinay] Of course, yeah.

– [Marty] A socioeconomic and racial disparity. And all of these experts in this topic, and there’s a lot of them just shut this out.

– [Vinay] Well, they shut out school closure, which was the greatest-

– [Zubin] Equity-

– [Vinay] Failure equity issue in their quarter century. But so now they’re sending another one out. You know, this whole asymptomatic testing of young, healthy vaccinated people, it’s the dumbest thing, are you, like you Scandinavian countries are laughing at us. They’ve all stopped this. They realize that these are scarce tests. You need to test people when they present to healthcare systems or are hospitalized, you need to present test people, presume, you could test people around nursing homes where they’re vulnerable, but testing asymptomatic college kids, it’s the dumbest policy on earth.

– [Zubin] Stanford just stopped their weekly testing of all stuff.

– [Marty] It’s COVID Zero. It’s, lower.

– [Vinay] Lower COVID-.

– [Zubin] Lower COVID, lower Corona

– [Vinay] Lower corona preyed and-

– [Marty] it to zero on the lowest risk population on planet earth, which are college students.

– [Vinay] And right next to the Lord Corona idol, alt is a Fauci doll, I’m just saying.

– [Zubin] With a bunch of vaccine needles stuck in and outside like a voodoo doll.

– [Vinay] You have to put in your Twitter bio Ukrainian flag, and then three vaccine needles. If you wanna prove you’re a good person.

– [Zubin] Yeah, exactly.

– [Vinay] You could only put two and then you have to have a Cali Academy taking up shit on you.

– [Zubin] Oh yeah, that’s a good, that’s good. That’s my special icon.

– [Vinay] Two in the calendar–

– [Zubin] I’m the only person in history to ever be banned from the California Academy of sciences. Banned.

– [Vinay] ] But you know.

– [Zubin] For ideological disagreement.

– [Vinay] You’re talking their booster policy, here’s the booster policy. Once you get boosted, then immediately the day after you can go, ’cause you know, it works immediately.

– [Marty] Oh, yeah. That day after the immune response.

– [Zubin] Make sense,

– [Vinay] It’s a first immune response.

– [Marty] It’s accelerated, they’re only-

– [Vinay] It’s a really first.

– [Zubin] But if you’re not boosted, you have to be tested that day.

– [Vinay] Yeah, of course.

– [Zubin] And so it’s like, hmm.

– [Vinay] But if you only had one dose, then you can’t go at all.

– [Zubin] Yeah.

– [Vinay] Because obviously, then the test doesn’t work anymore.

– [Zubin] Even if you had Omicron twice.

– [Vinay] Yes, no, of course. Or Delta and Omicron.

– [Zubin] Delta and Omicron.

– [Vinay] No, you’re not acceptable. You’re unpure, impure.

– [Zubin] You’re…

– [Vinay] Your thoughts are impure.

– [Zubin] Your thoughts are impure.

– [Marty] It’s a thought crime.

– [Zubin] It’s a thought crime.

– [Marty] It’s a thought, you cannot believe that. It’s a thought crime.

– [Vinay] And you know what? If you’re thinking about not getting the fourth dose, you’re not welcome.

– [Zubin] Oh my gosh.

– [Vinay] You gotta commit, you have to commit to the fourth dose. Probably no-

– [Zubin] You know, now they have brain scan, they’re working on brain scanning technology.

– [Vinay] Yeah, of course.

– [Zubin] They can read your mind. If you walk through a scanner and it’s like, “Are you really thinking the fourth dose is not a good idea. Get outta here.”

– [Marty] Well, it’s like.

– [Zubin] Impure.

– [Vinay] You know, Bourla only made 24 million last year in bonus payments?

– [Marty] Billions.

– [Vinay] Bill, no million Bourla.

– Bourla himself.

– [Vinay] The company made like I think 30 billion.

– [Zubin] Yeah.

– [Vinay] But Bourla himself got 24. So by the way.

– [Marty] That’s it.

– [Zubin] I know, right?

– [Vinay] But.

– [Zubin] I’m a little bit.

– [Vinay] you’re gonna need to take a few more boosters if you know what’s coming.

– [Zubin] Yeah.

– [Marty] I wanna get boosted every Monday morning for the shareholders sake.

– [Vinay] You were there for the shareholders meeting.

– [Marty] Yeah, I mean, I’m just trying to get to one B. I have very modest financial lost.

– [Zubin] One B.

– [Vinay] One B, oh yes.

– [Zubin] You want the card with the doors that go like this.

– [Marty] Very modest financial goals.

– [Zubin] I actually sorted an IVMRNA infusion. So it’s like a cause.

– [Vinay] Just wanted. Yeah, why have the gap?

– [Zubin] Right.

– [Vinay] It’s a bowl list, you need it continue.

– [Zubin] Booster. That’s for losers.

– [Vinay] Yeah, I know.

– [Zubin] This is a constant immunogenic,

– [Vinay] He keeps the pump on his hip.

– [Zubin] Yeah, I do.

– [Vinay] It’s constantly upon it.

– [Zubin] Yeah, and if you see me just suddenly break out into auto carrier.

– [Vinay] But you’re not allowed to change the construct. You gotta go with the ancestral strength.

– [Zubin] No, no, ancestral strength.

– [Vinay] The ancestral strength.

– [Zubin] You change the concept, who does that?

– [Vinay] The virus mutates. But the medicine is the same.

– [Zubin] Medicine’s gotta the same.

– [Vinay] The medicine is the same. It’s gotta be the same medicine.

– [Marty] So in Washington state, they had this vaccine mandate for snow, for city, for state workers. But it didn’t, wasn’t no, didn’t apply to city workers. So the snowstorm hit in January, and the city workers, state workers who drive the snow plows a lot of them lost their job because they were not vaccinated. They’re driving a snow plow truck by themselves.

– [Zubin] Non-essential job.

– [Marty] Right?

– [Zubin] Yeah.

– [Vinay] No, but a job that’s a high super spread.

– [Zubin] Higher super spread risk.

– [Vinay] Yeah, you’re right.

– [Marty] Super spreader.

– [Vinay] You’re out there alone in a snowy road.

– [Zubin] Right, I mean-

– [Vinay] Who knows, who may come look at me.

– [Zubin] They are deer.

– [Vinay] Oh, they all have movements.

– [Zubin] And they’re, yeah.

– [Marty] But they all had it. They’ve got natural immunity now, that’s zero

– [Zubin] That’s true.

– [Marty] Zero.

– [Zubin] We’re trying to get to deer zero. I was talking about.

– [Marty] Deer zero.

– [Zubin] This with Vinay.

– [Vinay] There’s only four doses after they have, you Know? They only wanna get

– [Marty] Yeah, they haven’t gotten, they’re unboosted deer.

– [Vinay] Unboosted deer.

– [Zubin] Totally.

– [Marty] Yeah, be careful.

– [Vinay] Okay so these.

– [Marty] I saw some unboosted deer once that’s good that scared the crap out of me. Okay.

– [Zubin] I understand most of the deer are dying with COVID they’re not averts.

– [Marty] Oh okay.

– [Zubin] So it’s probably okay.

– [Vinay] CDCs keeping count-

– [Marty] The Veterinary CDC the VCDC-

– [Zubin] The VCDC?

– [Marty] Yeah.

– [Vinay] The VCDC.

– [Zubin] That should be a thing.

– [Marty] Yeah, they like the job.

– [Zubin] They deal with Pangolins from China that are bringing in shortest breed.

– [Vinay] Whoever Wants to run the VCDC just put a few tweets out there. They pick you soon.

– [Zubin] Really love what Joe Biden, is doing about Pangolin.

– [Vinay] So here’s the.

– [Marty] Alright, you guys.

– [Vinay] There’s no snow truck drivers or what?

– [Marty] By the way you guys are weak on COVID. I believe bear and deer should be tested twice a week except, you know, like.

– [Zubin] You know?

– [Vinay] And you hold them down.

– [Zubin] Yeah, you go ahead and grab that deer. That deer, bear, “Hey, smokey, come over here. Listen, only you can prevent COVID.”

– [Marty] So the snowstorm hit and that they didn’t have any, you know, they didn’t have enough snowplow truck drivers.

– [Vinay] Sure, ’cause of the mandate.

– [Marty] So the main interstate that goes through this small town called Cantus, was basically unplowed and then it was paralyzed, you know?

– [Vinay] Wow.

– [Marty] So the city workers said, “Well, we’ll just plow it. We use that interstate.” And the state said, “No, you not allowed to plow it because you do not comply with the vaccine mandate.”

– [Zubin] Oh my gosh.

– [Marty] And then they had.

– [Vinay] A car accident.

– [Marty] Well, they had a similar mandate for healthcare workers. Now, I personally feel like if you wanna have an immunity requirement for patient facing soft-care workers.

– [Vinay] That makes sense.

– [Marty] That makes sense. But let’s make it an immunity requirement,

– [Vinay] So you can test.

– [Zubin] Data.

– [Marty] Let’s just say.

– [Vinay] Ten bodies and you’re good.

– [Zubin] Well, right.

– [Marty] Yeah, I mean if-

– [Vinay] Yeah, I like that. I like that, Marty. That’s a compromise.

– [Marty] Well, it’s ironic because when we, now that the data has come out and I just wrote this piece in the Wall Street Journal a few weeks ago. And the data now on natural immunity that is, it’s was 2.8 times more effective in preventing hospitalizations during Delta, than vaccinated immunity. Okay, that was natural immunity from any point. So a lot of that was longer immunity than the more recent vaccine immunity which as you know, gives you this antibody sugar high for a little bit, that gives you a little more protection that wanes over time. But, so even with that bias of comparing it with more recent vaccinations than long natural immunity, natural immunity is still almost three times more protective against hospitalization. Now neither is perfect. But those, when we fire those with natural immunity for not having the vaccine. We fired those least likely, to spread the infection at the workplace, right?

– [Zubin] Totally virtue signaling, yeah.

– [Marty] So, Multi-Care, which is also in Washington State, and I put this in the Wall Street Journal piece, I think it was titled, “The High Cost of Disparaging Natural Immunity.” And Multi-Care, which is this hospital system that has at least eight hospitals Olympus throughout Washington state. And so they had, they had to comply with this vaccine mandate, so they fired all these nurses. 55 total people were fired, and then probably about, I hear 200 people quit in the days leading up to this hard deadline. So they lost about 250 healthcare workers, okay. With the mandate. Now most had natural immunity they’ve been around COVID a lot the patient facing staff. So then Omicron hits weeks later and they have a lot of patients coming in, more work and staff are calling out with COVID, they’re testing positive, so they’re basically in like battlefield war conditions. And so the hospital tells people who are sick with COVID.

– [Vinay] Come in.

– [Marty] Come in, even though you have COVID.

– [Vinay] Yes.

– [Marty] Even if you have symptoms.

– [Vinay] Yes, yes.

– [Zubin] Yes.

– [Marty] As long as the symptoms not fever.

– [Vinay] Yes, yes.

– [Marty] And we need you to work. And then they send a memo to the managers in the hospital saying, “Please, the COVID positive staff that are coming into work right now, please try to assign them to the COVID patients.” or at whatever it takes keep them away from.

– [Vinay] Or make sure, you’re marching Delta, Delta, Omicron, Omicron. No, that’s not it. But you know what? You know what I think you’re pointing out Marty, this, oh my God, what a story? It’s so stupid. It makes my head hurt.

– [Zubin] Great.

– [Vinay] Whenever I talk to people who are like supporters of, you know, we should fire the healthcare worker who had COVID recovered, if they don’t wanna get vaccinated, they say things look, if they willing to do it to benefit their patients, we don’t want them there, or, you know, they need to be, if you’re really committed in this field, you’re willing to do it. You know, you have a more, these sort of moralistic terms. And I was like, moralistic terms will lead you a stray often in policy. Policy is about having some sense.

– [Zubin] Yeah.

– [Vinay] And the sense is, the facts on the ground are, they’ve had COVID recovered. They’re likelihood to be in the hospitals with COVID, which is much less than somebody just had a vaccine. They are very likely to endure a re-exposure. They may not even get sick, if they do get sick and it’s gonna be milder and we’re all gonna get COVID many times in our lives. We can ostracize these people. We’ll just get animosity. We might find ourselves in a pinch and we wish we had them. And we might have to do stupid things like have people actively with COVID come to work, because we kicked out too many people.

– [Marty] Really it’s stupid.

– [Vinay] So stupid. But a policy person will see all these things and then think on balance, in a perfect world, everyone will do everything, we always tell them. It’s not a perfect world, we have to make our bed and lie in it. And best thing to do is to keep people who’ve had COVID recover. They don’t wanna get vaccine, that’s okay. If they get one dose, that’s great. If they get two doses, that’s fine too. Let’s just be a little more flexible little bit. But we’re not in that world we’re in.

– [Marty] Come to rural America.

– [Vinay] Yeah, I know.

– [Zubin] Yeah.

– [Vinay] Go to, get outta your Twitter bubble.

– [Zubin] Yeah.

– [Vinay] But the other things, and then all the people commenting or people who are like, you know, these armchair Twitter experts and they’re in their social media zone, surrounded by political, political friends who are not representative of average America.

– [Marty] By coastal elite.

– [Vinay] By coastal elite.

– [Zubin] I’m by coastal, if you consider the Mississippi river one at the Coast.

– [Marty] You’re just not elite.

– [Zubin] I’m elite.

– [Marty] Mississippi.

– [Vinay] Feel like, why my Uber eats late.

– [Marty] I can’t stop.

– [Vinay] Let me tweet.

– [Marty] I can’t stop.

– [Vinay] At Uber eats, why are you late?

– [Marty] Uber eats.

– [Zubin] Where’s my Instacart delivery of fresh honey-crisp organic apples?

– [Marty] Do you guys get the same?

– [Vinay] And they don’t wanna go back to the office. I mean, that’s the new thing now. We’re one year after, they’re like, it’s only been a year I’ve been back seeing.

– [Zubin] Yeah, I don’t wanna go back.

– [Vinay] I don’t go back.

– [Marty] Do you get this thing when–

– [Vinay] But you wanna go to night club

– [Marty] show to a restaurant? And if I’m not wearing like a tuxedo, when I come to a restaurant, they immediately go DoorDash. Now, I’m here that you said that.

– [Zubin] I have never said.

– [Marty] Do you get that?

– [Zubin] It’s because we’re brown.

– [Marty] Well?

– [Zubin] Yeah.

– [Marty] I don’t know. I don’t see it.

– [Vinay] You just wear the drivers cap because…

– [Zubin] You know, so, well, what’s interesting though-

– [Vinay] DoorDash.

– [Marty] DoorDash.

– [Zubin] The think about the Twitter armchair people, for some reason Twitter, you know I hate Twitter. You guys know this is, this is a fact I hate it.

– [Vinay] I have. So I’ve heard.

– [Zubin] So I decide.

– [Marty] Can I see your boarding pass is the other one?

– [Vinay] Oh, yeah.

– [Zubin] Can I see your boarding?

– [Marty] You’re sitting in first class. Can I see your boarding pass? All right, sorry.

– [Zubin] It doesn’t help that, you’re ululating in the seat, you know.

– [Vinay] Well, I get that a lot. They’re like, “Oh, the machine has randomly selected you.”

– [Zubin] Uh huh.

– [Vinay] I just got recent.

– [Marty] Oh, yeah. Randomly select brown people.

– [Vinay] The machine has randomly selected for screening. And it really randomly selects me, if I haven’t shaved in a few days.

– [Zubin] That’s right.

– [Vinay] How does it randomly know that, to be fair?

– [Zubin] I need like Vin Diesel’s fake ID. So I could just say, “Look, I’m a celebrity.” I’m Vin Diesel. Like you don’t really wanna–

– [Vinay] You watch Fast and the Furious 24?

– [Zubin] Right, that was me.

– [Vinay] 25.

– [Zubin] Yeah, that Twitter has this cache, that the press sites, what people say on Twitter.

– [Vinay] They do whole news stories about like.

– [Zubin] Whole story, on some random on Twitter. attacked such as, “Well blasted on Twitter,” was Ashish’s Job by.

– [Vinay] No, they did, by Wall Lead because in the New York Times story about Ashish.

– [Marty] They find his thread

– [Vinay] They did. It actually says,

– [Marty] That’s news.

– [Vinay] You know, it said in the New York Times story.

– [Zubin] I was just kidding.

– [Vinay] It said, Walid Jarad tweeted people who immediately.

– [Marty] Oh my God.

– [Vinay] retweet what the president or people who do Op-eds two minutes after the president made announcement are not impartial experts. His tweet, is in the New York Times story. This is like the new journalism. It’s like you open your feed, you find what people are saying.

– [Marty] Yeah.

– [Vinay] And you’re “Oh, ZDoggMD getting slammed over, over beef.

– [Zubin] Cuff.

– [Vinay] Blasted.

– [Marty] Blasted. Cuff oval, yeah.

– [Vinay] Museum Curve-Levelle, Renegade comic, YouTubers. As in contra, no.

– [Zubin] Controversial.

– [Vinay] Controversial.

– [Marty] Controversial.

– [Vinay] ZDoggMD. That’s contrarian physician.

– [Marty] That’s a weapon.

– [Vinay] Blasted over battle with the steamed children’s museum. That’s a, that’s weaponized term.

– [Vinay] That’s emotional framing.

– [Marty[ I mean that term is weaponized.

– [Zubin] Controversial.

– [Marty] Controversial, knew what? That was Albert Einstein.

– [Zubin] Yeah.

– [Marty] Was he mainstream established from scientific?

– [Vinay] Even asshole, the nuclear Newton.

– [Zubin] Ignatius I mean. We could talk about him for hours, washing the hands. He was renegade that guy. I dunno what kind of accent that is, but it wasn’t the obesity man.

– [Vinay] Because I think an Austrian.

– [Zubin] Austrian?

– [Vinay] Austrian maybe.

– [Zubin] Uh, a model for neutrality for Ukraine, look what happens.

– [Marty] Is that what you use when the TSA is checking you out to see if they wanna–

– [Zubin] I do like, no, I’m totally right. What brown person talk like this, no.

– [Vinay] And by the way, you’ve set up your lighting discriminatory against me with dark skin.

– [Zubin] Darker skin.

– [Vinay] Yeah.

– [Zubin] It’s all electric.

– [Vinay] I’m all washed out.

– [Zubin] But we attract, ’cause we’re both.

– [Vinay] I’m all washed out.

– [Zubin] On the same side. I’m not designed for this. I’m a like Vinay you’re gonna have to sit forward because you need more light. You know.

– [Marty] So, I can’t wait till we actually can start talking about healthcare again.

– [Vinay] Oh, what?

– [Marty] Because it’s a freaking, it was a mess before we started and it’s we forgot about it. We forgot about all of our issues. We forgot about all these issues in oncology, about drug pricing, about the cost of healthcare. So this just came out, Kaiser Family Foundation. The cost of health insurance in the United States from 2022, is $22,000-to-$200,021.

– [Vinay] Jesus Christ, really?

– [Zubin] I think that’s roughly what we’re spending for our family.

– [Marty] Is that right?

– [Zubin] Yeah.

– [Marty] And this myth that we you’ve gotta get rid of that, “Oh, I’m not paying my employer is paying.”

– [Zubin] Right.

– [Vinay] No, it’s stagnating your wages.

– [Zubin] It stagnating, your wages.

– [Marty] It comes out of the pool money of wages and benefits.

– [Vinay] Yeah, your wages. And that’s why, like so many of these societal problems where people are more and more polarized and angry with each other and all these things, it comes from the fact that like, you are living a worse life than your parents did at your age. In every metric. Home ownership, marriage, children.

– [Zubin] Life expectancy.

– [Vinay] Life expectancy is down for four years in a row. You only blame COVID for some of it. You gotta blame Purdue Pharmaceuticals for the rest of the cycles.

– [Marty] Oh, yes. They’re doing fine. So you may be interested in this. This came out two days before I gave that presidential address at the Gynecology Conference. A study from the American Cancer Society that half of cancer patients and survivors are in debt from their cancer care in the United States. Now the breakdown was even more interesting. 73% said they worried about the cost of care during their cancer care. They got other stuff to worry about.

– [Zubin] Yeah.

– [Vinay] You’re right.

– [Zubin] And I’m sure that stress, that cortisol really helps the cancer.

– [Marty] Yeah, seriously.

– [Zubin] To shrink.

– [Marty] I mean, we take people who have one medical condition and we give them three more. They come into the hospital,

– [Zubin] We flock them in hospitals.

– [Marty] We give them financial toxicity and stress, which we know, is associated with everything, including your immune response. And then we give them malnutrition, ’cause they’re often on NPO as we may wanna get a biopsy and you’re on a wait list.

– [Zubin] A wallet biopsy.

– [Marty] And we’re feeding them total dog food in the hospital.

– [Zubin] Yap. And then we wonder why their sugars are high. They’ve never had diabetes, right?

– [Marty] Yeah, right. And then we give them sleep deprivation, by checking.

– [Zubin] Yap. By checking their vitals key hour.

– [Vinay] Yeah, waking them up to draw their blood.

– [Marty] Sneaking needles in them at 3A.M.

– [Zubin] Q-day blood draws that we act on every single day.

– [Marty] And then we Wonder like, they’re not, they bounced back after the hospitalization. Isn’t that strange?

– [Zubin] Yeah, right. Or you see your patient in the grocery store and you’re who is this? This wonderful vibrant human. That isn’t a shriveled wreck that we put in the hospital and pathologize.

– [Vinay] Hospital is no place for a sick person.

– [Zubin] It really isn’t.

– [Vinay] It really isn’t.

– [Zubin] It really isn’t.

– [Marty] Well, that’s fine.

– [Zubin] I used to tell my patients as a hospitalist, my sole job is to keep you out the most dangerous place on earth, which is this. So I’m gonna try to do everything I can to keep you safe and sound and get you out here.

– [Marty] Fall risk, blood clot risk, infection risks.

– [Zubin] Fall risk, blood clot, high-ultragenic infection. You wanna give vecuronium.

– [Vinay] These are the key issues that have plague us for the last, you know.

– [Marty] In fact, no one’s talking about.

– [Vinay] Of course, because COVID is dumb.

– [Marty] There’s no specialty, when you start, when you come into medical school, say you’re a second year and you bump in, you’re rotate a little bit in the hospital at the end of your second year, what’s the one question everybody peppers this student?

– [Vinay] What’re you going into?

– [Marty] What organ are you going to focus on?

– [Zubin] Preppy dentist.

– [Marty] What is that?

– [Zubin] Just the prepuce, or the foreskin and I just specialize in that, because, you know, listen my license plate just says with a dollar sign for the S Schmegma.

– [Marty] What if your maybe if students listening out there, you can be an evideceologist like Vinay Prasad, here.

– [Vinay] And a few others.

– [Marty] And many others. There’re many others.

– [Vinay] There’s 10, 10 of us.

– [Marty] The rest are dogmaologists.

– [Vinay] Dogmaologists.

– [Zubin] Dogmaologists.

– [Marty] There’s a lot of that.

– [Zubin] And then there’s a schmagmatologist.

– [Marty] Schmagmatologist, yeah.

– [Vinay] There’s a lot of self-proclaimed ones that we already know. So what did you say? You say you wanna be a surgeon?

– [Marty] I mean, I was always interested in sort of the overall.

– [Vinay] Oh, I see, yeah.

– [Marty] I mean I left medical school really after my third year. I felt a little disillusioned and.

– [Vinay] Really?

– [Marty] Yeah.

– [Vinay] I didn’t know that.

– [Marty] I started graduate school in public health and I just thought, you know, I’m gonna take a bunch of stuff that I am interested in, tropical diseases and epidemiology which I loved. And I took some extra epidemiology classes and then I really realized I missed the bedside patient care, you know, being with people. So I sort of came back into my fourth year and then somebody said, “What do you really, What could you do in an ideal world if, you know, money were not an issue?” And I said, you know, “I think I’d like to be a missionary doctor.” And he said, “Well, if you wanna do that, learn the surgical skills because you can read about a lot of the treatments and you can educate yourself on a lot of medicine. But you can’t learn the surgical skills on the fly.”

– [Vinay] You can’t know what we know from a book.

– [Zubin] Yeah, that’s right.

– [Marty] Well, that’s true. That was over simplify.

– [Vinay] The guild.

– [Marty] So.

– [Vinay] You have to live it.

– [Marty] So.

– [Vinay] Breathe it Marty.

– [Marty] That’s true, so.

– [Zubin] So you wanna do the Lord’s work? You gotta go through this.

– [Vinay] But to be fair.

– [Marty] And there’s–

– [Vinay] I did learn most of it from a book.

– [Marty] There is something appealing about general surgery.

– [Vinay] There’s a lot at the book.

– [Marty] There’s something appeal about the general surgery because it’s training a little bit in urology and orthopedics and neurosurgery and, you know, GI and transplant, with all the transplant immunology and vascular medicine so to me, general surgery was appealing.

– [Vinay] General surgery is kind of holistic, yeah you’re right. It’s a holistic surgery.

– [Marty] Yeah.

– [Zubin] That’s some, you know, for me it was a similar thing. Like I thought I was gonna do GI because I was just attracted to the butt and stool. But then I did the rotation and I was like, “This is, I don’t like this at all.” Like it,

– [Marty] Above or below the dentate line was.

– [Zubin] Oh, oh, man, yeah. The valves of fusion were just sort of cutoff.

– [Marty] The valves of fusion.

– [Zubin] And so for me, what it was I had this crisis in second year of residency where I was like, “Wait, I don’t wanna do what I thought I was gonna do.” But here I an internal medicine residency and I re-fell in love with medicine. But I left for a year and worked in tech because.

– [Vinay] I didn’t know that.

– [Zubin] Yeah, I work here in the Silicon Valley, 2002 to 2003.

– [Vinay] What did you do?

– [Zubin] I moon lit at a Urgent Care to keep clinically active. But then I work for two med-tech-startups that both failed. And learned ’cause I like to teach, but then it’s the same thing, Marty. Like I said, I missed, like, there’s something freaking magical about being in a room with a patient where they’re most vulnerable, they’re opening up to you and it’s just really, it’s a sacred thing.

– [Marty] Intimate.

– [Zubin] It’s intimate.

– [Marty] Yeah, and it’s.

– [Zubin] And it’s not just about science. In fact, the science got a little boring after a while. I was like, “You know, okay, yeah.” But it’s this.

– [Marty] Yeah.

– [Zubin] And that’s what drew me back into medicine for 10 years.

– [Marty] And you don’t get that anywhere else in any other profession.

– [Zubin] No.

– [Marty] Do you get that?

– [Vinay] People immediately open and honest.

– [Marty] They open up within seconds.

– [Zubin] Within seconds.

– [Marty] Of meeting you, they’ll trust you, to tell you secrets, they’ve never told their spouse.

– [Zubin] Yeah, yeah, yeah.

– [Marty] Or they’ll let you put a knife to their skin immediately because of, really centuries of trust that our ancestors medicine have, you know, earned from the the community, they’ve earned that trust.

– [Zubin] And that’s why we have the symbols and the rituals and the robes and all of that.

– [Vinay] Well then, what do you think about that issue though? Are we losing trust?

– [Zubin] Yeah, yeah, I worry about that.

– [Marty] Oh yeah. trust in the toilet

– [Zubin] That was a problem. Trust no one.

– [Marty] Right now.

– [Vinay] Well, I mean public health lost a lot.

– [Zubin] Yeah, that.

– [Vinay] What about. but like, I guess all right.

– [Zubin] On the ground.

– [Vinay] A tough question for you. Honest question. Okay, you know, there’s all, doctors have to be, I think advocates for patients in public health and important sociopolitical issues like disparities, but is it possible for doctors to be so nakedly, partisan, particularly in the outward appearance that they actually lead losing those trust? Naked part partisanship. Not about the issues but naked partisanship. Which I see a lot of.

– [Zubin] I see it constantly. But we’re in cycles on social media, you know?

– [Vinay] Well, I don’t look to it anymore.

– [Zubin] Yeah, I know you don’t.

– [Vinay] They’re sort of dumpster.

– [Zubin] Those post are ghost kind of a deals.

– [Vinay] They’re posting ghost, get the hell out here.

– [Zubin] Get out.

– [Marty] I think when people hear from a doctor, they want to hear the science and they don’t wanna hear political partisanship. And when they sniff it out, it’s a turnoff. And that’s what I perceive. That’s what I hear. And look, the people I respect the most in medicine, people like yourselves. People who have retained their scientific objectivity, despite a lot of political gravitational forces to say, “Hey, we gotta all stay on message on this.” “Or here’s the program just sign up for it.” “Or don’t question this.” And there’s a lot of these people out there and you see a bit of a community that’s formed around say, the issue of school closures. Didn’t matter if you were you know, politically-

– [Vinay] You’re right. there’re progressives in there and there like people opposed to school closures, is a range of political views.

– [Marty] Pothole in a community is not a red or blue issue. It’s a competence issue, right? It’s knowing.

– [Vinay] But Marty, I feel like your philosophy is a philosophy of you’re an old man now. You had soup you had soup for lunch.

– [Zubin] Dude.

– [Vinay] You had that fish last time, we ate.

– [Marty] I’ve eaten lunch.

– [Zubin] This is the oldest young man I had ever met in my life.

– [Marty] I was built to be a grandpa.

– [Vinay] You were, you really were.

– [Zubin] You really were.

– [Vinay] Is that a word there’s original in your pocket? Is that some hard candy, Marty?

– [Zubin] Then you’re like, you know, we’re ordering today at lunch, and it’s like so this juice, can I ask you waitress, like the juice, is it fresh squeeze?

– [Vinay] He’s like, “The soup isn’t too hot is it?”

– [Zubin] I think it’s too hot, my gum is react. I was wondering, and by the way that, yes. I was gonna say, I think the waitress liked you, Marty.

– [Marty] Wow, I wouldn’t notice. But I noticed.

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

– [Zubin] Its because he is the Pescatarian and the waitress was Pescatarian too.

– [Marty] That was our connection. Continuing with the results of the study from the American College

– [Vinay] I see. for American Cancer Society.

– [Zubin] But Marty it’s life. I wanna talk more about, now go ahead.

– [Vinay] I think that I agree with a lot of what you saying Marty. I think you unto something about what people want.

– [Marty] So this is one these issues, right? The financial toxicity, we gotta get back to this issues in health care, we spending so much energy on this fights over issues that not even that essential to health right now, you know, mask, cloth mask on two year-olds. Look at all the energy we’re spending. The booster mandate on college students, right? Thus are not, here is a real issue in America.

– [Vinay] But there are still in there Marty, but they are still the issues but right…

– [Marty] You that they tragic but let, here let me give you a real issues. From the same American Cancer Society study. 38% of cancer patients in the United State report having had to make difficult decisions about purchasing food and clothing as a result of their.

– [Vinay] Diagnosis.

– [Marty] Their cancer costs. 28% said that they spend all or most of their savings on their cancer care and 45% this is the care. If you believe you believe in access to health care if that’s an important issue. 45% said they would delay or avoid any future care because the costs.

– [Zubin] So to fix this, by the way, what an old man, look at these pen? Only an old man would use a click pen that he stole from a hotel room.

– [Marty] I’m gonna return it, I don’t want that prosecutor from Nashville coming after me. I mean. that guy is on a trip.

– [Zubin] That’s not even funny, that poor kinda get you.

– [Marty] I’mma try reach out to her.

– [Zubin] That would be lovely.

– [Marty] I’m gonna, I mean, I often will defend people that I feel have been, you know, I’ve treated unfairly.

– [Zubin] Yeah, I mean it’s hard to know, because we don’t know the full story, but I would just say.

– [Marty] Yeah, you don’t know the full story.

– [Zubin] So, for this business,

– [Vinay] Yeah, this is the business.

– [Zubin] We know the problems. So what are the solutions to this? Because in my mind there’s two things. There’s how do we pay for medicine? And then what the hell are we paying for and why is it so expensive?

– [Marty] So some of these comes to, what Vinay wrote about in that article that we are allowing Pharma to play this game of rolling the dice, right? Because every time they get a new drug, that’s FDA approved, even though it has no impact on overall survival.

– [Vinay] Correct, which is a lot of that. Two thirds of drugs are approved on the basis of a surrogate endpoint, not overall survival. And many of them don’t improve survival with long term follow up.

– [Marty] Only five to 19% do

– [Vinay] Yes. in that one study that I looked at.

– [Vinay] By Kim and Prasad–

– [Marty] yeah, that was a good study and this, I’m thinking, why isn’t anyone else doing? Why isn’t anyone else doing this study? I know why, because when you get pegged to a specialty in medical school, you come out, you’re put on a hamster wheel, and you’re whipped and you’re told more RVUs, in order to get paid more, you gotta do more. And this message that we’re sending out to doctors across the country and that is, the way to fix the problems in healthcare that we are dealing with is for you to work harder.

– [Zubin] Yeah.

– [Vinay] But Marty, along these lines like all of the incentives and academic oncology, like, for career incentives are run more trials for the industry, do more consulting for the industry. Do serve on boards that help promote the industry products even those ones that are kind of marginal. Now I think we have to concede like pharmaceutical companies do, do great things. The first two doses of vaccine and older people are tremendous good. And many cancer drugs are tremendous good.

– [Marty] Amen.

– [Vinay] But because you have some drugs that are really good, you get away with selling some drugs that are very marginal and a drug that has no survival benefit, real toxicity. That isn’t just?

– [Zubin] They’re costly.

– [Vinay] And real costly. That’s not just a neutral drug. That’s a harmful drug and it’s reallocating wealth, as you point out. It’s taking wealth from society and giving it to rich shareholders.

– [Zubin] You know what? You may have written a book on this.

– [Vinay] It’s called “Malignant.”

– [Zubin] “Malignant.”

– [Vinay] How bad policy and bad evidence.

– [Zubin] That was first time we ever talked, was by Zoom for that book.

– [Marty] Yeah, I interviewed him for MedPage and I think I read that book awhile back.

– [Vinay] And since that conversation. It’s been all downhill. Three people have read “Malignant.”

– [Zubin] Dude, that’s two more, than the last two–

– [Marty] Your problem is that it was published by John Hopkins University press, my institution.

– [Zubin] Oh, right into fact.

– [Vinay] Are you saying university press books aren’t the hard hitting.

– [Marty] They don’t know how to do marketing.

– [Zubin] They found quite a few of those books in the Wastewater review they did.

– [Vinay] He uses two to prop up his desks.

– [Marty] So here’s some good news, so on Friday, Equifax and the other two credit.

– [Vinay] Agencies. Agencies.

– [Vinay] Their medical debt, it’s not listed.

– [Marty] That’s right. 80% of medical debt is not going to be affecting your credit history.

– [Zubin] That’s great.

– [Marty] And that’s a result of a lot of advocacy and I think we as physicians, nurses, clinicians out there have tremendous cloud in the community to go to these organizations and say. Look, be fair and honest with people. Don’t violate our sacred trust with people by harassing them and ruining their lives financially.

– [Vinay] You know, it’s so interesting. There’s like two problems. Like one, we spend like 20% of GDP on healthcare, which is horrific and way more than any other like comparable nation. And two, even though we spend all that money, we still have like all these problems with debt, debt collectors, and debt, and other pocket expenses.

– [Marty] A lot of people are getting rich.

– [Vinay] Yeah.

– [Marty] Everyone in healthcare–

– [Zubin] Like you said, it’s a transfer of wealth.

– [Vinay] It’s a transfer of wealth.

– [Zubin] It’s a transfer of wealth.

– [Marty] Everyone in America is getting rich in healthcare except for one group and that is.

– [Vinay] Professor like…

– [Marty] Not definitely. Some people like nurses and a lot of physicians.

– [Vinay] Yeah, like those of us who are like working.

– [Marty] Physicians also…

– [Zubin] Slide a little over ’cause you’re out of focus, there you go.

– [Vinay] Oh yeah, yeah.

– [Marty] A lot of nurses and physicians have basically had wage stagnation for 30 years.

– [Zubin] Yeah. Like.

– [Vinay] Remember when COVID hit and then they like they cut everyone’s pay. And like didn’t give them bonus that first year while they pocketed that hundred billion dollar bailout from government.

– [Zubin] Yap. And now they’re trying to introduce legislation to limit the amount you can pay travel nurses. So it’s kinda like, oh, who can we get back at for all this? How about the nurses?

– [Vinay] Oh, they do that, I know, man.

– [Marty] Oh I see, making sense.

– [Zubin] I mean, yeah, I mean, who’s gonna pay what the market will bear because there aren’t enough nurses ’cause you treat them like crap. Because you put them in jail for making a mistake that could have been rehabilitated, you know.

– [Marty] So a lot of nurses and physicians have had wage stagnation, but the one stakeholder in healthcare that has really gotten hammered, is the patient, the consumers assistance, right.

– [Vinay] Of course, no one knows them.

– [Zubin] Who cares about them, Marty? We’re talking about us.

– [Marty] So here’s an interesting analysis that my team did where we looked at all federal spending, that goes to healthcare in its hidden forms. So for example, we know that 20 to 25% of the federal expenditure goes to Medicare and Medicaid either through that FAP program where they send money back to the states for Medicaid. But it’s, you know, you’ll hear 20% of GDP, you’ll hear different numbers.

– [Zubin] Yes.

– [Marty] But 24% of the federal expenditure of the budget goes to social security. And do you know where seniors are using their social security finances?

– [Zubin] On their medical bills.

– [Vinay] For medical bills.

– [Marty] Medical, 50%, according to Kaiser, copays, deductibles, non-covered interest.

– [Vinay] So that even more money.

– [Zubin] More money into healthcare system, yeah.

– [Marty] And so…

– [Zubin] Did you made an estimate of like it was close to 50%.

– [Marty] Yeah, because the, it’s almost 50%. It will be 50% this year because the defense department has its own healthcare system that’s 15% of their budget. They’re they have Tricare, they have doctors and hospitals. The VA.

– [Vinay] It’s like five more airplane carriers, you feel me?

– [Marty] It’s a lot of money and then the VA has its own system.

– [Vinay] Right. That’s about four and a half percent of all federal spending and then we pay for a healthcare benefits, we buy health insurance as a government, for 9.1 million federal workers. And that’s about 1.2% of federal spending and then interest payments on the debt are about 6% of all federal spending. This year it’ll be seven to 8%. I don’t know any expert that thinks that number’s coming down. Like we finally are bringing down our interest payments. So a part of that’s really healthcare debt. If we’re spending all this money on healthcare and we’re paying money on the interest payments, that’s healthcare debt. So when you add it up, it’s 50%.

– [Zubin] And that’s a massive redistribution of wealth.

– [Vinay] Yeah.

– [Zubin] It’s going from us.

– [Marty] Yes.

– [Vinay] Yeah.

– [Zubin] To them. Like whether it’s pharma, whether it’s big, you know CEO’s salaries, whether it’s ambulance companies, private equity firms.

– [Vinay] Insurers, PBM,

– [Zubin] PBM,

– [Marty] Yes.

– [Vinay] Academic hospital centers who are nonprofits.

– [Zubin] Oh, yes.

– [Marty] GPOs.

– [Vinay] Everyone’s nonprofit,

– [Zubin] Groups, yeah.

– [Vinay] But they’re four skyscrapers going up in the nonprofit world.

– [Marty] Yeah, I heard of that.

– [Vinay] Every new skyscraper in our nonprofit.

– [Marty] I just, I was working with 60 Minutes on a piece about GPOs. That’s gonna air, I think in the next couple months, I’m not in it, but I worked with them a lot and it’s gonna be a pretty interesting, no one really knows what a GPO is, we wrote the first piece in the medical literature in JAMA, defining what a group purchasing organization is. And the many games, including kickbacks that cause some of the drug drug shortages that we have because they give sole-supplier contracts to a company through kickbacks that they get from that company, which are legal through this loophole. There was an amendment passed in 1984, I believe, it was basically, it’s called the “Safe Harbor Exclusion” to some anti-kickback clause or law. And so that’s enabled GPOs to take a kickback, PBMs do the same. So a couple easy things, if we wanna fix healthcare, get rid of secret pricing and get rid of kickbacks, two simple solutions.

– [Zubin] Hmm.

– [Vinay] Exactly.

– [Marty] So the 60 minutes piece will be good on that.

– [Vinay] But Marty, I have a philosophical question for you. You know, obviously the U.S. trajectory in healthcare spending and with those point out, it goes hand in hand with like, we’re not actually providing much better care, than other nations, often it’s worse care, like worse outcomes. There are two ways, I think, philosophical ways we might address it. One, incremental solutions to try to curb this bend the arc of healthcare spending downward or two, we might wait until it becomes a catastrophic situation and then we’ll have to do something like reformative and I worry that, you know, every political cycle that I’ve been in, I’ve been very excited about the prospect of healthcare reform and bending it. But every time you get closer to the finish line and the lobbyists come out

– [Marty] The stakeholders.

– [Zubin] Yap.

– [Vinay] The stakeholders come out and they lobby you to death. Marty, they got dinner, dinner, drinks.

– [Zubin] Yap.

– [Vinay] You know, they lobby you to death. And so it seems like we have no ability to make incremental reform. I worry, we’re gonna reach a catastrophic situation where healthcare spending is just so much, that it literally is economically crushing. And then we might have to do something about it.

– [Zubin] I would argue we’re there.

– [Marty] We’re there.

– [Vinay] There already.

– [Zubin] But it hasn’t hit the tipping point in the sensibility where it’s like a existential disaster act in the minds of the public. Even though it is and.

– [Marty] It is.

– [Zubin] But yeah, that would then allow the metamorphosis of this caterpillar that’s been eating all the resources and destroying everything into a butterfly, some phase shift in healthcare.

– [Marty] It is.

– [Zubin] To three point out that I call it.

– [Marty] So let’s say household has a combine income of $120,000.

– [Vinay] The bay area, you’ll be poor, with that kind of,

– [Zubin] Yeah, you’re broke.

– [Vinay] The stroke.

– [Zubin] You’re on the stroke.

– [Marty] I think the average income in America is like, I dunno, 50 or 56.

– [Vinay] 50, 60.

– [Zubin] Right, yeah.

– [Vinay] But in other parts of America that’s, the top

– [Zubin] That’s lower, yeah.

– [Marty] So let’s say there’s, let’s say they have a combined income of 120,000.

– [Vinay] Hmm.

– [Marty] They’re going be paying about $35,000 in taxes of which half of federal spending goes to healthcare in its many hidden forms. That’s about 17,000. Add to that, the cost of health insurance for household, 22.

– [Vinay] 22 households.

– [Marty] It’s about $40,000. So about a third.

– [Vinay] A third of their.

– [Marty] About a third of their earnings through public and private spending on healthcare is going to healthcare. And it’s from their earnings. Let’s be honest, it’s not, oh, I didn’t have to pay the government, Medicare paid,

– [Vinay] You’re right,

– [Marty] I don’t have to pay, my employer paid it. It’s out of the pool of money wages and earning or wages and benefits. So I’m actually optimistic on the future of healthcare and I know the stakeholders are swatting down any reform, like to try to address these kickbacks and other things, but employers now are fed up and they’re pushing back and they’re saying, we’re just gonna go direct, with these doctors through direct primary care. We’re gonna go to direct with the hospital, do a direct contract. We’re gonna bypass all this middle industry and these entrepreneurs and innovators are doing condition specific treatments now. So you can channel somebody into attract, where they get great handholding and care for their diabetes,

– [Zubin] Plus hip replacement, we’ve heart disease, whatever, yeah. Centers of excellence, that whole thing. Or actually whole systems of excellence.

– [Vinay] I hope you’re right, Marty. But let me give you one counterpoint, two things we talked about. We have aggressively boosted adolescence and young people. And then we’re gonna give them the fourth dose. If Moderna goes through. Those are very similar to things they’re talking about. They’re making a company rich, this company is in billions, they got 79 bills in the bank from these vaccines,

– [Zubin] Government spending.

– [Vinay] You’re not gonna, they’re not gonna get, keep that great thing going on, if they’re just vaccinating older people, season to season, they need to get up all. And the FDA is saying, we don’t need to see severe hospitalization as the end point of the randomized trial. We don’t need to see symptomatic COVID as ran, endpoint of the randomized trial. We need to see non-inferior geometric mean antibody titers. They put the bar in the toilet and the government’s already committed to buying the product. Okay?

– [Marty] Yeah.

– [Vinay] This is an example of what you’re talking about. This is why that number, because this is happening in COVID, it’s happening in every disease.

– [Zubin] Everything.

– [Vinay] Everything rheumatology, cancer medicine, cardiology.

– [Marty] Opioid.

– [Zubin] Opioids.

– [Vinay] Opioids, and that got us in a lot of trouble. You know, everyone wants their pain to be zero. But you know, it gets you in a lot of trouble, shortens life expectancy. So I feel like the they’re just like a hungry, it’s like a hungry, hungry hippos game. And these companies are just eating all those marbles. And you come along and you, you say something like, hey, maybe, guys like before we start boosting 12 year olds, maybe we should get like some that clinical benefit data around here. And they say, “You anti-VAX, Marty.” They’re gonna call you like anti anti-innovation, Marty, wants to cut, Dr. Death Marty, they’ll call you that for these things.

– [Marty] Yeah.

– [Vinay] The lobbyists are getting ready.

– [Marty] Look, we gotta keep fighting.

– [Vinay] We gotta keep fighting.

– [Marty] We gotta keep fighting based on the data and the method, scientific method that we’ve valued.

– [Zubin] That maybe one positive that comes out of this COVID debacle too, is that people start to really wake up a little bit because there’s now loud voices that have reasonable influence that can say, hey, you know what? Remember all this stuff that happened during COVID, yeah? That’s just a symptom of the bigger problem.

– [Vinay] Symptom of a bigger problem.

– [Marty] It is.

– [Zubin] Nothing, it’s like, it’s a rounding error on what you’re getting jacked.

– [Vinay] Yes.

– [Zubin] Every single thing.

– [Marty] Yeah, yes.

– [Zubin] You don’t even complain, you haven’t gotten arrested so long. Why do you think that is? Look at how much it’s taken out for healthcare, and then here’s what’s going on with the government spending on. And by the way, the interest on that is this. So your kids are gonna be paying that. And guess what? You still have shitty outcomes. And guess what? We still, you know, we still,

– [Vinay] And if you do anything wrong at work? That work job you have to have,

– [Zubin] Ooh.

– [Vinay] And it’s not that we’re gonna put you in prison, and file criminal charges.

– [Zubin] File criminal charges against you. So don’t even go into healthcare.

– [Vinay] You know, it’s like a modern day feudalism.

– [Zubin] It kind of is, it kind of is.

– [Marty] I mean the opioid epidemic, for a moment, we were focused on it and the root causes.

– [Zubin] That moment.

– [Marty] That was really for a moment.

– [Zubin] Yeah.

– [Marty] That was a snapshot of healthcare.

– [Vinay] Yeah.

– [Zubin] Yes.

– [Marty] It was a snapshot.

– [Zubin] One slice.

– [Marty] One medication,

– [Zubin] one ring of the tree plus,

– [Marty] Of the hundreds,

– [Zubin] Yep.

– [Marty] Out there.

– [Marty] Now, you got a window, a peak into how industry was dominating the narrative. How many people had a piece of the pie, but the blame game was going around.

– [Zubin] Yeah.

– [Vinay] But Marty, it’s gonna be like that. There are definitely some people after COVID truly suffering. And there are people who have had prolonged hospitalization who need a lot of medical care and attention. But we have a long COVID industrial complex company.

– [Zubin] Oh yeah, it’s coming.

– [Vinay] You got more NIH grants flowing into long COVID research.

– [Marty] How can I even not say, I never saw that.

– [Vinay] We’ve got every hospital sharpening. Sharpening their machines to get people in for, you know, scans, PFTs, echos.

– [Zubin] Yep.

– [Vinay] Imaging, sequential. These clinics, they’re gonna suck up healthcare money. And if that made people who are suffering better off,

– [Zubin] Great.

– [Vinay] Are great?

– [Zubin] Pay it all.

– [Vinay] They’re not gonna even do the studies. They’re gonna do like the Moderna booster.

– [Zubin] Yep.

– [Vinay] No endpoint studies, no control arm. You know, these kinds of things.

– [Marty] Yeah.

– [Vinay] They’re gonna do like the fourth dose, you know?

– [Marty] Yeah, doing an MRI and everyone with long COVID is, does not help them.

– [Zubin] No.

– [Vinay] Yes but it’s coming.

– [Zubin] Oh yeah.

– [Vinay] It’s coming.

– [Zubin] Oh, a 1000%.

– [Marty] That’s here.

– [Zubin] And the thing is, no one will talk about this.

– [Marty] No one will talk about it.

– [All] No one will talk this.

– [Marty] ‘Cause it, sounds callous.

– [Zubin] It sounds callous. You’re not, you’re less the suffering of these people. You’re saying it’s not real.

– [Marty] You don’t care.

– [Vinay] What they don’t realize is, that MRI is prey upon their suffering.

– [Zubin] Yeah, It is.

– [Vinay] Their suffering is real.

– [Marty] Yeah.

– [Vinay] But they’re not addressing the root of the suffering.

– [Zubin] Yeah, you mean

– [Vinay] They’re preying upon you and using you as a pawn in scheme to reallocate wealth.

– [Zubin] And it’s like a Stockholm syndrome.

– [Vinay] Yes.

– [Zubin] You love your capital.

– [Vinay] Yes. You love exactly, right.

– [Zubin] You think, “Oh man.”

– [Vinay] Exactly, right.

– [Zubin] “If insurance would just cover this agent that will help my long COVID everything would be okay. And the Pharma guy’s like, “Yes.”

– [Vinay] Yeah.

– [Zubin] Yes.

– [Vinay] And I guess what? You know like, we always paint the insurers, the bad guy, the insurer, ACA has capped their revenue as our profit, the amount, the medical loss ratio, has been capped at 20%. So the insurer actually wants the pie.

– [Zubin] Wants,

– [Vinay] What they want is spending to go up.

– [Zubin] Wants the pie bigger.

– [Vinay] So they’re gonna be having put a lot of limits on this year to year. But over the next 10 years, they’re gonna capitulate to it.

– [Zubin] It’s like the 10, $10,000 COVID test, right? They’ll just pay it.

– [Marty] I saw the,

– [Vinay] $10,000?

– [Marty] I saw Francis Collins, the immediate past director of the NIH,

– [Zubin] Heard of him.

– [Marty] Make an announcement. He’s still there.

– [Vinay] Great.

– [Marty] But he’s still at NIH, now he’s head of the Health and Science Technology.

– [Vinay] Yeah, thing that, what’s the name, Eric Lander got booted from.

– [Marty] Yeah, he’s now.

– [Zubin] He’s so being a dick. They didn’t know dick-zone.

– [Vinay] Yeah.

– [Marty] These guys, man, they serve.

– [Vinay] So they brought, they brought the guy who was, in a factual,

– [Marty] They serve terms like presidents, you know.

– [Zubin] Yeah.

– [Marty] It’s like, they will, they,

– [Vinay] Like Putin, wasn’t he president? And then he was not for forty years, he’s extending it.

– [Zubin] Yeah, yeah.

– [Marty] Yeah, Prime minister then.

– [Zubin] Medvedev or whatever, he took it over.

– [Marty] Although unlike Putin, right? Collins is a nice guy,

– [Vinay] He’s a nice guy.

– [Marty] But he sort of separatist. Yeah, the terms, you know it.

– [Vinay] But he is not good at the job, no offense.

– [Marty] Well.

– [Vinay] He’s not good, actually. There’s too much,

– [Marty] Here’s an analysis, we just did.

– [Vinay] Wait a second,

– [Zubin] I met him once, and he was nice to me. So I’m not gonna say anything.

– [Marty] He’s a very nice guy. He’s a very nice guy as his virtue. Not good, but. I’ll just keep.

– [Marty] As his virtue.

– [Vinay] But okay, that is good. Oh that’s okay, dude.

– [Marty] And I’ve disagreed with him on maybe

– [Vinay] But that’s okay,

– [Marty] Just 20 aspects of COVID strategy.

– [Zubin] But even, before that, the genome, he put all the money in the genome.

– [Marty] That’s a controversy,

– [Zubin] That was awful.

– [Marty] No one knows about.

– [Vinay] He was quoted in the New England Journal medicine saying, by the year like 2015, “When you get, your blood pressure pills, we’ll do a genome sequence and give the one right for you.” That didn’t happen at all and he’s never punished for his like grand deals proclamation. Anyway, nice guy going on.

– [Marty] And the private and street.

– [Vinay] And he plays the big guitar.

– [Marty] Did the,

– [Vinay] Main guitar.

– [Marty] Did the sequencing of the human genome faster. Like there was, there was this big con, the big controversy was, does the government sequence the genome?

– [Vinay] Correct venture was

– [Marty] Or let, the private sector. Private sector did it faster and cheaper.

– [Zubin] Yeah.

– [Vinay] That happens sometimes.

– [Marty] But, the,

– [Vinay] Even a socialist like myself has to admit that happens sometimes.

– [Marty] Well, the history is written by the victor, right?

– [Vinay] Yes, yeah.

– [Marty] So Collins told the story of how, you know, they sequence human genome with all this crazy money, all over the labs across the country. Fed all these universities. And the promise was, as soon as we do it, we’re gonna be able to, you know, change the genome and sort of cure all these diseases. What diseases have been solved and the ones that we’re now seeing Crisper,

– [Vinay] Crisper’s atomic.

– [Marty] Like that came way after the,

– [Vinay] Of course, yes, no.

– [Marty] Sequencing, that was done by the private industry.

– [Vinay] Alright it was disappointing.

– [Marty] Disappointing.

– [Vinay] And the way, that he just, they just sunk too much capital in it. That’s what they do.

– [Marty] So they made some an announcement about long COVID funding. It was some crazy amount of money.

– [Vinay] I think it’s a, nearly a billion, wasn’t it?

– [Marty] Oh, more than that.

– [Vinay] More than okay.

– [Marty] Way more than that. So we just did a study, go ahead.

– [Zubin] I was just gonna say, it’s an insidious reductionism. Like somehow we can reduce this complex vibrating entity of human, into like DNA and so if we throw enough money into that or a drug or a one procedure or whatever, so long COVID is an MRI,

– [Vinay] Yeah, you’re right.

– [Zubin] And this and this, it’s taking the hole and turning it into parts instead of going, “Wait, wait, wait.” But what’s really going on. It’s bio-psychosocial, as my friend, Dr. Rachel’s often says, everything is, but anyways, back to you.

– [Vinay] But no, and even in the DNA thing like, you know, there’s that allegory of the cave in Plato where it’s like, imagine soldiers are changed and you have a lamp behind you, and you only see life through your own shadow, you may not know what three dimensional space is. And genome sequencing is like the shadows on Plato’s cave. The inside of a cell is so complicated. There’s the DNA, there’s the RNA, there’s all these parts moving. And you just see like a projection of the DNA sequence and you think you can solve everything, no.

– [Marty] Well, that was the storytelling of it. It was a great story.

– [Zubin] Great story.

– [Marty] Once we can uncode,

– [Vinay] Unraveled. Unravel.

– [Zubin] Uncode.

– [Marty] Uncode.

– [Zubin] using our computer model, which is what humans understand right now in history.

– [Marty] That’s right.

– [Vinay] Uncode the genome.

– [Zubin] They understand the computer model,

– [Marty] Decode human being.

– [Zubin] Brain is computer, DNA is computer. Binary being, yep.

– [Marty] Right. So that was all with, so that’s a controversy I don’t think people are aware of. But anyway, giving the benefit of the doubt, we looked at John Hopkins, we just did this study my team. Put it on the pre-print server, NIH funding in 2020, the year of the pandemic, less than 5% of the budget went to COVID research and of the money that went to COVID research, there were like six grants on how it spreads compared to 250 grants on other aspects of addressing COVID. Socioeconomic disparities and other topics in COVID, important.

– [Zubin] Important.

– [Marty] But how about, how does it spread?

– [Zubin] Right.

– [Marty] And none,

– [Vinay] There’s a big chunk on Rams Davis here. Right.

– [Marty] There was no funding for studying masks in children.

– [Vinay] Oh.

– [Marty] No study on children at all. Two studies on mask. One of them read out like year and a half later. Why can’t the United States government with 43 billion at the NIH in 2020. Why couldn’t they get the key answers immediately in one week to all the big COVID questions?

– [Vinay] That’s what I, that’s why I’m saying that he didn’t do a good job.

– [Zubin] Yeah.

– [Vinay] This is, this is a total failure.

– [Marty] Total failure.

– [Vinay] Total failure of course.

– [Marty] And as a result,

– [Vinay] Total failure yeah.

– [Marty] We didn’t have the evidence to answer to the basic questions on COVID. So what did we do? We gave opinions and politicians gave opinions and the country got divided.

– [Vinay] Unlike, unmasking kids, is a failure to run a trial. Like let’s say you run a trial. You might have learned things that like, we don’t even expect. Like you might learn oh, kids, it actually doesn’t want to wear surgical, not even cloth. And actually maybe you might learn, there’s a relationship between the cases per 100,000 in community and the efficacy of the mask and an interaction coefficient there, might be there. You might learn some compromise and you might actually use science to decide the policy, but instead you don’t do the study. And then it becomes quickly. Politicians sees that as an opportunity where it is, you know, a mark, a visible mark. And then they claimed it. And now it’s a political question. It’s not a scientific question, anymore. And what’s the cost of that? It’s massive.

– [Vinay] Massive.

– [Marty] Oh massive.

– [Zubin] Massive. It’s way more than any of the spending, they would’ve spent.

– [Marty] And this is affecting child vaccinations, public trust.

– [Zubin] Yap.

– [Vinay] It’s tearing society apart.

– [Zubin] Tearing society apart causing polarization.

– [Vinay] It literally tears us apart.

– [Marty] Tears us apart.

– [Vinay] I mean, because you’re having the, like the science, TM, you know, the science

– [Marty] the truth.

– [Vinay] Tell you the truth. The truth is telling you,

– [Marty] The truth Institute.

– [Vinay] You’re stupid, you’re stupid, anti-VAX bad person,

– [Zubin] Yep.

– [Vinay] If you think a cloth mask does, might not work in a two year-old when they take it off for two hour naps. You think that you are crazy.

– [Zubin] My daughter’s

– [Vinay] I’m done with other things.

– [Zubin] My daughter’s friends know who I am online. And they’re like, is your dad an anti-masker? Like I’m telling.

– [Marty] Anti-masker.

– [Zubin] Anti-masker. And then, did you, and they asked, “Did you get a booster yet? ’cause we all have our boosters.”

– [Marty] You know what’s wrong with you? And then she was like,

– [Vinay] “Okay you can’t come with us to the museum.”

– [Zubin] Yeah, exactly.

– [Marty] The,

– [Vinay] That’s better, yeah.

– [Zubin] The museum.

– [Vinay] But they’ve like all bought into this.

– [Zubin] Yeah, it’s like a thing.

– [Marty] The group thing knows that’s bad, right? So the proceeding in the National Academy of Science published a study, I think two months ago now, on the different types of mask and the transmission with a 20 minute interaction, you know, close together, close contact within 20 minutes of, wait a minute, 10 a 20 minute period. So they broke down the rate of transmission with an N-95 with and without a nose piece with a surgical mask. You could see the transmission rates, you know, go up with the quality of the mask. Why wasn’t that done on week one? Instead they goofed around, they were funding research on. They spent twice as much money on aging research in 2020 at the NIH. Then they did on COVID. We found that in our study.

– [Vinay] Wow, really?

– [Marty] Yeah, now. It was a report,

– [Vinay] Well, there’s no

– [Zubin] Vouching concept to live forever.

– [Vinay] Yeah

– [Zubin] Come on.

– [Vinay] They can’t, they can’t pivot. I mean, an organization.

– [Marty] They can’t, they couldn’t pivot.

– [Vinay] They can’t pivot, They can’t pivot.

– [Marty] Because they, because of that we paid a heavy price because there was this void of data, to arm doctors and nurses to answer the basic questions everyone was asking us. How does it spread? Do masks work? When are you most contagious? How long do I have to quarantine for? We could have answered that in 10 days.

– [Vinay] Of course, Marty. Of course, I mean you’re really onto something. And I,

– [Zubin] What’s the IFFR?

– [Marty] Oh, yeah.

– [Vinay] Right?

– [Marty] What’s the of my age?

– [Vinay] And then they get mad at these guys for running their study on a shoestring budget. But like, why are they the ones having to do this? You need to be doing this.

– [Marty] Well, a study on, our study on natural immune that we just published in JAMA,

– [Vinay] Well that’s heretical. And you should be burned.

– [Zubin] I can’t believe, they published it.

– [Marty] LinkedIn agreed with you. I posted the JAMA study, just so to thanked my residents.

– [Vinay] Hope they censored it.

– [Zubin] Right, they censored it.

– [Marty] They did, they took it down.

– [Zubin] They took it down as misinformation.

– [Marty] They took it down and,

– [Vinay] There’s probably some 26 year old there who knows better than you, Marty.

– [Zubin] Of course.

– [Marty] So,

– [Zubin] Who saw N-95 respirator outdoors at the pool.

– [Vinay] They probably, yeah.

– [Marty] That maybe,

– [Vinay] And they got the 10 line, probably.

– [Zubin] 10 line around it.

– [Marty] But media had called me to do an interview about it. About LinkedIn taking down the JAMMA study. There was no commentary. It was just testing the blood of people who had the infection.

– [Vinay] Wait, and it was published in JAMMA?

– [Marty] Published in JAMMA.

– [Vinay] I remember your story.

– [Marty] JAMMA, JAMMA not, you know?

– [Vinay] Mama JAMMA.

– [Marty] JAMMA opened a health policy.

– [Zubin] Not JAMMA lighter.

– [Vinay] Not JAMMA.

– [Marty] Mama JAMMA.

– [Zubin] JAMMA pre-print, right?

– [Vinay] JAMMA landscaping, total landscaping.

– [Marty] JAMMA gardening and.

– [Zubin] Marty a little this way, a little this way, we got the de-focus.

– [Vinay] There we go.

– [Zubin] There we go.

– That’s good, okay.

– [Vinay] Okay.

– [Marty] So we publish, I put it on LinkedIn, the media called me, “Hey, LinkedIn took down your post on, just posting on JAMMA study.” So yeah, I don’t know why they did it, did that. In 15 minutes, so it went back up. But why did the NIH not fund that study? I turned from an NIH researcher in New Jersey who has an entire career, 30 years of continuous NIH funding. And he said, “I applied to do this study and got top score and it was not funded.”

– [Vinay] No God. Well I mean, I don’t know. To be honest with you, I honestly think that if you like, one of the biggest jobs of the NIH is to allocate funding and they currently have a very complex system with study sections, et cetera.

– [Marty] Bureaucracy.

– [Vinay] A bureaucracy to do it. And it keeps a lot of people employed. If you took, I don’t know, the next billion dollars and you randomly assigned 500 million, to the way they’re giving it out right now, this total shit way, okay. And 500 million, it’s called a modified lottery. They get everyone’s names who’s just submit an application. They just check, is this person at a reputable institution, like a top 1000 institution? Did they spell things correctly? You know, is it one page proposal? And then they just like literally randomly give out the money. I bet if you followed those two portfolio of research for five years, 10 years, they’ll have better, maybe even better outcome.

– [Marty] More scientific, advancement.

– [Vinay] More scientific advancement, in the randomly given. That means, their bureaucracy is probably, I suspect, so shitty, it would underperform even random allocation of money. They have never, for a science organization, run a single experiment on how to fund research. They’re slow. They’re antiquated.

– [Marty] Cronyism.

– [Vinay] Cronyism.

– [Marty] And their journals too.

– [Vinay] This guy has been an NIH director since I mean when? It wasn’t, it was, first Obama, 2009, Collins.

– [Marty] Yeah.

– [Vinay] He did it for 12 years. They don’t wanna turn off. Fauci, he’s been the director for how many years? 30, 40?

– [Marty] 41.

– [Vinay] 41 years, I think he’s been, no.

– [Marty] Oh, he’s been at the NIH.

– [Vinay] But 30 years as the director,

– [Marty] Yeah.

– [Vinay] We need turnover. You need new ideas.

– [Marty] Do you know, he is not an Infectious Diseases doctor, did you know that?

– [Zubin] He’s an internist, right?

– [Vinay] I wouldn’t have guessed.

– [Marty] Rheumatology fellowship. I don’t hold it against that.

– [Zubin] Yeah, that’s fine.

– [Marty] I mean, how does the media crown him the nation’s top infectious disease doctor.

– But he hasn’t be sanctified by CDC.

– [Zubin] But he’s by Lord Zero-COVID.

– [Vinay] He’s the Pope, he’s infallible.

– [Marty] Well,

– [Vinay] He never got, he never made a signee. I dare you to one thing he said wrong. Just one thing, cause he got ever.

– [Marty] During COVID?

– [Vinay] Yeah.

– [Zubin] Not a thing.

– [Marty] Not a thing he’s perfect.

– [Vinay] He’s perfect, really a hundred percent betting average.

– [Marty] Yeah.

– I just saw that he, he said that we might have to lock down again. So maybe 110% betting average.

– [Marty] He answers everything with an open-ended question.

– [Zubin] I’m gonna say something a little heretical. I don’t think the study can be done. I wish we could look back over COVID when nobody was going to the hospital, when they locked everything down and no one was getting care. Separate out the screening failures and the necessary care failures and look at outcomes for people who didn’t get “standard American care” for those months. And see what happened.

– [Vinay] That’s a good.

– [Marty] So,

– [Vinay] I think we’re gonna, people are gonna be working on that space.

– [Vinay] I’m intrigued, I’m really intrigued.

– [Marty] Are they gonna be working on it or do they not wanna know?

– [Zubin] Nobody wants to know.

– [Marty] Because where is the definitive study of child hospitalizations in districts where this kids were in school free and clear, no mask open the entire time versus lockdown and mask.

– [Zubin] Yep.

– [Marty] Where’s that study.

– [Vinay] Lockdown save lives, Marty.

– [Marty] So Tracy Home did that study and showed no difference, right?

– [Vinay] Heraldically.

– [Marty] And she had a bear of a time, getting it published and the media basically did a take down of her study. She was scheduled to go on NPR and they did a pre-interview and then the night before told her, “Oh, we’re not gonna, we’re gonna go a different direction or something.” And then someone told her, “Hey, I heard a pediatrician’s saying, you know, this is why everyone has to wear a mask, you know, including a clock mask in school.” So this is NPR. This is why I sudden set her by your thought, a 100,000 kids were in the hospital at one point,

– [Vinay] Yeah, of course.

– [Marty] She’s listening to NPR and all this.

– [Vinay] I mean the media bubble, the New York Times, NPR, they’ve been terrible.

– [Marty] The Washington Post.

– [Vinay] Washington Post, terrible.

– [Zubin] It really, it really is that bubble that stop people getting the data.

– [Vinay] I wanna be, I perfectly clear, pre-COVID, there were, Wall Street Journal editorials had attacked some of the research I did because, you know, it was very sort of critical to pharmaceutical industry. And I cursed the Wall Street Journal, okay? And I really loved the Times and I loved Wall Poll and I loved NPR, but on COVID they have been so bad. That the only sensible person at their organization, David Leonhardt, you know, they wanna throw, at every year, every week, there’s a new vulture attack. Vulture article about David Leonhart the lefts, the lefts, pro-COVID are, you know, they think like.

– [Marty] Yeah, yeah.

– [Vinay] You know, they’re dogging this thing.

– [Marty] And they’re going after him.

– [Vinay] They’re going after him.

– [Marty] Yep, the public likes him ’cause he’s reasonable.

– [Vinay] Of course, he’s the, he’s the last sensible person. And he’s not even like, I don’t know. They portray anyone who isn’t like, if you are not willing to hold your breath, when you drink your bottle of water and put your N-95 busk, mask back on, they portray you as unreasonable.

– [Marty] Yeah, I think that was right.

– [Vinay] I think, that’s ridiculous.

– [Zubin] The synthesis position is, in short suppliers, yeah.

– [Vinay] Yes.

– [Zubin] I mean it’s, it’s either thesis or antithesis. There’s no synthesis. And you know, what we’re trying to do is talk about a synthesis. They’re alright we’re, we, people consider us antithesis adjacent for even talking about a synthesis.

– [Marty] That’s right, you’re not allowed to.

– [Zubin] You can’t.

– [Marty] we just did this analysis of Michigan versus Sweden, in terms of COVID outcomes, because Sweden was basically open the entire time. As a matter of fact, Sweden made a major mistake early. They were slow on the nursing home protection.

– [Zubin] Right, that was a big thing there.

– [Marty] Compared to Norway and the other–

– [Vinay] But they kept those elementary schools open.

– [Marty] They kept almost everything else opened. The restrictions,

– [Vinay] That’s because they hate children. Did you know that?

– [Marty] They don’t, they don’t have as many children in Sweden, but.

– [Vinay] I hear, they love them. And I hear they have higher spending on children than the U.S. does.

– [Zubin] Is that right?

– [Marty] Because there’s fewer per capital, I’m sure,

– [Vinay] Of course yeah. They do love their children.

– [Marty] So Michigan had some of the strictest policies in the country, I mean, just parks were closed, schools had some of the longest school closures of anywhere in the country.

– [Vinay] Someone told me,

– [Marty] You know the mask

– [Vinay] there weren’t like, these big grocery stores. If you stray out of the grocery store aisle, to go look at like the lawn care supplies, they’re like taped that off, and then you’re like reprimanded for them.

– [Marty] Yeah, that’s the kind of stuff was happening in Michigan, right? So Michigan,

– [Vinay] Because you can’t garden.

– [Zubin] Of course, not.

– [Vinay] COVID feeds off gardening.

– [Zubin] We know that.

– [Marty] So it’s interesting, Michigan and Sweden, you may say, “Why did I pick Michigan?” Michigan has the identical population of Sweden. They have the same age distribution. They have.

– [Vinay] Equal number of eye-cares.

– Yap. Freezing cold,

– [Marty] Eye-care, freeze, So actually the waves, you know when people compare like New York to other states, it’s not a fair comparison because the treatment was not as mature when New York got hit, right. It was too early. So the,

– [Vinay] High case fatality rate.

– High, Right?

– Yeah.

– [Marty] So you can’t make a apple staples comparison, but Michigan and Sweden had identical concurrent waves, of infection, same climate, right? And so in doing this analysis in the end, in the final analysis of the two regions, Michigan had about 34,000 deaths, Sweden had about 17,000.

– [Vinay] Wow.

– [Zubin] Age match and, I’ll be watching that

– [Marty] Same average age, average age is 40 in Michigan,

– [Marty] 41 in Sweden. percentage of the population over 65, 18% in Michigan, 20% in Sweden. So even the distribution. The only difference that is significant, the obesity rate, 36% versus 20%, that accounts for some of the difference.

– [Zubin] Yeah.

– [Marty] But remember they had half the deaths in Sweden, as Michigan have.

– [Vinay] I think when like the final tally is in and people do really formal global analyses, Sweden, which was the pariah state because they disobeyed the experts.

– [Marty] The media. The media went after them.

– Lord Zero-COVID.

– They didn’t pray hard enough to Lord Zero-COVID, they’re gonna be looked at as, you know, having fared pretty well and done okay.

– [Marty] Why couldn’t the, and I remember then, the media was trashing Sweden.

– [Zubin] Totally.

– [Vinay] Of course.

– [Zubin] I mean they had, they had it at the cover of the New York Times was the Swedish chef on a ventilator with a peg tube.

– [Vinay] You know, because Sweden was an existential threat to.

– [Vinay] It was a threat to what we were doing.

– [Zubin] Yeah.

– [Marty] Yeah, it was a threat to the eat it from a high.

– [Zubin] It it’s amazing because like the left in this country loves to point at Europe, when we’re looking,

– [Vinay] ‘Cause they have better nationalized health.

– [Zubin] Better national,

– [Vinay] Better social safety net,

– [Zubin] Better social safety net,

– [Marty] More taxation.

– [Zubin] More taxation.

– [Vinay] Which I used to like until I started making money.

– [Zubin] Me too, brother, me too. But then when COVID happened, it’s like, “Well, the Europeans are crazy.” You know I mean. They’re not masking kids. They’re just nuts.

– [Vinay] And like look, the way they talk about the Norway in Sweden. And we have to wrap up after this, because of time

– [Zubin] Oh, you gotta go.

– [Vinay] And I’m also melting.

– [Zubin] Oh, you hot?

– [Vinay] You have the temperature.

– [Zubin] I’ll turn on the AC.

– [Marty] Turn the French file plant down.

– [Vinay] Oh my God, I’ll take off my jacket, God!

– [Zubin] Oh metallic T-shirt.

– [Vinay] That’s worst.

– [Marty] That’s what you hiding, Yo, why are you wearing that coat, man? Take it off.

– [Vinay] Well, I started out cold.

– [Zubin] Yep, that’s true.

– [Marty] Okay.

– [Zubin] It’s been cold today.

– [Vinay] And I gotta look good. I started out cold, but I gotta.

– [Marty] Why couldn’t, why couldn’t the New York Times, the New York Times and the fact checkers. Why couldn’t they go to Europe and just describe.

– [Vinay] They can’t fly on a plane, Marty.

– [Marty] Oh, that’s what I thought.

– [Vinay] That’s dangerous. as Russian Roulette.

– [Marty] I forgot. So once they got, you know, quadruple boosted, why couldn’t they go to Europe and just do some reporting on the schools that were open free care without mask?

– [Vinay] They still haven’t. They still have never done proper reporting on how normal it is in Europe for kids under 12. In many countries, they didn’t even mask them.

– [Marty] Well, they recommend against masks, for kids under 12.

– [Vinay] Well, WHO, under six, they recommend against.

– [Marty] Against,

– [Vinay] And then, from six to 12, it’s like on a case by case basis.

– [Marty] Well, they say consider,

– [Vinay] Consider.

– [Marty] the psychosocial impact.

– [Vinay] Yep, well,

– [Marty] So it’s not, it’s not even a blind

– [Vinay] Well, we don’t accept that, RAEP knows that, you know, the moment you turn two, you’re ready to be a good person and join society.

– [Marty] And the Europeans,

– [Vinay] As a civilized person.

– [Marty] And the Europeans CDC, says kids should not wear masks in primary school. And Ireland,

– [Vinay] Theoretical.

– [Marty] has been basically, you know, open free and clear with school. So where’s the data on that? Like where, are we gonna learn, are we going to study the largest intervention in public health history? Or are gonna just follow the narratives that we’ve been believing? Where’s the funding. Where’s the NIH funding to say, let’s study the school properly.

– [Vinay] They don’t wanna study it. I don’t, I mean, you need new leaders to. Do you think that, like a person who went on TV, that’s another problem. The guy who gives the funding out, is the guy advocating for policy. That’s a huge conflict of interest. Nobody wants to say anything about voucher. ‘Cause they’re worried about their funding process.

– [Marty] That’s a huge, conflict of interest.

– [Vinay] It’s a huge conflict of interest.

– [Zubin] Yeah, I’ve heard that from many people.

– [Marty] Involved. Yeah, I’ve heard that from many.

– [Zubin] And they don’t wanna speak up because well, I get my funding through,

– [Marty] That’s right.

– [Zubin] those guys.

– [Marty] That’s right. Especially in the HIV community.

– [Zubin] Oh totally.

– [Marty] So the Baltimore City schools have teachers that were or are very frustrated with the Teachers Union. And that’s an important point, right? A lot of teachers had serious issues with their leadership. And so just like pediatricians sometimes have serious issues with the AAP,

– [Vinay] They say faces are an evolutionary nuisance. Mine is, I know that.

– [Vinay] They say, they say, what did they say? They said that you may be worried about kids not seeing faces for years on end, don’t worry. There are no studies that show it’s bad.

– [Marty] Oh yeah.

– [Zubin] ‘Cause there’s no study.

– [Marty] Parachutes.

– [Vinay And Marty] It’s a parachute.

– [Vinay] And we’ve never done it in human history. So it can’t possibly be bad.

– [Zubin] Our time is to mislead with facts. There are no studies showing, yeah, you’re right. There are no studies.

– [Vinay] There’s no studies showing the 20 year outcomes of the COVID pandemic. You know that?

– [Vinay] There’s no study showing 20 year outcomes.

– [Marty] There’s no study showing the fifth generation effect of masks.

– [Zubin] That’s right.

– [Vinay] There’s not, not a single one.

– [Marty] Not single one.

– [Vinay] And not me.

– [Marty] Or vaccines.

– [Zubin] For that matter, yeah.

– [Vinay] Except in the deer.

– [Marty] Worst still.

– [Vinay] Or maybe they’ve gone through five, I don’t know. Maybe the rabbit.

– [Marty] Or five generation.

– [Vinay] The rabbit or the, the hamsters have a five generations.

– [Marty] Hamsters have an average life of six days.

– [Zubin] You just making shit up.

– [Marty] So you can study 15. No, it’s about two years I think.

– [Zubin] I have a Hamster.

– [Vinay] It’s two years.

– [Zubin] I was gonna say, If it’s six days,

– [Vinay] Well,

– [Zubin] This hamster is like a non generic.

– [Vinay] If you were, if you really love Lord Corona, Lord Zero-COVID, you will

– [Marty] Yes, Lord Zero.

– [Vinay] You will mask the toddler.

– [Zubin] A.

– [Vinay] You’ll be willing to accept as many boosters as Albert Bourla himself tells you.

– [Zubin] AB, for life B.

– [Marty] He is the defacto director at CDC.

– [Vinay] He’s the, of course.

– [Zubin] Yeah, of course he is.

– [Vinay] Actually he is the EUA thresholder. If Albert Bourla says, and if Israel does, that’s our EUA criteria.

– [Marty] So we talked to these, I was interested in doing a study on schools. And you know, my research we basically try to study the things in healthcare that are very important that no one else has study. That’s basically what we done with opioids, with healthcare costs, drug pricing, so many different things.

– [Vinay] That’s strange.

– [Zubin] PDs production surgery.

– [Marty] That we haven’t covered, but we are interested in breast augmentation because we feel that, people, I should rephrase that. We are interested in understanding the effects of breast augmentation, because we think there are a lot of spine problems and back pain long term. Because the frame is not designed for that, all right. And women are never counseled, about that as a side effect.

– [Zubin] Interesting.

– [Vinay] But you know, you’re a strange type of person. You research and then have an opinion, because that’s not good.

– [Marty] You not allowed to have an emotional connection to your conclusions but you see.

– [Vinay] No, I think the modern ecosystem is, you conclude what’s right.

– [Zubin] And then tweet.

– [Vinay] And then you find articles that support your conclusion and publish those as MMWR.

– [Marty] And then the facts checker is good.

– [Vinay] And then the fact checker.

– [Marty] So we’ve talked to the teachers and they were saying that there’s a group of kids in Baltimore City, that when the schools went virtual, the kids never logged on. They never saw logged on for these kids. And then when they went to back to in-person eventually

– [Zubin] These are lost.

– [Marty] They never showed up.

– [Vinay] Oh my God.

– [Marty] These are kids that we harmed, the system harmed.

– [Vinay] Oh, definitely

– [Zubin] Irreparably.

– [Vinay] Irreparably.

– [Zubin] Yeah, I mean they’re like that.

– [Vinay] We need to we need to find these guys.

– [Zubin] You’re right.

– [Marty] We need to rescue them.

– [Zubin and Vinay] Rescue them.

– [Marty] We need to find them and bring them back and spend extra money and handhold them and offer them to come back into the system with extra help.

– [Zubin] And then make a Hollywood blockbuster about it. And we’ll become rich. What do you think?

– [Marty] My guess is to.

– [Zubin] On the back of these poor kids?

– [Vinay] I think that, they,

– [Marty] Do you have the same modest financial goals that I do?

– [Zubin] Just one billion.

– [Marty] Just 1 Billion.

– [Zubin] My wife told me, my goal for you at some point, is that just to be able to say, “I’m married a tycoon.”

– [Vinay] A tycoon.

– [Zubin] And I’m like, I don’t know the definition of tycoon, but it’s never, it’s an awesome tool I’m not even striving forward.

– [Marty] Sounds scary.

– [Zubin] It does.

– [Vinay] It’ll be the title of his biography, biopic movie, “Tycoon” the Zubin Damania story.

– [Zubin] It’s the unauthorized autobiography of ZDoggMD.

– [Vinay] How a modest, modest Central Valley boy, rose to riches and took over the largest media empire in the world.

– [Marty] Yeah, I think, you are the biggest influencer in healthcare.

– [Zubin] I like to put that on bumper stickers. I mean, seriously.

– [Zubin] But I no evidence of it.

– [Marty] A billion collective views. I mean,

– [Vinay] Are you at a bill?

– [Zubin] I’m over a bill.

– [Vinay] Wow.

– [Zubin] ‘Cause Facebook has a of view.

– [Marty] When I give grand rounds at institutions, people will often bring up that.

– [Vinay] But a 100 million is his mother watching.

– [Zubin] Yeah, oh yeah. And then, a 100 million emails. I saw you and VP. What are doing.

– [Zubin] You better be careful, he’s very handsome.

– [Marty] What do you do with emails? I struggle with emails.

– [Zubin] Oh, I still struggle with them. You know what? You know what happened, is I closed all my Facebook DMs. I closed Twitter, you can’t reach me. It’s just like it’s post and ghost by my team.

– [Marty] Good for you. The only way you can reach me is through my website contact form or my link bio-form that emails me. And I’ve just gotten really good at scanning those quickly.

– [Marty] LinkedIn

– [Zubin] LinkedIn people can message me, I don’t read them.

– [Marty] See I like LinkedIn because it’s not shouting, you can curate it. So if somebody’s uncivilized.

– [Zubin] That’s true.

– [Marty] Which is basically defining Twitter.

– [Vinay] Yes, that’s social media.

– [Marty] And that’s why it’s good for you for getting off Tweeter.

– [Vinay] Here’s how I do emails. Okay, patient care, number one. Okay, then like research projects and things like that I’m writing, that I think are really important,

– [Marty] But how can you tell what’s what? You can tell from the subject line?

– [Vinay] Or the person who sends it. Well, patient cares, I know the person who sent the view.

– [Zubin] Right.

– [Marty] And this, your work email, is this is like your you CSF email?

– [Zubin] It’s the next problem.

– [Vinay] I guess the research stuff will. Yeah, it’s all UCFF, I mean that’s subject. But then, but then.

– [Marty] Work email. Only work emails, I open have the subject line final notice.

– [Vinay] You know the third warning.

– [Marty] Third warning.

– [Vinay] Overdue.

– [Zubin] Right?

– [Vinay] It’s like Marty, you haven’t complied with your fourth booster requirement.

– [Marty] Recording, yeah. She’s safe.

– [Zubin] I’m a 100% sure, I’m no longer adjunct faculty, UNLV because I never accepted their invite from my faculty email. And that’s where they send all the requirements. Like, You need a PPD unit, you need this, you need that. I’m no I don’t, ’cause–

– [Marty] Mandatory virtual training.

– [Zubin] Exactly. On equity and inclusion and sexual harassment.

– [Vinay] Or on how to use Zoom. There’s a whole like virtual on how to use it.

– [Zubin] Oh, if it’s healthcare. It’s Microsoft teams.

– [Marty] So the DC.

– [Vinay] Oh yeah, we do have to wrap up.

– [Zubin] Oh yeah, yeah.

– [Vinay] Okay. We gotta wrap up.

– [Zubin] Oh yeah we got,

– [Vinay] Last point.

– [Zubin] Go, go.

– [Marty] I don’t know if this is a good last point.

– [Vinay] End on a happy note.

– [Marty] Well, DC is gonna mandate boosters to keep your medical license.

– [Zubin] Oh my gosh.

– [Marty] And so, I’m not you know, I’m not gonna do that.

– [Zubin] No way.

– [Marty] So, in New York they announced the same mandate 25% of healthcare worker said hard no.

– [Zubin] Yeah.

– [Marty] And so they backed off the deadline. In DC the deadline was March 8th. Most people, a lot of people didn’t get boosted, right? ‘Cause if you’re young healthier or had hybrid immunity.

– To keep your license?

– [Marty] Yes, to keep your license.

– [Zubin] are they insane?

– [Marty] So they’re the only state that’s pushing hard so come March 31st.

– [Vinay] No, I think this state. Well, at least the UC system has to be boosted.

– [Zubin] Yeah, UC

– [Marty] That’s the system, that’s the system thing.

– [Vinay] So why haven’t been boosted.

– [Zubin] Against your will, yeah.

– [Marty] But you’re not losing your license, right?

– [Zubin] No.

– [Marty] So this is a threat to losing your license.

– [Zubin] Losing your income.

– [Vinay] Yeah.

– [Marty] I have a license in other states.

– [Vinay] Well, I mean, I’m just getting a product that has very, like no proof that it benefits someone of my age and nor any proof that it benefit anybody,

– [Marty] Don’t talk data,

– [Vinay] Yeah, I know.

– [Marty] I’ll send it to the fact checkers.

– [Vinay] The fact checkers.

– [Marty] So positive thing. So the students get it. The students right now, they wanna be a part of something larger than themselves. They wanna, social justice is a generational value and they believe in addressing the underlying issues that are bringing people to care. Not just playing whack-a-mole on the back end. And they’re watching this sort of greed industrial complex that goes on, that violates everything sacred in the medical profession. I mean, Jonas Salk donated the polio vaccine. They know that. And so they see what’s happening today and they don’t wanna be a part of that. And I’m so inspired by these young people. So I just thought, I’d mentioned that.

– [Zubin] That’s good, man and that Albert Bourla because you’re forced booster’s gonna get.

– [Vinay] Is willing to donate boosters five through 22.

– [Zubin] Yes.

– [Vinay] Is that, is that–

– [Zubin] Actually now he’s taking it all and funneling it into another diamond nipple ring because, you know, he’s time for this diamond nipple ring. And on that note, Marty.

– [Marty] Okay, great to you see guys.

– [Zubin] Every time you come here I am filled with joy.

– [Vinay] It’s pleasure, Marty.

– [Marty] Great to see you, Vinay and Chris.

– [Vinay] We’ll see you again.

– [Marty] You too.

– [Zubin] And guys, if you haven’t checked out our latest VP, CD episode, it just dropped. So we’ll put that out, we’ll put this out. That’s it, dude.

– [Vinay] That’s good.

– [Zubin] I mean, this was good, this was fun.

– [Marty] I enjoyed it.

– [Vinay] Next time.

– [Marty] Always enjoyed it.

– [Zubin] We gotta let him outta here.

– [Marty] Yeah, let him go.

– [Zubin] Oh, we out.

– [Zubin] Peace.

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