Dr. Marty Makary joins the fray for a science & reason SMACKDOWN 🔥 How many Omicrons does this register on the media fear-o-meter? 

Check out all our shows with MedPage today editor-in-chief Dr. Marty Makary here. And all our shows with UCSF hematologist-oncologist Dr. Vinay Prasad here. And our new joint podcast, The VPZD Show, here.

0:00 Intro

2:17 Boosters for All?

8:47 Young people + Covid, flawed CDC studies?

12:45 Natural immunity, Myocarditis, population risk vs. benefit

21:15 The narrative of simplicity and one-size-fits-all in public health

27:12 How we’re treating college students re: COVID quarantine, boosting, testing

30:45 Omicron, animal source?

34:08 Journalistic responsibility, and natural immunity revisited, what healthcare CEOS should do

43:28 Dr. Oz and the state of politics due to COVID disruptions in economy and freedoms

47:40 Socioeconomic status effects under COVID policies

53:59 Why so slow to learn more about vaccine resistance and omicron? The role of media

57:31 Therapeutics like fluvoxamine (Luvox) vs. molnupiravir

1:04:50 Zero COVID is a delusion, so focus protection where it matters

1:05:27 Fluvoxamine and the hydroxychloroquine/ivermectin debacle

1:08:23 Fauci’s foibles

1:12:12 Gain of function research

1:21:56 Listening to doctors

1:26:45 Pandemic of lunacy, gain of fear, and Fear-naught values

1:32:57 Cloth masks, and masking as distraction from real risks

1:34:58 Chemotherapy shortages

Transcript Below!

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– [Zubin] Hey, guys, it’s ZDoggMD, VP, MD, Vinay Prasad. Marty Makary.

– [Marty] 3Ms.

– [Zubin] 3Ms.

– [Marty] Good to see you guys.

– [Vinay] Good to see you, Marty.

– [Zubin] Dude, we’re the three horsemen of the COVID apocalypse according to pretty much everybody. We’re doing a show. We’re gonna talk about all the things. We’re gonna talk about therapeutics, boosters, we’re gonna talk about omicron. I like to say it, put the accent on the wrong syllable.

– [Vinay] Uh-huh.

– [Zubin] Because it sounds more like a decepticon than ever.

– [Vinay] And we’re gonna talk about why we’re sitting so close together. Why don’t you start with that . He doesn’t have a third microphone.

– [Zubin] Yeah.

– [Vinay] We don’t have a third microphone.

– [Zubin] You know, my supporters fund the show and they’re cheap, they’re so cheap, no.

– [Vinay] All these resources, we don’t have a mic.

– [Marty] Are you guys boosted being that close or is this an unboosted contact?

– [Zubin] We’re unmasked, unboosted and unrepentant, Marty.

– [Marty] Well, I’m an unboosted male. That’s my preferred pronoun, by the way.

– [Zubin] Oh, is that your pronoun? An unboosted male? Yes, my pronouns are it, they, those and currently unboosted because I got Moderna, which apparently kicks ass.

– [Mary] Yeah.

– [Zubin] Like it’s a good vaccine.

– [Marty] Yeah.

– [Zubin] I’m 48, I don’t have a lot of comorbidities. I have some clotting stuff, but I’ve never clotted. It’s just like theoretical 23andMe, thank you very much, so how about you, you boosted?

– [Vinay] You know too much about yourself. I, it’s a HIPAA violation to ask someone if they’re, no it’s not, no it’s not.

– [Zubin] Yeah, never mind, never mind. You don’t have to say it.

– [Marty] Privacy is dead, my friend. Privacy is dead right now.

– [Vinay] But I do see that people do say that. That’s not true. You can, of course, ask anyone their status, but no, I haven’t gotten my booster yet and-

– [Marty] You mean this week you haven’t gotten, ’cause you do weekly boosters, I’m sure.

– [Vinay] Well, eventually, we’re all gonna have to keep boosting.

– [Marty] Yeah, boosting.

– [Zubin] You know, my vaccine card looks like one of those like frequent flyer like coffee cards where they punch the hole, like I boosted here and boosted here and boosted here and when I get 10 boosters, Fauci sends me a Fauci bobblehead that says I am the science.

– [Marty] I’m getting my booster sent with the GNC nutrition vitamins.

– [Vinay] They had the same evidence, you know.

– [Marty] What are the odds we get canceled now with the three time canceling incumbents.

– [Zubin] I get yelled at for platforming each one of you separately. All we need to do is bring Jay Bhattacharya and Monica Gandhi here and we’ll have like the horsemen of the apocalypse.

– [Marty] Oh, done.

– [Zubin] And Twitter will just melt. It will just turn into goo.

– [Marty] Nice.

– [Zubin] So the booster thing.

– [Marty] Yeah.

– [Zubin] What is the deal with that, Marty?

– [Marty] Mm-hmm, yeah, everybody forgot that the FDA external experts voted down boosters for everybody by a 16 to 2 vote just nine weeks a ago. Right, and then all of a sudden, there’s a variant that came maybe from South Africa and the immediate first response we have is we got to boost every single adult, even if they had a natural immunity from prior infection. It’s almost as it we, there’s association whatsoever between boosting a young healthy person and omicron because we haven’t, don’t have any data on.

– [Zubin] Don’t really know anything about it, right?

– [Marty] Yeah, we know nothing.

– [Vinay] I mean, I think that’s the paradox of what they were saying was they were saying that we don’t know anything about this. At the same time, we have information that changes our booster recommendation. Both those things can’t be true. If you have no new information about the variant, you can’t change your recommendation. Otherwise, you could have changed it three weeks ago, but there’s a reason why they voted against it. You want to get into that? Why did they not say a 20-year-old man who doesn’t work in healthcare? So they did have an allowance for 18 and up if you worked in healthcare, but if you don’t work in healthcare, the committee did not want those people to be boosted nine weeks ago, as you say.

– [Marty] We’re bordering on, when people say boost people who are over age 65, yes, definitely, at least that’ll reduce their risk and by the way, it’s important to quantify what that reduction is. It’s a tenfold reduction in hospitalization from an already very low risk of hospitalizations. So what is the risk of hospitalization in a fully vaccinated American? According to the CDC website, it’s 1 in 26,000. It’s 3.8 per 100,000 per week. And that was at the peak of delta, by the way, that was early September. So, if I told you, hey, you’ve got a level of protection where the risk of hospitalization’s 1 in 26,000, I’m gonna give you the option to lower that to 1 in 260,000. Some people might say yes. Other people might say there are side effects in ultra rare serious complications. I’m okay with the risk tolerance of 1 in 26,000. By the way, who is that one person out of every 26,000? The only state that gives us a breakdown of breakthrough hospitalizations, North Dakota.

– [Vinay] Of course.

– [Marty] Tells us the average age is 73 and the average age of a breakthrough death is 80.

– [Zubin] And if you look at a population of 80-year-olds, their time to death in general is not that long. So it’s kind of like what are we really doing in terms of vaccinating healthy young people in terms of boosters, right? Look, I understand the argument to vaccinate healthy young people as a herd effect and a community benefit and also some of those kids will actually get sick. It’ll be a small number, but they’ll get sick and they’ll clog up the hospitals and that kind of thing and they’ll expose grandma and so on, but that’s why you vaccinate them with the two doses.

– [Vinay] With the primary series, right.

– [Zubin] Exactly.

– [Vinay] But I guess, Marty, your point is and the figures are giving, I think that if anything somebody might say that those are like the upper bound figures of risk reduction from boosting, right? You’re talking about I’m think is Israeli data is what it sounds like to me, like the Israeli real world data on that figure?

– [Marty] On the tenfold reduction.

– [Vinay] The tenfold reduction.

– [Marty] That comes out of Israel on the rate of breakthrough hospitalizations being 1 in 26,000, that’s right from the CDC’s website.

– [Vinay] Right from the CDC.

– [Marty] And those are probably people with medical conditions, special situations or very old people.

– [Vinay] But your point is well taken, which is that people should know that the people who we think should be boosted, older people, older people in this age group that that’s the kind of ballpark risks you’re talking about.

– [Marty] That’s right, that’s right.

– [Vinay] Now you start to extrapolate that to a 25-year-old who’s healthy. Can you give us a sense of the numerical risk reduction for such a person? I mean, the initial risk is probably as low to zero as you can get.

– [Marty] Well, that’s right. If it’s 1 in 26,000 overall and we know people with a risk profile like Colin Powell had are those people, then what does that tell you about how skewed it is on the other end towards younger and healthy people, yet U Mass Amherst just announced they’re going to require boosters for every student. So you got young healthy people who arguably could have been okay with maybe one dose, I mean depending on what you look at, but they’ve got natural immunity half the time if they check for it and now we’re gonna take people with natural immunity who have two doses and say you must get a third dose in order to come here. There is this term have to, must that’s used in such a loose way. What is that quantified risk? Maybe you’re okay with the 1 in 26,000 risk. Maybe you’re okay with the 1 in 100,000 risk if that’s what it is skewed towards healthy people. The idea that you have to or your must, that’s the language we hear. And it’s not honest and we’ve seen this paternalism, we cannot accept, you cannot accept any risk of a mild infection. We’ve seen that level of paternalism before in medicine. Matter of fact, we see it all throughout medicine, like we couldn’t allow women to have home pregnancy tests because we have to tell them the results, but it was all men saying that.

– [Vinay] And you know, Marty, the other point that you made just briefly but you should push on a little bit more is that some of those people getting boosted, not only have they gotten two doses, they’ve also had COVID and recovered from COVID. So what’s the risk reduction for somebody who’s had two doses, recovered from natural infection, I think it’s as close to zero as you can get.

– [Zubin] Yeah, and there’s provision to even look at that. And the other thing is I think this all dovetails into this overall culture of safetyism that has emerged, especially on college campuses. On college campuses, it’s unsafe to use words, like the one thing that we have as humans that prevent actual violence and damage. Instead of violence-

– [Vinay] Can avert violence as best, words.

– [Zubin] It averts violence. We have words to avert punching each other in the face. But there are words that are the equivalent of punching someone in the face. Well, of course they’re gonna say you need two vaccines, plus a booster, plus you probably should go out and get naturally infected with omicron, which may be less severe, just to be sure and then maybe we’ll let you in if your little shaved ice punch card is all the holes are punched. You must, right.

– [Marty] You see that study out of Germany that of all young people age 5 through 17, not a single death from COVID in a healthy person. 100% of the deaths were clustered in people with a comorbid condition.

– [Vinay] Now I’ve heard the CDC data is that it is three quarters of the deaths in the under 11 age group was comorbid conditions.

– [Vinay] Let me tell you something about the CDC. Most of their studies would not qualify for a seventh grade science fair project. None of them have been published in any medical journal for a reason. The conclusions cannot be made from the data. The two crack studies that they put out on natural immunity, I mean how does the medical establishment not pile onto those studies.

– [Marty] Well, that’s a good conversation because one of the studies is the one, correct me if I’m wrong, it’s like among people with natural immunity, some of them chose to be vaccinated, some didn’t.

– [Marty] That’s right

– [Vinay] And both groups had almost negligible rates of getting SARS-COVID 2.

– [Marty] Less than 0.01.

– [Vinay] Right, but the group that chose to get vaccinated had a slightly even lower rate than the group that didn’t. But, again, they’re choosing, they’re very different people.

– [Marty] And it was a two-month window.

– [Vinay] And it was two-month window.

– [Marty] In one state of Kentucky, even though they have data on all 50 states from the pandemic and they won’t release the reinfection data.

– [Vinay] I see, so you’re saying that of all the places they could have looked, they’re only looking in one place, one narrow snapshot.

– [Zubin] Yeah, fishing.

– [Vinay] Yes, and I guess the point is, the reason it’s a flawed study is that you don’t know it was the vaccination that did it. versus the characteristics of the type of people who sought vaccination.

– [Marty] Sure, they’re gonna be more careful, yeah. But to your point quickly before. So the question was in the U.S., you made a comment that the CDC has suggested that roughly three quarters of people have a comorbidity who are young and died of COVID.

– [Vinay] Correct.

– [Marty] Yeah, so that comes from a hospitalization report in adolescents where they said 68% of those hospitalized for COVID had a comorbid condition listed on their diagnosis. They then later went back and said, but those hospitalized for COVID, we don’t know if it was hospitalized for COVID or with COVID and then we don’t code for obesity. I mean, how many times have you coded for obesity? You get someone obese comes in, oh, we gotta make sure this ICD code is on here.

– [Zubin] You’ll get yelled at for shaming them. You can’t do it.

– [Marty] And yes, and guess what the most common risk factor-

– [Vinay] Most common under discussed risk factor.

– [Vinay] Under discussed.

– [Zubin] Under discussed.

– [Marty] Most common leading, that’s right.

– [Vinay] The biggest risk factor’s age. But the biggest under discussed risk factor is BMI.

– [Marty] That’s exactly right.

– [Zubin] You had a paper where you looked at the top risk factors, right, for death from COVID?

– [Marty] Yeah.

– [Zubin] What were they?

– [Marty] Well, first of all, that paper is in its eighth submission. It’s been rejected from, so this is the largest study ever done in the world on risk factors of COVID mortality done by a large consortium of Johns Hopkins researchers, including three members of the National Academy of Medicine, top immunology folks, members from our Center for Health Security and so we have access to all the nation’s Medicare data in real time and we looked at risk factors for COVID death. All eight journals rejected it with no explanation. Right now, the journals are…

– [Vinay] Is it because you think that they are cautious about putting forth the narrative that obesity’s a risk factor?

– I don’t know what it is. I think that there’s just an oligarchy that decides what’s important and we’ve seen this with every area of medicine and if you’re not in the club of what they want to see.

– [Zubin] You know, I think you should play the race card, Marty. I think you should tell them I’m Egyptian and I’ve been excluded from publication, but actually-

– [Marty] That would work, but I’m one of like 17 research co-authors on it.

– [Zubin] Dammit. But, you know, that little bit of brown just colors the whole pot. But joking aside, this is a prime question. Why would CDC get to publish all this stuff that has a particular bent, right, whatever that is, right?

– [Vinay] Sometimes they publish in their own journal, “MMWR.”

– [Marty] Well, that’s where they published this crackpot study on natural, not the Kentucky one.

– [Vinay] No, no, but many of their studies that are poor quality, PIMA, Maricopa County and kids masking and you’re talking about natural immunity studies, but many have been published in “MMWR.”

– [Marty] So you’ve got 18 studies showing that natural immunity is at least as effective as vaccinated immunity. Two studies to the contrary, both are CDC reports that are unpublished, one is the crackpot study from Kentucky and the other is the study where they-

– [Zubin] I just picture a guy with a banjo doing science.

– [Vinay] Now that he’s labeled it that way.

– [Zubin] Yes, exactly. The crackpot Kentucky study.

– [Marty] They didn’t even involve anyone from Kentucky. They imposed these results because they have all the national data.

– [Zubin] Oh, I see.

– [Vinay] Of course yes, they have been looking.

– [Marty] So they basically, hmm, is there a sliver in the data where we could show that natural immunity is worse? Well, let’s look at all 50 states. Here’s one.

– [Vinay] Oh, I see, this is the study you’re talking about, yes, I see.

– [Marty] Where we’re seeing noise.

– [Zubin] I see.

– [Marty] And let’s just look at reinfection rates over a two-month window. The whole study is a two-month window.

– [Vinay] And your point would be the reason that matters is natural immunity will be more durable, you believe, in month eight, nine, 10, 12, then vaccine immunity and proof of that is what has happened in Israel, et cetera.

– [Marty] That’s right. That’s the largest study done worldwide and it shows it’s, adjusted for age, 27 times more effective. It can be 27 times more effective and half as effective. Both can’t be true.

– [Vinay] But let me ask you one question, Marty about the boosters. You know, the argument that we’ve all been making is the argument that at an individual risk level, the individual risk to an older person, you’ve quantified it, and, you know, people can choose that or not, to a younger person, it’s gotta be smaller.

– [Marty] Much smaller.

– [Vinay] And to somebody who’s already had natural immunity in addition to the vaccination, it’s probably verging on zero, okay, that’s the argument of our individual risk. Now what about the person out there who says that at least some part of boosting is for a communal benefit? So, therefore, the 20-year-old kid in IT who’s staying in his house all day, he should go and get a booster because maybe it’ll help my grandmother. What are your thoughts on that?

– [Marty] I think it’s a reasonable argument. I think there’s value to getting, increasing your immune protection to reduce community transmission, but remember, the peak level of viral shedding was equal in vaccinated and unvaccinated people in the recent Lancet study. It’s just the window was-

– [Zubin] Squeezed.

– [Marty] In somebody vaccinated.

– [Vinay] I would, you wanna say something?

– [Zubin] No, I was just gonna say, and then you have to weigh that communal benefit against the communal cost, which is days missed at work from having side effects from the booster, potential myocarditis, those kind of things we have to also factor in when you’re holistically looking at well, this is a policy decision now.

– [Vinay] Yeah, I’m with Z on this now because I think that it is okay, I think, to have policy that is driven by community benefit as long as the individual recipient is not suffering a decrement in their health. And I do worry when you’re talking about upper bound benefits in a 25-year-old getting the third Moderna that the upper bound hospitalization benefit is basically as close to zero as you can get, but the risk of myocarditis, it’s not gonna be 1 in 5,000, I don’t think. It might be less because that’s what the data has emerged so far, but it’s not gonna be zero and it might exceed the benefit of hospitalization. So you can’t ask a young person to literally take a harm for a societal benefit that is theoretical. You know, these people who talk about what the pandemic might be if we boost verse if we don’t, they’re the same people who made a bunch of models that last I checked, ain’t very accurate.

– [Marty] Yeah, right. It is the same geniuses that told people they can’t visit their loved ones as they’re dying in the ICU.

– [Zubin] Yeah, they were not just geniuses, they were real humanitarians, those people, and you know . On top of that, there’s this argument, well, you’re gonna hurt grandma by not boosting, right, which is very specious argument because the grandmas you’re gonna hurt elected not to get vaccinated, most of them.

– [Vinay] Oh, okay, that’s an interesting point.

– [Zubin] So they’ve already-

– [Marty] That’s right.

– [Zubin] Made their decision on where they want risk to be, which is fine, that’s fine. And you’re gonna take that risk, that’s fine. Your risk in that age group is not the 1 in 26,000. It’s considerably higher.

– [Vinay] Much higher.

– [Zubin] But still, right, and it’s the same thing, you know in the early days I’d always say your risk of getting, if you’re in your 20s, your risk of dying in a car accident is something like 10 times or two times higher than your risk of dying of COVID, whereas it inverts when you get older. So, you know, we just don’t understand risk well.

– [Marty] Somebody, and I’m gonna get a pile of criticism for saying this.

– [Vinay] You think what you’re gonna say now is gonna get the criti-, what about all the stuff you’ve BEEN saying, you’re get you fired, you’re gonna get a deluge now.

– [Zubin] The man has no self insight at all.

– [Marty] I’ve never been criticized for anything I’ve ever said, but now I will get my first criticism.

– [Vinay] Okay, now you will, now you will, got it, got it.

– [Marty] And that is in the “New England Journal of Medicine” paper on vaccine complications, somebody died.

– [Vinay] Yes.

– [Marty] A 22-year-old died in that group of 134 people who got myocarditis.

– [Vinay] Yes.

– [Marty] That was in Israel-

– [Vinay] Yes.

– [Marty] A country 138th our size.

– [Vinay] Yes.

– [Marty] And that’s the one case that’s documented, that’s confirmed that we know of and I’m not making my own conclusions about it, I’m just telling you what was in the “New England Journal of Medicine.”

– [Vinay] But why is that so important?

– [Marty] Well, if we take that number and extrapolate it to the U.S. population, are we prepared to extrapolate that number of deaths from vaccination and how does that compare with the deaths from COVID in healthy people.

– [Vinay] Correct, and I think, Marty, to your point, two things can be true at the same time. The people who want to, I think, have you not talk so much about myocarditis. They say things that is true, which is that it’s mostly mild. But all adverse events exist on a continuum.

– [Zubin] A spectrum.

– [Vinay] A spectrum.

– [Marty] COVID’s mostly mild.

– [Zubin] Yeah.

– [Vinay] You could say that.

– [Vinay] Right.

– [Zubin] Oh, don’t say that.

– [Zubin] You’ve said so many dangerous things, Marty, keep going.

– [Vinay] But that doesn’t mean, but your point is well taken that it’s not just what happens to most people, it’s what happens to the tail people. It’s what happens to that, you know there’s a distribution of events and most myocarditis will be mild, thank goodness, most will self-resolve. Some will have long-term late gadolinium enhancement. We don’t really know what LGE means on T2-weighted MRs.

– [Marty] That’s right.

– [Vinay] We don’t really have the full implications. Will some lead to chronic arrhythmia, chronic cardiac disturbance? Will some lead to shortened life expectancy down the road? But what we do know for sure is that it does have the potential to have catastrophic short-term failure and death as in this case report from Israel and that should give people some caution that it’s not all mild. It’s mostly mild, just like COVID is not all benign. It’s largely, a lot of people recover.

– [Marty] Good point.

– [Zubin] Right, and I think to put a little container around this Chernobyl activity, which I love, you know, we’re not trying to invoke fear by saying oh, potentially there’s arrhythmias.

– [Vinay] No.

– [Zubin] We’re just saying listen, you have to think about all these things when you’re looking at a risk benefit for a population and I’ll add another piece here that a lot of people don’t talk about because I get the emails, right? These people are-

– [Marty] I don’t read ’em.

– [Zubin] Yeah, you don’t read ’em?

– [Marty] Life is great, life is great when you don’t read the emails.

– [Zubin] Listen, I’ve gotta say this, I’ve been increasing my meditation amount to like two, three, four hours a day. I get up at like four-

– [Marty] Hours, okay, I thought you were gonna say minutes.

– [Zubin] Yeah, I meditate to two hours in the day, yeah, I know, minutes. Well, that’s the best, I mean, the real actual quality of meditation is one minute of thoughtless space. The rest is all just me watching my thoughts and getting angry about something someone said on Twitter. But since that’s happened, I’ve looked at email less and I’ve batched them and only do them on the weekends. So I’ll sit for three hours and I’ll go through 400 emails and what I read is young people who’ve maybe had COVID, maybe they’ve gotten the first two doses, now they’re talking about boosters and number one, they have deep needle fear, so there’s something that conditioned them when they were young, they got stuck five times at once, which is all fine, but now they have this terrifying piece of needle fear. They are worried about myocarditis because they have some family, their anxiety level’s through the roof, the media’s already stoked their anxiety fear contagion and they’re asking me what should I do, I’m scared to do it, I’m scared not to do it and this has a cost.

– [Marty] Yeah, I can’t go to college unless I do it.

– [Zubin] Right.

– [Vinay] Yeah, that I think is problematic and I mean, to Zubin’s point, I guess I wanna also be clear that I’m a huge proponent of vaccination.

– [Zubin] Yeah, both of us are.

– [Vinay] You know, we both are. The reason is you can be a proponent for something, but recognize that there are always populations or groups where you need to have a lighter touch and in this case, for instance, other countries around the world, they’re not using Moderna under 30, such as German, Denmark.

– [Marty] That’s right.

– [Vinay] They’re not using Moderna, why? Because they say we have Pfizer and Pfizer has less myocarditis than Moderna, so why would we take more myocarditis when you get-

– [Marty] They recommend against it.

– [Vinay] They recommend against it. Some countries explicitly against it, some countries don’t even let you get it, some countries let you get it if you choose to opt into it, but different strategies. But this country-

– [Marty] All or nothing.

– [Vinay] It’s all or nothing.

– [Zubin] All or nothing.

– [Vinay] It’s three or you’re not quote fully vaccinated. You know, that’s a problem.

– [Zubin] And you know what’s really interesting is you can’t talk about masking a two and three year old as a question, but the WHO says don’t do it.

– [Marty] Yeah.

– [Zubin] So the U.S., I feel like we’ve lost the ability to even have the discourse about it because of the same thing you talked about where there’s a narrative that has to be kind of pushed and I don’t know how this became a narrative. What happened here?

– [Marty] So I’ve talked to public health officials behind the scenes, you know, I’m in the Washington, D.C. area and here’s something that they argue and it’s not a, it’s not a completely flawed argument. It’s just one I disagree with and that is there is value to a very simple streamline message.

– [Zubin] Sure.

– [Marty] In other words, vaccinate everybody. Ignore natural immunity, just vaccinate everybody and maybe that simplicity of the messaging will result in more vaccinations among those who don’t have natural immunity. I disagree with that because I believe we should be 100% honest with people and not be so paternalistic. And we’ve, again, seen this in so many areas of medicine up to this date. We’re seeing it with the booster conversation. You must, have to. How about quantifying that risk to them? And the other thing they say is that with the kids, you know, sure, yes, maybe for a child who’s had COVID, they don’t need to vaccinate, but there are those with comorbidities and really wanna get them vaccinated, so do a universal vaccine policy.

– [Vinay] You know what’s simple? If you’re tiling a room, it’s simple to just use the tiles that come from the store, but when you get to the corners of the room, you gotta start cutting the tiles or you’re gonna have some problems on the corners. And so, you know, simplicity can be a problem. It can be such a problem that there’s groups of people who are actually hurt by simplicity.

– [Marty] And you lose credibility.

– [Vinay] And you lose credibility.

– [Marty] Should we do mammograms for all men and women, including children?

– [Vinay] Just to keep it simple. Keep it simple.

– [Marty] Just to keep it simple.

– [Vinay] Keep it simple.

– [Zubin] What are you saying, Marty? Listen, this is not breast tissue, it’s muscle.

– [Marty] Are you suggesting that kids don’t need a colonoscopy? Are you gonna just let them die?

– [Zubin] I would just do the genetic test on their stool to rule out the possibility of colon cancer which doesn’t exist.

– [Marty] I’m glad you’re anti-colon cancer in children because for a second there I thought you wanted to just let them die.

– [Zubin] You know what? You’re dangerous. The other thing I wanna say, though, Marty, about this is this is America, so we have a certain cultural set of norms about not having the government tell us everything that we’re supposed to do. So, pros and cons of that, for sure, but this is ‘Murica, so Americans don’t like when people aren’t just direct, like hey, here’s the deal, here’s the nuance, right? Okay, you know what? We’re asking you not to wear masks because there aren’t enough freaking masks for the people who really need them. Let’s just say that.

– [Vinay] Right.

– [Zubin] Instead of what Fauci did the flip flop and so on.

– [Marty] Surface transmission.

– [Vinay] All the surfaces.

– [Zubin] All the mites.

– [Marty] All the geniuses that kept loved ones out of the ICU.

– [Vinay] But good thing you scan your menu for the QR code, ’cause that’s what keeps you safe at night, right?

– [Zubin] You know what? And the hygiene theater of putting your mask on until you sit down and then taking it off.

– [Vinay] Only when you walk around a restaurant do you need to wear the mask.

– [Zubin] When it’s best ventilation.

– [Vinay] Yeah, right, that’s fine.

– [Zubin] When you sit down next to all these people.

– [Marty] Sit down, talk for two hours, loud, yapping, singing songs in the bar. That’s okay, ’cause you’re sitting down.

– [Vinay] But can I offer one more suggestion about this? I mean, one narrative for why these policies are wrong in these places and I do think it’s not just you and me and Zubin to some degree and Cody Meissner and Waleed and some other people who think that there’s some problems on the margins with these policies. One explanation is that they’re trying to keep things really simple. Okay, another explanation is that there is a tension, what do you think? I’m posing this as a question to you. There’s a tension between what is good politics and what is good medicine and from a political calculation, if you are somebody who’s future is tied to the current pandemic. If you’re in the White House, you know, you might view it as like anything that gets the cases, and maybe this can lead to the case discussion we’re gonna talk about. Anything that can get cases down is something we ought to pursue and you don’t think about it the way a doctor things about it, which is like for this 16-year-old boy in my office, who I documented he had COVID and he recovered from COVID and he’s an athlete who’s poised to get a scholarship and he already got one dose of the vaccine. Should I give him the second dose?

– [Marty] No.

– [Vinay] Okay, right. That’s what a doctor would say. I think you’re right. I think if you’re really honest, most pediatricians would say that for such a boy.

– [Zubin] Absolutely.

– [Vinay] Absolutely, okay. But now you’re the White House. Now what’s the risk benefit to you in the White House? Because if this kid goes out there and he ends up getting the sniffles and he gets a swab and it’s positive, that’s another case that you have to deal with that’s holding the S&P 500 down, that’s holding us all captive. He could potentially be a, you know what I’m saying?

– [Marty] Yeah.

– [Vinay] So, what do you think?

– [Zubin] I gotta say this, though. You know what’s holding the S&P 500 down? Omicron madness.

– [Marty] Omicron.

– [Zubin] So the same political apparatus that puts this thing into motion, theoretically, we’re not saying this is happening, but theoretically, then creates the omicron panic, like oh, my God, we gotta . S&P goes rump. Over something we know nothing about.

– [Vinay] And that’s you buy.

– [Zubin] That’s when you buy.

– [Vinay] That’s when you buy.

– [Zubin] Oh, hell yeah.

– [Vinay] You get me, you buy the dip.

– [Zubin] I’m an insider COVID trader, dude.

– [Vinay] That’s when you buy, okay.

– [Marty] I’m an omicron trader.

– [Vinay] So what do you think, though, on this idea that there’s a tension between the people are are leading the effort and truly impartial medicine?

– [Marty] We would never have a White House press conference for the new variant of influenza that’s seasonal that comes every fall. We would never say it’s now arrived. We have a case in San Francisco.

– [Zubin] Influenza A. Hemaglutanin and “antigen 3.6”.

– [Vinay] You got a good memory.

– [Zubin] Yeah, you know, no formal training.

– [Marty] That guy’s a genius, man.

– [Zubin] No formal training.

– [Marty] And so if, look, the problem is we’re hunting for a now colonized endemic pathogen, so would we test everybody for meningococcosis? If we do, 10% of the population will come back positive.

– [Zubin] Colonized.

– [Marty] A tiny fraction of them will develop meningitis, a tiny fracture. I mean, there may be less than 50 cases a year total.

– [Vinay] All I know is one thing. If Z is positive, then by the end of this interview-

– [Zubin] We’re all positive.

– [Vinay] I’m gonna be positive.

– [Zubin] That’s right. I already got C-diff sitting next to this guy, man. So, sorry, so like 50 cases roughly.

– [Marty] Yeah, I’m just saying we’re gonna get to a point very soon where it’s gonna be endemic, colonized and if we keep hunting, I mean, look at what Georgetown University’s doing right now. Everybody is required to be vaccinated. They’re wearing masks, they’re taking precautions, they don’t have a lot of social activities indoors ’cause they’re on hold or at least last time I checked. And if you test positive on surveillance testing you are basically put in a jail cell. You are put in solitary confinement for 10 days and told if you leave there could be severe repercussions like losing all your tuition and being banned from campus. You have food dropped off at the door-

– [Zubin] Forced to rush a frat.

– [Marty] That might even be more pleasant. And you have food-

– [Vinay] Probably, yeah.

– [Marty] Dropped off at your door once a day. And so what are we doing?

– [Zubin] These are kids.

– [Vinay] But you know, I’m-

– [Zubin] Healthy.

– [Vinay] I think this is like the height of madness and I guess the people who believe in it, they say things like this is what’s necessary to control spread. But the kind of evidence they’re marshaling for that are like models that have often been made by the companies selling the test on campus, right? So there’s this huge conflict of interest I don’t think people recognize. Which are the schools that are doing this? It’s not Brooklyn Community College. It’s Georgetown.

– [Marty] Bryn Mawr College.

– [Vinay] Bryn Mawr College.

– [Marty] Amherst.

– [Vinay] It’s schools with money. And why do they do it? In part, perhaps to placate the anxieties of the wealthy parents that send their kids there. In part they do it because they have the money. In part they’re being, I think perhaps to some degree bamboozled by the testing companies that have developed models that support their own testing.

– Let’s be honest. Lawyers are writing COVID policy in America right now.

– [Zubin] Oh, yeah, come on.

– [Marty] It’s not physicians.

– [Zubin] They’ve been writing medical policy for years. All our cover your ass stuff that we do, it’s like why would I get an abdominal CT on every single person who comes into the ER when it raises their cancer risk over years? Well, to cover my ass. I’m saying I do that, ’cause I don’t. I don’t work in the ER. I’m a hospitalist, I’m better than that. I’m kidding here, guys, I’m kidding.

– [Marty] But why are we waging World War III against mild infections.

– [Vinay] On campus, but the moment-

– [Marty] On campus.

– [Vinay] You’re one block off campus, there’s no war at all.

– [Marty] That’s right.

– [Vinay] So that’s another distinction, like what’s the bene-, even the people who are articulate, there must be some benefit to the community. They’re forgetting the fact you walk off campus, you go to the grocery store, no one’s doing any of this stuff.

– [Marty] We have now an accompanying pandemic of lunacy that is now following the-

– [Zubin] What’s the are not of the contagion of fear, Marty, have you calculated it?

– [Vinay] It’s 22. No, it’s like way higher, it’s way high.

– [Zubin] Yeah, like one crazy news announcer or some lunatic on Twitter who’s a fear monger who probably has, you know, panic disorder themselves, it can infect 22 other people with fear.

– [Marty] Yeah, if-

– [Vinay] He lost his train of thought ’cause we kept blabbing. We totally derailed him.

– [Zubin] I know, he had this, he had this-

– [Vinay] He had this great idea.

– [Zubin] He had this profound, like it was like-

– [Marty] He does a lot of TV interviews, but he’s not used to this.

– [Zubin] No, because it’s never like-

– [Vinay] This is the lion’s den.

– [Zubin] So, anyways, did you rush a frat, Marty, ’cause which one was it? Was it Pi Alpha Data Omicron? Did you rush to Omicron frat, bro?

– [Vinay] Yeah, he’d never do that, but let’s give you a chance.

– [Marty] I went to a fraternity house once and that was to drop off a lab experiment project. I told everybody that I was there, you know. And the following weekend, people were like, “What are you up to this weekend?” And I’d say, “I don’t know, I’m thinking about maybe going to the Fiji house again.

– [Vinay] Been there before.

– [Marty] Yeah.

– [Zubin] Delta Delta Delta.

– [Vinay] You were a pre-med, you were working on getting into medical school. Marty, okay, let’s talk about this one thing that you mentioned before that we gotta talk about. Omicron, the genetic sequence, it’s closest relative, where did it come from?

– [Zubin] Ah!

– [Marty] Animals. I’m convinced it comes from an animal reservoir.

– [Zubin] Have you seen “District 9?”

– [Marty] Yeah.

– [Zubin] Those aliens look like they have COVID, don’t they?

– [Marty] South Africa, yeah, that’s where they landed.

– [Zubin] That’s right, the prawns. It was the prawns.

– [Marty] Yes, so what percent of deer have had COVID-19?

– [Vinay] 70% I thought.

– [Marty] I saw 30%.

– [Vinay] 30%, okay.

– [Marty] In the Penn State study. The deer were in Idaho, so I don’t know where it’s from, I’ve said enough. Are Idaho deer representative of U.S. deer?

– [Zubin] They’re more conservative as far as deer go. They’re more likely to eat-

– [Marty] They’re red deer.

– [Zubin] They’re more likely to eat corn fed grass than grass fed grass.

– [Vinay] 30% deer. And I guess the explanation around that is when you look at the genetic sequence, it appears the last known sequence that this is to human SARS-CoV-2 is a long time ago in the past. And so I think there’s three explanations. One is it jumped to animal reservoir, jumped back. Second explanation, it was replicating in populations that are not being surveilled, so perhaps such as very rural people, but the problem with that is you would expect inevitably some of the other strains would leak back into places that are surveilled and you would catch the sort of other ancestral strains that are closer and then the third possibility is it was replicating in an immunocompromised host for a long period of time.

– [Zubin] That’s the old alpha theory.

– [Marty] That’s the old-

– [Vinay] Yeah.

– [Marty] That’s the old, those Africans gave it to us, right.

– [Zubin] Yeah, the immunocompromised Africans.

– [Marty] Immunocompromised, people with HIV, the right third of-

– [Vinay] Well, that’s what NPR is saying.

– [Marty] I know, it’s amazing how it gets parroted.

– [Vinay] But like the animal reservoir theory.

– [Marty] By the way, the media has fallen, they now parrot whatever the government officials put out there.

– [Zubin] Yeah, that’s true, yeah.

– [Marty] So when the government says natural immunity does not work, the government puts that out there, the media falls in love with it. They fell for it. And they just parrot the same thing out there. I mean, they haven’t seen something they love this much since weapons of mass destruction.

– [Zubin] Oh. Pour some out for Colin, okay.

– [Marty] Okay, so here’s why the animal, here’s why the animal reservoir point that you made is so important because there are millions of deer in the United States. I don’t think this came from deer-

– [Vinay] But some animal in Africa.

– [Marty] That’s right, there’s many animal reservoirs. There’s 10 to 15 million bear in North America.

– [Zubin] Is that the plural of bears?

– [Marty] Bears. But, English is a second language.

– [Vinay] You’re gonna derail his whole train of thought again.

– [Zubin] I know, I just can’t, I just am curious. Bears, or are they bear, I don’t know.

– [Marty] And the bear statistic is unrelated to anything we’re talking about, but I just though I’d drop it. So rodents are one of the vehicles in-

– [Vinay] Yes, yes, yes.

– [Marty] Right, so how many rodents-

– [Zubin] Oh, come on, I have a hamster.

– [Vinay] But you’re building to your point, which is that this virus will never be eradicated, it’s going forever.

– [Marty] It’s gonna keep spitting out variants forever. Forever. We’re gonna have a White House briefing every time a variant comes out that gives mild illness?

– [Vinay] So, Marty, let me ask you this. I’m with you on your point that I do feel as if the media is uncritically parroting press releases that come from this administration. Hypothesis, see what you think, you’re the Washington insider on this.

– [Zubin] The swampologist.

– [Marty] That’s right, the swampologist.

– [Vinay] I feel like they feel like there’s two choices in this world. Either if they are very critical of this administration, the alternative will be an administrative that comes back to power that they really don’t want and so they are really giving a pass on this administration and to some degree they’re not doing the work of journalism, which is hold power accountable. Thoughts?

– [Marty] What we are seeing right now with journalism is identical to what we saw with justifying the Warne rock. Whatever the government puts out, thank you very much, we’re gonna put this out there and just broadcast it as is. And I’ll tell, the medical community is complicit in this. These two studies on natural immunity put out by the CDC were so flawed, no respected honest physician would ever say that you could make those conclusions from the date presented. The second study, the one we didn’t talk about, not the Kentucky one, but the other one, surveyed people in a hospital and derived population risk levels of natural immunity being protective versus vaccine. You can’t-

– [Vinay] So they’re conditioning on going to a hospital.

– [Marty] That’s right.

– [Vinay] As a collider in this issue. Okay, so I guess the point you’re making here is that-

– [Marty] By the way-

– [Vinay] Yes.

– [Marty] We’ve ruined the lives of millions of Americans-

– [Vinay] Who have natural immunity.

– [Marty] Who have natural immunity.

– [Vinay] I agree.

– [Marty] We’ve ruined them.

– [Vinay] I agree.

– [Marty] We’re gonna be fine no matter what happens with COVID, right?

– [Vinay] Yeah.

– [Marty] People are dishonorably discharged from the military, nurses walking out. We can’t get chemotherapy now for patients.

– [Zubin] Our frontline heroes.

– [Vinay] Well they were hero, now they’re anti-vax deniers.

– [Zubin] Now they’re anti-vax deniers. Now they’re killing grandma.

– [Vinay] But I guess the point you’re making here is that if you look at all of the studies, all of the studies would suggest that natural immunity is at least as good, but probably better than vaccine-induced immunity and while we might want, while there are lots of people in this country we want to get vaccinated-

– [Marty] That’s right.

– [Vinay] We can put these people on the back burner, we can let them have, and many other European nations, the pass says if you’ve actually recovered from COVID-19, you know, you get the pass, too, right?

– [Marty] That’s right.

– [Vinay] We’re not doing that. We’re continually, we can only look to Europe for Medicare for all, but all the other things, we can’t learn anything from them. You know, we can’t learn about Moderna from them, we can’t learn about natural immunity from them. So you’re saying that what we’re doing is we’re punishing these people of natural immunity. We don’t need to punish them so hard and we can let them back into the fold, we can let them work in hospitals, staff the hospitals that are understaffed and the net result will be better public policy.

– [Zubin] And the smart people know this. Like Paul Offit said, “Yeah, natural immunity’s pretty good, it’s just a bureaucratic nightmare trying to figure out who’s immune and not.” Well, okay, then do we as a policy invest in that bureaucratic nightmare to try to figure it out because of the cost of trying to immunize naturally immune people, like which we’re bringing up. I think it’s valid. You know, by the way, speaking of the natural immunity piece, that’s one of the explanations for why this legendary Israeli booster trial thing where they said, oh, look, you know, the vaccines are waning in efficacy over time. Well, part of the reason is their control group, the unvaccinated are-

– [Vinay] Yes, yes, yes.

– [Zubin] Increasingly naturally infected, so they have a very high level of immunity so now you’re comparing that high level of natural immunity-

– [Vinay] That’s an excellent point.

– [Zubin] To vaccine immunity and the vaccine is not looking as good.

– [Vinay] And actually the same person who would espouse this explanation for why vaccine efficacy has declined, which is that the control arm has got some substantive natural immunity in it, that’s the same person who will later deny the natural immunity

– [Zubin] Natural immunity.

– [Vinay] When they make you get the booster.

– [Marty] It’s such cherry picking, I mean-

– [Zubin] Go ahead, go ahead, go ahead, go ahead.

– [Marty] Well, there’s just so much cherry picking, right, because when the study came out of Israel through the Israeli Health Ministry that boosters reduced the risk of hospitalization by tenfold in people over 65, Dr. Fauci immediately described it as quote unquote dramatic data and they wrote up lots of policies around boosters before the FDA even saw it. And then the same Israeli Health Ministry announced in the largest population study every done that natural immunity was 27 times more protected than vaccinated-

– [Vinay] Correct.

– [Marty] Mum.

– [Vinay] Yes.

– [Marty] Not a word. How do you call one set of data dramatic data and the other you dismiss? We’re seeing the same with fluvoxamine, totally dismissed.

– [Zubin] Which we’re gonna talk about. We’re gonna talk about fluvoxamine in a moment, maybe now’s the time?

– [Vinay] I guess now’s the time. I guess the only thing I wanna say on this point is that, I mean, I think you’re onto something in the sense that there’s so many of these issues where the evidence base is a mix of like really good quality randomized studies and other issues where the evidence base is largely like confounded observational studies. And the only way to approach such a space is you gotta go in with some rule, some rule book where you say like what you think good evidence is, you know, and then apply that rule book to all the issues, no matter which side they fall, but what you point out is that I think they’re selectively applying their rule book, so, you know, it says something that goes the direction they like, they amplify it, when it says something that goes in the direction they don’t like, they push it down.

– [Zubin] We have a word for that, right? Isn’t it, it’s confir-something, has bias in it somewhere, confirmation bias.

– [Marty] Confirmation bias.

– [Zubin] Is that what it is?

– [Marty] Selective outrage is how people are dishonest right now with information where they should be objective. You see it in the media. You see it with political partisanship, you know. Can you believe they did this? You know, well, they’re selectively outraged at the people, they just otherwise are prejudice against for whatever reason.

– [Zubin] I’m gonna say something that is a little controversial.

– [Vinay] Now.

– [Marty] First time.

– [Zubin] Yeah, now?

– [Marty] First time.

– [Zubin] Yeah, I’m never gonna get canceled-

– [Marty] The first ever, a controversial comment.

– [Zubin] A controversial statement. Doctors themselves are so politically divided that they themselves will cherry pick trials and data to support what they think based on what they’re politics are. So there’s the sort of vaccine hesitant contingent of doctors that are like these aren’t the magic things, masks don’t work at all, lockdowns are killing us, this sort of antithesis position and they actually practice a little bit that way. They kind of tell our patients and then the thesis side that just basically watches the news for how they’re getting their medical data is saying, you know, lockdowns yes, omicron dangerous, mass absolutely for newborns. And vaccinate until your punch card is full.

– [Vinay] In utero actually.

– [Zubin] And we’re supposed to be the arbiters to some degree of the scientific literature. So we can’t get out of our own human bias and frailty around that, so we gotta look at that.

– [Marty] To me it’s just amazing that you as a say respiratory therapist or a nurse risked your life, you jumped on the grenade when COVID hit. We didn’t know what the case fatality distribution was. You took a huge risk.

– [Vinay] Yeah.

– [Marty] You got the infection. Now you have circulating antibodies that neutralize COVID-19, but they are not antibodies that the government recognizes. To me, that is a massive, massive dishonesty in the medical community. No one’s really talking about this at the high level, but when you talk to doctors on the ground and nurses, like half of them are like thank you for talking about this. Why is nobody else talking about this? This is what I’m telling my patients. If you have natural immunity, you don’t need a booster. You may not even need a second dose.

– [Zubin] I get emails from 30 and 40-year-old, 40-year veteran nurses who are like I got COVID early on, I nearly died. And they’re telling me I haven’t, you know I’m gonna be fired if I don’t get two doses, like I’m willing even to get one.

– [Marty] Soon to be a booster.

– [Zubin] Soon to be a booster, three doses, ’cause you know once the CDC says should get. By the way, you know what else the CDC says? You never eat beef medium rare. The only way to eat beef, they say don’t eat it. So are we gonna listen to everything that they say in the sense that these are like, of course they’re gonna say that because the one person who gets E. coli, is gonna go, “Well, the CDC said.”

– [Vinay] Do you think the shoe will drop, like these people, I mean, there are some hospitals I read that are being closed or are really facing healthcare system crunch, will the shoe drop? I mean, is there a possibility there will be a big wave and hospitals will have shot themselves in the foot.

– I talk to a lot of hospital CEOs and they tell me that they’re really struggling with staffing issues and they ask me what to do and I tell them use a more flexible immunity requirement. Allow for natural immunity. Allow for more exemptions. People have exemptions that are sometimes being rejected and they’re legitimate medical exemptions. I’m not talking about religious, but medical. And, finally, you don’t have to have the immunity requirement in people who are not patient facing and don’t interact with people who are patient facing. We’re losing a lot of our staff-

– [Zubin] Support staff.

– [Vinay] Are you legally allowed to do this with the Biden mandates?

– [Marty] Well, you know, right now there’s a stay put on by this federal judge saying that-

– [Vinay] The Fifth Circuit Court-

– [Marty] Yeah, and that’s for healthcare workers.

– [Vinay] Oh, okay.

– [Marty] Many of us think that’s not gonna hold up in court.

– [Zubin] And the other thing you could tell these CEOs, because I talked to them, too, is hey, how about this. Go have lunch with your staff. Don’t send them pizza. Go sit and eat the pizza and say what can I do for you, right? Give them the tools, resources and autonomy to do their jobs and acknowledge that they’ve been through hell.

– [Marty] Yeah.

– [Zubin] Right, because I think a lot of people who are quitting in this great resignation are saying I’ve never felt so devalued. You know, we’ve been through this hell and now they’re telling us this and this and this and this. It’s not about money. ‘Cause you can go be a travel nurse, make three X what you’re making, but then you gotta work next to a nurse who’s been there forever and gets paid one third what you’re getting because everyone else quit. Like this is demoralizing.

– [Vinay] Am I the only one not talking to CEOs here? I don’t get any CEO phone calls.

– [Zubin] You know I was gonna make some correlation about having hair and not having hair and talking to CEOs, but this guy has hair. Both of you have such wonderful hair. How’d you do it?

– [Marty] Well, that was a transition I wasn’t expecting, yeah.

– [Zubin] Yeah, forget it.

– [Vinay] Supplements. Dr. Oz supplements.

– [Zubin] Dr. Oz supplements. Are you voting for Oz in the Pennsylvania Senate?

– [Vinay] We should ask you.

– [Marty] You know, it’s funny, we have, we’re friends, we’ve never really talked politics and I know that you’re on the progressive side, Vinay, I don’t know where you are Z, a green party or something.

– [Zubin] I’m kind of a little of everything, yeah. I’m the Brown Party.

– [Marty] Brown party, brown. But, yeah, so Oz is interesting, right, because he is running on healthcare and he is running in a state-

– [Zubin] Where he just moved a year ago from New Jersey.

– [Marty] Yeah, and there’s a really good candidate, who-

– [Zubin] Carpetbagger , sorry, I had some phlegm.

– [Vinay] Who’s the good candidate?

– [Marty] He was Assistant Secretary of the Treasury and he was raised in a town very close to where I grew up, he was raised in Bloomsburg, right in central PA, coalmine region, his dad was head of Bloomsburg University, which is an amazing university, something like 70 plus percent of their students are first generation college students.

– [Zubin] Wow.

– [Marty] So it’s in rural Pennsylvania, an amazing family and he’s been rumored to put his name in, but he’d be up against the star power of-

– [Zubin] And the money.

– [Vinay] I mean, I think, yeah, we were talking on our show, VPZD Show.

– [Zubin] VPZD, no formal pitch, we’re the number two science podcast in the nation.

– [Vinay] Number two.

– [Zubin] This guy.

– [Vinay] But we were talking about it and I mean Oz has got the name recognition, he’s in the Republican primary. I suspect the general election will go the Republican, whoever wins the Republican primary is gonna win Pennsylvania because of the way the Republican senate is going.

– [Marty] The Republicans are gonna clean house coming out with, I know-

– [Vinay] I think the only thing that might change that dynamic is what the Supreme Court does with Rowe because that’ll animate the-

– [Marty] That’s right, that’s right.

– [Vinay] That’ll animate the Democratic party.

– [Marty] And, by the way, I’m not saying that’s good or bad. I’m just describing-

– [Zubin] We’re not political opponents, we just play them on the show.

– [Vinay] I have no, I mean, yeah, I have no actual political interest other than as a commenter.

– [Marty] I was in Portland, Oregon recently-

– [Vinay] At the ANTIFA protest.

– [Marty] No, no, actually.

– [Vinay] You had your ski mask on, probably.

– [Zubin] False flag, man.

– [Marty] The mask does not anonymize me.

– [Vinay] They knew, Marty’s here.

– [Marty] They can still figure out who I am.

– [Zubin] Especially since you basically wear a lace panty as a mask. That’s your way of being oppositional against masks.

– [Marty] My IRS profile is basically on the internet. Clear put in on there in collaboration with the NSA. And, by the way, any cyber criminals that have hacked in here, people from the NSA, welcome and good to have you on board.

– [Zubin] Yes, nice to have you guys. Bob.

– [Vinay] So you’re in Portland, Oregon, my favorite town.

– [Marty] Yeah, a great place, right?

– [Zubin] OHSU.

– [Marty] 130 restaurants and pubs in downtown Portland have closed, in the Portland area, sorry, have closed permanently. They will never come back. People are upset. I’m in there in a hotel, it’s at 10% occupancy. It’s a big hotel in downtown Portland. 10%, people are angry right now. They’re like what are we doing? We now recognize the risk of COVID was heavily skewed towards those with comorbidity and advanced age and yet the entire society is shut down because of this war on mild infection in low risk people and people are angry and I’ve asked them, like “How are you gonna vote in the upcoming election?” And they’re like, “Republican or Democrat, we’re just voting out whoever is in power right now.”

– [Vinay] Nice.

– [Zubin] Well, you know, and that’s Portland. Like that’s Portland we’re talking about. This is a liberal bastion and I think, you know, people forget that health and wealth are deeply intertwined and when you take away someone’s life work, their small business, their restaurant that they’ve built, you are shortening their life span probably. If you were actually to study this longitudinally, assume they didn’t recover well, right, which a lot of them will recover, let’s be honest. These are go-getters, these are tough people, but you’ve given them a major blow and if this is a young productive person, this is not a 90-year-old who is gonna die of something in the next year and it happened to be COVID and I’m not dissing 90-year-olds, I’m saying kill 90-year-olds. This is a classic like when Dr. Oz says, “Well, you know if opening schools kills 2 to 3% more people, it’s probably worth it.” You could have phrased that better, bro.

– [Marty] You and him are friends, aren’t you?

– [Zubin] Oh, we’re tight. Me and Dr. Oz, we go way back to my rap song “Sucker MDs.”

– [Vinay] They drink the same tea.

– [Zubin] Oh, yeah, we drink the same cambogia extract.

– [Vinay] But you’re point is well taken, I mean, I guess I’d say that in the heat of the moment, the initial shutdowns, shelter in place, you know, I understand people can have a range of views on that. That’s okay. But when you get a year, two years into something, you know, you really have to use these tools only if you really know they’re working and I just don’t think that they way they’re done as porous as they’re done, the fact that a lot of what you do is you just displace people from the restaurant to meeting up in someone’s house. You know, is that really doing anything for the SARS-CoV-2 pandemic? What it is doing is certainly have an economic and business impact. Is it even doing anything for the pandemic? We really don’t know.

– The number one driver of health status has always been in every study ever done in health policy has always been socioeconomic status. When you move people into poverty, then you drive down their health status.

– [Zubin] And this is the thing. On net, there’s probably been wealth generation throughout this, but where’s it gone.

– [Vinay] To people like you two. To people like you two talking with CEOs.

– [Zubin] Listen, we don’t just talk. We take their money, okay, and then we fan ourselves with it.

– [Vinay] Just kidding, just kidding.

– [Zubin] No, no, no, but that’s his point, his point is right.

– [Marty] Oh, rich people-

– [Zubin] We are the Zoomocracy.

– [Marty] Yeah.

– [Zubin] So, yeah, we can make a living, we can make money, we can do all that, but what about the person who cleans the house who when they had a lockdown, they couldn’t come and even clean your house or my gardener, who I paid to not come because there was a rule in the Bay Area that they couldn’t blow your frickin’ lawn.

– [Vinay] You still use the leaf blower, I hate that thing.

– [Zubin] Well, you know, I don’t use it, I use it by proxy to hiring people to use it.

– [Vinay] Come on, it’s so noisy.

– [Marty] He doesn’t use it to remove leaves, he uses it to put them other properties.

– [Zubin] Neighbor’s property. I told my gardener, I’m like, “Listen, I need you to actually not rake them up after you blow them. I need you to put them on Phyllis’ lawn just because we have a thing going.”

– [Vinay] But I was wondering about that, you know, the wealth creation to point is that you know, we do have, it looks like across all sectors this great resignation and you’ve talked about it and people are trying to figure out what are the factors and I think there’s gonna be a lot more research in that space, but some of the factors are that some of these mandates may displace people in ways that we’re not really capturing through surveys because surveys do suggest that the displacement has been low, but maybe there displacements in other ways. Another thing is people are just realizing what you want out of life and what you want out of life is not going to the office five days a week. That’s what you were talking about.

– [Zubin] Yeah.

– [Vinay] I mean, the other thing is, though-

– [Zubin] A great awakening.

– [Vinay] Yeah.

– [Zubin] Yeah.

– [Vinay] Wealth generation, though. I mean, let’s say you’re somebody who had some modest amount of money invested in the stock market, the stock market has done very well over the last year and a half and you could be slowly selling off some of those assets and having a lot of cash and you may not need to work and then the fourth thing is, you know, we’re starting to see the beginning of the baby boomers who have had tremendous amount of accumulated wealth are starting to unfortunately pass away and leave some of that to the next generation and it’s gonna be the greatest wealth transfer in human history and that may also change. Some of this generation might be saying you get that wealth transfer in, maybe it’s time for me to retire.

– Another reason the young people should be against any COVID restrictions.

– [Vinay] Oh, good.

– [Zubin] Kills off the boomers.

– [Vinay] They get their retirement check.

– [Zubin] And get that inheritance faster. No, no, I think this is spot on. A lot of people are saying, you know, this is not what I wanna do. They wanna switch from being a consumer economy to being a creator economy where they’re actually doing something they love and even it’s not making them a ton of money, you know, so I think that’s happening.

– [Marty] Rich people have done very well the entire pandemic.

– [Zubin] Yeah, and before the pandemic.

– [Marty] And before and for all of time.

– [Vinay] For most of human history, except for post World War II and 1980 in the United States, rich people have done well, yeah.

– [Marty] I mean, I go to some of these areas, I have a cousin in Florida and you go near that Palm Beach community, there’s no nails at Home Depot. Everybody is renovating their home and they’re not making them smaller. And so that has been the project, right.

– [Zubin] Shave a wing off.

– [Marty] That’s right. You go to inner city Baltimore and you look at these kids where the dropout rate was about 50% pre-COVID, now the schools are closed and they give the kid an iPad and tell them, you know, here go try to learn like this for over a year for 15 months. So the untold story of the pandemic is how it’s disproportionately affected disadvantaged communities.

– [Vinay] Yeah, and, Marty, that’s the point that’s where I think Twitter has been really probably the most pernicious thing. Twitter and the “New York Times” in getting the schools closed because they’ve been banging on the drum. I’ve even seen with the omicron before we knew anything, back out there again.

– [Zubin] Close the schools again.

– [Vinay] Close, close, and one of the things that somebody said that actually struck with me was like it’s like a faculty member much like ourselves and mid-career faculty member saying that as hard as it’s been on my kids, they’re doing okay. And I was like you make six figures of money and you live in a comfortable suburb.

– [Marty] Come to Baltimore.

– [Vinay] You’re a professor.

– [Vinay] Yeah, come to Baltimore. Go to Chicago, go to the south side. Go to the places that have been devastated and now the schools have learned that they can close. You see, now in Portland they’re asking for every other week will be a four-day week for high schoolers for whatever, teacher, teacher get well day or something. This is un-gettable.

– [Zubin] Yeah, my kids have hardly been in school even though it’s been open. The teachers have like every half day. Everything’s a half day. I have to look at the schedule, am I gonna have to get my kids at like one again? And they’re like, I’m like, “What are you learning?” “I don’t know, nothing.”

– [Vinay] And this guy’s gotta work nine to five every damn day.

– [Zubin] Every day.

– [Vinay] Every damn day he’s working nine to five.

– [Zubin] It reminds me, this whole thing reminds me of Peter Teal actually spent money defending Hulk Hogan against some like-

– [Vinay] The Gawker.

– [Zubin] The Gawker, Gawker. And this is what he said about Hulk Hogan. He goes, “Now here’s a guy down on his luck. He’s a single digit millionaire. So…

– [Vinay] He can’t even afford to tear the shirts like he used to.

– [Zubin] Oh, my gosh.

– [Vinay] Only a three a day.

– [Zubin] He can’t hire people to tear them for him.

– [Marty] These multi-billionaires. I think that’s excessive. I’m just trying to get to one B.

– [Zubin And Vinay] One B?

– [Zubin] You know, I just want the doors to do this on my car.

– [Marty] I don’t wanna deal with these doors that open sideways.

– [Zubin] These doors that open like this. I need the doors that do this. ROI, radio on the internet.

– [Marty] Radio on the internet, ROI. Could I just say one last thing about omicron.

– [Vinay] Yes, please, yes.

– [Marty] Is it omicron or omicron?

– [Zubin] I had to look up the pronunciation when I did my video, I think it’s omicron.

– [Vinay] Omicron.

– [Marty] A friend of mine looked it up for me and said, “You can say it either way.” I said, “Come on, ask a Greek person.”

– [Zubin] Yes.

– [Vinay] There’s some viral video, I saw this morning where-

– [Zubin] There are no Greek people, extant. They’re an extinct race. Can’t find one.

– [Marty] Here’s the thing. Why do we have the entire world economy on hold until we find out whether or not the omicron variant is encompassed by vaccinated or natural immunity? Do the experiment now. We four BSL-4 labs in the United States. We’ve got 59 in the world, many of which we have partnership with as a country. Get the variant, do the laboratory experiment as has been done with the other variants, but do it quickly and see whether or not, what percentage of the antibodies neutralize-

– [Vinay] You mean binding efficacy?

– [Marty] That’s right, that’s right.

– [Zubin] Neutralizing binding assay.

– [Marty] That’s right. I went to our immunologist, our geniuses in the lab stuff and I talked to them a lot and we all have our networks of people in the virology and immunology world we’ve talked to nationwide. So, I talked to them and I said, “How fast can you do that experiment?” “We could do it relatively quickly.” “Well, how quickly?” “I mean, we could do it in a couple days.” “Could you do it in one day?” “Yeah, yeah, we could do it in a day.” “Could you do it in 12 hours.”

– [Zubin] I love how you’re haggling with these guys.

– [Marty] “Yeah, probably 12 hours. We’d have to get this reagent, get that reagent.” “Could you do it in six hours?” And basically, in the course of one business day, this could be done. Instead of all of these press conferences and we don’t know and the unknown-

– [Zubin] Three weeks to find out.

– [Marty] Why do we have four BSL labs? God knows how much they cost us as a country for bioterrorism prevent-, that’s why they’re there, okay. They’re not there just to play around and so if ever we needed the resources of our country to mobilize quickly, it’s right now and yet we’re here all speculating, relying on these computer models to say yeah, it probably binds. Now, look, all the indicators are that we’re not seeing severe illness with omicron, that the molecular models show good binding when you take the shape of the new variant, omicron. By the way, 95% of that spike protein is identical to the previous variant.

– [Zubin] Right.

– [Marty] And that’s what people are missing. So why all the speculation? Use these BSL-4 labs, go to work and stop talking. Start doing and stop talking.

– [Vinay] But I guess the speculation is, you know, you talk about the huge global economic market that’s on hold while all this speculation is happening.

– [Marty] And elective surgery in New York.

– [Vinay] Yeah, and all these things. And widespread panic. But there is a market that’s thriving. It’s the media market.

– [Zubin] Oh, they’re crushing it.

– [Vinay] They’re crushing it.

– [Zubin] But omicron itself is basically like a container ship swedged in the Suez Canal. They’re like we can’t move it. But it’ll take us weeks.

– [Marty] The fear market is doing well, too.

– [Zubin] The fear market is crushing.

– [Vinay] And with Trump gone, Trump for their ratings was like-

– [Zubin] Oh, God.

– [Vinay] A thousand omicrons, right?

– [Zubin] Dude.

– [Vinay] He was like an omicron a day.

– [Zubin] Oh, my God, that’s a great-

– [Vinay] Like it gets the ratings, right?

– [Zubin] That’s a great like media hyper measure now, how many omicrons.

– [Vinay] How many omicrons of news coverage.

– [Zubin] It sounds legit.

– [Vinay] I mean like CNN-

– [Zubin] That’s a 12-0.

– [Vinay] They’re like going on the street asking people to watch the TV.

– [Zubin] Totally, totally.

– [Vinay] They’re going to airports, turning it on everywhere just so you might catch a glimpse.

– [Zubin] They’ve got Christiane Amanpour being the scud stud again, but talking about omicron.

– [Vinay] But I guess we underestimate, but a media ecosystem that’s so heavily geared towards attention economy was going to blow anything, it was only a matter of time before they blew something up.

– [Zubin] How quick did that go viral? A day. A day and it went from zero omicrons to infinite omicrons.

– [Marty] Oh, it was like the freakin’ Afghan airport video.

– [Zubin] Oh, yeah, yeah, exactly, exactly. Yeah, so okay now, we said we’d talk about therapeutics.

– [Vinay] Yes, and this is your wheelhouse.

– [Zubin] Yes.

– [Marty] So, why won’t anyone talk about fluvoxamine? So here’s a situation that happens on rounds, okay? Somebody says, “You know, I think I’m gonna change this dressing twice a day.” And someone says, “There’s no evidence to support that that’s any more efficacious than once a day.” And then they’ll go back and forth and then somebody’ll say, “Here’s the study.” “I need to see a larger study.” “Well, here’s a larger study.” “It’s not a randomized controlled trial.” “Here’s a randomized controlled trial.” “I need to see two randomized controlled trials.” Fluvoxamine has two randomized controlled trials published in “JAMA” and the “Lancet.” Some would say those are good journals.

– [Vinay] Sometimes.

– [Marty] Sometimes. By the way, the pace of scientific discovery is only three articles per week.

– [Vinay] Okay.

– [Marty] And you can’t have more than that because of word limitations even though they’re published online.

– [Vinay] Well, because of impact factor growth limitations. That’s why we gotta limit that stuff, yeah.

– [Marty] So here you have two RCTs showing fluvoxamine reduces mortality significantly in both. In the second one, up to 91% in people who are fully compliant. Here’s a drug that’s already on the shelf, no one’s gonna become a billionaire in the pharma industry ’cause there’s not patent on it, and you have solid RCT data. Why is nobody talking about it?

– [Zubin] So, this is an interesting piece. So, Angela Reiersen is one of the psychiatrists who’s a lead author on the piece and I have been in cahoots for some time waiting for this data to come out and she’s been telling me, you know, “This could be something promising and I’ll let you know when it is,” and the did and it is and the reason this thing may work, we don’t know, is that fluvoxamine, Luvox, the brand name, SSRI, it has these anti-inflammatory effects-

– [Marty] That’s right.

– [Zubin] That have been described before and they were screening drugs and they said oh, this thing seems to have some effect. And they followed up and a lot of the other drugs fell off that list of potentials, but fluvoxamine continued. Then they do this randomized controlled trial, I think it was in Brazil where the rates of transmission were so high and they could do this and they show these really great outcomes. Now I haven’t dived into that data set, but why is nobody talking about it and I think she’s asking the same question because this is, again, off patent, you know, cheap, relatively safe drug that has the side effect of making you feel good. Why are we not talking more about this?

– [Marty] It’s amazing and again, I did do a deep dive into this data, incredible data, as good as it gets, right? I mean without observing each person enrolled in a study with your own eyes-

– [Zubin] You’d have to learn Portuguese.

– [Marty] You’d have to learn Portuguese and I’m maxed out on foreign languages right now, especially with Latin.

– [Zubin] Oh, pig Latin, Latin.

– [Marty] Pig Latin. Did somebody trick you guys into saying that Latin would help you with medical school.

– [Zubin] They tried to pull that shit on me, but I didn’t do it.

– [Marty] I feel for it.

– [Vinay] I guess I was so far beyond, I was in the generation where we didn’t fall for it anymore. The last people who could teach it were gone, by the way.

– [Zubin] We got E. Pluribus Sucker over here.

– [Marty] I do, I have a Greek farmer, that’s helping me a lot while not.

– [Vinay] Well, meanwhile, while fluvoxamine has been under discussed, molnupiravir-

– [Zubin] Has been over discussed.

– [Marty] And boosters in young people, zero data. That’s all we hear about.

– [Zubin] Let’s talk about molnupiravir, because the FDA Advisory Committee just met on this and said hey, you know what, they said in the initial press release data, which is how we do science.

– [Vinay] Medicine by press release.

– [Zubin] Medicine by press release, how many omicrons worth of press was that, by the way?

– [Marty] Three omicrons and one Afghan airport video.

– [Vinay] Yeah.

– [Zubin] Afghan airport video, AAV. So three omicrons and one AAV worth of press coverage and what they said was all 50% reduction in hospitalization in the group that they studied.

– [Vinay] Then they cut it to 30%, right?

– [Zubin] They cut it to 30% with really little explanation of what the difference was when they asked the Merck people, they were like meh, I don’t know, we ran it up, I don’t know. And so FDA Advisory Committee was oh, let’s weigh this here now. It’s probably less efficacious. It may be even less efficacious if you’ve already been vaccinated because the net benefit is gonna be small. And what’s the downside of this thing. We don’t know the effects on pregnant women because it is an RNA polymerase inhibitor.

– [Vinay] It competes for the-

– [Zubin] Yeah, that’s right, for the nucleotides.

– [Vinay] Reduces mutagenesis.

– [Zubin] It’s not supposed to do that to humans, but you never know. You’re not gonna give it to a pregnant woman and roll the dice with that.

– [Marty] Right.

– [Vinay] No.

– [Vinay] You can only do that with boosters, really. Sorry.

– [Zubin] Oh, man, that’s where, I need like a prop where I push a button and then the big canceled thing comes.

– [Marty] What I love about what Vinay is saying is it’s how medicine deals with uncertainty and we deal with it with this incredible cocky arrogance of just do it, right?

– [Vinay] Right, with a Nike swoosh.

– [Marty] Right, we knew nothing about this vaccine in pregnant women when we were out there saying you still need to get it.

– [Vinay] I wrote that article in “Med Page,” which you’re the editor-in-chief about exactly that. That ultimately I think we were vindicated, or people were vindicated that it is safe in pregnancy.

– [Zubin] And we wanna double down on that.

– [Vinay] Yes.

– [Marty] 100%.

– [Vinay] At least the first two doses, but certainly the rhetoric that it was safe in pregnancy preceded the evidence that it was safe in pregnancy.

– [Zubin] That’s right, that’s right.

– [Vinay] And that the booster is a different question and you were on Bari Weiss and you had a really good example of a woman who I thought she is pregnant and she was in her early 30s or something and she has gotten two doses and was it you who said, no, it was Bari who said-

– [Marty] Bari’s friend.

– [Vinay] Bari’s friend and Barry’s friend asked a doctor at like the Brigham or someplace like that and the doctor said, “You want me to tell you the answer I’m supposed to tell you or what I actually think?”

– [Zubin] Exactly, right.

– [Vinay] That’s what a lot of people think.

– [Zubin] I got a lot of women in their 30s, 20s, emailing me saying, “I’ve had two shots, they were back in February. I’m pregnant now, I’m in the first trimester, they’re telling me I need a booster. I’m not comfortable getting this during pregnancy if I don’t absolutely need it.” And I’m like, “I don’t know where the evidence is that you absolutely need that.”

– [Marty] And the evidence with if you don’t have a booster is that 1 in 26,000 will be hospitalized and the average age of that one person is 73.

– [Vinay] Right, right.

– [Zubin] Now we don’t know about where pregnancy fits in that because pregnancy’s a risk factor of itself.

– [Vinay] Sure, yeah.

– [Marty] That’s true, it could be a pregnant 73-year-old.

– [Vinay] But 73 might make moving from a 30-year-old risk to a 45-year-old risk.

– [Zubin] Exactly, right, right, right, right.

– [Vinay] But to the point of molnupiravir, it induces mutations in the virus itself.

– [Zubin] That’s the other, that’s the other downside, so let’s talk about that. The idea is it mutates this virus to death. So the virus can’t replicate right without incorporating this bogus, you know, RNA bits and bytes. The next thing you know, it’s like . It’s a Cronenburg mutant, right? Well, some of those may escape that don’t get terminally mutated.

– [Vinay] You’re gonna run out of Greek letters with this bad boy on board, right?

– [Zubin] Zeta, pi, alpha, epsilon. I mean, you’re gonna go through all of them and you’re gonna have to do with what they do with the hurricanes, right? It’s gonna be like alpha one.

– [Vinay] Hugo. No, I thought they go-

– [Zubin] Once they get to like Zemetria, they have to start at like alpha, they start at the Greek alphabet.

– [Marty] The New York City rats have a patent on zeta because I guess they’re planning to produce that one.

– [Zubin] Oh, perfect. Those rats are gonna crush the end.

– [Vinay] You really do think it’s the jump to the end, we’ll jump back.

– [Marty] How do you get 32 mutations all of a sudden? In one person?

– [Vinay] And why don’t you think the immunosuppressed, ’cause I hear Trevor Bedford, he thinks, he believes it’s in an immunosuppressed host.

– [Marty] First of all, I think it’s a reasonable hypothesis and since I’m not in the genetics world, I’ve been talking and I’ve been probing a lot of these people in the field and a bunch folks just say how do you get 32 mutations in one person. It’s just too much randomness in one host, as opposed to what we now are recognizing to be species where millions of different animals within that species have had the virus jump around.

– [Vinay] Yeah, I mean, I guess the point is well taken that simply because it exists in so many animal species, zero COVID is a delusion.

– [Zubin] Oh, delusional, yeah.

– [Vinay] And always sequencing everybody every day for the rest of their life is a delusion. You’ll just keep finding it places and it’ll just cause damage. You really need to keep your eye on the prize, which is minimize hospitalizations and deaths.

– [Zubin] Hospitalizations and death.

– [Vinay] And maximize living life, the thing that we all do outside.

– [Zubin] That whole narrative has a zero omicron value for the press.

– [Marty] That’s right.

– [Zubin] Minus AAV.

– [Vinay] Yeah, minus Afghan airport video, yeah.

– [Marty] Why, on fluvoxamine before we leave that, I wish our public health officials would talk about it. There’s no evidence to the contrary. It’s safe. There’s none of these concerns. It’s solid evidence.

– [Zubin] And the data blows this ivermectin data set out of the water.

– [Vinay] Ivermectin fell apart.

– [Zubin] Yeah, that’s just nonsense, but, yeah.

– [Marty] The start of the ivermectin hydroxy backlash has resulted in scientists losing their objectivity.

– [Vinay] That’s an interesting theory.

– [Zubin] Yeah, I think it’s true with fluvoxamine because one of the, I won’t, I’m not even gonna mention this because that will poison the whole talk, forget it, because there is that component and I think people are so gun shy now, right. Dr. Oz was promoting hydroxychloroquine in the early days, so.

– [Marty] I take it you’re not gonna endorse him for his race for senate.

– [Zubin] Can you imagine? I’m ZDoggMD and I endorse this message. My colleague, Dr. Oz, and by colleague I mean professional clown.

– [Marty] Doug McCormick is the other guy that many people are hopeful is gonna throw his name in the race.

– [Zubin] Oh, that’s his name, okay, yeah.

– [Marty] I wish Dr.-

– [Vinay] We’re gonna have to make a note of that.

– [Zubin] Yeah.

– [Vinay] ‘Cause I think Dr. Oz is gonna win.

– [Marty] Yeah, the name recognition’s high, 94%.

– [Zubin] Should we fly and change our residency to Pennsylvania.

– [Vinay] He said he’s from Pennsylvania.

– [Marty] Yeah, I’m from Pennsylvania.

– [Vinay] Why not Dr. Marty?

– [Marty] No, I have zero interest in government.

– [Zubin] Dude.

– [Marty] No.

– [Zubin] You live in DC, you have zero interest in government?

– [Marty] That’s right.

– [Vinay] He has zero interest in participating in government.

– [Zubin] Were you born in the U.S. or were you born in Egypt?

– [Marty] I was born in the U.K.

– [Vinay] That just keeps him out of the presidency.

– [Zubin] Yeah, that’s fine.

– [Vinay] You could be a long-time state senate.

– [Zubin] That means you’ll have a limit to your ambition, which means you won’t be as insane as-

– [Vinay] Yeah, you might be a great governor.

– [Marty] I was born in the U.K, which is why I can slip into a British accent and I’m from Egypt.

– [Vinay] Why have not been doing that this whole time.

– [Zubin] You can speak in cockney?

– [Marty] I can slip into a British accent.

– [Zubin] Hello, governor. Let’s talk about molnupiravir.

– [Marty] And then people think you’re smarter.

– [Vinay] That’s they one YouTube video guy is really popular because he has that nice accent.

– [Zubin] John Campbell, exactly. He’s like okay, let’s talk about ivermectin.

– [Vinay] Ivermectin.

– [Zubin] And then he puts up like a thing.

– [Marty] He’s a genius all of a sudden. But my family’s from Egypt, which is why my skin is dark, but I was raised in the United States, which is why I have type-2 diabetes. I actually don’t have type-2 diabetes, but, I’m on the brink.

– [Zubin] You’re type-2 diabetes adjacent.

– [Marty] I am adjacent to a lot of things.

– [Zubin] Yes, that’s true.

– [Vinay] You’ve got an elevated A1c?

– [Marty] Right now I’m okay. It does run in my family, though.

– [Zubin] Mine, too, yeah. Yeah, my A1c approaches the asymptote of diabetic.

– [Vinay] Really, you?

– [Zubin] If I don’t take care of myself. Like the minute I go off the rails and start munchin’ on them snacks. Like if I have more than zero meals a day, I’m fully diabetic.

– [Marty] I’m usually diabetic in the mornings.

– [Zubin] Yeah, a.m. diabetes.

– [Marty] Yeah I’m cured in the evenings.

– [Zubin] Pretty standard, yeah.

– [Vinay] A few glasses of wine will cure that right up, huh.

– [Zubin] Oh, yeah, dries it right up.

– [Marty] I like Dr. Fauci. I think he loves his country. I think he means well. I think he’s well intended.

– [Vinay] But, I’m waiting for-

– [Zubin] Yeah, three dots.

– [Vinay] Big boom.

– [Marty] That’s all I have to say.

– [Vinay] And he’s never gotten anything wrong in this whole pandemic, he’s been spot on.

– [Zubin] Yeah, yeah, yeah, exactly.

– [Marty] He got warning about the pandemic wrong. He got surface transmission as opposed to airborne.

– [Vinay] Small error.

– [Marty] Which was, by the way, it’s not the riddle of the sphinx. It’s identical to SARS-CoV-1 transmission air slide virus.

– [Zubin] Ball dropped.

– [Marty] And the mask thing and then-

– [Vinay] He got wrong one way or the other, one way or the other, he’s getting it wrong.

– [Marty] Quiet about schools.

– [Vinay] No he was vocal about keeping them closed, actually, I have a half a dozen quotes of him keeping them closed. When De Santos reopened, he was against it, yeah.

– [Marty] And then the vaccine allocation guidance overly complex and age-based.

– [Vinay] Age-based, that was one and also he was against the one dose to everyone, which was in the U.K.

– [Marty] We may not be talking about boosters if we would have spaced them out because you get better immune protection.

– [Zubin] Better coverage.

– [Vinay] That’s another good point, the fact that we crammed them together in 21 days where the antibodies are going to wane in a way that wouldn’t have happened if you did it 16 weeks or 28 weeks or something like that.

– [Zubin] And the vaccine update might have been higher early on if he just said just take one right now and then we’ll think about something.

– [Vinay] You know what else? Also all other people who had the dose two reactions telling their friends about how they felt. You would have silenced that whole thing up, right, ’cause they wouldn’t have had the dose two reaction.

– [Zubin] I did a video that got something like 15 million views on Facebook where I was like, “Dose two sucks balls, guys, it’s terrible, it’s terrible, but you still need to do it.”

– [Vinay] He filmed it from his bed and he under the covers. Help me guys, I’m cold.

– [Zubin] No, you don’t get off the hook. I interviewed you the day that I had those symptoms.

– [Vinay] Oh, yeah.

– [Zubin] I was on the tail end of that and he’s talking at his frickin’ transmission speed, which is like yeah, there’s .

– [Vinay] I’m an omicron news transmission speed.

– [Zubin] Omicron news speed. I’m at AAV minus 10 and I’m like rigoring here, I’m like, “Yeah, yeah, tell ’em Vinay. You tell ’em.”

– [Vinay] Okay, so yeah-

– [Zubin] So keep going, keep going.

– [Marty] Natural immunity-

– [Vinay] Natural immunity.

– [Marty] There’s such a long list, I’m just-

– [Vinay] Natural immunity he got wrong because he doesn’t acknowledge it.

– [Marty] That resulted in the deaths of tens of thousands of Americans.

– [Zubin] How do you calculate that?

– [Marty] Because we were giving vaccines to people already immune for a long time when we were supply constrained and there was actually an analysis published in “Annals of Ventral Medicine.”

– [Vinay] Good point.

– [Marty] Doing a calculation of the tens of thousand whose lives could have been saved-

– [Vinay] ‘Cause this was right when it was climbing in the winter last year.

– [Zubin] And people were desperate, like rich people were cutting in line, remember that?

– [Marty] That’s right, rich people that have-

– [Vinay] And Stanford professors. Didn’t they get-

– [Marty] Oh, board members, a lot of people with BLM on their profiles. All of a sudden their life matters more, insert themselves in the vaccine line ahead of more vulnerable populations. So not acknowledging natural immunity resulted in the unnecessary deaths of tens of thousands of vulnerable Americans who were clamoring for a vaccine and we said there’s not enough for you just yet and we lost a lot of people in that January-February wave. So it’s so, I’m mean it’s so frustrating. Now we won’t talk about therapeutics like fluvoxamine. It’s just non-stop.

– [Vinay] He actually was also pro border bans for omicron.

– [Marty] That’s right.

– [Zubin] Oh, right, yeah.

– [Vinay] Probably don’t do much.

– [Marty] In fairness to him, he said when he was asked about travel bans, vaccine requirements in general for travel, a little unrelated, he said if the White House wants to do it, then I would support it.

– [Vinay] What the hell, what does that mean?

– [Zubin] I thought he represents science, not politics.

– [Marty] Well, I think some would suggest that he’s gotten too tainted by politics and he should have been speaking up about a lot of issues that he has not spoken out about, like where is the data on reinfections from the CDC? Why are we learning everything we’re learning from Israeli studies and not from the CDC. And, of course, the gain of function thing, I’m not one of these people to look back and assign blame, but let’s just agree now once and for all, Dr. Fauci, if you’re listening, that we should ban-

– [Vinay] You know he’s listening right now. He loves us, loves us.

– [Marty] And all the pro gain of function scientists out there, we should ban gain of function of any kind forever in perpetuity, let’s all agree. I mean, that’s something we should agree to right now.

– [Vinay] Pardon me again, what’s the upside to the gain of function that we hear?

– [Zubin] More function.

– [Vinay] More function.

– [Marty] When you have an old guard medical establishment and let’s be honest, look at the age of Dr. Kessler, who’s behind the scenes in the White House, Dr. Fauci and Dr. Collins.

– [Vinay] Are you saying you don’t like your leaders to all be close to like 80-

– [Zubin] With telomeres the size of-

– [Vinay] Running leadership for 30 years in a federal agency.

– [Marty] We got a small group of people making all the decisions. There’s no ethnic diversity and there’s no age diversity in that group.

– [Zubin] That’s racist, buddy.

– [Marty] So, no comment.

– [Vinay] What about ideological diversity? There’s not really much-

– [Zubin] Oh, there’s zero ideological diversity.

– [Vinay] Conflicting opinions, yeah.

– [Marty] There’s cancellation of those other thoughts, but here’s the thing is that in the old school mindset that I believe they’re coming from, this is their bias and we all bring biases, right, but this is their bias, to sequence something used to take months or years, right? That was Collins’ big project, right? So in the old days you would want to, you wouldn’t have time to sequence a new virus so you would wanna almost Frankenstein manufacture it in a laboratory-

– [Vinay] To have it available.

– [Marty] To be able to work on it, right? But now technology has improved and you can sequence an entire genome in 20 minutes.

– [Vinay] Yeah. I also think that there are risks to gain of function research, we’ll agree.

– [Marty] We got burned badly.

– [Vinay] Yes, okay, and then, but the benefits are largely theoretical, so I don’t think there is any evidence of doing the research so I would agree with you that I wouldn’t recommend doing it and I’d probably halt all the funding to do it.

– [Marty] Do you know about the 2012 ferret study?

– [Vinay] It’s obviously one that I have pinned on my refrigerator. 2012 or the ’14 ferret.

– [Marty] How many studies are on your refrigerator?

– [Zubin] They’re like vintage wines. He has a cellar full of different-

– [Marty] Studies.

– [Zubin] Ferret studies.

– [Vinay] I was like do you want the Ferret from ’21?

– [Zubin] Oh, the ’14 Ferret.

– [Marty] Reprints, the original reprints. You ever get those emails, can you send me a reprint of your article.

– [Zubin] It’s online, bro.

– [Marty] Yeah, we have computers.

– [Zubin] You have a dot matrix printer, just print it out.

– [Marty] And if it’s not online, just ask the NSA, they’ll give you a copy. So, in 2012, Dr. Fauci and Dr. Collins were still promoting gain of function research. They wrote an op ed in the “Washington Post” and this was pre, I think it was 2010. They were just talking about why we need to be doing this in very controlled settings, as if that’s, you know, 100% reliable. So just asking anyone who’s worked at a lab.

– [Zubin] Ask the Chernobyl employees.

– [Vinay] Where do you put your coffee?

– [Zubin] Yeah, exactly.

– [Vinay] I like to keep it right here.

– [Zubin] I just need Homer Simpson at the controls. Man, this thing, is this the part of the good virus or the bad virus, Flanders!

– [Marty] So, Chernobyl people aside, so in 2012, Fauci funded a research study to do gain of function research of an influenza virus that was done in Wisconsin and at another center, I can’t remember, and so what they did is they juiced up an influenza virus and infected ferrets. It was more contagious and it was much more lethal, like a 60% lethality rate and they infected different ferrets and it was controlled and then it was published. No leaks, nothing went wrong and they published this. And the world scientific community read this publication funded by the NIH and they basically reacted by, and I’m gonna paraphrase. Holy smokes, you did what? No one should ever do this, ever. And so the movement came about to ban all gain of function research and they lobbied Obama in 2015 to create a moratorium on all gain of function research and Fauci and Collins didn’t like it, they lobbied against it, but it became the law and then part of that moratorium was a committee that was gonna be set up at the NIH to screen all research, to see if it met the criteria and then it would have the power to block that research. And that committee became nicknamed the Ferret Committee. And the Ferret Committee over time, over the subsequent five years was dismantled internally but the bureaucracy, by Dr. Fauci and by Dr. Collins, all documented in an amazing investigative journalism piece called “Science in the Shadows,” in the “Washington Post.” They took their power away, they assigned people there who were weak. They changed the definition of gain of function research and they changed their power from blocking research to purely advisory and they continued to fund gain of function research around the world, including the Wuhan lab. Now I’m not saying those dollars directly funded this coronavirus, but that is the debate on gain of function research and even though they may not have juiced up this virus in the Wuhan lab, they had published another paper that they juiced up another virus and even though gain of function research wasn’t funded, may not have been funded at the Wuhan lab by those NIH dollars, it was 100% funded at other labs with NIH dollars directly and credited in the publications.

– [Zubin] Man, you know and who’s standing up for the ferrets, no one. Okay, the armadillos have their frickin’ lobby. That’s the only reservoir to study microbacterial replication in. And they have a whole bunch of people picketing for armadillos. I’m making this up. I have no idea-

– [Vinay] For leprosy?

– [Zubin] I think it’s leprosy, I think you’re right, I think it’s leprosy.

– [Vinay] Yeah, I think you’re right, leprosy.

– [Zubin] Yeah, yeah, Hansen’s disease. Sorry, you don’t call it leprosy, that’s racist.

– [Vinay] Is it?

– [Marty] I’m with the-

– [Zubin] Yeah, they’ve changed-

– [Vinay] You can’t call it an eponym.

– [Zubin] You have to call it Hansen’s disease.

– [Vinay] That doesn’t sound right. I thought we’re moving away from eponyms. No Wegener’s, no, you know.

– [Zubin] Actually I have no idea.

– [Vinay] I have no idea, I have no idea.

– [Zubin] But you’re right, we are moving away.

– [Marty] I don’t know what you guys are talking about.

– [Zubin] Rocky Mountain spotted fever. That’s not called omicron-2.

– [Vinay] Oh, you’re right, it’s named after the place.

– [Zubin] That’s right.

– [Vinay] But you know, it’s called omicron, but when you make your travel ban, you want to make sure you get South Africa in that ban.

– [Zubin] You wanna make sure it’s right there.

– [Marty] Only countries with brown people, okay, only countries with brown people.

– [Zubin] Yes.

– [Marty] Get the travel ban, right?

– [Zubin] The countries that have been described as Shitholé countries.

– [Marty] Countries in southern Africa. Immediate travel ban.

– [Vinay] But that’s sort of like your hypocrisy about the person who has the BLM bumper sticker getting in first in line for the vaccine, the person who is against calling it variants by the region that identifies them or is known for them because that’s racist, it’s pro travel ban.

– [Zubin] It’s pro travel ban.

– [Marty] And look, I think BLM was a healthy conversation, it’s not a criticism of BLM, but it-

– [Vinay] It creates some hypocrisy.

– [Zubin] Yeah, exactly.

– [Marty] It’s total hypocrisy.

– [Zubin] Of the white person with the BLM sticker who-

– [Marty] It’s like what you said, people insisting kids be vaccinated, even though they had natural immunity. None of these kids got their kids vaccinated for influenza, ever.

– [Zubin] We talk one thing out of one side. These people, I mean, them, we. I’m gonna say we because I’m in the Zoomocracy and then we do a totally different thing.

– [Vinay] But at least you talk what you do.

– [Zubin] Yeah, that’s true ’cause I have no filter because of my frontal lobe damage.

– [Vinay] Back to your thing about gain of function. So, I guess it sounds like you’re building a convincing case that gain of function puts us at high risk and has very little upside and is no longer necessary with the speed of sequencing.

– [Marty] That’s right.

– [Vinay] So probably faux pas.

– [Zubin] Let’s not do it.

– [Marty] And people are hungry for honesty and humility now among public health officials. Come out and say look we shouldn’t have supported gain of function research. We, with good intentions thought there was value to it and to save lives. We now recognize the risks don’t outweigh the benefits. We are calling for an all out international ban of gain of function research.

– [Zubin] And an investigation into the origins of COVID-19.

– [Marty] I don’t think you’re gonna learn anything from doing any of that.

– [Vinay] You don’t think so?

– [Marty] No. They’ve flushed everything in the toilet after they burned it in a bonfire.

– [Zubin] Yeah, but the NSA still has the phone records. You can just listen to those.

– [Vinay] I think the way you find out is you have to have like unfettered access to the people who work in the laboratory.

– [Marty] Yeah.

– [Vinay] And interview them.

– [Zubin] And waterboard them.

– [Marty] Witness protection.

– [Vinay] You need to like fly them out to a place and provide them like safe-

– [Zubin] Oh, so positive waterboarding. Right.

– [Vinay] Safety.

– [Marty] And their family, you’d have to fly all 200 contacts.

– [Zubin] Right.

– [Marty] Of everybody who knows that person.

– [Zubin] And a village in China has 3 million people, so I hope you got a good budget for this, bro.

– [Marty] Wow, that’s a stat.

– [Zubin] Yeah, I made that up, but it feels right.

– [Vinay] No.

– [Zubin] Well, no, I mean like a small town in China.

– [Vinay] Yeah, but it’s a one child policy, so those families may be-

– [Zubin] Oh, yeah, they’re more contained. That’s true, that’s true. We’ll only get man, that’s a problem.

– [Vinay] So what you’re saying about Fauci is you think there’s a few places you could criticize, just a few.

– [Zubin] At least 10.

– [Vinay] 25.

– [Zubin] Maybe 16.

– [Vinay] But I mean, to think about a science, yes, he’s a scientist, but he’s been acting like a policy maker. That’s what we talked about on our show.

– [Zubin] That’s the rub, that’s the rub.

– On VPZD podcast.

– [Zubin And Vinay] VPZD podcast. Number two podcast.

– [Zubin] In the nation on science.

– [Vinay] Two weeks in a row.

– [Zubin] Suck it Sam Harris, you hack.

– [Marty] What category is this?

– [Vinay] No, I actually like Sam Harris.

– [Zubin] I do, too.

– [Vinay] Me, too, okay, so.

– [Zubin] Let us on your show, Sam.

– [Vinay] Please, Sam.

– [Marty] What’s the category that you’re number two in?

– [Vinay] Science.

– [Zubin] Science.

– [Vinay] Why do you gotta go there, Marty?

– [Zubin] I put us in science because-

– [Vinay] Obviously, it was general interest. Come on, Mary.

– [Zubin] Yeah, come on Marty. What’s wrong with you Marty?

– [Vinay] He assumed it was a category.

– [Marty] I thought it was general, general interest.

– [Vinay] Of course, why wouldn’t it be?

– [Marty] Yeah.

– [Zubin] I mean it’s of general interest-

– [Vinay] Not just science.

– [Zubin] And non-scientists.

– [Vinay] Because I am, we are, we’re almost science.

– [Zubin] Almost science.

– [Vinay] Yeah, we’re almost science.

– [Zubin] We’re almost science. We have just beat “Hidden Brain.”

– [Vinay] Shankar Vedantam.

– [Zubin] Yeah-

– [Vinay] But Shankar Vedantam.

– [Zubin] He’s a brother.

– [Vinay] He can’t be dethroned. He’s powerful.

– [Zubin] He’s a brother, yeah.

– [Marty] That’s 50% science.

– What’s the other 50%?

– [Marty] It’s kind of half-baked dogma that’s laced in opinion.

– [Zubin] That’s a good sense of insight. Yeah, I’m like 30% mysticism. 5% tar, you know, from cigarettes, just because I think, you know.

– [Marty] But can we learn from bedside clinical wisdom because right now you have all of these doctors in South Africa saying this is what we’re seeing on the ground and you’re having this dismissal that we cannot make any conclusions until we have in our CT.

– Yeah, and these guys actually brought it to our attention and how do we reward them? Okay, you’re off the map.

– [Vinay] That’s our first mistake.

– [Marty] We shut down.

– [Zubin] Yeah.

– [Vinay] When you find a variant, you keep it quiet until I tell you you can say something about it, right?

– [Zubin] Exactly. Shh.

– [Marty] If you’re coming from Africa, if you’re in Africa. Otherwise it’s different, you know, there are probably different rules.

– [Vinay] Let’s just say if China identified some mutational variant, I promise you that news ain’t going to nature first.

– [Zubin] No way.

– [Vinay] It’s going through the premier.

– [Zubin] No, it’s going through the Greek letter Z. All right, XI.

– [Vinay] It’s going to XI, it’s going to Xi.

– [Zubin] Exactly Xi.

– [Vinay] It’s really gonna get there. There’s like this variant doesn’t exist.

– [Zubin] I think we gotta hard out at like 12:15.

– [Vinay] We got five minutes, though.

– [Zubin] Why not, why not, five minutes. How are we gonna, okay, let’s bring it, first of all, I wanna say something, a little meta-analysis here. Since this guy’s a podcast host, it’s funny. I go off the rails, say something stupid, frontal lobe’s released, I’m like snouting all of the place ’cause of my brain disease, this guy always brings it back. So Marty, what you’re saying is this. And I gotta say is he’s a, I need him permanently on my-

– [Vinay] On your hip.

– [Zubin] On my left hip.

– [Vinay] Well, I will say my takeaway is the first five minutes I was disoriented. I keep looking at my own face in the stupid thing. I wasn’t looking at the right spot and then I was like really discombob-, I’m not used to being on this side of the table.

– [Zubin] It’s a weird side to be on, it’s stressful.

– [Vinay] They don’t really know how absolutely close we’re sitting together.

– [Zubin] Yeah, it looks like we’re miles apart because the camera adds five pounds, but listen, we’re practically Siamese twins.

– [Vinay] Actually, it’s one chair.

– [Zubin] We have twin-twin transfusion right now.

– [Vinay] It’s one chair, yeah.

– [Zubin] We may have to sacrifice one of us-

– [Vinay] But he could probably separate us-

– [Zubin] In order to be born safely.

– [Vinay] He’s a surgeon.

– [Zubin] Have you ever done Siamese twin separation?

– [Vinay] In your career?

– [Zubin] Didn’t Carlson do that? Isn’t that how-

– [Marty] Ben Carson, that was his specialty, yeah.

– [Vinay] Brain doctor.

– [Marty] I’ve never been involved in any Siamese twin separations.

– [Zubin] Could you imagine your specialty being Siamese twin separation? Like how many of those-

– [Vinay] Like he did for the ones that were cranially attached, but can’t they be attached at any part of the body?

– [Marty] Yeah, and he’s traveled all over the world.

– [Vinay] You never done one?

– [Marty] I’ve never-

– [Zubin] That’s like the Whipple for general surgery, right?

– [Marty] It’s like liver biopsy.

– [Zubin] Totally, yeah.

– [Vinay] I see.

– [Zubin] The worst is when they’re attached at the testicles because then you have to get like urology and they’re such a pain in the butt.

– [Marty] With that comment, you just went from being number two to number one.

– [Zubin] Yes.

– [Marty] In the science category.

– [Vinay] That’s what it takes.

– [Zubin] Shankar.

– [Marty] Here’s something I was gonna say that is semi serious, at least as serious as I get.

– [Zubin] Okay.

– [Marty] Is we can learn from individuals, we can learn from cases, we can learn from patients, we can learn from the bedside observation of doctors. Instead we have this rigidity that we can only learn from an RCT and if the RCT doesn’t show us what we already want to believe, we need a second RCT and if a second RCT shows us what we don’t want to believe, we just don’t talk about it. In cancer I can tell you that, you know, I’ve kind of drifted into this hybrid pancreas autotransplant community now, but pancreas has always been my clinical focus and in pancreatic surgery, people are interested in what the outliers are doing. When I tell a patient you’ve got pancreatic cancer, they’re not interested in what is the median of the overall group. They wanna know who beat this and how did they beat it and what were the characteristics of those who beat it. There’s a case of stage 4 GBM, glioblastoma multiforme, and the person basically beat it. They were 20 years out and there’s no evidence of recurrence.

– [Zubin] Which is unheard of, man.

– [Marty] It’s unheard of. I don’t know if it’s ever been described and people, actually most of the time we see some appearing miracle like this that there was a mistake in the path or the diagnosis. This path has been re-reviewed every year in a teaching conference. It’s stage 4 GBM. What happened in that case? Turns out the the patient developed after the resection of the tumor a bad infection of the surgical resection bed and the abscess was relieved with a second procedure where they removed the bone plate, drained the infection, in a stage procedure.

– [Vinay] It’s the original immunotherapy.

– [Zubin] Yeah.

– [Marty] It might have triggered immunotherapy.

– [Vinay] But actually, you know, in like the 1800s, that’s Coley’s toxin guy at MSKCC used to inject people with cancer into the lymph node with pus and he did actually engender a few of these very durable immunotherapy responses, but it’s sort of similar to what you’re saying.

– [Marty] It’s like maybe, I don’t want to tell people to inject the-

– [Vinay] Of course, no, no, but you’re saying that discovery happens when you have your eye open to unusual findings.

– [Marty] And we listen to ideas that are different from deeply held assumptions that we otherwise have.

– [Vinay] As long as those are said by people who we like.

– [Zubin] We like. On Twitter.

– [Vinay] And Twitter, yeah.

– [Zubin] Well, no, go ahead.

– [Vinay] Well, I was just gonna say, I think the last thing we should talk about for a couple of minutes is the pandemic of lunacy you called it. You know why don’t you-

– [Zubin] Fear not.

– [Vinay] You said we’re dealing with two pandemics. I listened to your recent podcast. And then I texted him ’cause I said I really liked it. One pandemic is, of course, SARS-CoV-2, but what is this pandemic of lunacy that you talk about? And where is it’s origin? Pandemic of lunacy I think it’s the Twitter variant.

– [Zubin] It’s a gain of fear research.

– [Vinay] Yeah, it’s a gain of fear research and there are some people who are experimenting on Twitter.

– [Zubin] Oh, yes, they are. They’re doing it quite well. Some major organizations.

– [Vinay] With emojis and their little-

– [Marty] I’m impressed. I don’t really read Twitter, I just put stuff out there, like if I put out an article or a piece.

– [Zubin] I dump and run, yeah.

– [Marty] And I just assume, dump and run. Dump and run, drive-by shooting is not it, right? But basically put something out there and then just not look because people get so preoccupied and there are a lot of people probably listening and watching and somebody’s put a comment on their page or something they’ve posted and they’re so distraught by it. People would never act like that in a face-to-face civil conversation, but they’re anonymized and they throw these grenades. So all that to say that this pandemic that we’re dealing with now, pandemic of lunacy I call it and it’s not to dismiss what’s happening right now with COVID-19. With COVID-19, there’s a very surgically precise problem. 10 to 20 million Americans are adults with a risk factor and no immunity, no vaccinated or vaccinated or natural immunity and they are dying and they’re continuing to die in high number and we have to do everything possible to encourage them to be safe, avoid these risks, get vaccinated quickly and to do it today. That is our challenge. It’s not omicron, it’s not mild illness, it’s not positive case numbers.

– [Vinay] It’s not the Georgetown kids in college.

– [Marty] It’s not the kids in solitary confinement at Georgetown University.

– [Zubin] It’s not a two-year-old with a mask on.

– [Vinay] It’s not a two-year-old without a mask on either.

– [Marty] It’s not a cloth mask on a two-year-old that wants to join their parents at a coffee shop. It is a very precise problem of a vulnerable population that we’re not talking about with a risk factor we still don’t talk about, obesity, and instead this sort of blanket policy is indiscriminate across the whole population. That is something we’re not talking about right now because we’re distracted with all these other issues. The other issue is this sense of oh, here’s a theoretical construct by which somebody could be harmed by one of those people. And we saw this before with the highly stigmatized HIV virus.

– [Zubin] HIV, yeah.

– [Vinay] You’re right.

– [Marty] There would be a kid in the school with HIV and you’d have-

– [Vinay] People didn’t wanna hug that kid.

– [Marty] People would not want to be near it, people wouldn’t let their kids go to that school and you’d say-

– [Zubin] It’s terrible, awful.

– [Vinay] Awful.

– [Marty] And the doctors would say hey, wait a minute.

– [Zubin] Kid gets it from a transfusion.

– [Marty] That’s right, there’s no contact transmission. There’s no documented case. People say well, theoretically, they could cut themselves on the playground and that could go into an exposed wound on somebody’s lip.

– [Vinay] You remember people didn’t wanna play with Magic when Magic came out and said he had HIV.

– [Marty] That’s right.

– [Vinay] Yeah, I think it was Carl Malone who said I don’t wanna play with that guy.

– [Zubin] Oh, yeah, right, yeah, right, right, right.

– [Vinay] I guess your point is we should at least now look back at this and say how disgraceful it was that we ever succumbed to let our fear be so great we wouldn’t show compassion and humanity to people.

– [Marty] That’s right.

– [Vinay] And now we have fallen into it yet again because we show no compassion or humanity to people who are getting very sick from this virus who are mostly a risk to themselves and not to us who have been vaccinated and we have no compassion left and 10 years from now we’re gonna look as despicable as we looked, ’cause I remember being a kid and people saying those sorts of things.

– [Zubin] Oh yeah, oh yeah. Yeah, our circles of compassion have shrunk rather than widened. The natural progression of humanity as we widen our circles of compassion, it used to be just family, then it was tribe, then it was state, then it was nation.

– [Vinay] Ferrets.

– [Zubin] Then it was ferrets. The minute we get to armadillos, that’s when we’ve arrived.

– [Vinay] But you know fear makes you narrow your circle.

– [Zubin] It does, it does.

– [Vinay] When you’re scared and anxious and then you go on this shitty website-

– [Zubin] Contracts.

– [Vinay] That makes you lose your head.

– [Zubin] Actually fear makes us contract in general.

– [Vinay] Yes.

– [Zubin] So you may have an expansive sense of love and connection to other humans, the minute you get scared or your primal drive to survive is triggered, you contract and you can feel it. You feel it in the body, you feel it in interactions and you feel it in the news. You feel it on Twitter, you feel it on social media.

– [Vinay] I guess I’d say this about Marty. I think that there’s obviously a lot of people who love you, Marty, and a lot of people who have been critical of you, but I wish that people would acknowledge that even those people who have criticism of you should acknowledge that your broader point that we need to think about the people at highest risk and do more for those people to lower their risk and think less about the people at low risk and how we can torture and screw up their lives. How can that be even debated. Like his broad point is right that you have to think less about the Georgetown kid than the unvaccinated 85-year-old right now in Alabama who’s never had this virus before, ’cause that person is playing Russian roulette and this person is gonna be fine.

– [Zubin] But that sounds like targeted protection, Vinay.

– [Vinay] Oh, yeah, what is it called.

– [Zubin] And Jay was saying-

– [Vinay] Focused protection.

– [Zubin] Focused protection, the great Barrington declaration.

– [Vinay] We know focused protection doesn’t work. You know, like in medicine, we know you can’t treat individuals differently, you just gotta give medicines on the wards, you throw them out, you give everyone the same medicine. We know you can’t do anything-

– [Zubin] We know ulcers aren’t caused by H. pylori.

– [Marty] We know it’s surface transmission and if you don’t wash your hands for 20 seconds, try to think of a song-

– [Zubin] Two happy birthdays, two happy birthdays. Not one.

– [Marty] Two happy birthdays is better than one.

– [Vinay] You know, it’s the QR code that gets me.

– [Zubin] Oh, that’s the best.

– [Vinay] The QR code.

– [Zubin] Although I will say this.

– [Marty] What is the QR code?

– [Zubin] For menus at restaurants.

– [Marty] I mean, I know what one is, I’m not-

– [Vinay] You go to the restaurant, you scan the code.

– [Zubin] It’s a Bay Area thing.

– [Vinay] Yeah, you wait for your menu to load.

– [Zubin] You wait for your menu to pop up and then you-

– [Vinay] ‘Cause they don’t wanna give you a handout menu. They want you to touch the QR code laminated thing and that has got-

– [Marty] Yeah.

– [Vinay] That’s a filthy QR code.

– [Zubin] Although I will say this. So there’s a Japanese restaurant I go to here in San Mateo. You order through the thing-

– [Marty] Half, we’ve been there.

– [Zubin] You pay through the thing, yeah, oh, no, yeah, yeah, yeah, well, that’s one and then there’s another I can take you to.

– [Marty] Oh, okay.

– [Vinay] Let’s go.

– [Zubin] And it’s great because you don’t have to talk to another human being until they come when you complain that they got the order wrong, but you put it so clearly on the thing.

– [Vinay] Another way to dehumanize us.

– [Zubin] And they’re masked and you’re not.

– [Vinay] That’s, of course.

– [Zubin] That’s very, very good.

– [Vinay] Only the people who are helping at dinner parties mask and I think that’s another part of the problem you talked about in your podcast. Go to these galas, you watch these politicians, you know.

– [Zubin] Now if anything you could say you’re protecting them, but they’re wearing garbage masks. It’s not like they’re wearing surgical or N95s.

– [Vinay] That’s another thing, Marty. Why can’t we all agree that like-

– [Zubin] Cloth masks are garbage?

– [Vinay] Yeah, like even if you, I don’t know, even the most vocal masking person, why are they encouraging the use of the mask that doesn’t work? I don’t get it.

– [Marty] We have these massive arguments with COVID over the most peripheral issues, like cloth mask versus no mask in somebody already immune. Or the age group like kids 5 to 17 where we don’t have any documentation that healthy kids are even at risk of dying of this. Now there’s still risk of MISC and other things, but look what we’ve done to that.

– [Vinay] MISC’s fallen actually with Delta, didn’t it? It’s been decoupled a little bit.

– [Marty] It has, the numbers are down and that German study was pretty powerful that just came out.

– [Vinay] All right, well-

– [Zubin] You mean Hasselhoff It All? That’s my favorite German author.

– [Vinay] It’s pinned right next to the ferret study on the refrigerator. Okay, so this is good.

– [Zubin] I think we’re calling this “Pandemic of Lunacy.” I think that’s the title of this episode. I think it perfectly summarizes everything we talked about.

– [Marty] People are gonna think we’re not recognizing the important.

– [Vinay] He’s right, he’s right. ‘Cause it is a real pandemic, but it’s a secondary pandemic.

– [Zubin] The thumbnail is “Pandemic of Lunacy,” the title is “Real Pandemic Also Lunacy.”

– [Vinay] Or how about a conversation of rationality.

– [Zubin] Ooh, that’ll never sell.

– [Marty] It’s accurate and it’s true.

– [Zubin] This is why your podcast, your YouTube podcast only gets like a million views.

– [Vinay] It also why “Plenary Session” is a cult classic.

– [Zubin] With titles like, “Cancer, Can We Ever Fix This Particular Unusual Type of Thing in the Study Apparatus.”

– [Vinay] Yeah, it’s like titles like, “ALL Drug, Nelarabine, Was It a Good Approval?”

– [Marty] By the way, we’re seeing in, at least in the patients I talked to, national massive shortages of chemotherapy drugs.

– [Vinay] Oh, that’s true. I mean, we have decarbazine shortage, we are, I guess I’ll just say it once, it’s a super big problem, it’s related to all this global disruption and some of the drugs that you’re shorting are drugs that are curative. And if you short a curative drug, you’re going to have-

– [Zubin] Murder on your hands.

– [Vinay] Yeah, you’re gonna have increased deaths on your hands.

– [Marty] Bleomycin, for Hodgkin’s, Abraxane. I know we use Abraxane for pancreatic cancer. I think breast also you would know.

– [Vinay] That’s the Patrick Soon Shiong, you know, Patrick-

– [Marty] That’s how he made his billions?

– [Vinay] He has 11 bills.

– [Zubin] Oh, that guy.

– [Marty] That’s disgusting, 11 billion?

– [Vinay] Yeah.

– [Zubin] Yeah.

– [Vinay] From that one drug.

– [Marty] 1 billion is enough.

– [Zubin] I mean, I invented blue fartane but no one’s paid me shit for that.

– [Marty] I just want 1 billion.

– [Vinay] I just want 1 billion.

– [Marty] Do you also aspire to 1 billion?

– [Zubin] I just want the doors to do this, Marty.

– [Marty] You know modest goals are good.

– [Vinay] I just want a car without a dent on the side. He’s seen it, he’s seen this dent.

– [Zubin] I’ve seen it. Okay, we gotta go, we gotta go.

– [Marty] I’m sorry I did that then.

– [Zubin] You’re the best, Marty. I love you.

– [Marty] Good to see you guys.

– [Zubin] I love you like an obese child loves a high glycemic index food. And-

– [Vinay] And I know you like I’ve never known you before.

– [Zubin] We finally got to touch each other.

– [Marty] Well, this is an experiment and it was fun. This is cool. And keep pushing the field and thanks for what you guys are going.

– [Vinay] Same to you, Marty.

– [Zubin] You, too brother.

– [Vinay] Keep going out.

– [Marty] Different ideas are good. Conversations are good.

– [Zubin] I’ll tell these guys, share the show, become a supporter, zdoggmd.com/supporters, oh, but more importantly.

– [Vinay] Watch-

– [Vinay And Zubin] The VPZD Show.

– [Zubin] On all the platforms. You can find it everywhere.

– [Vinay] Leave a review.

– [Zubin] Leave a review because that-

– [Vinay] We gotta get past Shankar.

– [Zubin] Listen, we’re gonna get him. We’ve already just totally slapped Sam Harris across his meditative face, all right. I’m like, oh, you like atheism, here you go, whap, science. I’m kidding. I love Sam Harris.

– [Vinay] I do, too.

– [Zubin] I really do.

– [Zubin] All right, guys, I love you and we are out, thanks, Marty.

– [Marty] Great, good to see you guys.