0:00

You're listening to the pandemic podcast. We

0:02

equip you to live the most real life possible in the face

0:04

of these crises. My name is Matt Boettger and I'm joined

0:06

with my good

0:07

friend, Dr. Stephen Kissler.

0:08

And if you actually watch this video, I tell, I forgot to get

0:10

rid of the other empty face or Dr.

0:13

Mark Kissler. Who's not here whatsoever.

0:15

So we're going to move that right like this.

0:17

So we're over with just the two of us. So,

0:20

Stephen, I've got you on. Good to see. Yeah,

0:23

it's good to see you too.

0:24

It's a, how's the weather in Boston. Can I do the normal,

0:26

like a cliche?

0:29

I know. Yeah, it's a it's cool enough.

0:31

Allie and I got to go out and see some of the leaves

0:33

this past weekend, which was great. Took a drive up through

0:36

Western mass in the Southern part of New

0:38

Hampshire. And it's great. This is,

0:40

this is a special time of year

0:42

now. Are there any tips in that for, so those

0:44

of us who are those of you who are listening, who are

0:46

kind of up in the Northeast daily

0:48

tips for great places to see tree, because

0:50

it has here in Colorado, it's

0:52

an as you well know, it's not all over. You've

0:54

got to go drive to find the

0:56

Aspen leaves and there's certain hotspots. Is

0:59

it similar or is it just everywhere? They're

1:01

just a matter of where you go.

1:03

Yeah. It's most places are good,

1:05

at least at some point that there's this like gradient

1:07

from north to south. So it gets really good, like way

1:10

up north first and then it's coming down.

1:12

So here in Boston, actually, most things

1:14

are still green. We're gonna have little bits of

1:16

color. So, so it was part of why we ended up driving

1:18

up north. So there's there's a highway

1:20

in New Hampshire. That's in the white mountains. That's absolutely

1:22

beautiful. So that's where we ended up driving them.

1:25

If you're really into this Vermont publishes

1:27

a weekly foliage report and

1:30

it's this newsletter it's, even if you're not living

1:32

up here in the Northeast, it's the most charming thing you

1:34

can imagine. So if you need a little bit as false spirit

1:36

in your inbox every week the Vermont

1:38

department of tourism gives you

1:40

a detailed update of where exactly

1:42

to see the leaves in their state. It's just wonderful.

1:45

So we're going to go out of our way in

1:47

your life and

1:48

put that in the show notes, because that sounds awesome.

1:51

It's awesome. Now better yet is if they have an Instagram

1:53

feed, so I can be inspired every day by

1:55

the foliage of of New

1:57

Hampshire will be great. Yeah. We'll work on that. I'm

2:00

sure with all your extra free time. Well,

2:02

good. I'm glad we could connect. Again,

2:04

this Monday morning, kind of get back on a regular

2:07

schedule of on Mondays. A few

2:09

things are normal stuff. You could leave a review. We haven't

2:11

had one in a little while. We've

2:13

had a couple more five stars.

2:15

It was great, but no comments. So leave a comment, inspires

2:17

us to keep us going. If

2:20

you can support us. We'd love that as little

2:22

as $5 a month at patrion.com/pandemic

2:26

podcast, you can see it in the show notes or

2:28

just a one-time gift, PayPal, Venmo

2:31

again, all in the show

2:33

notes. So Stephen it's been a couple of

2:35

weeks just shy under a couple

2:37

of weeks since we were on a Wednesday. And I've

2:39

been perusing the news. And as you well

2:41

knows, it's, it's a slow,

2:43

which is kind of a, I guess, maybe a good sign. Maybe

2:46

you can fill me in it's it's, it's, it's

2:48

slow right now in the news on the pandemic

2:50

and COVID-19 and maybe

2:52

part of it is I honestly,

2:54

to be full disclosure, I had. Quite

2:57

as invested in checking the news every single

2:59

day, a lot of things on my other life

3:01

that kind of preoccupy me. But I want to get

3:03

with you because you've mentioned there's been a couple of things

3:05

that you've been seeing that's been surfacing.

3:08

Can you give us an update on the two

3:10

things you talked about? He was the vaccine, the boosters,

3:13

and then any variant information that we need

3:15

to be, to be known.

3:17

Yeah. So, and I think first

3:19

of all, I want to kind of echo the,

3:22

the feeling that you have, where it really

3:24

does feel like there's No less than

3:26

the news. And, you know, I also

3:28

have been sort of like checking my usual dashboards

3:30

a little bit less frequently. And and I think that that's,

3:33

you know, that's something that a lot of people I've spoken

3:35

with have been sharing as well. And, and in large

3:37

part, I do think that's, that's a good thing we have

3:39

seen largely you know, declines in cases

3:41

across the year. For the most part, which is,

3:44

which is great. And so, and it really,

3:46

you know, the question is we're, we're coming into this

3:48

winter season and there's a lot of uncertainty as to

3:50

what's going to happen with COVID

3:52

with flu. What do we need to do to be prepared

3:55

for those things? And I think we'll probably get

3:57

into each of those things one by one over

3:59

the course of this episode, but you

4:01

know, some of the, the major things that have

4:03

come across my radar over the last. Two

4:06

weeks or so as first of course, the

4:08

FDA approvals of boosters

4:11

or third doses, or in some cases,

4:13

second doses for those who've received the J and

4:15

J. And and so the, for

4:17

the vaccines that have been approved in the U S so

4:19

the Pfizer, the Medina and the J and J

4:21

additional doses are now approved.

4:24

And so there's a matter of supply trying to figure

4:26

out, you know, how. To get doses

4:28

to those who need them.

4:31

There'll be some time that it takes to ramp up. And right

4:33

now I think that while they have been approved, I

4:35

think they're currently recommended for people over

4:37

the age of 65 and those who are working

4:39

in high contact settings. So healthcare

4:41

workers, teachers people who

4:43

are at high risk of in fact, So

4:47

I think this is all really good news. One of the questions

4:50

that I've gotten about these is that we're so far,

4:52

the guidelines all have to do with

4:54

getting an additional dose of whatever you've

4:56

already gotten one or two doses of. And there's

4:58

also been a lot of research that's come out that

5:00

is still in the early stages, but I think is really

5:02

maturing quickly. Mixing

5:04

and matching and looking at, you know,

5:07

what is the best dose to

5:09

follow up and given your previous dose? There

5:11

are no clear cut guidelines on that yet,

5:13

but in the same way that we got a lot of information,

5:16

I think it was this past week on third

5:18

doses. I expect over the next couple of weeks

5:20

for there to be some more information about

5:22

mixing vaccine types as well. And

5:25

there's a lot of really It's difficult to

5:28

there, there are a lot of layers of difficulty with

5:30

us because the trials

5:32

of those who have received different vaccine

5:34

doses are there are fewer of

5:36

them because of vaccine company is not going

5:39

to administer another. The

5:42

vaccine to their own cohorts. So you know,

5:44

a lot of the initial information we got is from Pfizer

5:46

or from Medina. Whereas now we have to rely

5:48

on these more independent agencies who are running their own

5:50

studies for people who have gotten different types

5:52

of vaccines. So that's part of the reason why the information

5:54

is a little bit slower to come out, but it's coming. And

5:57

generally from what I've seen certain combinations

5:59

of doses do seem to be performing pretty well

6:01

in terms of the duration and level of antibody

6:03

response. And we've seen that to some extent

6:05

in the UK too, where simply

6:08

because of supply issues and the

6:10

need to vaccinate people quickly, many

6:12

people got an AstraZeneca dose first, and then

6:14

that was followed by a Pfizer dose. And those people

6:16

seem to have fared pretty well. So that's where some of our

6:18

information is coming from as well. Keep

6:20

the eye, keep an eye out for that kind of information coming up.

6:22

So, so the vaccination is really sort of one

6:24

of the big areas of news that I've seen. The

6:26

other really is just sort of been emerging over

6:28

the last day or two. And this has to do with

6:31

the AOI for variants, which is a sub

6:33

lineage of the Delta variant. And there've been some

6:35

substantial increases of this

6:37

particular variant that we've seen in particular,

6:39

in the. I think part of that, part

6:42

of the reason we've been seeing those increases there is again,

6:44

because the UK is surveillance is unbelievable.

6:47

And so it's not to say that it's the only place

6:49

where a sub lineage of Delta

6:51

might be taking hold. But they've been able to detect

6:53

it and to identify the fact

6:55

that this Is a somewhat mutated

6:58

version of the original Delta that we've

7:00

been seeing spread. So again, it's

7:02

still too early to say if the

7:04

mutations that we've seen in this new variant

7:06

are sufficient to give it. Some

7:10

escape from immunity or increased

7:12

transmissibility. It does seem to be spreading

7:14

a little bit more rapidly than other

7:17

variants of Delta that, that came before

7:19

it. And so I think there is reason to believe that it might

7:21

be either somewhat more infectious or able

7:23

to get around some level of. But

7:26

it also doesn't seem like it's the

7:28

orders of magnitude difference. Like we saw

7:30

going from alpha to Delta, if it

7:32

is it's maybe a little bit more fit, a little

7:34

bit more able to spread. But I don't

7:36

think from everything that I've seen so far

7:38

and from all the commentary that I've seen from my colleagues

7:41

we may see this additional variance sort of starting

7:43

to. Represent more and more cases.

7:45

But it doesn't seem like it's going to be nearly

7:48

like what we saw with the transition from alpha to

7:50

Delta. So that's, you know, that's, that's good news,

7:52

but it's also something that we're going to be watching closely.

7:55

We've spoken about this topic so many times about

7:57

you know, just the difficulties of figuring out

7:59

what makes a variant a variant. And is it just

8:01

getting lucky or is it actually,

8:03

you know, genetically biologically better in

8:05

some way. And how does that depend on the

8:08

place in which it's spreading and the population.

8:11

All of those are still, you know, those same questions.

8:13

I'll still hold here too. And that's why we're

8:15

still uncertain as to really what exactly is

8:17

going on with this thing. But it's something we're watching closely.

8:19

Great.

8:20

Well, a couple of follow-ups in this, so I'll go reverse.

8:22

Where, what the most, the topic you just

8:24

mentioned right now, and that

8:26

is a variance. It seems as though now,

8:28

maybe this is because Delta

8:30

is just a dominant force.

8:34

But it seems as though, like the variants have

8:36

kind of, been tapering off a little

8:38

bit. And for those of you who might be

8:40

hearing the background, my son's kids screaming

8:42

in the background. Sorry. It just happens. It's part

8:44

of the life of the, of the household. So it seems like

8:46

the variants are kind of tapering off. Is

8:49

this amongst the colleagues

8:51

who you're talking to. Is there

8:53

a sense by which it's starting to stabilize or

8:55

is it more of a, just Delta is just such a dominant

8:58

force that there's just no other chance.

9:00

And it's still like, where do

9:02

you guys find yourselves and kind of landing on

9:04

those areas of like, is it stabilizing or we find

9:07

ourselves maybe the next six months, this

9:09

is going to be kind of really being a taper off

9:11

or is it just nothing has a competed

9:13

quite yet. We're just waiting for it. A

9:16

new dominant variant.

9:18

Yeah. You know, it's, it's really hard to

9:20

say famously when

9:22

one tries to make predictions about biology

9:25

one has always proved wrong. And so, so

9:27

it's hard to say, but you are right. The

9:31

rate at which we've seen new

9:33

variants emerging and spreading

9:35

and sort of taking over has declined. And that

9:37

is largely because Delta is just so

9:39

contagious. It's really hard to

9:43

supercharge something past something that is

9:45

already so supercharged. And uh, you know, part

9:47

of the reason for that is I imagine

9:49

because you know, there, there are some constraints

9:52

on Respiratory pathogens

9:54

that use certain strategies to infect

9:56

ourselves. So COVID 19, the

9:58

SARS cov two virus uses these ACE

10:00

two receptors in our epithelial cells

10:03

to attach and then bind and then enter into ourselves.

10:05

And you can get better and better at that, but ultimately

10:07

they're there. We expect there to be

10:09

some limit that just biologically speaking, you

10:11

can only be. So sticky and

10:13

you can only become, you know, so fast

10:16

at invading cells. And that you

10:18

know, you can explore this evolutionary

10:20

space, basically you can mutate and spread

10:23

and that sort of optimizes one part

10:25

of this equation, but then at some point

10:27

you just can't really optimize it that

10:29

much more. So, so

10:31

I think that that may be partly why we

10:33

haven't been seeing anything emerging past

10:35

the Delta. So it's kind of both, both of those

10:37

things that you said. So first, you know, Delta is already so

10:40

infectious. And second, because the virus

10:42

may maybe starting

10:44

to exhaust some of that what we call

10:46

evolutionary space it's ability to sort

10:48

of explore these different strategies that make it more

10:50

and more infectious. But of course, you know, basic

10:53

infectiousness is just one part of the equation.

10:55

People I think are rightly concerned about right now is also

10:57

the ability to evade immunity and

11:01

virus can do that in a lot. Generally

11:03

speaking, there are a lot more ways to do that,

11:06

partly because Are if for

11:08

anyone who's, you know, seen either actual

11:11

microscopic images of the SARS,

11:13

cov two virus, or even just a cartoon

11:15

versions of it, it's sort of this circle

11:17

looking thing with these spikes sticking out of

11:19

the top. That's the name? The Corona virus stands for

11:21

the crown or the Corona that surrounds

11:23

the virus, which are these spike proteins that are so

11:25

infectious or that are so. Much

11:28

responsible for the infectiousness of the

11:30

virus. So these, these spikes

11:32

help the virus attached to ourselves, but they're also

11:34

the first thing that our immune system is exposed

11:37

to. And our immune system doesn't always recognize

11:40

the bits that are most important for the virus is

11:42

actual function. Sometimes the virus will just

11:44

display things

11:46

on these spikes and it can

11:48

change those to trick

11:50

our immune system, basically. And, and this is a

11:52

very common thing with. So this is why

11:54

we need flu vaccines every year. This is why flu

11:57

can infect us year after year after

11:59

year, because it's essentially

12:01

like the virus is the same, but it's like, it's

12:03

changing its outfit. And so it has this, you

12:05

know, wide range of you know, coats and hats

12:07

and sunglasses that can put on so that our immune system

12:09

doesn't quite recognize it as well. And

12:12

so those things don't actually disrupt the function of the.

12:14

You know, the virus itself is still the same, but the thing

12:16

that it looks like to our immune system is a little bit different.

12:19

And so I think that's what we may start to see here,

12:21

where we have the, you know, sort of this, this Delta

12:24

base of the SARS cov two virus,

12:26

but the variants can now sort of lead to these

12:29

subtle shifts. And I expect this might be what's

12:31

happening with this new AOI for variant is that

12:33

it's found sort of a different coat to put on. And our

12:35

immune system can't quite recognize it as well as our

12:37

response. And I think that that

12:39

is something that we might see. For

12:42

a long, long period of time. And so if we start

12:44

to see COVID-19 or the SARS

12:46

cov, two virus coming into the seasonal circulation,

12:49

something that looks a lot like flu, I think that this

12:51

might be part of what's behind it is that it just sort of

12:53

keeps changing its outfit from year to year. And

12:55

that's something we're probably never going to totally be able to

12:57

get ahead

12:57

of. Okay. That's helpful. I mean, I never

12:59

really made the distinction between. The

13:02

variant and maybe it's a leveling off

13:04

and its ability to kind of only be so efficient.

13:07

And that is a separate dimension to

13:09

evading the immunity. I always saw them as being one-to-one

13:12

like once it kind of plateaus

13:14

out. So, so is it for

13:16

its immunity, its ability to skip immunity, but those are two

13:19

separate variables you're saying,

13:21

and that you could actually level off, but instill

13:23

in her infinite amount of like

13:25

hats and coats throughout

13:28

the lifetime of its of its existence. Right.

13:31

Okay. Alright, great. And then the other

13:33

question then is dealing with this, the

13:35

vaccines and the boosters. Right? Well, now that we

13:37

have James J and J and, and Madrona

13:39

being available for boosters,

13:42

you know, I'm kinda thinking, first of all, I saw Fowchee say something

13:44

about, oh, this is good news. You know, we could now mix and

13:46

match. And so is it

13:48

not quite available to mix and match yet? Are you just saying

13:50

this is kind of the radar? Or could I go into a Walgreens

13:53

and get my little menu and be like, Hey, do I want to today?

13:55

Do I want the modern, I don't want the Pfizer. Do

13:57

I want the Jane. Or do they,

13:59

I mean, this may be beyond what you know right

14:01

now. Or when you go in, do I have

14:04

to show them my card and say, oh, you had the Pfizer's

14:06

you're going to get the Pfizer again. Or do I, am

14:08

I going to have a say, you know, right.

14:10

Even right now on grant, I'm not 65 rollers.

14:12

I wouldn't get one right now. Whatever, say

14:14

to actually change it up by one to two at this point in time.

14:17

Yeah. So I think my understanding

14:19

is that if you you

14:21

know, Walk into a

14:24

drug store. They go to your local CVS

14:26

that if you

14:28

are truthful about your vaccination history,

14:31

then, and you say that you need a booster,

14:33

then they will give you a dose

14:36

of whatever it is that you've gotten before. So it's

14:38

not yet approved for for a person

14:40

to mix and match. That said a lot

14:42

of, I do know that people have.

14:45

And and I do think that that requires

14:47

you to not be truthful about what you've already received.

14:49

So there, you know, so that's

14:51

that's in play there. But

14:53

but that's one of the really interesting things about, you know,

14:56

the way that we've structured our vaccination system

14:58

for COVID-19 here in the U S is that there's really,

15:00

there's really not a lot of oversight. Generally

15:02

people haven't really been necessarily

15:04

registered with individually identifying

15:07

information. So the. We can

15:09

clearly track exactly who's received

15:11

which doses. And even if we are,

15:13

then it's actually very easy to sort of subvert

15:15

that system. So these are not things that I would recommend

15:18

at the moment I think that,

15:20

you know, the, the FDA exists for a reason

15:22

and the oversight is, is,

15:24

is good. But I

15:26

do know that it's, it's possible to do that. But

15:29

not neither recommended nor

15:31

nor you know, within the boundaries

15:34

of what has been approved. So, so,

15:36

so that's, you know, that is all, that's

15:38

all Yeah, that's all there that

15:40

said, I mean, I know that. So from, from,

15:43

just to sort of give a gloss over the research, I think

15:45

I already mentioned this, but it does seem like, especially for

15:47

people who have received and adenovirus

15:49

type vaccine as their first dose. So something like

15:51

the J and J and the AstraZeneca, and then

15:53

have followed that with an MRI and a vaccine.

15:56

Generally it's been well tolerated. Generally.

15:58

They've gotten very good immune responses that have far

16:00

surpassed the initial dose of the adenovirus vaccine

16:02

they've gotten in the first place. So, it's not something I can

16:04

recommend at this point, but again, this, these are the

16:06

studies that I'm pointing to that I think we'll start

16:09

to hear a lot more about very soon. Great.

16:11

Okay, great.

16:11

Okay. So let's switch gears for a second. I'm going to go

16:13

back. I know probably like every four to

16:15

six, maybe eight weeks now, since we're every

16:17

other week we mentioned the flu and

16:19

then another, another article came out

16:22

from the Atlantic. About the

16:24

flu, which kind of sparked my

16:26

interest of the idea that

16:28

the concept that maybe is the flu gone,

16:30

like, are, is this kind of like not gone

16:32

below? For years and years and years,

16:34

we've kind of just a defaulted. The fact

16:37

that's always going to exist. That's always going to

16:39

dominate during the winter that

16:41

we're going to have tens of thousands of

16:43

deaths, you know, all these

16:45

things. And so we get the flu vaccine.

16:48

Now, then last year happens and we have

16:50

this freakish episode by which we have almost zero

16:52

flu cases. And so now

16:55

we're wondering, you know, maybe in August

16:57

and July, I was one, Hey, it's going to be a bad flu

16:59

season because now I'm thinking.

17:02

You know, not so great thoughts of like, okay,

17:04

well, you know, we had a whole year where it didn't surface

17:06

and now it's been underground building, you know, Dr.

17:08

Evil like this, this next year, it's going to be

17:11

just atrocious. Right? They've they've had

17:13

more time to think about what they're going to do and

17:15

it's going to be way worse. And now I'm starting

17:17

to wonder, you know, because of habitual

17:20

changes, because now that. You

17:22

know, the pandemics going to an endemic where it's like,

17:24

it's, it's going to live with us forever. So we're slowly

17:26

changing our habits. You know, like of

17:28

course we, you know, no more lockdowns, that kind of stuff,

17:31

but you know, like things like working

17:33

remotely for a couple of weeks or, you know,

17:35

having school go remote for one week

17:37

at a time during high, you know, high outbreaks

17:39

or wearing masks here and there. So all these random

17:41

things wash your hands more, just having

17:43

a little bit extra space between people at the grocery

17:45

store. That's not even that much, you know,

17:48

all these have a significant impact. Could

17:50

it be the case that like this whole flu thing

17:52

is just like going to be behind us for the rest

17:54

of our lives, as long as we continue down this path.

17:58

Yeah. It's, it's pretty amazing

18:00

to me. I mean, I think that what

18:02

happened to the flu last year, it

18:04

was just mind blowing,

18:06

absolutely mind blowing, because flu has just been

18:09

such a, as you said, it's such a regular part

18:12

of our experience know

18:14

certainly for our entire lifetimes and for

18:16

as long as you know, any of us can remember

18:18

And it

18:21

is a remarkable thing that globally,

18:23

we basically saw no

18:25

flu last year. You know, it wasn't absolutely

18:28

zero, but it was historically low and

18:30

basically everywhere that collects flu

18:33

related data. Which is unbelievable. So I think, I

18:35

mean the first thing, and I think, you

18:37

know, this is, this is what you were talking about already,

18:39

but it, it really did

18:41

cause us to take

18:43

a step back and be like, wow, like. There

18:45

are things that we can do that we didn't realize

18:48

would have this level of impact. And

18:51

it is forcing us to

18:53

think a little bit differently about infection

18:55

control. I think you're right, that there are things that

18:57

we took for granted

18:59

that now we're starting to

19:01

think, well, do we, do we have to

19:04

and you know, like you said, that's not to say that we're

19:06

going to. Impose

19:09

all of the restrictions that we imposed last year,

19:11

so that we're living in a flu zero world for

19:13

the rest of our lives. But but it

19:15

is a really important Testament

19:18

to the fact that like these non-pharmaceutical

19:21

interventions. Do something,

19:23

you know, they really, they do something

19:25

and we can use them

19:27

in, you know, to, to reduce the

19:29

burden of flu and other respiratory

19:31

diseases. And and I think

19:33

we really need to think critically about how, how best

19:36

to do that while, you know, while maintaining

19:39

all of the other benefits

19:41

of living in a social society, you

19:44

know, that we have So, so I think it's,

19:46

it's going to be a really exciting and interesting time to think about

19:48

what's what's going to happen with the fleet now. So

19:51

part of the question is, you know what, what's in store for us

19:53

this year, next year, and over the next five, 10 years.

19:55

And there's been a lot of speculations

19:57

that after the near

19:59

eraser of the flu season last

20:01

year That there could be a very strong season

20:03

this year. And that's in large part due to

20:05

our own immune systems, not

20:08

so much the virus itself, but the

20:10

fact that because essentially nobody

20:12

was exposed to it last year that sort

20:14

of timer on our immune systems

20:16

that gets weaker and weaker over time is

20:18

not going to have gotten that reminder that

20:20

it usually. Annually or every couple of years. And so that

20:23

means there's going to be a lot more people running around who

20:25

are not as protected as they usually are. So the

20:27

flu is going to be able to spread more easily, might

20:29

be more intense for the people who do get infected

20:32

because that immune response might have declined

20:34

to some extent. And so I think

20:36

that's been one of the big concerns. But there are,

20:39

you know, there are some counter. To

20:41

this too. So there was, we

20:43

should put this on the show notes as well, but there

20:45

was recently this writeup from a couple of my

20:47

colleagues from the UK including my PhD

20:50

supervisor, Julia Gaga, who has done she

20:52

spent her career working on flu and its transmission

20:55

dynamics. And and she's far from

20:57

convinced that this coming flu season

20:59

is going to be. The, you

21:01

know, this big, bad, scary flu season,

21:03

it could be. I think there's reason to believe that it could be.

21:05

But one of the other really interesting

21:07

things about essentially driving flu cases

21:09

to near zero is that we

21:11

don't really know how long it's going to take for it to rebound.

21:14

Usually the flu

21:16

Sort of spreads from the Northern to Southern hemisphere.

21:18

And so even though in the up here,

21:20

you know, we're in the United United States right now,

21:23

I'm in the Northern hemisphere. We

21:25

have our flu season during November,

21:28

December, January time of

21:30

year. I'm in the Southern hemisphere.

21:32

It's June, July, August because that's

21:34

their winter. And so even though

21:36

the flu is very periodic. In

21:39

our own experience, there's actually

21:41

usually a decent amount of flu

21:43

circulating everywhere in the world at some

21:45

point. And so one of the really interesting things about the

21:47

COVID pandemic. Essentially stopped

21:49

to that pattern. And you can sort

21:51

of, you can sort of think of this. You

21:54

could sort of think of this as a pendulum in a way, right? Where

21:56

if you have a pendulum that's swinging to

21:58

keep it swinging, all you really need to do is just sort of

22:00

poke it a little bit. Right. And, and if

22:02

you just give it the slight little push, once it

22:04

reaches sort of the top, then it'll keep swinging

22:06

for a very long period. But

22:09

if you stop that pendulum, if there's this bowling ball

22:11

at the end of the string, it takes a lot of effort

22:14

to get it back to the point where it's swinging

22:16

back and forth like that year after year after year.

22:18

And so, so we could be in a scenario

22:20

like that for flute, where it might actually take some

22:22

time for it to get ramped up, back to speed.

22:25

I don't know for sure if that's going to be the case, but I think

22:27

it's a really interesting idea. They've, they've

22:29

actually done some formal modeling work to suggest

22:31

that this might be the case. And before

22:34

the pandemic a lot of this work was done pre COVID

22:36

19. So it was really this sort of theoretical study

22:38

that was like in the night deal world. If we could just stop

22:40

flu for a year. What would happen. And now all

22:42

of a sudden we're living in that world,

22:44

which is pretty crazy. So we're going to actually be able to

22:46

see and test whether these

22:48

projections turn out to be true.

22:51

So, all of that is a long way of saying that I have no

22:53

idea what's going to happen this year. And

22:55

and I think it'll be really interesting to see what happens over the next

22:57

couple of years. I think that. My

23:00

hunch is that you know, the flu

23:02

flu does spread pretty well. And so I,

23:05

I I'm, I'm actually scheduled to get my flu.

23:08

This afternoon. And so I'm planning to do

23:10

that, especially because I do, I do expect

23:12

this year to have flu circulation.

23:14

And I think that it could be, even

23:16

though it's not guaranteed to be bad, I think that there's enough

23:18

of a chance that I'm definitely going to do everything

23:21

I can to protect myself and the people around me by

23:23

getting vaccinated. I'm probably going to be

23:25

wearing a mask pretty fastidiously

23:27

all winter long. When I'm in indoor spaces with

23:30

others who are not part of my normal

23:32

pod. And so, so that's, that's

23:34

how I'm going to approach it. But I do think that

23:36

it's, it's worth noting that We don't know for

23:38

sure. Yeah. Yeah. Yeah. There's

23:40

one thing I learned in physics and

23:42

I know nothing about physics. I took a class

23:44

in college and I thought, I

23:46

was like, oh, you know what, I'm going to love physics. And

23:49

I realized, I hated it because it was just too complicated

23:51

for me. But there's one thing I learned and that was the friction

23:53

coefficient. And that was like, that

23:55

was like the one thing that stick with me because it was

23:57

like, oh, this was like a life lesson.

24:00

And what you just did where there's this a coefficient

24:02

of friction, right. Where we know that when something is not moving.

24:05

It takes so much inertia to get it to move,

24:07

but once you get a going right, it's so much easier to keep

24:09

it moving. And that's why I was thinking about the

24:11

Fleming. To what extent did we, you know, like you just said it

24:13

stopped and how much more momentum you

24:16

have to exert to get it to go again. And this is

24:18

like a life lesson for everybody. This is where like, not

24:21

to go on a tangent and I will, I'll spend less than 15

24:23

seconds on this. I hope. And then. That

24:25

goals are really, really cool.

24:28

They actually don't get the work done. You know, it's,

24:30

it's the habits, right? It's the tactics

24:32

that, you know, instead of putting the one thing down a

24:34

day to do, to actually think of a recurring

24:37

15, 20, 30 minutes of doing an

24:39

area of your life that you want to look forward to

24:42

so that you keep doing it to build momentum

24:44

to where it becomes easier, right? Just like habit formation.

24:46

So, taking this example of the

24:48

flu and hope. Th the

24:50

end result will be exactly that, right. It just takes

24:53

too much inertia and we're going to have a a

24:55

slow percolating flu season, but

24:57

yeah, that's one good news. Second. Good news is

24:59

guys get on some good habits, get some good

25:01

tactics in and build, get rid of that friction

25:04

coefficient. So that to

25:05

make life a little bit simpler. I think that's to

25:07

turn your 15 second tangent into a 32nd one.

25:09

I think, I think that that's really timely, you know? I,

25:12

I was, I was just having a conversation the other

25:14

day with Allie about how

25:17

yeah, just, just how strange this, this year has

25:19

been in sort of this it's sort of this. Appendix

25:21

to the crisis where we're still sort of living in crisis,

25:24

but also it's, it's like different

25:26

and I've, I've personally found it really hard

25:29

to get and maintain momentum

25:31

really this entire year it's felt like. And

25:33

so I, I really appreciate that cause it's,

25:35

it's true. It's sort of like science,

25:37

reflecting life, reflecting all of these different

25:39

sorts of things. And I don't know. It's I think it's

25:41

a message that. We could all stance

25:44

to here right now. Yeah,

25:45

I agree. I spent a lot of time this weekend

25:47

working on my own life. I felt the same thing. Like I'm trying to get

25:49

momentum in my life a little more and do some more stuff.

25:51

And when I set goals out, sometimes they feel

25:53

daunting and so scheduling out my day

25:56

and just make even 15 minute blocks to

25:58

do something that I haven't done for a while and

26:00

do it every day. And then you find yourself 30,

26:03

you know, 30 days down and feeling like, oh, this is once

26:05

was a hard thing. And now you want to do 30

26:07

minutes an hour. And so. Really

26:09

encouraged people. If you haven't done anything for a long time,

26:11

because of just the pandemic

26:13

or just life or whatever, then just

26:15

seriously blocked 10 to 15

26:17

minutes. And just commit to it every

26:20

day, five to six days a week, close up

26:22

shop for that 15 minutes. You're gonna find yourself

26:24

in a different place, 60, 30 days from

26:26

now feeling better about yourself and all that jazz.

26:28

So that's our life lesson for today,

26:30

but, you know, continuing on with the flu for

26:32

a second, now that we talked about

26:34

this off. The the recording.

26:36

But I really curious this idea

26:38

of where you kind of reflected a little bit Stephen

26:41

and myself, for sure. This idea of pandemic

26:43

fatigue and just exhaustion and then not building

26:45

momentum. And then I was thinking, you know,

26:47

okay, I'm going to be vulnerable here. Like I'm

26:49

not the greatest impact in the world. My wife

26:51

is she, she really can

26:54

feel for the world deeply. Right.

26:57

I don't have quite that sensitivity. And it's

26:59

something that I want to cultivate in my life. The

27:01

pandemic did not help me Stephen.

27:03

Right. Because I feel even more exhausted.

27:05

I feel a little bit apathetic towards

27:08

people, full disclosure, but I'm working

27:10

on this. So my curiosity is,

27:12

have you had any research or no. Talk to anybody

27:14

about like the flu pandemic of whatever 19, 18,

27:17

whatever it was that after the entire

27:19

thing. So-called ended

27:21

after the next crises where

27:24

people are like whatever. I just don't care.

27:26

I can't do it anymore. I mean, is there kind of like, any

27:28

kind of studies on what, how we deal with this

27:31

crisis afterwards and how we engage

27:33

the next crisis? Cause you know, a little, a little careful

27:35

and like, you know, next price for the guy or whatever. And

27:37

then it becomes actually a worst scenario because we're like, I'm just

27:40

exhausted. Is there any kind of research

27:42

about this, of like how we behave?

27:45

Yeah, there is, and it's,

27:47

it's a body of work that I'm not super

27:50

familiar with, but that I I'm

27:52

just beginning to dig into. I have

27:55

another set of colleagues from

27:57

the UK who who sort

27:59

of work on the, on the social science side

28:01

of epidemics and of major crises.

28:04

But especially infectious disease related crises.

28:06

So there's there's this wonderful in

28:08

a way maybe wonderfully morbid, but I think they're

28:10

super interesting research group over there

28:13

called crash. And this is at the university of Cambridge

28:15

and the acronym stands for the center

28:18

or, no, sorry. It's not. It's

28:20

Cesar C E S E R for

28:22

the it's the center for the study of existential risk.

28:24

And so they collect a bunch of people together who are

28:26

basically studying existential risks

28:28

as such. So that includes pandemic

28:31

pathogens and global

28:33

warming and artificial intelligence

28:35

taking over the world. And, you know, all of these different

28:37

kinds of things and thinking about these things as, as

28:40

such but also thinking about them very broadly.

28:42

Not only the scientific sides, but also

28:44

the social sides. And so. A lot of their seminars

28:46

are posted online. So

28:49

if anybody is got a one of

28:51

these slightly apocalyptic streaks like ideas

28:53

sure. Feel free to take a look at this. And

28:55

I, and it's actually really interesting and can be illuminating

28:57

towards these, these kinds of things. So,

29:00

so the research is out there and but I think

29:02

that. Th this pandemic is

29:04

really going to spur a lot more of

29:06

it and I'll be interested to see what comes of it. But

29:08

I think that for me, one

29:10

of the most interesting places to look

29:12

at this, that I think that we all have some amount

29:14

of access to is to look at

29:17

how art has

29:19

changed over time. And to some extent, both

29:21

art and philosophy, but I think art is in some

29:23

ways, a little bit more immediately accessible

29:26

in a way. And one of the things that has always

29:28

really struck me is the

29:30

shift in art

29:32

that took place from the

29:34

late 18 hundreds, early 19 hundreds

29:36

to the 1930s, forties,

29:38

fifties, up until the present day. I'm a. Musician.

29:41

So I've, I've played the violin for a long time.

29:44

So my first point of access

29:46

to this was through classical music. And

29:48

you can see this really huge

29:50

shift from sort

29:52

of the classical period and

29:55

You know, entering into the romantic period of

29:57

music where oftentimes there are these

29:59

very lush melodies and it was very creative

30:02

and spontaneous, but also had this very

30:04

like clear internal structure. It

30:06

it, it broke from tradition, but

30:08

still like had this very strong

30:11

tie to the tradition of classical music

30:13

up until that point. And then you hit

30:15

world war one and world war II. And also

30:18

of course, the, the 1918 flu pandemic

30:20

laid over the top of this and

30:22

music becomes

30:25

really different. It, it loses

30:27

a lot of its sense of internal

30:29

structure and coherence and fidelity to a tradition.

30:32

It tries to express things in different

30:34

ways. And it becomes a

30:36

lot more impressionistic. It becomes a

30:38

lot more it draws on instruments

30:41

that one would never necessarily think of as an instrument.

30:43

So a lot of modern

30:45

music pieces have, you know, there are people banging

30:48

on pots and pans, or maybe you've recorded

30:50

a rainstorm. Features at some

30:52

point in this piece of music famously Phillip

30:54

glass writes this piece of three minutes of

30:56

silence and that's all it is literally, it's just three minutes

30:58

of silence and it he's composed of this piece. Right.

31:01

And so, and there's this really interesting sort of anti

31:03

structuralist movement in

31:05

art. And I think we can see that in visual art as

31:07

well, you go to any sort of art museum and

31:10

the art, you know, before the 1920s

31:13

is vastly different from the art that came out

31:15

of. And I think that that's expressing

31:18

something about a response to crisis that in

31:20

a way we're still living through. I think that

31:22

the it's, it's easy to forget just what an upheaval

31:25

the early part of the 20th century

31:27

was, and the fact that. Even

31:30

though, you know, we've been talking during the pandemic

31:32

about returning to normal life to

31:35

regular life. I think we forget that we've for

31:37

the past decades, we've, we've been living in a post-crisis

31:39

world. And we're still living, you know, we're now

31:41

living in a post post crisis crisis

31:44

world where, you know, there's,

31:46

some of these crises are layering on top

31:48

of each other, but but I can't say that the world

31:50

we were living in before. Normal,

31:53

you know, to the extent that anything ever has been

31:55

normal. And in some ways, like we've

31:57

still been trying to respond and grapple with this,

32:00

this major crisis that that sort of ushered

32:02

in the 20th century. So

32:05

I think that there'll be a lot of interesting work, sort

32:07

of doing some comparative. And analysis

32:09

of the art and poetry

32:11

and music that comes out of the post COVID

32:13

world to the same

32:15

sorts of things that came out of the post

32:18

world war one, world war two world where

32:20

all of it is responding to each other. And, and I think

32:22

it'll be really interesting to just see what happens

32:24

there, because as you said and my

32:26

interpretation of a lot of that art is that there is

32:28

the sense of Artists sort

32:30

of pushing the boundaries of

32:33

of, of the assertion that I can do whatever

32:35

I want and, and call it art.

32:37

And that's not, that's not to diminish any of this. I think

32:39

that that's actually a really remarkably artistic

32:41

distillation of what's happening or where

32:44

it's like, really pushing the boundaries of what's possible

32:46

to be called art. And

32:48

that's really interesting question. And,

32:51

but I do think that in some art there's also this

32:53

Almost nihilist streak to where there's the sense

32:55

of almost playing with the idea

32:57

of structure and meaning, and sort of using art

32:59

as a vessel to say that those things don't actually

33:02

exist in any sort of substantive way,

33:05

but I don't think that that's a necessary corollary

33:07

of living through a crisis either. I think

33:09

that crises can have both. Obliterate

33:12

our sense of meaning or they can intensify

33:14

it. And this seems to be embodied even in your

33:17

personal sphere, in the responses that you and

33:19

your wife have potentially felt as well. And

33:21

then I think that many of us have felt with our friends where, where

33:23

some of us have been tempted. To

33:26

hopelessness and a

33:28

sense of lack of meaning and this

33:30

feeling of, of real despondence

33:33

in the world and its state and others

33:35

have been really spurred to action and

33:38

charity and love for the other and solidarity

33:40

from. You know, people who may have never really

33:42

considered these things or may have only done so on a theoretical

33:45

level before the pandemic. And

33:47

it's really interesting because we have all of these little internal

33:49

responses that are going to be integrated and

33:51

emerge as this cultural phenomenon. And

33:53

I have no idea where that needle is going

33:55

to land. But it's going to be really interesting to

33:57

see, and that that's one of the things that I'm really

33:59

excited to pay attention to over the next

34:02

years. That's

34:03

great. You know, now this is beyond my pay.

34:06

Stephen and all these are listening, but I've

34:08

always felt, or not always felt. I felt recently

34:10

in the past few years, like music and art

34:13

at least made for me, I'll state just for me and maybe not.

34:15

So prescription is a descriptive

34:17

reality and film is a prescriptive

34:20

reality. It wouldn't mean by that is like for me,

34:22

music helps me feel my current

34:24

circumstances. That's that that's that there's a play that

34:27

for that reason or the field to do

34:29

more, describe of what's going on in my life.

34:32

Whereas film. Is

34:34

more prescriptive, prescriptive, like how

34:36

I want to be. So w I

34:38

think about this, I had this philosophy that like,

34:41

like in calm seasons

34:43

in America, in the U S right when things are relatively

34:46

stable, Not like this past year,

34:48

maybe, maybe when I was growing up in the nineties

34:51

and things were like, cool.

34:53

And grunge was all over the place. Right? So

34:55

that, that the movies for living for me, I would

34:57

get like, I, you know, I it's

34:59

chill. It's relaxed. So the movies

35:02

were. Hydroma high conflict,

35:04

all the stuff to reflect the opposite of what I

35:06

was feeling in some sense, like to cultivate

35:08

motion because my life was so

35:11

Alexa days a call. Right. But then

35:13

in high conflict, high situation, at least

35:15

I can feel in the pandemic. Right. The last

35:17

thing I wanted to watch is high drama. I wanted

35:19

funny humor, relaxed, hopeful,

35:21

inspiring, right. I'm looking for something.

35:24

On the opposite end, right. That whatever

35:26

I'm in. And I'm just, I'm just curious if I wonder

35:29

if that's how even sometimes filmography is actually

35:31

done, like you're in it, maybe in

35:33

a war time, you're trying to put out films

35:35

that actually inspire and uplift and are lighthearted.

35:38

And during calm times you get war scenes.

35:40

So it to like evoke that emotion that

35:43

you're not really feeling. Totally up.

35:45

So I might pay grade, but that's how I feel

35:47

anyway about when it comes about how art and

35:49

film, and maybe at least maybe that's not

35:51

how it's actually produced, but that's how I

35:54

digest it. At least in those. Thanks

35:57

for sharing that, Steve. And I appreciate that. That that's some really great

35:59

insight. I think we're going to end here one

36:01

small thing, cause it's only takes a minute. I

36:03

saw this mark talked about it two weeks

36:05

ago. We talked about the Japan article

36:07

that I, that, that I had given him that

36:09

was probably published a year ago. This

36:12

one came out recently again, which, which

36:14

is, I think quite, just ironic stating

36:17

the same thing. Japan becomes a surprise

36:19

overnight COVID success story, right? July,

36:22

August, September, they're being slammed. Maybe

36:25

partly because of the Olympics, probably because they

36:27

had low vaccination rates. And then out

36:29

of nowhere, they're re the, the cases

36:31

just plummeted. Once again, Japan

36:34

has just been coming this shine light of being able

36:36

to deal with COVID and they haven't been dealt,

36:38

you know, not through lockdowns. Granted,

36:40

we, as I shared with you back in

36:42

July, it was like 10% vaccination rate for

36:44

Japan. Now, as of October, I think

36:46

it's 75%. So I'm guessing that's a little

36:48

bit of a game changer when it comes to dealing with infectious

36:51

disease. But do you have any, any thoughts

36:53

before we close up on that particular story about

36:55

Japan being this shining beacon of hope

36:57

for dealing with the infectious disease, like COVID

36:59

outside without having to do that.

37:01

Yeah, and I think it's, it's really

37:04

inspiring and amazing and impressive.

37:06

And at the same time, mysterious

37:08

and confounding, and I, you know, it's really hard to know

37:11

what this is what's happening here. I think

37:13

that one of the areas that I'm

37:15

also really interested in digging into in

37:17

the coming years is just, how do we make sense

37:19

of the vast. That

37:22

in, in how different countries responded

37:24

and in how they fared in terms of

37:26

their, you know, the pandemic, because it it's

37:29

clear that certain interventions

37:31

did have certain effects, but it's also clear

37:34

that there's not this perfect one-to-one correspondence.

37:36

And I think part of that is because of how everyone is so

37:38

interconnected. But I also think a big part of it probably

37:41

has to do with these really subtle unmeasurable

37:43

or at least so far on measured, but

37:45

very difficult to measure elements. Play

37:48

into infectious disease control as well. So

37:51

one of the points I often like to bring up is that

37:53

you know, we often look at mass

37:55

mandates and lockdowns as these,

37:58

you know, interventions. But if you actually look at

38:00

how people behaved during and around

38:02

those times, people were changing their behavior

38:04

long before any sort of lockdown for

38:06

what was horrible. And meanwhile, people were also changing

38:09

their behavior in the opposite direction long before those lockdowns

38:11

were actually lifted. And and so there's

38:13

this really sort of porous divide

38:16

between, you know, the things that we can measure, the things that

38:18

we can identify as this is the beginning of a new

38:21

thing. And. The actual

38:23

underlying things that, that affect the

38:25

spread of disease. So w you mentioned the vaccination

38:28

rate, so first and foremost, yeah. That's, that is

38:30

a huge change in vaccination

38:32

rates in a very short period of time and

38:34

increasing the number of people who are vaccinated. We'll

38:37

go a very long way towards reducing

38:40

the number of cases that are around and preventing

38:42

people from getting really sick in the first

38:44

place, which also really helps to bring the observed

38:47

case counts down. But to

38:49

me, one of the even more

38:51

striking things about that is that they were

38:53

able to do that, that,

38:55

that, that in Japan, in this

38:57

very free society that. There

39:00

was that fast, a vaccine

39:02

uptake once they become once they became available.

39:04

And so what that suggests to me is that there's this

39:06

really interesting. Culture

39:09

as well, that is amenable

39:11

to being vaccinated and to doing so very

39:13

quickly when there arises a need. And

39:15

so that I, I can't help, but wonder

39:17

sort of what other small scale

39:19

decisions are being made on a minute to minute basis

39:22

for people who are making choices to protect

39:24

themselves and other people in a way that makes

39:26

it so that there's this emergent qualities such

39:28

that Japan has actually fared much better than many

39:31

other countries in ways that are

39:33

really difficult to measure. Take place

39:35

in this fear of policy and

39:37

have these grand scale interventions that were so attracted

39:39

to in the Western world. But in fact

39:42

is probably an entirely different

39:44

implicit cultural philosophy of contagion

39:46

and of cultural responsibility and

39:49

of hygiene and of all of these

39:51

other things that that are a lot

39:53

more nebulous, a lot less hard to pin down

39:56

or a lot harder to pin down. Probably play a profound

39:58

role in how COVID actually behaves at a given

40:00

place. So, yeah, so

40:03

that's, that's another very complex way of saying the same thing I

40:05

always say, which is that I don't know. But but

40:07

that that's, that's, that's where my thoughts

40:09

are sort of pointing. Yep. That's great.

40:11

Yeah. You know, there's so many things I want to say with this. I don't

40:13

want to keep us too much longer, but. Number one.

40:15

I saw an article in the Atlantic about, you know, the U

40:17

S and the dine sense of the pursuit of the

40:19

common. Good. I don't want to make that a trite

40:21

reality. I know it gets becomes complicated, but I do

40:24

see that as a general trend and

40:26

that's, it's always been the case for the U S because

40:28

we come out of a rebellion, a particular

40:30

abelian of being. Dominated. Right.

40:32

And w and so, per sir, the pursuit

40:34

of individual freedom has always been a hallmark trait,

40:36

which is a wonderful trait, right. But when

40:39

it's a clips to not accentuated

40:41

and complimented by the pursuit of the common good,

40:43

it becomes a very difficult reality

40:46

and self-centered, and becomes hard

40:48

for everyone. Now I have to ask this question,

40:50

even though it was on the docket, we didn't get through. It's

40:52

a loaded question again, and it probably takes a lot of time, but you

40:54

mentioned it kind of at hand, when you said

40:57

how, Hey, Japan, free society do

40:59

all the stuff that, you know, just it's a cultural

41:01

reality, but then we have the U S

41:03

we have vaccine mandates, right?

41:05

It's a different, a different reality, right? We're

41:08

trying to enforce this law. And

41:10

I wanted to ask at the very beginning, like if you could, without

41:12

being political, if you could rate your response

41:14

to the white house currently, not through necessarily

41:16

public policy or like, but as a scientist,

41:19

like, you know, trying to do the best

41:21

to bring about the best laws

41:23

and guidance how would you grade it in light

41:26

of, you know, this, this crazy reality

41:28

of trying to get mandates and get people vaccinated?

41:31

Where do you sit in?

41:32

Oh boy, it's, it's super complex. And I think

41:34

that, you know, it's tying into the

41:36

discussion that we were just having is that you

41:38

know, the white house is, you know, in, and our,

41:41

our government and political

41:44

system more broadly is certainly

41:47

an element of the response, but also

41:49

is not the end all be all

41:51

of the response and that You know, we can think

41:53

about the white houses or, or like our

41:55

government, you know, I think it's easy to think of it as

41:57

sort of this almost like this, this

41:59

head that is dictating the

42:02

motions and movements of the body, but

42:04

in many ways, Politics

42:06

and government is, is, is an emergent

42:08

quality of this culture that we

42:10

already have. And so any,

42:12

any grade that I pass on our, our

42:15

current government or our government more broadly

42:17

is also a reflection of the culture that we live

42:20

in and, you know, the individual decisions

42:22

that we all make as well. So it's, it's really difficult.

42:24

I don't think that I can give like a you know, a specific

42:27

rating, but that I can sort of highlight some of the things

42:29

that both This administration and the previous administration

42:32

have done well and have done poorly from a scientific

42:34

epidemiological perspective. So, I mean,

42:36

coming into the pandemic, I think that I was,

42:38

I was extremely frustrated at the slowness

42:41

at which testing was encouraged

42:43

and made available. I think we we

42:45

were unbelievably slow in, in

42:47

improving our resources for testing. And

42:50

I think that we put Yeah, it just really just put

42:52

too much single-minded faith into developing

42:54

a vaccine. There was really poor messaging about

42:57

responsibility for one another. And

42:59

the really just like communicating

43:01

this very clear sense that we were in a very bad situation,

43:04

which as epidemiologists, we were all pretty

43:06

certain about. But but it was never really clearly

43:09

communicated, but on the flip

43:11

side, by, by putting so much

43:13

emphasis on a vaccine, A

43:15

lot of the work that the previous administration did really

43:17

helped us to get vaccines as quickly

43:19

as we did which was a surprise

43:22

to me and to many of my colleagues that

43:24

they, you know, came about so quickly. And

43:26

of course that's not. Just

43:28

the administration that is also, you know, the scientists,

43:31

we were also poised with MRN technology

43:33

that has, you know, the research that has been done over the past decades.

43:36

So does not, you know, certainly not the single handed

43:38

success of the administration, but also,

43:40

you know, a lot of the funding that the administration poured into

43:42

that. Did help produce in

43:44

particular, the Pfizer vaccine. Right. And

43:47

and that's been one of the major success stories of the pandemic

43:50

now transitioning into the current administration.

43:52

I do think that the messaging has been a lot more on point

43:54

with with, you know, what, what is needed

43:57

for Just mounting a

43:59

rational public health response on a, on a large

44:01

perspective. But honestly the testing has still

44:03

been slow. I say it's

44:06

really nuts. And you know, finally, you

44:08

know, just recently there was this announcement that the

44:10

administration was going to put a lot

44:12

more funding into rapid tests, which I'm thankful

44:14

for. It's great. So hopefully we will be able to pick up rapid

44:17

tests a lot more easily. It'll be cheaper. But

44:19

good gracious. Like how did it take this long?

44:22

And and so I think that there have been

44:24

you know, a lot of, a lot of promises that I was excited

44:26

for that have taken a long time to come to

44:28

fruition. I do think that one of the things that this administration

44:31

has also done well is. Making

44:33

vaccines rapidly and widely available

44:35

and really ramping up our vaccination efforts, especially

44:37

early on. But of course, we've, we've hit a bit of a wall

44:40

there too. And now there's this really sticky question

44:42

as to how, how to encourage vaccination.

44:45

And that then becomes a question that is no longer

44:47

a scientific and one that I don't know how to answer.

44:50

'cause you know, there has been a lot of

44:52

movements towards vaccine mandates and

44:54

I don't know if that's the right option. I think

44:56

that that really gets into, you know, I think that

44:59

increasing vaccination rates is, is something

45:01

that we ought to be focusing on as much as possible, but how

45:03

we do that is gets into so many

45:05

really sticky areas of culture

45:07

and freedom and social science and all of these things

45:09

that I don't even begin to know how to comment on. So,

45:12

So it's mixed, it's mixed throughout.

45:14

And boy we're going to have a lot of work

45:16

to do in the coming years to figure

45:18

out how to streamline all

45:20

of this stuff. The next time one of these things comes around.

45:23

Absolutely.

45:23

Thanks for sharing Stephen. That's good, good insights

45:26

and fair analysis. Thank you guys

45:28

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45:46

And by the way, I read an article the other day that

45:48

said that most

45:50

of this whole. Like scientific

45:53

discourse was done through

45:55

Twitter. Like all the big

45:57

leagues like that. That's probably the main places where,

45:59

which they, you could see it unfold,

46:01

not on Instagram. So if you want to go on a Twitter

46:04

and kind of see all the latest going on,

46:06

you can

46:06

also follow Stephen as well.

46:08

And a, sorry, you can hear a ghost in the background because

46:10

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46:12

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46:15

But so you can, or you can email us

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46:20

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46:28

bye-bye.