Omicron begins to lose steam and defining what "it" is...

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Matt Boettger (00:00):
You're listening to the pandemic podcast.
We equip you to live the mostreal life possible in the face
of these crises.
My name is Matt Barker and I'mjoined with my good friend, Dr.
Steven Kissler andepidemiologist, the Harvard
school of public health.
How are you doing good for.
Hey, I am doing all right.
Or look at that.
I'm in the background twice.
Sorry.
You don't see me, but for thoseof you who can see this, I'm in

(00:20):
there twice.
I'm not going to change it rightnow.
Change it later, but that'll beokay.
Good.
I'm glad you in.
Well, how's the how's wintertreating you and Hey, I hear
good news up Northeast there.
Right?
There's some you guys are notreally experiencing sweats,
quite switch, such huge peak.
Yeah, thankfully, the cases areturning around with our Omicron
surge finally.
It was a heck of a spike.
And so it's really nice to seethose coming down and maybe we

(00:42):
can dig into that some more, butit's the, the wastewater
surveillance has been comingdown for about a week and a half
now.
And it's been dropped.
Basically just as fast as itrose, which is really, really
encouraging, good cases arecoming down.
Unfortunately, hospitals arestill very full.
I have a couple of friends whowork in the hospitals around
here and it they've said that,you know, the number of people
with COVID and the, the amountof burden on the hospital has

(01:05):
been similar to early 20, 20.
So hospitals are still reallystruggling with this way.
Then it'll still be a littlewhile.
I think before there, they startto see some relief from the
declining cases, but but it'sdefinitely encouraging to see to
see them turning around.
Yeah, that's good.
And I've been hearing thesecases over and over and over, or
these, a lot of articles andjust sat at the constant talk of
like the headlines of burnout ofnurses and doctors.

(01:27):
And I mean, I haven't talked toyour good brother mark for a
while and I'm sure you're incontact with him.
I don't know if you can speak onhis, on his behalf at all.
Yes, he has.
He'd been having to go into thehospital a little bit more or
has he been kind of more, youknow, segmented?
Cause I know he does differentkinds of rounds and sometimes he
gets pulled into the COVID wardsand that kind of stuff.
But are they seeing a little bitmore of like they're tapping

(01:49):
into additional resources inColorado or has it been a little
more.
Yeah.
You know, they they've, they'vereintroduced a lot of their
surge measures in, in Coloradoas well.
So they have been calling indoctors who normally wouldn't be
coming in and it just takes alot more a lot more hands on
deck to deal with patients.
You know, it's one of the thingsthat They, that there's been a

(02:11):
lot of conversation about latelyis you know, distinguishing
people who are in the hospitalfor COVID versus with COVID.
And you know, it is, it is truethat the prevalence of Omicron
is so high that we do have a lotof people who are in the
hospital, not necessarilybecause they have COVID, but
they definitely have COVID.

(02:32):
And you know, that that'snaturally going to happen just
because there's so many peoplewho are currently infected.
But I think one of the thingsthat is worth mentioning is
that, that that's notnecessarily that helpful to the
health system because they stillhave.
Give people who test positivefor COVID all the same
protocols, all the sameisolation measures require as
much higher standards of carerequires, you know, different

(02:55):
types of segmentation from otherparts of the hospital.
And so it's still generates ahuge burden on the hospital
healthcare system.
Even if the person might not becurrently seriously ill with
COVID.
So, that's part of the reasonwhy this is still, it's still
such a huge issue.
I mean, it's helpful because Ithink a lot of.
We since we're not, I mean, Ispeak for myself.

(03:15):
I mean, obviously I'm not partof the healthcare system for me
at all.
So it's easy to just talk aboutwords as simply like
juxtapositions, like width andfor, and you know, that kind of
stuff like, oh, see, no there'smost of these cases are just
happened to be with, you know,but those words are not empty.
It's not like it's like a Flike, like it's not so much of a
easy dichotomy that even thoughthey're with, I didn't even

(03:35):
think about that.
Like, A huge amount of resourcesif they did not come in with
COVID.
Right.
Right.
And so it's, it's not thatsimple, right?
Like we've been saying for whichI am now utterly shocked,
Steven, by the way, I'm thinkingabout this, we were approaching
two years as podcast and likeone year was like, like, oh,
like that made sense.
But when I realized I'm going tobe tears, like holy smokes, I

(03:58):
know time has flown so much.
So.
It's just really complicated.
So I'm glad you made that, that,that, that you gave that nuance
for us as well.
Before we continue to go on it'sthe same stuff.
We had another review, come in,love this, wanting to read this
by HR senior leader.
And this was on January 10th.
Recently.
I listened to almost every knownpodcast on.

(04:18):
And this always delivers freshinsights, not found another as
Dr.
Kissler is clear kind andreasonable balls and strikes are
used information to protect theworkforce.
I oversee and see around cornerswith this, every changing
information landscape, the host,Matt Bottger asks about the real
world concerns.
We're all facing to greateffect.
So thank you, HR senior leader.
He's also.

(04:38):
He was, he sent me an email gaveme a sweet mask.
The checkout, when I, when I didthat, when I did a crowdsourcing
question.
So I'll put this in the shownotes, it's a 3m mask.
It looks like it'd be a good oneto use.
And it's still on back order.
I'm waiting for it to come in.
But it might be helpful for theold glasses.
So if you want to leave.
Please do so you can do to helpus support us, keep it going.
patrion.com/pandemic podcast.

(04:59):
That's for as little as$5 amonth can help us keep us
sustainable.
We're just a one-time gift,PayPal, Venmo all in the show
notes.
If you check it out there.
So let's start with thisquestion.
I know this sounds kind ofweird, and this might get into
conspiracy theory stuff, but if,for me it's real world, because
I was presented by it just aweek ago.
And basically I was talking tosomeone and I was hesitant to go

(05:22):
into an indoor bar in the, inthe middle of a peak time.
And you know, I think they werea little.
Not really happy.
They didn't want to go to thisbar with them.
And it just kinda made a slideremark about, you know, gosh.
Yeah.
And I don't know how, where itcame from Steven, cause it kind
of felt like it was out of the,out of the, kind of the context
of what it was talking about.
But the person just mentionedabout, Hey, you know, if, if.

(05:43):
You know, I got a polio vaccineand, and also I got polio.
I'd be very raised, skepticalabout you know, the, the, the
vaccine itself and kind of leftit at that.
I'm like, you know, there's alot of dots to fill in there.
Cause I wasn't even talkingabout vaccines.
I was talking about going to thebar, you know, so it was kind of
a weird punch, but then I waslike, huh, I wonder where this
person got this.
So I just did a quick Googlesearch.
I like, oh, it looks like thismight be some some kind.

(06:04):
Headlines, just like a monthago, comparing polio to to
COVID.
This might be a good thing of alesson for me of just comparing
the two, because it's not just,you're comparing the two as
absolutes.
You also have to compare them inpoints of time.
Right?
When polio was, was, wasresurrecting its ugly face and
when covered with red writingout of the place, and I would
imagine.

(06:25):
They're both different diseases.
They both have different kindof, you know, levels of, of, of
intensity and how it hasvariants.
Right?
So maybe just using this as alaunch point, to help me to
understand like how these arereally the similarities between
the two and the dissimilaritiesbetween the two to help us get
perspective of that.
This is not the same kind of.
Yeah.
Yeah.
I mean, I think it's I reallyappreciate you bringing this up

(06:48):
because it gets at the heart ofa lot of Yeah, conceptions about
infectious disease that I thinkhave, have, are deeply rooted
and have not really served uswell during this pandemic.
And I think, you know, first andforemost is that a lot, a lot of
us have forgotten what it waslike to live with polio.
And you know, I, I thankfullynever really had to experience

(07:09):
that.
Because polio was eradicated,you know, like.
Yeah.
You know, not, sorry, noteradicated, it's eliminated.
Meaning that we don't havecirculation in the U S in many
other parts of the globe, butit's not eradicated in the way
that smallpox is because we dostill see polio circulating in
different parts of the globe.
Although it's, you know,hopefully on the docket for
eradication.
But that said people who werevaccinated against polio could

(07:31):
still get polio.
The reason we're not gettingpolio right now is not because
so much, it's not so muchbecause we're vaccinated.
It's because it's very wellcontrolled.
Because.
We don't have the opportunity toget infected.
Now, a big reason why that's thecase is because of the
vaccination, because vaccinationhelps reduce the spread of
polio, but that wasn't the onlything.
There were plenty of otherpublic health measures in place

(07:51):
as well.
That helps to reduce polio casesto the point where we were
essentially helping the vaccinedo its job by preventing it from
getting challenged andpreventing it from getting
tested so much So, so that's onething, you know, actually one of
the really key differencesbetween the polio vaccine and
the COVID vaccine is that unlikethe COVID vaccine, the polio
vaccine is what we call a liveattenuated vaccine, which means

(08:12):
that there's actually a smallamount of, of you know,
weakened, but live polio virusin the vaccine.
And in some rare cases that canactually lead to an active polio
infection.
And that's been one of thereasons why it's been really
difficult to fully.
Eradicate because in very rarecases, the vaccine actually
actually cam leads to a case ofpolio, which can then spread

(08:32):
out.
That's not true for COVID atall.
You know, so in many ways thepolio vaccine differs in that
key respect and, and, and theCOVID vaccine is actually in
some ways superior in thatsense, because it cannot cause
COVID so that's one thing, youknow, and the other, th th the
main thing that you know, Ithink is most sort of surprising
to me about that statement isthat, like, it just Puts the

(08:56):
value of vaccination into such abinary and such an individual
perspective that it really kindof misses a lot of the point,
which is that, you know, thevaccines Th there are still
plenty of breakthroughinfections happening with
vaccines early on.
We hoped that there would be avery give you a very strong
protection against infection atall with the new variants,
especially it turns out thatthat's not the case.
You can still absolutely getinfected, but the evidence is

(09:18):
absolutely rock solid that itwill keep you from getting
seriously sick and it will keepyou from dying.
You know, Not in a hundredpercent of cases, but that the
difference in hospitalizationsand deaths for people who are
vaccinated in a specialty whoare boosted relative to people
who are unvaccinated is, I mean,it's just remarkable.
It's like so incredibly high.

(09:39):
And that's reducing strain onour healthcare system, which is
helping keep everyone safe,regardless of whether it's,
you're going to the hospital forCOVID or not.
It's keeping, you know, you,it's basically helping us to
translate.
To a period of time whereCOVID-19 is a manageable
infectious disease.
Rather than something that'sturning our society upside down.
So yeah, absolutely.
I mean, I kind of get the sensethat like, okay, if I got a

(10:02):
vaccine for something and gotinfected, I'd be skeptical about
the vaccine.
That just the, the implicitassumption there is that a
vaccine should guarantee that Ido not get infected ever with
this pathogen.
And that's just a misread.
Like, that's just not the waythat most vaccines work.
And so, but, but that doesn'tmean that they're not extremely
helpful.
So it really it's sort of likepaints it back to that, to my

(10:24):
personal experience.
It's like, well, I could getinfected.
We absolutely, you could.
But it probably protect you andyou'll never get to see what
would have happened otherwise.
And you know, it, it, it just,it has so many benefits that
compound across an entirepopulation that it's it's really
about thinking about this as apublic health problem.
Yeah, no, that's helpful.
I mean, probably so many thingsas well.
Like I, you know, I read a fewthings, but how, like, you know,
again, I don't know much aboutthat.

(10:45):
I polio is likegastrointestinal, obviously.
And COVID is, is in, I mean, thediseases are vastly different
and the viruses are vastlydifferent.
The way they evolve is totallydifferent.
The way they spread is totallydifferent.
I mean, they're there.
It's almost difficult to findtwo more dissimilar pathogens.
So it is so, yeah.

(11:07):
And that was really helpfulcause I, yeah, I was just struck
by that.
And like in, I think there'sbeen this false sense of
security, especially in the U Sparticularly, right.
I can't speak on being an orsince generally because public
schools do demand a level ofvaccination we've successfully
really, you know, eradicated orgot rid of, or.

(11:27):
Really reduce the amountinfection of so many serious
disease that have feels as.
Once you're vaccinated, you're ahundred percent protected.
So there was like, and so, and,but that's now we're learning
that that's actually not thecase, but thankfully when you
get up to 95% of vaccine, peoplebe in vaccine, like polio, it's
really effective.
Right.
And then they're just not a lotof fight going on and a

(11:49):
competition.
So I hope that helps thelisteners.
Some of you guys I know helpedme cause I was like, oh, I want
to get a little bit deeper intothis.
The next thing I wanna ask youabout is there's been about a
year with the Bidenadministration in the white
house.
We did this previously with theTrump administer.
And we're getting, we're notpolitical here, but just
epidemiology perspective,looking at a year, where do you
feel like the white house whitehouse kind of hit the nail on
the head?

(12:09):
And where do you feel like maybethere's there's opportunity for
growth for this 2022.
Yeah.
So, I mean, I think thatthere've been you know, a number
of different ways in which theadministration and you know,
sort of governments all the waydown have have responded to the
COVID pandemic during this mostrecent year.
And one of the big successesthat I see is the.

(12:33):
Making vaccines available anddistributing them early and
quickly and effectively.
Especially in the early stageshere in the U S our rate of
vaccinating, our population wasthe highest in the world or, you
know, among the highest in theworld.
And so it And that was reallyimportant because in many ways
we were trying to suppress anactive raging fire.

(12:53):
So, so the speed at whichvaccines are taken up was
incredibly important.
And so, by securing a lot ofdoses of distributing those
doses it was by no meansperfect.
It was, you know, very despiteall of the efforts that were in
place, that they were stillunequally distributed.
And then there were there wereless available for people who
have.
Higher barriers to care ingeneral.

(13:15):
You know, a lot of, a lot ofthese issues remained, but
nevertheless vaccination ratesrates really did increase very
quickly.
And I think to great credit ofyou know, governments all the
way down from, from the byteadministration all the way down
to, you know, local communitiesthat were, that were actually
the ones, the boots on theground, getting these vaccines
and doses under the arms ofpeople who needed.
So I think that's been verygood.

(13:35):
And I think that sort of theoverarching emphasis on the
pandemic has been important.
Just making sure that it's aconsistent part of the
discussions about what's goingon and that it is an issue that
we, that we need to deal with.
So I think that it's I'm glad tosee that there's been Attention
paid to it, at least in thesense that it's, it's remained a
part of sort of the nationaldiscussion.

(13:56):
Of course, one of the placeswhere I had hoped that we would
make greater and faster progressthan we have is with the
availability of testing.
I still think that, you know,that this part under the
pandemic, the difficulty ofgetting either PCR tests that
rapidly turned around or Thecheap rapid tests.
You know, I think that that'sI'm, I'm really surprised that
we're still having so muchtrouble with that at this point.

(14:16):
Especially given the ways thatother countries have, have
managed to solve a lot of thoseproblems.
So, so, so that's been a realfrustration for sure.
And yeah, so, and then ofcourse, you know, I think that
the The United Statesinterfacing with the rest of the
world.
It's also been mixed.
I mean, I think we've, ofcourse, you know, w thankfully
we've, we've given a lot ofvaccine doses to countries that

(14:38):
need them.
We've made them available, donea lot of manufacturing and
helped to build some of theinfrastructure for global
vaccine distribution, which Ithink is very good.
But of course, there's always,always more to be done there.
Great.
That's helpful.
You know, you were talking abouthow a little bit late to the
game for rapid testing, youknow, I, you know, it's been
good.
I think as of this week up inthe show notes, you know, you

(14:59):
can sign up to get four freetests, at least I'm not sure.
Maybe it's all you get.
I'm not sure.
From from the federalgovernment.
So.
I'll put a link in the show as Isign up for USBs super simple.
It was great.
I read an article about how thisis one of most successful things
the government's done, becauseit was like, I mean, so many
people signed up probablybecause I was released.

(15:19):
The way I signed up Steven, Iactually thought there's no way
this could be a government signup sheet because it literally
took one minute.
I feel like it would take likepages of like proving this and
this, and what's your socialsecurity number, all that stuff.
But it was just basically your,your postal code.
Right.
And that was just putting youraddress.
And there you go off to theraces.
So I'll put that in the shownotes.
I also, you know, I don't knowif you know anything about this
Steven, but I saw it.
I hear about this about free and95 masks.

(15:42):
And if that's part of thefederal thing as well, I hear
it's coming soon.
I saw linked.
Is that true or is thatsomebody, you know, I, I don't
know.
I, I think, I think we'll we'llknow it when we see it, for
sure.
Sure.
I, I think it's, you know, Ithink it would be great, you
know, like I, again, like Ithink that there've been a lot
of opportunities to invokethings like the defense
production act to to justgenerate the supplies that we

(16:03):
need to deal with this pandemic.
And I think that rapid testscould fall under that.
I think that high quality maskscould fall under that.
It really does seem to be thecase that and 95 or similar
masks really do help bothprotect you and to the people
around you.
And so all of these things Ithink are really common sense,
pretty simple, straightforwardthings that we can do.
You know, and I'm saying thissimple, you know, from, from my
armchair here, somebody who likeruns mathematical models, but

(16:25):
doesn't actually have to do anylogistics, but that said, you
know, as a country, we've, we'vepulled off some pretty
impressive things, you know?
Right.
Like we put people on the moon,I think, I think.
We can, we can send out somerapid tests and then 95.
That's awesome.
Great.
That's helpful.
You know, and speaking of which,you know, this is a, there's an
article I read here just thismorning.
I really enjoyed it.

(16:45):
I'll put in the show notes,COVID loses 90% of ability to
infect within 20 minutes and airthis study.
I'll let you guys read this asbeyond my pay.
Did I to, to provide theanalysis to this, but what's
interesting about taking,talking about how taking an
older method what I'm trying tolook for here, which I find is
Goldberg drums with, with, withairborne viruses, a little bit
more of a mainstream normal way,realized that when it comes to

(17:07):
Omicron virus, it really doesdegrade rather quickly.
And this just goes to, to, Ithink, confirmed the fact of
the, of the.
Four and 95 masks because it'sreally the close proximity.
That's the most dangerous,right.
We've kind of been knowing thisfor a while now.
So, you know, maybe it's notnecessarily at a restaurant and
doors and it's the person 150feet away from you.

(17:28):
It is possible.
It's always possible, but it'sprobably more likely if this is
true.
That it's the dude right next toyou or the person you're talking
to and why it's.
So if you're, if you're withinclose proximity to have a mask
on for the protection,especially during this time when
we are really tapping so manyresources, as Steven mentioned,
so I'll put that in the shownotes.

(17:48):
I'll also put in the show notes,we've talked about over and over
and over.
This is why I think getting freeand 95 mask, it would be so
helpful because there there's somany knockoffs that you can get
that aren't and 95, right.
To be able to.
That's actually officially, no,you're getting the right stuff
and get it for free, but I'llput a couple links into the show
notes about places you can go tobe absolutely confident that

(18:09):
what you're getting is the realdeal and not some kind of
knockoff that is.
So let's talk about this,Stephen, you mentioned about how
now that the, the kind of, whatwe're thinking about as being a
transition, right?
The case is starting to plummet.
They're starting to come down inthe U S not everywhere, but
we're starting to see this.
So now the mindset starting toshift to pandemic, to endemic.

(18:30):
So what is it going to looklike?
I know this has been on yourmind where you're studying this,
what the stuff's going on.
What's the talk going on, whatit might look like when this
becomes an endemic and how willwe know that, you know, Fowchee
mentioned a couple of thingsabout maybe when we see a new
variant that shows up, that'slike, you know, not, you know,
kind of like Omicron, but itdoesn't have its

(18:50):
transmissibility craziness thatwill really start getting to the
endemic phase of things.
So kind of give me your thoughtson this transition.
Yeah.
So I think that there's, this isreally the a major topic of
discussion amongst my colleaguesright now, too.
Or just sort of like, how, howdo we think about this next
phase of our experience withCOVID-19?

(19:10):
And so I think the first thingto note is that when, when we
think about an an endemicinfectious disease, I think that
there can be this, thisimplicit.
Almost like sigh of relief thatlike pandemic is this big, bad,
ugly thing.
And that endemic means thatwe're, you know, we, we've kind
of kicked it and it's likekicking around and, you know,
causes some issues, but we're,you know, we're, we're basically
doing all right.

(19:31):
And I think, you know, we're,we're fortunate in places like
the United States, that forpretty much all of our endemic
infectious diseases, that's thecase, but I think it it's worth
remembering that endemic doesnot necessarily mean good.
Malaria is endemic.
Tuberculosis is endemic to manyareas of the globe and caused
hundreds of thousands of deathsevery year and disability and

(19:51):
all sorts of different things.
And so when we say endemic,Really in my mind, what it
refers to is a Anacknowledgement that that the
dynamics of the disease havebecome regular or predictable in
some way.
So one of the reasons why Istill believe that at least
through the Omicron wave, we'vestill been very much in the

(20:11):
pandemic phase is because therehave still been so many curve
balls, so many surprises,especially with the emergence of
variants.
We can contrast that to ourexperience with flu.
Every 30 years or so we have aflu pandemic where there's this
crossover from animals intohumans, but so far, you know,
for quite a while, it seemed tofollow a pretty regular pattern
where temperate regions of theglobe have a flu epidemic every

(20:34):
year, right around the sametime.
And, you know, within a certainamount of variation, that's of a
similar size and we havevaccines and we're able to
predict sort of which flustrains come out every year.
Not so with COVID.
At least up until this point,but the hope is that we will
transition into a period of timewhere we can at least predict
and therefore anticipate thedynamics of COVID-19.

(20:55):
And that'll allow us to stay onestep ahead and hopefully control
it a little bit more easily, butjust because it's endemic does
not mean that it's harmless.
And so I think we really need tobear that in mind.
Now, some of my colleagues havealso been trying to make a third
distinction between pandemicendemic and epidemic.
So you can think about someinfectious diseases trying to

(21:15):
think of good examples.
It's, it's, it's difficultbecause a lot of the infectious
diseases that we're mostfamiliar with here in the U S
are, are in fact epidemic in asense that they have these
cycles that, that that happenannually.
But there are, there are plentyof other examples of illnesses
around the world that are maybemore properly endemic in the
sense that the risk staysrelatively constant over the

(21:36):
course of a year.
And just sort of continuouscirculating regularly as opposed
to in these sort of majorepidemic cycles.
And that's important too,because you know, the.
The, it, it doesn't just matter.
The total number of cases thathappen, or the total number of
hospitalizations or deaths, itmatters how quickly they happen
to.
And that's one of the big issueswith flu is that if we could

(21:57):
somehow even out the flu seasonand spread it out over the
course of the entire year, thatwould actually be kind of
helpful because flu can alsocause a lot of problems in our
emergency departments and in ourhospitals during the winter
months when it's released.
If you layer COVID over the topof that, if we expect it to
become an annual wintertimeillness and we still have flu
circulating and COVID-19 like,that starts to cause a lot of

(22:19):
issues.
And so I think there are acouple of things that we still
need to understand, you know?
To what extent are we going tobe able to predict the dynamics
of COVID-19 moving forward?
I'm hopeful that we will sort ofsettle into a more predictable
pattern of COVID-19 spreadprobably with spikes in the
winter, like many of the otherrespiratory viruses that we
have.
But the difficulty with that isthat means that we'll be layered
on top of the other respiratoryviruses we already have.

(22:41):
And I, I really do think thatour for, for.
Years to come.
Our healthcare system is goingto have some difficulty dealing
with us.
And and I think that what thatmeans is that there will
probably be a knock on effectfor those of us in the general
public as well.
Where during times of peaktransmission in the winter
months, we might have to wearmasks indoors again.

(23:02):
You know, that might also be aperiodic review.
Of our lives.
And you know, maybe that's notto say, you know, who knows what
the policies will be, who knowswhat we will actually do.
But I think that it may well bea sensible thing to advise
depending on how severe theseCOVID-19 surgeries end up being
in the winter months.
And then the last possibilityis, you know, COVID-19 SARS, cov
two is very infectious and moreso than many of the other

(23:24):
respiratory viruses that we,that we know of currently.
So, so it's possible that itwill buck the trend of seasonal
wintertime transmission and thatwe might actually see COVID
epidemics sort of happeningsporadically around the year,
much.
Like we see the spread of flu inmore tropical regions of the
globe that don't have as cleardelineation between their
seasons.
But we don't know yet.
And that's precisely why we'renot yet in the endemic phases

(23:47):
because we, because we justdon't know.
Okay.
That's super helpful.
So there's a couple things that,that really shed light on this.
Number one, it kind of remindsme of this idea of it.
Not that I want to compare thisto like nine 11, but it's like a
lot of us who are of age.
It can wreck it.
Remember the time where youcould go to the airport and not
have to go through so manysecurity to actually meet them
at the gate and go, you know,all the travel seemed to be a

(24:08):
lot easier and that part of ourlife is completely gone now.
And it's always been gone now asmuch more security.
Will it be like this where itwill look back and like, do you
remember the days before?
COVID where we actually went torestaurants in the winter and we
didn't have to wear masks, butis it a permanent fixture
seasonal, you know, this becomesa permanent reality, like here
and there during the peak seasonthat.

(24:30):
Could be that's one thing I wasthinking about, the second thing
is I think you helped meunderstand to my next question,
which I keep kind of maybe it'sbeating a dead horse or whatever
it is, sorry for that.
There was a terrible phrase tosay or whatever, but it's this
idea of whether this is the timeto, you know, be okay to get
Omicron.
If you haven't been infected,it's still in the headlines.

(24:52):
I feel like you kind of begin totap into this because.
Right now we're still in thepandemic and that, you know,
it's a much, it's, maybe it's amuch safer time to venture out
when it's getting close to theendemic, when it becomes more
predictable, predictable.
Cause I'm trying to understandlike why, why do I want to force
myself to stay in right now and,and stay away from this?
Which is like so far, the lesserof evils have shown its ugly

(25:14):
face in the past year.
You know?
And, and the reason why I saythis is because.
Staying.
So I don't, you know, thebiggest thing I'm going to do is
I don't want to overwhelm thehealthcare system, which has
already tapped in burdens.
So that's, that's my, my primaryconcern right now.
Right.
That's I think that's a higherrisk than me having going to the
hospital, myself me, me transmitto somebody else who might have
to go and then burden the healthcare system.
But there's some articles that Iwant to just to throw your way,

(25:36):
vomit them at you.
So to speak.
And then you can just kind ofwrestle with that and helped me
understand, you know, there wasa couple of articles, one that
said they knew that from theCDC, natural immunity, stronger
than vaccine alone and Deltawave.
I mentioned about the naturalimmunity, six times stronger
than the vaccine.
Now, of course, there's lots ofcaveats to this that I want to.

(25:57):
Before I give the mic back toSteven.
It clearly recognized the factthat it's not recognizing
boosters is fact that it'stowards the end of the
vaccination rollout.
So it was probably alreadylosing some sense of its
strength.
So there's all these caveats,but there's this sense?
Of natural immunity in somecertain situations being more
effective, I'm not advocating,not getting the vaccine.

(26:19):
My thing is always like, oh, aboth and combo.
Like if I'm I'm fully boostedand if I somehow get it, maybe
I'll be a little more protectedif there's some really ugly
faces coming down the road sixmonths from now, right.
I'm going to stay on top of myvaccinate vaccination.
And then I think the other onewas this whole thing with this
article.
Off the record helped me tounderstand it.

(26:39):
It really confused me and ofthis thing.
T-cells from common cold canprovide protection against
COVID-19.
You mentioned before over a yearago, Steven we're well, over a
year ago, there's been evidencethat other coronaviruses just
the common cold type can helpbuild our immunity, which makes
sense.
Right.
There's a natural exposure.
That's somewhat similar.

(26:59):
And those T-cells really help usas.
The build a sense of protection,right?
But there is a sub part of thisarticle that was confusing to
me, there was saying, well, youknow, kind of juxtapose
juxtaposing, the vaccinationbeing current COVID 19 vaccines
target the spike protein, whichmutates regularly creating
variants, such as Omicron, whichless than the efficacy of

(27:21):
vaccines against symptomaticinfection.
Right.
And then says on the other hand,in contrast the eternal proteins
targeted by the protectiveT-cells, we identified mutate
much less.
There is almost as kind of thislike distinction between, oh,
almost telling me Stephen, like,well, if you get vaccinated,
that's really good.
That's just the, that's just thespike protein.
But if you get it, but naturalmuni, like the common cold, you

(27:43):
get the breadth and scope ofthose, the deeper proteins of
that virus, which is moreprotective and really emboldens
the T-cells and then you weretelling me, and that's where I
hand it to you.
That that's not necessarily thatsimple of, of, of, of of Yeah.
Great.
So, yeah, so a lot of differentthings here, you know, I think
the first thing about like thedifference between immunity from

(28:03):
natural infection versusimmunity from vaccine, from
vaccination there have beenresults on this that have been
all over the shop.
I was, I was just looking atanother study that said
actually, yeah, Vaccinatedpeople are five times more
protected than people withnatural immunity during the
Delta wave.
And I think, you know, the, thecritical thing to bear in mind
here, you know, when we'retrying to sift through these
things is, you know, first theimportance of consensus that any

(28:24):
one study especially anobservational epidemiological
study, it's going to have a lotof biases that we need to
account for.
And so.
A single study is not a veryreliable thing to base our
information on with respect tothese, you know, sort of, one
phrase understanding of, of ourimmune response to COVID-19.
In my understanding based off ofall of the studies that I've

(28:46):
seen it seems like naturalimmunity that natural infection
does provide pretty goodprotection against Definitely
severe disease from COVID-19.
I basically judging by the factthat I've seen about as many
studies saying that naturalinfection is better.
And as I've seen studies, thatvaccination is better.
I'm inclined to think that theyprobably give you similar
degrees of protection.

(29:07):
And that probably the mostprotected people are the people
who have had both.
That said, you know, when youget natural, in fact, You were
at a risk you're in a risk toyour own health.
You're in a risk to the healthof the people around you.
And I think that that needs tobe weighed very heavily as we're
thinking about these thingsthat, that you don't get that
immunity for free in the waythat you sort of do with the
vaccine.

(29:27):
And I say sort of, because, youknow, getting the vaccine did
not feel good to me, right?
Like I paid for it for a day,but I knew that I wasn't
contagious to other people.
And I knew that like I was goingto recover from that nasty
headaches that I had.
You know, and, and so that'sfine.
Like that, that to me was, wasvery it was a much greater value
than the immunity that Imight've gotten through natural

(29:49):
infection.
Now that said, like, we're nowin a period of time where
Omicron is spreading, a lot ofpeople are asking if they should
just get the infection and getit over with.
And you know, I, I don't thinkthat that last.
Phrase is, is accurate becausewe're not necessarily going to
get it over with.
We're in the sense that we getreinfected with flu year after

(30:12):
year after year.
And there are plenty ofbreakthrough infections, both
vaccine, breakthrough infectionsand re infections post-infection
that happened.
And so, you know, it's, it's notreally so much getting over it,
you know, over our experiencewith COVID.
W w again, we're going to bedealing with us for quite some
time.
But with all of that said, youknow, I, I was just reflecting

(30:33):
the other day with with somefriends about how it's easy to
forget that this time last year,you know, we didn't have the
vaccine.
I didn't have the vaccine.
A few people did you know,healthcare workers might've been
vaccinated by now, but like weretotally unvaccinated at this
point last year and Alfa wasspreading.
And.
My behavior around COVID-19 wasvery different than it is now.

(30:54):
My risk tolerance was verydifferent because being
vaccinated and now boosted myrisk of both acquiring and
spreading COVID-19 is verydifferent than it was at that
time.
We know more about the virus.
And so I've been more I, yeah,I've, I've been like, I'm going
to the grocery store that, andyou know, more often than I

(31:14):
would, you know, at that time ofyear I'm not dining in doors,
but I feel better about likeseeing people one-on-one Yeah.
In like an apartment or in a, ina space where we're not expected
to see a lot of other people.
And that's sort of where I'veset my risk tolerance right now.
Especially because we're in themiddle of such a nasty surge
here where I'm really trying tomake sure that I'm not one more
link in the chain oftransmission.

(31:34):
But that will all change too.
As our cases come down, then allsort of relax my behavior some
too.
So I think the main thing isthat I have a lot of confidence
in the vaccines and theirability to protect me and the
people around me from severedisease.
And that's part of why.
Sort of less restrictive with mybehavior right now.
Why I'm less concerned aboutgetting a Macron.
And I mean, I don't, I don'tparticularly want to, this would
be a pretty inconvenient time tobe laid up for a week, which I

(31:56):
may well be, or I may feelnothing, I don't know, but
either way, you know, I'd rathernot right now, but you know, th
that's very different than whatI was thinking last year, where
it was like, I absolutely do notwant to have this.
And again, that that's me.
Everybody has their owndifferent considerations.
If they're taking care ofsomebody who's elderly or
immunocompromised or kids whowould have to stay home from

(32:17):
school, if they were, you know,like that could COVID means
something so utterly differentto different people.
That I think that's worthbearing in mind.
So I'm trying to be a littlemore conservative with my
behavior because I recognizethat I'm around people who have
a lot more to lose from gettingCOVID than I do.
And so I don't want to spread itto them, especially now that
COVID rates are so high.
But you know, I do think.

(32:39):
If you're vaccinated and boostedthat provides a lot of
protection against Omicron.
I, I'm less concerned aboutgetting infected now than I was
a while ago, but I'm still doinga lot to make sure that I don't.
Yeah, that's helpful.
I mean, the fact that sometimeswe get so stuck in the phrase,
like, just get it over withthat.
We don't stop to ask ourselvesor maybe even ask our friends,
like, what is it like, you know?
Cause, cause I think that's abig question.

(33:00):
Cause it's.
W w the face, the honest truth.
It's not, we're not gettingCOVID over with, but there may
be something underneath that,that I need to be compassionate
with myself or compassionatewith that other person.
Right.
Like this sense of it could be,I just want to have more
connections.
Right.
I feel really isolated again.
Right.
Well then, okay, well then, thenyou need to explore that it
right.
It to figure out.
Cause I, I, we don't want to becompletely abandoned our

(33:22):
critical friends.
How can we actually, and yougave the perfect expression, you
know, perfect illustration oflast year.
There's there has been a lot ofgrowth for you personally, in
the sense of where I was lastyear and now with protection
where I'm at this year.
Yes.
Am I still doing things toprotect myself and people around
me?
Yes.
Am actually doing more things Idid last year.
Absolutely.

(33:42):
Right.
And so really diving downpersonally, what it is.
And then being able to talkthrough that and going back to
what you said Thanksgiving, andthen incorporating what's your
risk budget.
And so there's your own riskbudget as well as the risk
budget of the community aroundyou.
And both those that be put intothat equation, which of course,
as we say, every single, maybeevery other episode, it's

(34:04):
utterly complicated and there isno.
I wish, you know, I, myundergrad in computer science, I
sometimes, you know, maybe Idon't, I mean, sometimes I wish
that life was maybe a littlemore binary, like a microchip,
but it's just not, it's just notthat way.
Life has complicated and itbrings up, you know, I think a
more general point too.

(34:24):
And I've been thinking a lotabout like when, when somebody
comes to me and asks for adviceabout.
The COVID either they've had anexposure or they become infected
themselves or somebody they knowhas been infected.
And it's like, what do I do?
And I imagine a lot of us havebeen in the scenario where a
friend or family member has cometo us and been like, Like this
was the situation that'shappened.
Like what do I do?

(34:45):
And I really do think that as,as I've sort of watched my own
response to that question andwatch it to the response of
other people around me to thattype of question, it's so easy
to Again, not ask what that itis to sort of project our own
uncertainties and insecuritiesand presuppositions about
COVID-19 into that person's lifeand say like, well, you got to

(35:05):
do this, this and this.
And I, there were, there weretimes when I did that, you know,
early in the pandemic andrealized that I was not really
hitting, hitting the mark atall.
And so, you know, I've, I'vereally tried to transition to,
you know, somebody says like,this is the scenario.
And then to just sort of ask andlay out, like, you know, first,
how are you doing?
How are you feeling?
Are you okay?
And then like, what are yourconcerns?
Like, what are your parameters?

(35:26):
What are your constraints?
What are your most fearful abouthere?
What's the situation youabsolutely want to avoid?
What's acceptable to you.
And oftentimes these are likethat, that yields so much more
of a fruitful discussion becauseyou know, a lot of times the
people I've spoken with arelike, not particularly worried
about their personal health, butmaybe they're teaching a class
full of 30 students who haveparents who are unvaccinated.

(35:48):
And it's like, okay, well,Great.
So, so we can think about waysto help you keep your class
safe.
And that's a very differentthing than like trying to
prevent any sort of spread atall.
Like, you know, it's and I thinkthat that allows us to really
get into the meat of thesethings and it's really worth
recognizing just like.
Again, I mean, how differenteach of our experiences with
this virus is and how differenteach of the things that we need

(36:09):
to consider when we've beenexposed, when we've been
infected are and really tryingto enter into each other's
realities with that, I think isjust just really important.
Man you gave us some, some goldthere, a buddy, and I'm going to
go back two minutes.
I looked at it and then at 39,and I'm going to document as
questions you asked.
I'll put them in the show notes.
I think they're really importantquestions.
I mean, I know you just riff andI'm sure you could probably get
more deeper questions, you know,if you thought about it, but

(36:32):
those are really strong andevocative questions.
And you know, I'm thinking ofthat, that HR senior leader, a
guy who gave us a great reviewand the struggles that he asked
it.
To to face he's he's going intoplaces by which he has staff
that has to go in for the sakeof just for, for a lot of
reasons, right?
The, the, to keep communitygoing, keep business going.

(36:54):
And there are people whoprobably have a lot of
perspectives on how they feelabout going into a public.
And to be able to, instead ofjust bringing down judgment,
either a, you know, one way oranother, to be able to sit with
these people and ask them theright questions to get, get at
the core and then help to beaccommodating, say, okay, well,
you know, we have to protect andyou know, you have to do your

(37:16):
job and.
Yeah, I want to protect, I wantto do both.
And a lot of times it's easy tomake it a policy when really
needs to be personal.
Right.
And that's, and that's, that'swhat I really appreciate the
personal touch you gave to that.
So I'll go back to minute 39.
I'll listen to Steven's w wordsof wisdom for them.
And bullet point questions.
Use them with friends.
I'll use them myself.

(37:37):
And oftentimes I think we needto use them with ourselves first
because we get so excited.
About things that we don't evenknow what the reason is behind
the motion.
We're like, no, I don't want todo it.
Like what, what is it?
You don't even know yourself.
I don't know.
Oftentimes, so maybe start usingyourself as a, well, well,
speaking of complexity, Stephen,let's end on this, which just
because just shows the nature.
And I reason I want to highlightthis because.

(37:57):
One thing I love about you,Steven and mark, when he, when
he, when he's on is that this isnot political.
And this is just like, we're,we're trying to ride this middle
ground of just pursuing thetruth of what's going on and
helping to protect people on anindividual basis and as a
community.
And so this one article I readthe CDC is flawed case for
wearing masks in school, whichof course I trust the CDC.

(38:18):
I, I, I, I, you know, Iappreciate all the CDC.
Does I follow it on a regularbasis for my own family?
But here you had an interestingarticle by the Atlantic,
suggesting the CDC aired in kindof adopting this study that was
done from Arizona.
Again, I don't know much aboutit.
I just read the article, but itwas fascinating.
And I also trust the Atlantic.
They have a really goodjournalism there about how

(38:41):
basically this was a very, veryflawed study.
That's trying to promote theidea that masks in schools for
kids for kiddos, you know, sayslike three and a half times.
Three and a half timesprotective against getting
COVID.
And so this is a very, it was a,just a crazy study in the sense
of like, there was no say likethis showed the how effective
mass war and basically wentthrough this whole thing,
showing that it's actuallyprobably a terrible study and it

(39:03):
shouldn't wasn't even used.
They didn't even follow really.
Scientific regimen.
Right?
And that there's a, been ahandful of other studies that
show that's not the case.
Look, wait, like you were sayingjust like 15 minutes ago.
It's not just one study.
It's it's consensus.
You got to look for that showed,but I just want to throw it to
your way of like it'scomplicated because even when
the CDC gets involved andthey're there, they're not a
hundred percent perfect.

(39:23):
Nobody is.
And so things happen like this,that just throw things in a loop
and us lately.
We're just sitting here watchingTV, watching our screens,
getting advice.
It makes things even moredifficult to hear.
Okay.
Now, you know, I don't know.
Did the CDC do this for a favorfor someone?
Did they not?
I don't, I have no clue.
Was it just a mistake?
Whether just an oversight, butit just lead us in a, in a, in a

(39:44):
hard spot of like, Hey, where dowe go to make sure we're doing
our best to, to, to get theright information?
Yeah.
So I think one of the thingsthat I Yeah, I I'm really
interested in sort of thecommunication of scientific
understanding and of healthpolicies.
And that was not reallysomething I thought much about
at all until this pandemic.
But the CDC is of course the,the central public health

(40:07):
communication agency in the U Sand one of my big frustrations
up to this point is that I thinkthat There could be a lot better
communication around themotivations and parameters
around the policies that arebeing recommended.
And so, yeah, I think that whatI suspect is that, you know,

(40:28):
this, this study from Arizonamay have come out and raised the
issue of masking in schools backto the forefront.
But I doubt that the policy Imean, first of all, it, in my
understanding, it's just kind ofa continuation of
recommendations rather thanreally a change.
And and while, you know, thisstudy gives us very impressive,
suggested gen of the protectivedegree of masks.

(40:50):
There are a lot of other studiesthat show much smaller, but.
Meaningful protective value frommasks.
And so, again, there's sort ofthis consensus lurking in the
background that, you know, the,the, the coincidence of these of
the statement being made on theheels of this article makes it
seem like the two are linked andthey may well be.
But my hope is that thesedecisions are being made on, on

(41:10):
really sort of three differentlevels.
You know, one of them.
His degree of need.
We have a lot of COVIDcirculating right now, and we
really need to do what we can toreduce the spread because of the
amount of strain that there ison the healthcare system, in the
amount of hospitalizations anddeaths that are still occurring.
Second, you know, of course thescience and, you know, do we
have evidence that that what theinterventions that we're

(41:32):
proposing are likely to beeffective and that science can
take all sorts of differentLayers of evidence in a way you
can have randomized controlledtrials, which are sort of the
gold standard of evidence.
But science sometimes also meansthat there's a plausible reason
to believe that something maywork based off of experience
with other viruses or in othervenues, maybe not in schools,
but in workplaces or somethinglike that.

(41:52):
All of that is then beingsynthesized and then applied.
Third thing which has beenreally operational during the
pandemic, which is this idea ofthe precautionary principle,
which is that we don't knowreally what Omicron is going to
do.
We don't really know.
Or at least we do have a muchbetter sense now, but that
wasn't the case three weeks ago,right?
Yeah.
And so, so, so there's, this,trade-off where we have this

(42:12):
intervention that we know islikely to help and very unlikely
to hurt.
And and, and we can deploy thisto at least to give us the best
chance we have to blunt thiscoming tsunami of infections.
And so there's the sense oflike, where.
While we're waiting for betterevidence.

(42:32):
We're going to take reasonableprecautions based off of what we
already know to avoid a future,you know, to, to try to at least
avoid a scenario that we reallydon't want to get into.
And so those, I think are thelayers on which, on which
decisions are being made.
Okay.
Each of these different sort oflevers play to different degrees
into different decisions.
And I would love for there to bea lot more transparency as to

(42:54):
how each of them inform thepolicies that are being made.
Because then I think we might bea lot more likely to say like,
oh yeah, like I understand that.
Like, and maybe we're really notsure how useful masks are, but
Hey, you know, basically whatthey're saying is like for the
duration of the surge, it'sprobably not going to hurt as
much as it could very well help.
So, all right.
I can get behind that logic.

(43:14):
But if I'm basing it on.
Study, that's really poorlycontrolled and wasn't conducted
in a very good manner then wouldbe like, why should I trust you?
It's the same advice, but it'sdifferent reasoning.
And that changes my behavior andmy response to you, to the
guidelines that are being made.
So, so I think that that'ssomething that generally we can
do a lot better with, aboutscientific communication, but in
the absence of that, I thinkit's helpful for us to keep in

(43:35):
mind, you know, those of us whoare trying to abide by and
understand the.
Policy recommendations torecognize that there really are
these different elements in playand that it's not always.
A causes B and you know, aprompt B policy decision.
But that there are a lot ofother things sort of going on in
the background.
And and sometimes it can behelpful.
You know, if the public healthagencies can't do this for us,

(43:58):
at least we can think forourselves through what does,
does this make sense?
Like, is this a policy that Imight come up with on my own.
Even in the absence of, of thisstudy.
And I think that that can sortof help us to sift through these
things and and maybe give alittle bit more grace for those
who are trying to develop thesepolicies on the fly.
Yeah.
Thank you, Steven.
Yeah.
I just think like, it's like,you know, I'm sure it's even

(44:19):
more than, than even complicatedthan this, but digging as, as a,
you know, these three legs ofthat tripod of science and that
really be able to understandthat like, okay, when something
like this is done and everyoneit's great to see that, like
everyone, it's not like it's,it's, it's a study proving the
opposite thing that's been.
So that maybe it'd be a callcall for a while.
But it's, it's maybe anexaggerated reality of something

(44:40):
that that's already been shownin one way or another, that it's
effective.
So that's one thing.
And then if it's using aparticular leg of the tripod of
precautionary, right.
It's probably saying like, look,maybe this study isn't perfect,
but it continues to lend itselftowards the precautionary
reality and the evidence that wesee already that it does
protect, right?
So it's not like a blatant lieor an error.

(45:02):
It's actually in the vein of theright direction of what science
has been going.
And.
Precaution says let's continuedown this path and elevate it.
Right.
That's helpful.
I appreciate Steven.
Thanks for that clarification.
Always words of wisdom from Dr.
Dr.
Steven Kissler.
I appreciate it, buddy.
We're going to end on this notefor the next couple of weeks.
Thank you all for listening.
If you want to get a hold of us,ask a question, tell us how

(45:24):
you're doing.
If you have questions around theglobe that I don't have time to
research, you can dothat@matlivinginthereal.com.
If you want to get ahold ofSteven on Twitter, I really,
really, really suggest to youHis channels on Twitter, a lot
of great information there.
S T E P H E N K S S L E R.
If you can support uspatrion.com/pandemic podcast.

(45:45):
One time gift PayPal, then Mo inthe show notes, and please leave
a review.
It inspires us and keeps usgoing.
Have a wonderful next couple ofweeks.
We'll see you then in two weeks,take care and bye-bye.

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