Pandemic: Coronavirus Edition

Will the vaccine be too risky, more herd immunity clarity, and looking for happiness in all the right places.

July 22, 2020 Dr. Stephen Kissler and Matt Boettger Season 1 Episode 35
Pandemic: Coronavirus Edition
Will the vaccine be too risky, more herd immunity clarity, and looking for happiness in all the right places.
Show Notes Transcript

Matt circles back with Stephen on the herd immunity confusion, vaccine hope, and a few tips on how to stay happy and hopeful as we continue our physical distancing.

We offer transcription now! Caution, it is AI transcription so please excuse AI errors.

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Things Discussed on Episode:

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S1E35-Pandemic Podcast
[00:00:00] Matt Boettger: [00:00:00] You're listening to the pandemic podcast, where we equip you to live the most real life possible in the face of these crises. My name is Matt Barker and I'm with my one good friend. And I feel like my only friend right now, before I met dr. Stephen Kissler, an epidemiologist, the Harvard school of public health.
[00:00:16] Dr. Marcus was not here. He is on call and not on call. He's actually at the hospital doing his work and he'll be back next week. it feels like forever. Stephen. Good to see. It's been forever. 
[00:00:25] Stephen Kissler: [00:00:25] Yeah. It seems like it has been. It's really good to see you too. 
[00:00:28] Matt Boettger: [00:00:28] Yeah, this is good. I love the FaceTime. it's it feels good to be connected.
[00:00:32]it's good to have a live audience of zero. so it makes me 
[00:00:34] Stephen Kissler: [00:00:34] feel like it was very fitting for the tenders. Of course, there's 
[00:00:40] Matt Boettger: [00:00:40] absolutely zero people. anyway, I'm glad you're doing well. I'm glad to be back. I am appreciate all the listeners from last week. We did, we weren't live, but I think the recording went well.
[00:00:51] It was well received and we're back together in our audience connect. We used to grow, which is really exciting. So please share this with people. So let's get straight into that. First of [00:01:00] all, thank you for all of the reviews. I didn't post them right here. We just had another recent one who thought this one of the best, pandemic podcasts.
[00:01:07]I'll if I can find that before we end, I'll give a shout out. Otherwise I'll shout that out next week. So thank you for all their views. Please come them. Please continue to have them come through. we reached a hundred, the goal last week, I really wanted to get a hundred views. We reached it literally at the 12th hour.
[00:01:21]so we're good. but I want more than let's go to 125, 200, keep this going to help get this into other people to help bring sanity to people's worlds in the midst of confusion. And we'll talk about that confusion. Cause I'm like, I keep telling Steven Mark. I'm part of this podcast. Now I'm not the informer, I'm oftentimes the informed, but I'm part, I'm part.
[00:01:39] I hate these people and I still have no idea what to say. Sometimes when people say, well, it's all conspiracy, blah, blah, blah. I'm like, I don't even know how to begin. And I feel like I don't even know. So if I'm feeling that way, I would imagine a lot of you who are listening to feel the same way when you get the same stuff.
[00:01:53] So we're here to help share this with people. I'll continue the reviews. Do you want to financially support [00:02:00] us? We still have a decent amount of things like doing this live costs money. And we want to offer this as a small token of a thank you. You can give us a little dollars a month.
[00:02:09] patrion.com/pandemic podcast. Or if you figure, if you're liking like, no, I can't give them monthly, maybe just one small donation. That's great. You can do that through Venmo or PayPal. All in the show notes and also one last drop Steven and I chatted last week or a couple of weeks ago. It dropped last week on living the real it's about talking about what it means to live the most real life possible.
[00:02:29] In the context of Steven's life, his profession, his history, it was really, really good. I got a lot out of it. I think you will too go over living the real.com. Subscribe to the podcast. Check out my episode with him. I'm now trying to force Mark to do the same thing. We'll see. He's been totally not even responding to me.
[00:02:44] So that's what we'll see what we'll see what happens. Okay. So let's get started. First thing, Steven, 
[00:02:49] Stephen Kissler: [00:02:49] guess what? Hey, but 
[00:02:54] Matt Boettger: [00:02:54] I went out, so I went outside. now I went outside. I had to go to a meeting for a [00:03:00] client and, this is my first time. And we've been outside when the Rocky Mount national park, we didn't really get out much cause it was packed like two weeks ago and there was wearing masks.
[00:03:07] And so we just like, didn't want to risk it. We were, we were okay. We did see a big moose and a mom and a baby moose, like swimming in this Lake 
[00:03:13] Stephen Kissler: [00:03:13] horribly. Awesome. 
[00:03:14]Matt Boettger: [00:03:14] Yeah, they were the only two that was amazing that those moose, they, they, they got it down. That was awesome. So we went there. we've gone out for like mantras.
[00:03:24] We've seen Nana, but this is the first time I had to go see a client, had a team meeting and it was crazy. We went to top golf, which definitely is not probably recommended. I don't think that's a necessary travel, but we went there. It was a really good time. I wore my mask nonstop and I was the only one wearing a mask.
[00:03:39]and I was, I was trying to be as careful as possible. I know the staff was trying to be as careful as possible, but it was just a weird world, Stephen to go in. And now we were in mass, everybody just having a good time, which I, I, I want people to have a good time. but just, it just the weight of feeling like you're tempted.
[00:03:52] Like there's nothing going on. I mean, this, this all seems, it's all seems normal, right? There's there's, there's no, there's no problems. So, [00:04:00] I, it was a weird experience. I felt like I was in like, in two different worlds. So that was crazy. Okay. Let's let's continue on. We had a lot to cover in the news.
[00:04:09]so first thing I want to go straight to you, Steven. I saw this article about how deadly is COVID-19. Of course, this is always in the news. Where are we at? But it just wanted to bring this back into a full circle of this has research. We're getting closer to the answer. In light of where you're at from where we started in March and the fear of what it was going to be and what we're kind of seeing the data show more and more, where do we see we're at now?
[00:04:32] Whether with it's kind of a lethal nature. 
[00:04:34] Stephen Kissler: [00:04:34] Yeah. So it's, going back to some of the conversations that we had before, you know, figuring out how lethal a new viruses is, is really difficult because, there's usually a lot of uncertainty in both the numerator and the denominator, basically the number of deaths you have and the number of, Cases that you have.
[00:04:51]and there's, there's all sorts of reasons for that. One of that is, you know, incomplete testing. One of it is misattribution of deaths to its [00:05:00] causes. I mean, actually assigning to a particular cause can be really difficult. Like did covert kill this person or did they die with COVID or what? and then there's also the, the town portal aspect where, Yeah, we know that that deaths follow cases by a couple of weeks.
[00:05:15] So if you divide the current number of deaths by the current number of cases, you're going to get an underestimate because the people who are infected now who might go on to die later, I just haven't done that yet. and so, so, so it can be shifted in all of these sorts of different directions, which is what makes it really difficult.
[00:05:31] Now, the reason why we're getting closer now is because, what we really need is, is sort of these retrospective studies. So places where an epidemic has already come through. And we need the serological tests. So we know how many people have been infected in the past at any point. And that's why it's taken this long to sort of start to pin down these numbers.
[00:05:49]as far as I can tell, it's, it's not terribly different from kind of what we expected. it still seems to be on the order of a half to 1%, depending on the population, depending, you know, because [00:06:00] that, that of course is like, Glossing over a huge, huge amount of variability, depending on how old you are, male, all female, socioeconomic status, all of these different things play into, basically what, what the risk of death is.
[00:06:13] So, we're beginning to pin it down. but I think the most important things we're beginning to pin it down more and more precisely for different. Parts of the population. And that's always a big goal in epidemiology is to understand specifically how certain things affect certain populations, because that, that allows us to see, you know, who's, who's at greatest risk and what's the best way of responding 
[00:06:30] Matt Boettger: [00:06:30] in light of the East.
[00:06:31] Talking about the increased cases, we continue to see a rise in cases. Now we're starting to see what I think is right. we're starting to see the effects of the cases. In in mortality, right? I saw the news, maybe this was yesterday, today. U S records over 1000 coronavirus deaths in a single day. First time since early June.
[00:06:47] I'm not sure what that really means. you know, and I also see right. That California is really struggling. And in light of this, I have to kind of part question, where do you see us in the death toll right now? Do you see, it's continuing to, do you expect it acute arise? [00:07:00] Are we starting to peak at this thousand thousand cases in a single day and.
[00:07:04]In light of what we see with California and the rise of cases. Are we seeing the effects of July 4th now? Or when do you, when do you, when do you expect to see those effects sort of trickling, which was already kind of Memorial day in the, in the aftermath of the opening as 
[00:07:18] Stephen Kissler: [00:07:18] well? Yeah. So, and right, as you mentioned, we talked a couple of weeks ago about like, why, why aren't we seeing more deaths right now?
[00:07:24] And the primary, my primary thought was that it was probably just a matter of time and it seems like that's, that's the case here. And so if you, I think, I think the best way to look at it is just, you know, it, you know, on a lot of these different dashboards that you can look up online, you can see the number of cases over time and the number of deaths, and you can sort of mentally sort of shift one of those curves.
[00:07:43] Yeah, a little bit forward in time and see where they line up. and I think that that's probably the best way to anticipate where we're going. And so, unfortunately I think that, that means we're going to see probably another couple of weeks of increasing deaths across the country as well, because that's just these cases that we've observed, just sort of following their [00:08:00] progression of illness over time.
[00:08:02]it does seem like as far as I can tell, I'm like, Hmm. Been trying to follow Florida for example. And it seems like their positivity rate is. Maybe plateauing a little bit, the last week or so it's been a lot more stable than it has been. As well as the total number of cases. So I'm hopeful that that's some of the interventions that we've put into places are starting to take effect and that those are starting to level.
[00:08:23] And then eventually that that will cause the deaths to plateau. But I think there's going to continue to be an increase for awhile unfortunately before then. So I think, I think, I think we might be on for another difficult couple of weeks around the country. So. 
[00:08:37] Matt Boettger: [00:08:37] and do you expect September, October to still see an increase?
[00:08:40] I'm curious that what we've seen all of this going up, it's pretty significant. you say, well, you know, the next two or three weeks might seem a little bit of a difficult time for us. Do you expect this to kind of then maybe hopefully begin to subside a little bit? Or do you still expect that September, October is going to maybe ramp back up again?
[00:08:58] Stephen Kissler: [00:08:58] Yeah. So, and I guess this gets back to a [00:09:00] bit of the second part of your earlier question too, is that I think, you know, It seems like three to four weeks is about the amount of time between something happening and then cases really starting to show up at least at the public level. So I think probably starting maybe next week or so if, if 4th of July gatherings is contributing to spreads, then we'll might maybe start to see an increase again, in some places that's sort of kicked off by that a little bit.
[00:09:23]but yeah, so I'm, I'm hoping that things will plan to a little bit, but I do, I mean, I do, I do really worry about, sort of this fall wave that that could be coming. As far as I can tell, it really seems like there's no reason to think why that it won't. it doesn't seem like we have enough immunity in the population to prevent it.
[00:09:42] It does seem like this Corona virus is biologically similar enough to the other human coronaviruses. And depending on that flu, that it ought to follow similar patterns. and so, I mean, a mathematical modeling aside, I think that our historical experience with these sorts of viruses suggests. That there's a very good chance that it will [00:10:00] continue to spread.
[00:10:01] And we'll, we'll probably see another increase in a lot of different places come September, October. And I think that's, that's really kind of what we need to be preparing for now. and you know, improving contact tracing and PR you know, there's a couple of things we can talk about, but there's been a lot of talk recently about the importance of these paper strip tests that we were talking about way back when.
[00:10:19] Oh, yeah. and how, if, if, if we could find a way to. get people to take these tests really frequently, like on the order of every day or every other day, even though the tests are not very specific. So even though you'll get a lot of calls, negatives, that would still be enough to identify early.
[00:10:36] Enough people who are positive and caused them to change their behavior, to stop interacting with people that it should be able to sort of flatten some of these curves a lot more effectively. So that's, that's one of the, I, I feel like that's one of the things that I've been trying to tell everybody I know about, because it's like, it seems like one of the most, one of the most important things that we can do going forward, because I.
[00:10:56] I think that we're going to need sort of all hands on deck, all the tools we have [00:11:00] available to mitigate whatever could happen this fall. And again, maybe it will be eye thing, but I think that that's unlikely. So. 
[00:11:06] Matt Boettger: [00:11:06] So these, these paper tests, like we talked about, are these now available? I'm just out of the loop, but can I go to amazon.com and buy some 
[00:11:12] Stephen Kissler: [00:11:12] or like, right.
[00:11:14] I think so. I think that a lot of them are still sort of undergoing licensure. and I think that part of the issue for that though, is that they're being considered as diagnostics. but, but we wouldn't be treating them really as diagnostics we'd be treating them as surveillance tools. And I think that that's a lot of what the advocacy has been around right now is that we're not actually determining people's care based on these things.
[00:11:32] The idea would be that if you get a positive, then you go to the doctor and you get the full on PCR test. That's a lot better and a lot more specific and sensitive. And then, then, you know, really, truly whether or not. You've got COVID. but this is sort of like a Sentinel thing and this, this helps us sort of modulator behavior.
[00:11:47]and so I think, I think one of the roadblocks there is the licensure, but that's sort of, because of the paradigm with which we're, we're, we're thinking about what these things actually are. And I think that what they'd actually be used for is something different. yeah, so I think that that's, that's the hope is that we can sort of [00:12:00] push through that and say, you know, actually we need to ramp up the production of these and the dissemination of these things.
[00:12:06]For the sake of public health rather than necessarily for clinical decision making. and so maybe we can talk about this more next week, too. I'm planning to do a lot of research over the course of the next week to see sort of where the roadblocks are. and I, maybe some of the listeners have thoughts on this too, or they've done some research into this themselves.
[00:12:21] Let's let's hear about it because I think that this is a super interesting area to think about, you know, I'm just trying to learn as much as I can. Sure. 
[00:12:28] Matt Boettger: [00:12:28] Yeah. So yeah, email us, you have any information mad@liveinthereal.com or give it to Steven. Now, are you talking about like particularly the roadblocks or the paper test?
[00:12:35] Like this is the, this is the big thing. Like try to get this into the hands of people, as quickly as possible and get the license for it. 
[00:12:41] Stephen Kissler: [00:12:41] As far as I can tell that it seems like the best things we can do, right? Yeah. 
[00:12:45] Matt Boettger: [00:12:45] Great, man. That'd be awesome. I love it. Let me know when there is, I'll be on amazon.com and I'll be buying a bunch.
[00:12:49] So on top of that, we have. Sweden coming in, mentioning that now with immunity. So we're talking about testing antibodies, this hope of herd immunity. And this [00:13:00] has been, I think the past couple weeks has been a lot of them. The discussion on herd immunity. Is it possible? How long to what extent will vaccines work?
[00:13:08] All this stuff mixed metal. And here's a Sweden saying that they, their studies show that maybe the immunity will last about a half a year. So in light of that, what have you seen this? And what's going on with this piece of information? Because it doesn't seem to go with the idea of a yearly flu, like a, you know, in my mind, I'm like crap.
[00:13:27] I have to get up booster every six months, which sounds ridiculous. So what's with this. 
[00:13:31] Stephen Kissler: [00:13:31] Yeah. So, I think that it's, there's been a lot of talk recently about sort of what constitutes the immunity. So we're at the point where we can measure, measure certain parts of the human immune response to COVID and, and sort of see how it's responding, but we still don't know how that translates actually into how your body responds to an incoming infection.
[00:13:50]and the, the immune system is. Insanely complex. And I have a very, very passive understanding about it. I know that there are letters attached to types of cells and that they do [00:14:00] different things. And so I think that I'm, I'm, I'm gonna, I, I th I really wish Mark was here because I, you be able to just, you know, run laps around my immunological understanding right now.
[00:14:08] But in my, in my rough understanding, A lot of what has been measured is B cell response. and B cells are sort of like the things that run around and, recognize, recognize invading pathogens and then sort of like ramp up your immune response. but there are also things called T cells, which are related to the B cell response, but they also sort of.
[00:14:27]act as this sort of adaptive immune system. So they can sort of like linger in your immune system and help with that immune response as well. And it seems like these things decay at different rates and that you might retain some of one, but maybe not as much of another. So all that's to say, it does seem like there's evidence that the immune response to COVID probably declines.
[00:14:45]there are a lot of pathogens that this happens for. And this happens for all of the other Corona viruses that we know of. So this, this is not really surprising. And this was actually one of the fundamental, assumptions that we built into the models that we produced back in April, where we actually thought the [00:15:00] most likely scenario was that we would see this pandemic, maybe a couple of waves of it, but then it would keep circulating every year or two, depending on how long that immunity lasts.
[00:15:08]But the other good thing is that. So even if, even if you're susceptible to reinforce, again, experience with past Corona viruses suggests that your body's recognition of the virus will help prevent that re-infection from being as severe as well. so that could be very helpful too, because even if covert keeps circulating, it might not be the COVID that we think of now.
[00:15:30]And if there is truly this seasonal variation and how likely it is to transmit, then that would also extend the amount of time that we need between our booster shots. It would be more similar to flu where, since, since enough of the population would have sort of low levels of immunity, that might be enough to sort of prevent transmission altogether in the summer.
[00:15:49] And then we would need our shots. Yeah. I, you could even imagine combining it with the flu shot, you'd have a flu in COVID shot all at once. and then that would hopefully be enough to sort of. Reduce the effects of both, [00:16:00] both of those infections in the, in the winter time. So that's, I think that's actually the most likely scenario there is that we'll probably get.
[00:16:07] Annual covert shots along with the flu 
[00:16:09] Matt Boettger: [00:16:09] great way to expose again, once again, the complexity of it, just whether the way you said it, it made total sense, but all that is even though right, that we may see it last six months, there's still all these other factors to help contribute to the seasonal effects.
[00:16:22] The fact that even somebody is immune for three to six months, does help curb it versus someone who doesn't. So, excuse me. All this goes into, into, into the, into the consideration of, there's still a lot of hope for the, the immunity and the herd immunity and those kinds. Now you mentioned vaccines. This is also huge.
[00:16:38] Usually in the news, I got like seven articles on it. That's just in the past, like five days. I don't know if it's hope week or where we're trying to get energy going. We're just like, there is an end because. Times Steven. I don't feel like it's ever going to end. It's just like, I feel like I'm just treading along.
[00:16:53] It's just a difficult road and I get these articles, it gets us excited. It gets our family excited. What can you speak to this? [00:17:00] We know we got the Boston one, which is, which is, whether or not what's the name of that one. 
[00:17:04] Stephen Kissler: [00:17:04] Madonna 
[00:17:04] Matt Boettger: [00:17:04] Madonna. Right. But now we have Oxford and China in the mix. some headlines seemed to lend that Oxford is ahead of all the game.
[00:17:12] I'm not sure. can you speak into where we're at with these vaccines, and to what you might see in the next coming months and what you might expect potentially for, for us, 
[00:17:21] Stephen Kissler: [00:17:21] for a vaccine? Yeah. So, I'm I'm admittedly encouraged by the fact that there are, there are sort of multiple shots on goal right now.
[00:17:29]and it's still, it's still not in a guarantee that they will, that any one of them will necessarily come through. But I think this is about as optimistic of a scenario as we. Could be in right now. the, all three of these vaccines that you mentioned are sort of pushing through the regulatory phases about as quickly as one can do safely.
[00:17:46]and, and there's been promising results. I know I've been following, especially the, the vaccine results from Oxford and from Madonna, and both of them seem to contribute a substantial immune response. Both of them seem to have relatively [00:18:00] mild, side effects. I think especially the Oxford one seems to be, especially.
[00:18:03]at least on the people who it was tested on, I think that's right. there, there weren't many side effects at all with the Madonna one, there, there were some, but yeah, they seemed pretty manageable for most people. And so, so I think that's very encouraging and the fact that they're mounting an immune response.
[00:18:17] So, so I think a part of the reason why this was hope we could, I think is partly because of just the regulatory process, because there's, they're fixed amounts of time that you need to run these studies. And so to a certain extent, what we're seeing right now are essentially the front runners coming through those Gates.
[00:18:33]and, and it needed to take this long and, and they're, they're getting there, which is, which is really exciting. And so, so I'm definitely hopeful. it'll be, it'll be really interesting to see what happens over the coming months. You know, the big, the big question is whether these things are going to be safe on a very large scale.
[00:18:48] So these are the phase three trials that the vaccines are going into now. and I think this is where the, the idea that the Oxford vaccine is a little bit ahead, because I think they're going to enter that phase three trial a little bit sooner [00:19:00] than the others. and so this is the stage where a lot of people get it.
[00:19:03]I think on the order of thousands and then you monitor both effectiveness and then also safety at that large scale and try to understand what the, what the very rare side effects could be, so that you can make sure that it's safe for the entire population. so that'll be key, you know, it's, Any one of these stages, any sort of vaccine or therapeutic can get tripped up.
[00:19:21]and safety is safety is hugely important, right? It's like, the last thing we want as a therapeutic, that's worse than the thing that it prevents. Right? Sure. like that's and at, and those things happen, you know, we have, we have a history of those sorts of things that, that, that it can, it can happen.
[00:19:37] So we do really need to be cautious for sure. and that's part of why it's going to take awhile before, before this, this comes through, But, like I said, this is about as optimistic of a scenario as I could have imagined. So I think that's great. 
[00:19:48] Matt Boettger: [00:19:48] Do you still expect maybe into the year, early new year or what's Harvard talking about when you're like, Oh, this is good news.
[00:19:53] Are they, are they. Having speculations. 
[00:19:56] Stephen Kissler: [00:19:56] Yeah. I mean, I think it's, just to get through the trials again, it will, it will take sort [00:20:00] of the rest of the year and to analyze the data from those. So, so I think, I think the soonest we could expect as early next year, again, if these things just sort of keep the merchant right through the process.
[00:20:08]and so we'll just have to see, but that's, it's, it's still a possibility and it's a possibility that I think was. At the beginning of this, I would have thought that possibility was pretty remote. Now. I think it's, it's, it's a lot more plausible. That's great. 
[00:20:20] Matt Boettger: [00:20:20] You're talking about the safety now. I, this is a curve ball.
[00:20:22] Yeah. We didn't talk about beforehand, but I have to caution myself how I ask this question because there's people who are listening probably who were aware of these people. but I heard right that some come a couple of close people. I mentioned that the they're going to not take the vaccine. because of there's just too many complications and I was, and then this got into a circle and there's somebody who is very susceptible, like, and then thinking that maybe it's not worth it.
[00:20:46] Right. so that that's a little, it's a little, so where are they Guinness information? Because in my mind, I'm like, it's, we're not even into phase three yet to do, we would do even. I mean, who's, who's determining the final verdict on its safety are, have there been [00:21:00] like gross, terrible side effects that that's, that's circulating in the media.
[00:21:04] That's causing some people to say, wow, this sounds more dangerous to take it then to now I get it. Like for me and my demographic. I'm 42. You know, it is an option probably for me to take the vaccine or not, because it may not affect me as much or whatever, but for someone who's 80 or 70 or 60 or immune compromised, I feel like in my mind, I'm like the vaccine seems to be a way bigger pro than the cons by the side effects.
[00:21:29] Is there anything in the news you've seen or what you and your research that even supposes that some of these vaccines can be pretty harmful? 
[00:21:36]Stephen Kissler: [00:21:36] So, I mean, there's, there is definitely a risk, to many different vaccines. There are, there are things. So I think the most common one that's silent that's cited is the Julian Baret syndrome, which is like basically, an overactive immune response that you can get for certain types of vaccines.
[00:21:52]it's pretty rare. it's quite rare, but, but it does happen. I, I, I know someone who's for it, to, for him that happened. And, so I think that [00:22:00] it's, You know, it's basically. Yeah. It's, I, I think that it's really important to hear the voices of people who are concerned about getting a vaccine, especially in the very quick timelines that are happening right now.
[00:22:13] I mean, I think that there, there is reason to be reasonably, you know, Cautious about receiving a vaccine. I personally, I mean, being familiar with a lot of these trials and even with, with many of the people who are conducting them, I have a lot of trust, frankly, in them. I think that they're, they are really sort of seem to be crossing their T's and dotting their I's and really, really doing their best to make sure that this is, this is this, this will work.
[00:22:39]And so, but, but you're right. I mean, I think that it's one of the things that I frequently hear, people talking about, you know, when somebody says, like, I don't want to get a vaccine there, there's a lot of this sort of like shaming about like, you know, how could you, they're safe, they're effective.
[00:22:52] And it's like, well, you know, I, I am absolutely an advocate for vaccines for sure. But I think that there's a lot of the people who are [00:23:00] arguing against them. You know, some, some are, some are truly based on, on things that don't have any evidence base, but, but some, there are some nuanced arguments there for that, that I think are worth, at least being heard, even if they can be argued against.
[00:23:13] So, I think I want to actually address sort of what you're saying from a, from another perspective, which is that, as has been the case throughout this, this epidemic, The most, the most crucial thing by far is not only what we're doing to protect our own health, but what we're doing to protect the health of the people around us.
[00:23:29] And that is the value of vaccines. That's why I get a flu shot every year, because I, so, and it's especially important with vaccines because usually vaccines are most effective. In younger people, they're, they're effective in people who can Mount an immune response. And oftentimes the efficacy of vaccines declines in the age groups that are most susceptible for that, for the worst outcomes from infection.
[00:23:52] And so I have an ability to protect those older groups who might not actually be protected, even if they get vaccinated from [00:24:00] infection. And so I see that as my responsibility to even take on some amount of personal risk, even though, and I, and I'm convinced, I mean, I'm I'm, I'm very hopeful that that personal risk will be lower than the personal risk that I would face if I were to actually get COVID.
[00:24:13]otherwise we shouldn't be getting the vaccine anyway. Right? Like, like the personal, the personal risk of vaccination should never exceed the personal risk of getting it. Right. So that, that, that, that comes first. Absolutely. But also I think that there's just like wearing a mask. It's my responsibility to protect the people around me.
[00:24:28] And that's the paradigm that I'm thinking about vaccination from and why I would advocate for, especially. Young healthy people to get it, 
[00:24:35] Matt Boettger: [00:24:35] man. You just dropped a bomb. Stephen Kessler. That's awesome. So that gets to the other thing. We're number one, you've, you've really kind of helped motivate me in the sense of my responsibility, my personal help, help.
[00:24:45] I hope it's affected some of the listeners and share this other people, but you just led to another thing that I forgot. I read in the article about how, Hey, there's a, there's a, there's a huge footnote that some of this may not be that effective these vaccines for 70 and 80 year olds, because he just turned a mountain [00:25:00] and I'm like, Oh my gosh, that is so.
[00:25:02] I was wondering, is this specific towards this vaccine? And you think you just answered the question that no, it's not. This has a tendency to be in general, all vaccines suffer from its effectivity when it comes to older generations. Right. And so this one is just no different and all the more. You know, not to, not to like, you know, preach from a pulpit it's, it's, Steven's poppet here right now.
[00:25:23] I'm just echoing it, that, that all the more that the younger people had the greatest chance to, to take, to have it be effective and help protect those around us. Right. 
[00:25:32] Stephen Kissler: [00:25:32] Absolutely 
[00:25:33] Matt Boettger: [00:25:33] awesome bomb. That was great. Loved it. So speaking of bombs, another big bomb. the, the, the white house administration had decided to take away, all hospital data from CDC and move it to their own, their own system.
[00:25:47]I don't fully understand this whole complexity. It sounds like there's some redundancy. My first initial, my first initial question was, do they even have a system to take care of this? I mean, this is, this is a pretty big, I mean, this is a pretty big deal, right? It's not like a little Excel sheet. You can just kind of run pivot tables on [00:26:00] it's a little bit, it's a little bit bigger.
[00:26:01] So. I'm just curious, not getting into the politics of stuff, but does this affect you Steven any way? I mean, I mean, you're getting data all over the place. I get it. But it is now data going to be a little more difficult for you to obtain. Now, this is no longer in the CDC or is it still going to the CDC or is it no longer?
[00:26:18] Where, where is it at today and how does it affect you? 
[00:26:20]Stephen Kissler: [00:26:20] Yeah, so my, my understanding is that, a lot of the data and, I need to double check this, but it seems like most, if not all of the same data that has been reported by the CDC will still be reported by them. It just won't be reported to them first.
[00:26:33] It will be reported to a second agency that has a sort of different. Part of control over it. So, I'm a little concerned about that. Just given that the CDC has historically always been the agency that has been responsible for these sorts of things. and so we're just not really sure what to expect from that transition.
[00:26:49] We're not really sure what to expect with like, how that reporting is going to go. but similarly, many States have been sort of taking charge of a lot of their own reporting as well. In [00:27:00] various other platforms, universities, journalists have been involved in collecting data as well. So I think that there are a lot of different repositories out there and things.
[00:27:09]yeah, so frankly, I, I haven't been sure. I think the CDCs number as much, I check the Johns Hopkins university dashboard, which, which is based on who the COVID tracking project. and, and that's, that's where I get the most reliable information that I, that I. I can tell. Okay. frankly, so, that, and then peer reviewed publications that are coming out, so, okay.
[00:27:28]so I don't think it'll change my day to day business very much, but I think, I think it is, you know, from a, from a social and political perspective, definitely an important move and one that I'm not entirely sure how to make sense of yet. 
[00:27:37] Matt Boettger: [00:27:37] Yeah, sure. Yep. And I, yeah, I'm, I'm the same concerns. Like I just sent it what's, what's the purpose of this?
[00:27:41] I mean, I can, I can get into the theory of what they, what the white house thinks about the CDC and maybe their particular slant. And now the remove that, but you know, there is fear like anything on both sides. There's this fear of. What's going to happen with the data once a good tenant. How's it communicated?
[00:27:57] I'm glad. I mean, in my mind, I'm kind of angry at this. I'm ignorant of [00:28:00] this. I checked the Hopkins, right? That's my major, my major place. So the right go to, but I said no, where they got their information was the CDC, and this is just a nice gooey interface for it, or is it their own research? And which sounds like that's what they do.
[00:28:12] They pull their own data from multiple sources and there's, there's no there's other places, right? It's not, it's not just a monopoly. On data. Okay, great. All right. So talking about that, next thing I want to talk about the news is infections with kids. So again, this, this, this affects me. at least not directly, we're going to have our, our son either homeschooled or online classes for the, his kindergarten this year, but I have a friend.
[00:28:36] We're in a staff meeting and talking about how, Hey, the, the, the, the district that really doesn't know the ramifications or the impact of how kids transmit, in fact, so we're opening up and we're gonna be cautious. We're gonna plan for the worst case scenario. and so that, just, that just kind of brought back into my head.
[00:28:52] Well, is this true? Like. Have I know back in March and April, we were, we were really in intensive. Like there may not be even one [00:29:00] infection of a kid. now we've learned that from that actually do kids do get infected. Right? do we know anything more about the extent that they're infected and the difference between infected and the possibility for them to transmit it to another person?
[00:29:14]Stephen Kissler: [00:29:14] Yeah, so absolutely it's possible for kids to get infected. We know that for sure. Now, it does it seem like, As I think the most recent evidence that I've seen is that very young kids, transmit covert substantially less, whereas older kids like adolescents seem to act a lot more like adults too.
[00:29:31] Okay. and so, and we've seen it in schools that have reopened in different parts of the world. and I have had to shut down again because of outbreaks that are happening. And so I think that really what this underscores is that if we are going to bring schools back first, you know, I'm really encouraged by the fact that, That they say that they have a plan in place for the worst case scenario.
[00:29:51] I think that that sort of planning and very clear communication about at what stages certain decisions will be made super important. I mean, the most important [00:30:00] thing, really in any public health intervention at all is, is trust fundamentally because without that, none of this is going to work. So as long as you have the trust and the buy-in of the teachers, of the staff, of the students with the parents, then I think that there's a lot more possibility of this working and working safely.
[00:30:14]And it seems like probably, going back to school would be a much safer thing to do for very young kids. The nice thing is that, that overlaps with the age groups where they benefit most from in-person instruction. whereas a lot of times older, your students can sort of cope a little bit better with, with remote instruction.
[00:30:30] So I think in some sense, we're kind of like, okay there. and so it's an incredibly complex process. I think this is, you know, again, one of those places where frequent testing could be a really valuable aspect of this and the fall, So I think that all of these different things will have to play in to it.
[00:30:46]and we'll just have to be paying really close attention. So I think that, I do think there are ways to, To open schools safely, but we really need to be mindful about how we're doing it and really be mindful of that. Probably variation in the propensity of transmission [00:31:00] among different age groups.
[00:31:01] Matt Boettger: [00:31:01] Yeah. This has been complicated. Again, the idea of having a plan is just so important. I know that's probably like obvious, but the complexity of the plan. I mean, just going back to work, you know, I'm starting to go back to work and go to the office. And before I can go out to work, my family has been sick for the past 10 days.
[00:31:15] I start having a cough two days ago, and then at the last minute we just pull the trigger. Our boss had just don't come in. And because, and because of this, we were like, Oh crap, we didn't have a policy of like, if a family member is sick, if a kid is sick, if I'm sick, what does it mean to be sick? What does it mean to have a temperature?
[00:31:31] When do you not come in? Would you, and like, we didn't even discuss this. Like we need to have this plan in place because I need to know whether. If, if, if Kiran, like right now, you woke up this morning with a tummy ache and now he's resting on the floor and he's wants to sleep. I'm like, does that disqualify me from going to work?
[00:31:44] Just because I have someone and everyone's gonna have their own need to have some plan in place to answer these questions, to keep people safe. And that's exactly. And so my question to you as well is you mentioned that it seems as though the younger kids, six years, maybe seven years up into adolescents may not transmit as easily.
[00:32:00] [00:32:00] Is there any theories why. They're like young kids may not is because their bodies are so small. So you don't have as much virus. I mean, I'm just like looking at my mind or is there any theories, 
[00:32:09] Stephen Kissler: [00:32:09] you know, I don't know, because, it clearly lots of other viruses can spread super well. Right? Like, yeah. So it's, it's a little bit surprising actually.
[00:32:19]I don't know what the, what the biological mechanism is behind that. it's, I think it's still. Yeah. It's still something that we're going to be looking at for a while to come. 
[00:32:27] Matt Boettger: [00:32:27] Yeah. The fact that they just suggested it clearly, because they're a little bit, it may not transmit. Just shows me how absolutely ignorant I am of science, PSA, everyone.
[00:32:35] I, my theory is that the pills are a little 
[00:32:39] Stephen Kissler: [00:32:39] totally closer to the ground, so 
[00:32:40] Matt Boettger: [00:32:40] yeah. Cut droplets. Oh, yeah. Oh, maybe it's true that I can't go go in the air. Okay. we're gonna keep going here, Bruce, from Australia. Thank you so much for emails back. He was letting me in letting us know about how there's a rising, confirmation case Australia.
[00:32:54]he has a question for you, Steven here's he's apparently a source came from a breakdown of quarantine travelers from overseas. That's where [00:33:00] it came from. And to Australia, the big debate here is on suppression versus elimination. So he, his question to you is how long and at what cost. Is is, is elimination if were to choose that track.
[00:33:12] Stephen Kissler: [00:33:12] Yeah. So, that's, that's great that there's, this is the vocabulary that they're speaking into because all of these words sort of have distinct meanings from a public health perspective. So there's, we can think about suppression elimination, eradication. All of these are sort of different things that have different nuanced meanings.
[00:33:28] So, eradication that, in my understanding being the most severe basically, meaning that that's like what we did with smallpox, where there is none of it left except for in vials and laboratories. That's, you know, it's great. but we're, that's not where we're headed with COVID for here for a very long time.
[00:33:44] Okay. so elimination is, is a local phenomenon where you basically have no local sustained transmission of something. Even if you have very small outbreaks. I think whereas suppression means that there could be limited sustained transmission. And basically you're just trying to keep it at low [00:34:00] levels.
[00:34:00] Presumably in this case at levels that are low enough to manage through testing and tracing. As opposed to widespread societal lockdowns. So basically the question is, from what I can tell is like, do we want to keep all COVID out of our borders or can we tolerate some transmission and just sort of accept that some people might get it, but we're just going to try to avoid these big flare ups to the extent that we're able,  I think that's a great question.
[00:34:21] And it's one, I have absolutely no idea how to answer other than, the, the, the fact that I think that boy, I think that. elimination is an incredibly tall order, especially for a country. you know, as, as large and diverse as Australia is certainly as the United States is, who has travelers coming in from all over the world at different times, you know?
[00:34:44]it's, it's really difficult to imagine a scenario. In which, true elimination is, is sustainable without some really massive effort. And really, you know, just like a huge, a huge burden on society. You know, now, now maybe, maybe that's worth it, you know, depending on what [00:35:00] we think, covert could do, if it gets past that elimination phase, It may well be worth it.
[00:35:04] And that's, that's a political decision at that point because that's, that's really weighing weighing goods. and they're, they're, they're a very diverse set of, goods that are hard to measure against one another, that, where we're sort of public health can speak to one side of that. But really it's, it's, it's a very, it's a very human and very political decision at that point.
[00:35:22]but from the public health perspective, I do think that elimination is, is, is a tall order and, and. I have trouble imagining even how that would be totally possible. Now, suppression, I think is probably something that is much more possible. And it's probably a more realistic scenario moving forward. trying to keep cases to the point where testing and tracing is enough to prevent big flare ups of infection.
[00:35:43] So my guess is that that's probably the direction that things will head, just from a pragmatic standpoint. but it'll be really interesting to see what different measures, different countries adopted. 
[00:35:52] Matt Boettger: [00:35:52] Curious. The only you can talk about suppression. Is there like a demarcation for what that really means in the sense of, to the level by which contact tracing [00:36:00] and those things are, or easily be able to build it.
[00:36:03] Do what is that like? Is there like a number or like, how do you know, like, Hey, well I think we're there or was it like, ah, we got a feel for it. Like, seems like things are good. We can, we can handle it. Or is there like a scientific, like, Nope. Once we get to here, that's usually about where we can engage this in a more, 
[00:36:17]Stephen Kissler: [00:36:17] yeah.
[00:36:17] Pull harder way. in different infections that we're very familiar with do have pretty distinct cutoffs that, that are often just sort of, there's a consensus as to what constitutes suppression. but we're not at that point with COVID and, And it, and it matters so incredibly much on the, on the public health resources that are available in any given setting.
[00:36:35]if, if you've only got two contact tracers that you're going to read, you're going to exit out of that suppression phase pretty darn quick. So employment it's yeah, exactly. So, so that matters a lot too. And, but I think that that underscores it. Other important thing is that, Yeah, suppression to some extent is, is in our control, not only to the effort that we exert in finding individual cases, but in, in the sort of funding and the sort of resources that we allocate and that we're building up [00:37:00] right now, the sort of training that we do, that sort of raises that level of, of what constitutes suppression.
[00:37:06]and really what we're trying to avoid is sort of these big shifts from being able to manage an epidemic through contact tracing. Just things sort of spiraling out of control and needing much broader societal outcomes. So, so those are the sort of levels that we're thinking. And there aren't clear numbers behind that, but it can definitely be helped by hiring people, training people, expanding the capacity for that kind of, for that kind of effort.
[00:37:28]Matt Boettger: [00:37:28] And you were saying to Steven, this was actually almost kind of a fascinating and even question to consider the district. Cause like you just seen Australia with their intensely proactive nature. You were to say like just 200 cases and they locked down for six weeks and here we are in the U S just dominating the score on coronavirus.
[00:37:46] And just to just a two different wild worlds, 
[00:37:49] Stephen Kissler: [00:37:49] it blows my mind. It's you know, w barring any sort of judgment aside. It just, it just is. Is really unbelievable to me, the, just the difference, just the difference [00:38:00] in experiences that different places are having with respect to this virus right now. And the difference in responses that we have.
[00:38:05] I mean, it was like, yeah, you're you're right. It was like 200 cases. And I think it was at that point in Melbourne were shut down for six weeks and I was like, Oh my God. Like, you know, that is, that is just such, such a fundamentally different response than, than, than we're seeing right now in the United States.
[00:38:18] And, There's. Yeah, it's just, it's just truly mind blowing. I think it's easy to forget. And to assume that sort of people's experience everywhere is roughly similar, but like, man, it's. That is just like such a fundamentally different, different approach to responding to the pandemic. Yeah. and, and again, that's, that's a, that's a political decision.
[00:38:36] That's, that's something that needs to be made based on the way and give different goods. And, and to a certain extent, sort of, we've chosen one thing here in the States and they've chosen another thing in Australia and it's yeah. That's that's just where we're at right now. 
[00:38:47] Matt Boettger: [00:38:47] And I think sometimes we choose the other thing and we flip flop here.
[00:38:51] I mean, at least we now hear that just recently a white house administration has, it seemed like explicitly condoned. A face mask, which is a really nice thing to hear. 
[00:39:00] [00:38:59] Stephen Kissler: [00:38:59] Right. 
[00:39:00] Matt Boettger: [00:39:00] I applaud that. Yeah. That's a huge, a huge, great step. So, another one we keep going here. I talked to my friend, Steven, just the other day and we're having a chat and I was talking about man, you know, September, October could be rough and.
[00:39:11] You know, we're already seeing Texas and Florida rereading, you know, reaching some sort of capacity in the hospitals. And then he immediately responded, you know, gosh, you're just listening to the media. Like I have doctors that I'm talking to and they're like, there's like, it's maybe 10% up in the hospitals.
[00:39:25] There's plenty of space. There's no big deal. And then, then, then he throws us the side hook to me. And didn't mention that, Hey, there's even this, like this lab that only, only produces positive results for COVID a hundred percent positive role to how likely is that? You know, so leading this whole concoction of dude, you're just getting blown by the, by the media.
[00:39:45] This is not a big deal. lockdowns are only for keeping the hospitals down, which I agree, and there's no need for it. There's been only New York is the only one that ever even showed a sign of that. and the, and, and it's kind of ridiculous. So I'm gonna turn it back to you here. I am. Part of this podcast had no idea how to [00:40:00] respond.
[00:40:00]how do I w first of all, what is, it's the truth? If you know anything about this, like, is there, is this, is there. Is Florida in color, not Colorado, but, Texas and Arizona suffering at any level and the positive test cases. And then how do we discuss this with people? 
[00:40:16] Stephen Kissler: [00:40:16] Yeah. Yeah. So, yeah, I think it'd be, I'd love to address sort of these specific questions and then maybe talk a little bit about just sort of this, this phenomenon.
[00:40:25]so, right. So, you, you mentioned this conversation that you had had earlier. and I, I spent a while to sort of. Digging up data, you know, I wanted to figure out like, what's what is going on. and as a, as somebody who's been following public health for a really long time, I sort of know roughly sort of where to look and how to follow these trails.
[00:40:44] And, and, and there are things that any, that anyone can do. But I think that there's a really interesting thing going on here. So, so basically what I ended up doing was, was looking at Florida as a case. there had been a recent report in a number of news agencies. That there were on the order of 50 [00:41:00] odd hospitals in Florida whose ICU capacities were, were full, maxed out, no more room in the ICU.
[00:41:05]and, and sorry, I wanted to see where that came from. And, many of the news articles that I saw, Weren't very well cited, but a few of them were. And so I followed them up and it turns out that number was coming from Florida's central hospital management. They, you know, it's publicly reported data.
[00:41:20]they're the people that manage Medicare and Medicaid in Florida. They're like, they're like Florida's hospital management group and they have a spreadsheet that is tracking week-to-week hospital capacity pulled down that spreadsheet looked at it and sure enough, there were 53 hospitals that had no more room at the ICU.
[00:41:34] Right. And so, and that was on a list of about 200 hospitals. Okay. And so basically what that's suggesting is that there, there are a lot of hospitals that still have room, but there's a sizable minority that seemed to be full. Now there's also a lot that can be done in hospitals to expand capacity. so even though the hospital's stated ICU capacity might be full there, they might be going into overflow search capacity sorts of things, which allow them to handle patients who are coming in at a higher [00:42:00] volume.
[00:42:00] And I don't know what the status is there, but I do know that the, the reports that were in the media are. Factual they're accurate. They're right there. Those hospitals are at their state at ICU capacity. and I think, you know, there's, there's this real, difficulty here where it's like, there's, there's this real, I think, a tendency to, to really value sort of personal and anecdotal evidence.
[00:42:23]your friend basically saying like, you know, I know people in hospitals in their hospitals aren't full and it's like, That's true. There are a lot of hospitals that aren't full and also the hospitals that are full are often in places that. Are distinct and geographically separate from the hospitals that aren't there.
[00:42:42] They're often in underserved communities, among people who are essential workers. These are the hospitals that are full and they're full of different, you know, like the, of, of, frankly, you know, a lot of, a lot of racial minorities and, and people of Porter communities. Like these are the people who the epidemic is hitting hardest and.
[00:43:00] [00:42:59] And there's, there's a lot of segregation still, you know, just in, in living communities right now, and different hospitals serve different communities. So, knowing someone who works at a hospital that isn't full, I mean, that's great. I'm glad that not all of the hospitals are completely overwhelmed and hopefully we can help divert traffic to those hospitals that still have resources.
[00:43:17]you know, that's, that's a very good thing. And that was true in New York city. It not, all of the hospitals in New York city were overwhelmed, but. But many were. and I think that, you know, the, the epidemic is still, certainly in terms of people being admitted to hospital is still accelerating in Texas and in Florida.
[00:43:32] And so hospitals that are fuller are still seeing patients coming in. So, so I think that that's sort of what the statements are glossing over. There's a lot of variability. You look at the CDC web, website on hospital capacity. And I think it said like in Florida that, Basically 75% of ICU beds are 80% were full and there was 20% left.
[00:43:50] And so if you look at that number, you say, well, there's still plenty of room, right? But, but at specific hospitals, there's a lot of variation. And so I think that's what that overlooks and that, that overlooks that there are specific [00:44:00] communities that are getting hammered by this right now, and others that are relatively left unscathed.
[00:44:04]And if we, if we ignore that fact, then we can come away with, with sort of false, false conceptions of what's happening. That's great. Yeah. So I think it's, it's difficult and it's, there's, there's this notion of like, like how do we know, know what to believe? And I think that there's, you know, W what we're trying to do is sort of bring in information from all of these diverse sources.
[00:44:23] You know, I'm, I, we have the privilege of talking to Mark and hearing what's going on at his hospital. I know a number of other people who are hospital workers in New York and in Florida and sort of hearing what's going on on the ground there. And I've heard. From some of them that, that their hospitals are filling up and just getting full.
[00:44:38] So, but then also there's the different dates that's coming and do we trust the data sources and these sorts of things, and there's never going to be a conclusive evidence of anyone specific thing. We can't reach a level of mathematical proof for really anything that matters in life. and, and so what we're left with, with this sort of these converging probabilities, that's, that's, that's an idea from, John Henry Newman, where we're just trying to like, do the best [00:45:00] that we can with, with.
[00:45:01] With these different sources of evidence, I'm trying to synthesize them in the most real personable way, knowing that there's, there's always going to be this element of, there, there's going to be this gap between. Belief and absolute certainty that, that can't really be done away. but I think our responsibility is it's to sort of cultivate the sorts of, ability to rely on diverse sources of income information, to understand what those are, and to know how to synthesize them.
[00:45:27]and that's really only something that can happen with practice, with communication, with community, with, with seeking out opinions that differ from ours, and really checking the, the claims of the people who disagree with us. and who, who seemed to be coming to different conclusions and trying to understand what's behind it.
[00:45:40] Matt Boettger: [00:45:40] Great. I love that idea of converging probabilities. It's such a good, like just tagline that in the end it is it's complicated. And I keep saying this and it's so easy to just to play the numbers game. Like you said, there's 53 hospitals that are overrun. There's out of maybe 200 look, there's plenty of room, right?
[00:45:58] But that that's the mind, [00:46:00] the mind and city is always the simplify and I get it. It's probably an evolutionary propensity. Like, like I got to find out quickly where they need to run from this lion or, or fight him. Right. But, but, but, but it's hard to get into that. We, we kind of get into that. We re reduce everything to its simplest form.
[00:46:14] Right. So you can make, to make a decision, but with maturity and post-modernity, it becomes so much harder because now we have all this information. It's not just whether there's a line in front of me, there's data all over the place. It creates complications. And that's a good thing because that means we're more nuanced.
[00:46:27] We could take a much more nuance approach. We can see more, more variables and make better decisions, but we've got to realize that just because, you know, Some hospitals are full. And on top of that, it's the whole idea that you're saying, Steven, that it's not like if you do things now that things stop.
[00:46:44] Now, they continue to arise for two to three weeks and maybe it might be a month before you see your measures. And so if you're already seeing 53 hospitals run, maybe it's a time to be in high alert because if you start now, you might have three or four more weeks of increased cases. And 53 could be all 200.
[00:46:59] I'm [00:47:00] not saying it is, you just don't know. Right. And so all these factors being put in place, so. Sometimes, like, it seems like we're crying Wolf, but because the Wolf is actually really far away and some people can actually see the Wolf coming. Right. Yeah. And that, and that's the complexity of all. Love it.
[00:47:15] Thanks so much for that, Steven. I really appreciate that. We only have a few more minutes left. I want to land on a couple of articles. I said, do you want a deeper reflection? First one was why some people fear social isolation more than COVID-19. I think we don't take this seriously enough, especially among teenagers and adolescents seen people I'm on college a lot.
[00:47:33] And how much this affects, you know, at the very beginning of March, I, Steve and I was thinking, and man, this is gonna be the biggest wake up call to soy people who are already isolated, disconnected, because they're obsessed with social media, but they get just enough fix from physical contact that makes still stay in that relate.
[00:47:50] Another pandemic of their own life and that's that isolation. So I was thinking, man, this is gonna be a great wake up call. We're going to like rise to the occasion. Now in summary, it was, it was definitely [00:48:00] a wakeup call, but it was a wake up call. I think, of our, of, of the disparity of our culture in many ways in politics and that kind of stuff.
[00:48:07] But. I'm seeing now the length of this, how long this has been going, it's been really severely affecting. I mean, I, you know, I I'm, I'm with my wife and I'm with my kids, so at least I have some, some sense of physical contact, but I think my mother-in-law who has none, you know, and, and teenagers and how it's affecting them and the depression rate.
[00:48:25] And how much more sensitive and how we really need to as public health need to take this to consideration. And I totally agree. It's probably an overlooked thing. That's not talked about enough that like, look there's implications that are really bad. Maybe just as bad as COVID-19 in certain populations.
[00:48:39] I really struggled with this and I think I don't have much to say, except for. It awakens the idea, the idea that connection also, there's nothing that can replace a physical hug. I know that man, that's like, nothing can replace this, the physical embrace at this end. At the same time, there needs to be a call a calling to like have [00:49:00] a deeper connection with people.
[00:49:01] So I want to land on this. There's another article that is related to this. It was just looking at the people, dealing with COVID dealing with the people who were really struggling, dealing with. Those were actually maybe happier, actually kind of a rising to the occasion in what was distinctive with the two and a few things.
[00:49:16] I mean, these are kind of obvious things, but it's a great way to close and call you guys to something that's a little more intentional that this is a time by which we're in it for a few more months on a long haul to be more intentional about our days and our weeks. To keep ourselves motivated, happy, connected, fulfilled in life to the best we can in light of our limitations.
[00:49:33] But the things that they saw that really brought people down was passively scrolling through social media. Of course, I mean, I mean, I'm actively screw scrolling through it because of our, our, our, our, our, our podcast. But it's, it's tough to constantly to see these things in my face all the time. I want, I want to, you know, I don't mind the top golf experience, even though I'm like, this is not healthy for anyone, but a sense of awareness that there is something other than this in my life.
[00:49:56] And it's other connections. and the second one is interacting with people [00:50:00] purely through chat or text that this, that these people, these, these ones are highly negative results to people. for sure that, so the, the response was, D definitely daily exercise. Those who did some kind of like, if you walk, walk fast, if you run.
[00:50:15] Do some sprinting, right? If you don't have much time, you can sprint for 10 minutes. You don't have the capacity. You can walk for a briskly for 10 minutes, but get your heart pumping. Get outside. It's so important. Self care, hobbies, relaxation, pick up a hobby, engage a hobby, pick up an old one. You know, I just sold him a guitar.
[00:50:30] So I can't pick it back up again, but the family's thankful because it would just be really, really, really terrible relaxation, spiritual activities. Those who pray, meditate. Relaxation hobbies, exercise meditation and not just text, but a lot of FaceTime. And I get a lot of energy by being with Steven and Mark weekly with it's just seeing their faces right.
[00:50:50] There are humans outside of this world who are my friends. And one day I will see them face to face again. And the last thing they saw is going out of your way, a way to help people. That is huge. And he did [00:51:00] it just because you're confined does not mean you can't. I can't help. You can actually help even more because we're more sensitive to it.
[00:51:05] Those people who are on the fringes margins, who are struggling, who could use financial. Lots of different kinds of help. It just goes back to living the real, this idea of the margin. And that's really as the whole four, four, four, four framework of, of having to live the most ordered life, check it out, living the real, it's I think it's episode four, about what I mean by margin, but this idea of w really establishing permanency in your life, looking at life at discovery, not trying to get sucked into like, ah, this sucks.
[00:51:31] I can't stand this, that language. I mean, there's always a time event, but the majority of time needs to be fixed on where is the gift? Where's the opportunity on this responding and gratitude. And again, just like the other one, is this idea of need to be able to give ourselves to another. And we follow that four framework.
[00:51:47] We live a happier life, especially if we move and have exercise to get that stress out of our life. So. We're good in there. Do some of this. If you haven't exercised in like four months like me, I'm going to get outside. I'm going to do some brisk walking [00:52:00] and engage in meditation. Prayer more face time with my friends.
[00:52:03] And definitely I'm going to really strengthen my ability to make a strong act of generosity each day to someone that is unusual and outside the box had a great week. We'll see you with Mark next week and take care. Bye bye.