Can you Rate and Give us a Review in Apple Podcasts?
Thank you to all of you who helped us reach our goal to pay off our equipment for this podcast! If you would like to still financially support us for the monthly upkeep and to help hand off some of the editing responsibilities, you can give a one-time donation or become a Patreon member for as little as $5 a month. See the links below. Thank you!
Highlighted Resources:
Other Things Discussed on Episode:
Can you Rate and Give us a Review in Apple Podcasts?
Thank you to all of you who helped us reach our goal to pay off our equipment for this podcast! If you would like to still financially support us for the monthly upkeep and to help hand off some of the editing responsibilities, you can give a one-time donation or become a Patreon member for as little as $5 a month. See the links below. Thank you!
Highlighted Resources:
Other Things Discussed on Episode:
You are listening to the pandemic podcast. We equip you to live the most real life possible and the face today's crisis. My name is Matt Boettger and I'm joined with my good and handsome good friend, Dr. Mark Kissler. I think you got a haircut.
Stephen Kissler:You just called me my brother. Oftentimes when people say handsome, Mark just sort of comes out immediately.
Matt Boettger:I have no idea why he just said that that's crazy. It's as short as so you two are like twins Did you get a haircut. I
Stephen Kissler:did. I did. Yeah, that was that's has been getting pretty good at pretty good at, you know, crafting air up here. So it's
Matt Boettger:She's. Yeah, she's awesome, man. She's she's got a second, second gig with, once we get out of the pandemic. Well, that's Dr. Stephen kisser where we're hearing from right now. He's an epidemiologist at Harvard school of public health, and we've got lots of chat about beyond just haircuts. I got a haircut too, right? You may not notice Stephen, just because I'm losing so much hair. So you're probably thinking, because you always look so good. Thank you, buddy. You're so, so good. So I got, got got a super bowl, haircut, happy, super bowl to all of you. Maybe I should be maybe should make a caveat with that. It depends on what team you're going for, how happy you might be today, but I didn't know which team to root for. I, I was ambivalent chiefs because of my sister and her family are obsessed and they're from Casey. So I really want them to win. And I don't know, they're both, they're both great teams. There's an awesome game. My boys, just like any reason to celebrate a holiday. So we had seven layer dip. We had homemade pizza, we had chocolate fondue, so they were sugar high and they were having a great time. And my sons are, this is sort of how ignorant they are of. Of like basically football last year, they called it soccer. I was telling Steve, and this year they kept calling it the football, which is good football, but the football movie. So you see where their minds are at on a daily basis. I'm like, it's not a movie. Fair enough. And they kept asking, well, who wins? Who wins? I'm like, I don't know, just sit at a bar. Oh man. Okay. Well, we got so much to talk about. I have a whole litany list of things. That I want to explore it. Stephen, I have tons of questions for some odd reason this week, and then maybe if we get to whatever reflection, just because man, last week's episode with Mark and Stephen kind of hit me in the gut at the end just reflecting about the stress and just what's going on. And I realized I've been keeping my head is so low. Just kind of keeping, keeping to the grind, doing things, getting my work done. I guess I didn't really allow myself to feel that much. And I know I was stressed. I know that I've been kind of a little overwhelmed and feeling a little like just. Unnerved a little bit. And so I spent the whole week reflecting at some point. We'll see if we get there, but if you can give us a review first and foremost, we love that. We love reading them. You can do that on Apple podcasts, in the link, in the show notes as well. You can donate to us to support us, to keep us, keep this going. You do that at patrion.com/pandemic podcasts as little as$5 a month. It really does help us keep this going for the long run or just a one-time payment Venmo. People all in the show notes. I think it's all the bare necessities. When you get to, let's start talking about all the fun things, Stephen, and some things are just not that fun. For example, I heard this thing about we're in the eye of a hurricane and they go, man, every time we get these metaphors, I get a little unnerved. So I know we talked about this before, Stephen, again, I'm not trying to have you play witchcraft or all this kind of stuff. I know it's hard to predict the future. I just keep seeing good news every day, every week I need to follow in the Hopkins tracker. And do you still feel we're now entering mid February? And close to March. Do you still feel like we could be in an eye of a hurricane in th that we're going to hit another another kind of rev up, especially in light of what we're talking about, you know, just a couple minutes before we recorded, and that was the super bowl and how every big holiday oftentimes has an increase. And now we're on the heels of some variants, which make things even more complicated. What's your sense right now, as of this
Stephen Kissler:Monday, Yeah. So I mean, taking a step back, actually, it's, it's been really interesting to hear how all of the sort of narrative descriptions of this pandemic have changed over time. How, like, you know, we've been like using all of these different ways of sort of trying to conceptualize like where we are and where we're going. And it's just, it's super interesting. And so, yeah, we had like first, like the, the main, the main surge and others, like the flatten, the curve, and then there's the multiple waves. And then there's, you know, now there's the eye of the hurricane. And so, yeah. I, yeah, I would love to like, do a retroactive study of these things once this is a little bit further behind us. Yeah. So I think definitely the How'd you say it's hard to say what exactly is going to happen? But I can, I can refer back to some of the conversations we've had earlier about the spread of the variants in the UK. Now, one of the things why I distinguished the UK from where we were in the U S is that it seems like in the UK, they had one of their variants spreading. During the winter right around when the holidays were happening. Now we're fortunately a little bit later on in the year, but I had failed to anticipate the super bowl which which happened, you know? Right, right. At a time when some of these variants are starting to dig their heels in here in the U S So it's, it's not totally clear to me what's going to happen. I mean, again, the good thing is that we're sort of starting to enter into February, March when coronavirus transmission usually isn't as high. So it might be a little bit harder to spread. But that said, I mean, after Thanksgiving and after Christmas in various places, we did see surges of infections. So we've seen those in the U S we've seen those around the world. I expect we're probably going to see another bump after this weekend. Cause I know, I mean, a lot of people got together and And also, you know, with cases coming down across the U S there's, there was also sort of a, a higher sense of security in a way. So I think that some of the inhibitions that people may have had around the holidays might've started to come down because we've just been in this for so long. Right. It's just, yeah. I mean, I, I, yeah, I would have loved to go to a super bowl party this weekend, you know, like that, you know, like that. Yeah. So, you know, yeah. It it makes some sense to me, but you know, I'm hoping. My, my anticipation is still sort of what it was that we may still see a bump, but I think we're basically just going to see sort of a long. Long tail, I think across the United States with surges and various places. And I hope that that's, I hope that that's the case and that we don't end up really surging the other direction. So rather than being in the eye of the hurricane, we're just sort of like on a, on a locomotive, that's just trying to slow itself,
Matt Boettger:add that to the mix and the locomotive now. So that's great. That's good. I'm glad you're. Yeah, you're going that way. And just thinking about you, and of course you like to go to a super bowl game, which the last week of the sacrifice he has made and like, then you have been like, you know, I I'm surprised you even had that much of a tan and you don't have one, but like literally, like, I mean, I, I know you're in that apartment all the time and just natural light. And I know you could add a little bit, but I, we need to get you a ticket the first time you can get out and we're going to take it to a fun game. You deserve it. Okay. Well, that's good to know. I'm, I'm hopeful. I'm feeling the same thing again, I'm not an expert, but I keep watching at least Colorado and, you know, having a little ups and downs, ups and downs, but still remaining steady like that locomotive and just, we're just cruising with no big fears quite yet. So next topic I want to talk about. I am obsessed with the flu right now and I, this is the third time I've mentioned it when I first kind of became aware of this two weeks ago. And I read another article from the Atlantic. That was really fascinating. I'm gonna put this in the show notes, but I really want you to talk about this and you just, you just tell me, you just wrote something up about this, a newspaper, which is great, because I want to hear about the complexity of the flu. I'm guessing for you right now, as an epidemiologist and seeing what's happened, the flu, this is just kind of like a goldmine for you to figure out how it behaves what's going on. You know, hearing as extreme things. They're like 20,000 flu tests. Being beaten down and like no results coming out. I mean, it's like nearly non-existent and so many other respiratory viruses are just not even showing themselves. And we've talked about in the past, but how this is real, this is good news about what we're doing, but I kind of want to talk about just the complexity of what you're seeing of like, why is the flu behaving this way and what does this mean for maybe the flu for next year
Stephen Kissler:as well? Yeah, so. It is super interesting. You know, there's, there's a lot of A lot of information about this that we're going to be looking at as epidemiologists for a long time. So there are, there are a couple of reasons why I think flu, sorry, seems to be down this year. And I think the first thing is that, you know, the, sort of the obvious one, which is that wearing masks and physical distancing and these kinds of things work like we talked about and seasonal flu is just less. Contagious. It's less transmissible than COVID. And it's, it's less contagious, not necessarily inherently, but we all have some amount of immunity built up to seasonal flu. And so that makes it practically less transmissible. The reproduction number is on the order of 1.1 to 1.5. Whereas for COVID it's in a, in a natural population, it's closer to three. Gosh, so COVID is on the order of twice as infectious as the flu. So if we bring COVID down to a place where it's just sort of like on the edge of its ability to spread, which is basically what we've done, if you, if you look at the COVID reproduction number trackers in a lot of places, the reproduction number just hovers right around that threshold of one. Yeah. So anything that's less spreadable than COVID is going to be sort of pushed down as long as it spreads in sort of the same way. So I think, I think that's the main same thing, so that's kind of cool. You know, so. There are a couple of other ideas sort of being tossed around. I mean, one of the clear ones too is like, well, maybe people just aren't. Going to the doctor and getting themselves tested for flu, like they normally do. And I think that there's something to that, but of course, we're also not seeing the severe flu cases. You know, if people are in the hospital with pneumonia you're going to test to see what they have and we would be picking up flu cases there as well, but we're not to nearly the same level we usually do. So that's another sort of. Piece of evidence that it's not just down to you know, you don't find something you don't look for. Like we're, we're, we're looking for it. Like you said, like people are running tests for flu. We really want to know if it's there and it just doesn't seem to be. Many other respiratory viruses are this way as well. So art has a V a, which is a childhood respiratory virus has been down across the board. And so now in the Southern hemisphere, the respiratory illness season is sort of opposite to ours up in the Northern hemisphere. And in Australia, for example the, their RSV season, which coincides with flu and coronavirus spread was really tamped down. But then once they lifted their lockdown, they had a later RSV season that sort of hopped up. And so that's another little bit of evidence that physical distancing, these sorts of things are really affecting the spread of these respiratory viruses. Some people have also suggested that maybe there's something about the immune dynamics that basically once you've been infected with COVID that that can give you some short-term immunity to other viruses and. That may be true. So in 2009 when the spread of the H one N one flu pandemic was happening, the pandemic seems like it was able to also bump the RSV season a little bit later. And so we think there is some amount of sort of short term immunity that S that some respiratory viruses can give you against others. Okay, but that's probably not enough to explain basically the complete absence of flu that we've been seeing this year. It could have sort of adjusted the timing of the flu outbreak, but it, it wouldn't have obliterated it entirely if that was the only thing that was going on. So a lot of different ideas sort of being tossed around, but I think, I think the clearest and most consistent one with all the data we have available is just that masking and distancing is basically just wiped out the flu this year. Now that's phenomenon people aren't getting infected with the flu this year, which is a good thing. But then that also raises the question of, are we going to see flu spread this summer? Is it going to be worse next winter? Maybe maybe I think it's less likely that we're going to see widespread flu transmission over the summer, but I do worry a little bit about next year. Next flu season could be since we haven't really built up that level of underlying immunity, it'll spread a little bit more easily. Our defenses won't be quite as high. And so we might well see a worse flu season next year, then than normal, partly due to the absence of flu this year. So I think it's something we're going to have to pay attention to. Maybe another reason to start thinking about wearing masks during the flu season, once in a while, you know, like to some extent, especially if you're feeling ill.
Matt Boettger:Oh yeah, absolutely. You know, a couple of follow-up questions. The first one is w is it possible that number one, that like a virus can bow to another virus? Like even like, like, like, okay, you're in, you're in the play. You're COVID, I'm kind of leaving for a little bit until we can work together better or in an epidemiology. Does that kind of reality work or because I'm trying to think, Hey, there's the behavior changes, which we see. Is there anything else going on? You, you mentioned natural immunity. Is there anything within virus communication and a sounds weird like as the director intelligent, like, Hey, Mr. Flu. Yeah. You know, is there anything like that in epidemiology where one virus may bow to another temporarily and leave and then come back? Or is that not part of the the equation in this?
Stephen Kissler:Yeah, that's interesting. It's usually usually that doesn't happen for viruses. That are very distantly related. So like between flu and coronavirus, that probably wouldn't happen. Sure. Between different strains of coronavirus. Absolutely. One strain can sort of get completely displaced by another one. But usually we don't see things quite to that extent, okay. With with, with really distantly related
Matt Boettger:viruses. Okay, great. And my other one question is about the you know, Could this be like another great benefit. And we talked about how, okay, we're doing all this research, we're in a pandemic. We have M RNA vaccines where we preparing or we're preparing ourselves for the next pandemic, you know could the next fall be one of those really awesome benefits of the pandemic, where with MRNA coming out with the vaccines and. You know, us delaying in some sense, having a flu season because of wearing mask and with potentially having a much worse flu season next fall, but at the same time, having technology and marinade to be able to iterate so quickly, could this be one of the first fruits of a potential, you know, widespread, may wouldn't say another pandemic, but a hard season being, being mitigated by be able to iterate so quickly with a vaccine that it specifically addresses. The particular kind of flu, flu strain that's going on? Is that a possibility? Yeah,
Stephen Kissler:I think that, that's a really interesting idea. I think there's a huge amount of potential for using MRN vaccines for other illnesses and potentially even for flu. I am, I would be surprised if we had an MRI and a vaccine that was ready for next year's flu season, unfortunately, because Part of the reason is that it would have to go through the same series of testing that the COVID vaccine went through. And while we were able to do it for the COVID vaccine within a year, part of the reason we were able to do it so quickly was because to test a vaccine, you need there to be spread of the pathogen that you're testing against. So part of the reason that COVID vaccine trials went so quickly was because they were really going into phase three justice COVID was ramping up for its fall wave. So they had a bunch of data coming in. So actually the absence of flu. In some ways, it makes it more difficult to test MRN vaccines against flu, because you can't find anybody who has the flu right now. So that's going to be an interesting box. Yeah, I know. It's tricky. Yeah. But I think people are working on this on MRN type vaccines for all sorts of different things, including flu. So I don't know if we'll have them in time for next year, but but we're getting there.
Matt Boettger:Okay. Well, okay. I was hoping for that to be a big bang, but again, like the season of all of our episodes, it's complicated and it's okay. So, okay. Another thing I want to chat about is just briefly mentioned about mass. We mentioned it last week, couple weeks ago, about the deer between N 95 mass K and 95 mass. I'm not going to go over that again. Okay. That was going to mention a couple of things. I put a great article from sea net of all places about their kinds of masks and how to kind of find the right mask. So look in the show notes for that to help you find my question to you is it's been a lot of Oh. There's been a lot of information about mask wearing and now this kind of push for double masking is that I want to get your input on what you think about that because it's, it's, it's, it's starting to have its manifestation. We're seeing it around here, people double masking. Is that something you would advocate as well? Or is that too much or what, you know, what's kind of.
Behind
Stephen Kissler:that. Yeah. So, I mean, I think it's, I think it's not a bad idea. It's not something I've been doing. But again, I'm also not generally in places where I don't spend long periods of time, usually indoors and places where there are lots of other people who might be unmatched, for example. And so I think that, like, for example, if I were If I were working in a restaurant, for example, or if I were in a public facing business where I had lots of different people coming in, that sort of thing. Absolutely. I consider wearing two masks. I think, I mean, I think that one of the things that I wish we would have been doing from a. A long time ago is providing people in front facing businesses with the same protective equipment that people in hospitals have. We should be supplying them with N 95 lines and it shouldn't be up to them to get them really, you know, that should be provided by their employers. It should be subsidized by The government. And and I think that that would go a long way towards preventing spread. But now we're sort of in this place where we're trying to find stop gap solution, and I think two masks can help them. But the thing, the thing that I've really been trying to emphasize to the people I've been speaking about with this is that it's much better to have one mask that fits well. The two masks that fit poorly. So really one of the key things about wearing two masks is that Hopefully, you know, the, the mask that's closest to your face. Maybe if it's like a surgical mask, for example, those can form really well to your face. And one of the biggest issues with wearing masks, one of the reasons why they. Fail to be helpful. Most of the time is because they're not being worn correctly because there's spaces where air can get out and or maybe you're not even wearing them over your nose anyway, you know, it's two masks over your face, but like over your mouth, but not over your nose is not like not effective. So I think that, you know, great, absolutely wearing two masks, extra layers of protection, especially if you're wearing them well. But the thing that I would really try to. Get people to think about it. Just make sure you're wearing your masks well, and make sure you have a mask that fits well. And I think that that will, that's really the thing that we should that we should be focusing on right now.
Matt Boettger:Okay, great. Yeah, I feel the same way. I mean, there's been a lot of, some backlash about double masking and that's, but yeah, I think it's still, the PSA is just, just wear a good mask, wear it. Well, and I get it, man. I just I'll report back in a week, but I got some anti-fog spray. Cause that's, that's the perennial problem for me wearing glasses. Like I just don't wear mask. I still wear them, but like, it's something that can even see where I'm going. I got so much fog in my glasses, but I'll, I'll check back to see how the, how well that works for me. If it's a, if it's a good solution, now here's another thing. I'm surprised that Stephen, I came in, I saw this article. Was it yesterday or maybe a couple of days ago, but Biden present by, he was talking about school closures and talking about this as a national emergency that we got to open up school safely. And then he mentioned somewhat casually that as early as this Wednesday, the CDC may come out with requirements for opening safely and my jaw kind of dropped metaphorically speaking. So I was like, Oh, wait, We haven't done this yet. And so I just wanted to check back, is this something that we haven't even done with the CDC yet? Or is this our first time coming out with some, some guidelines for schools? Yup.
Stephen Kissler:Which is I mean, there have been some rough guidelines provided, but this has been one area that has been frustrating, Leanna clear. And and I think a lot of that, I mean, it's, it's hard to point to exactly why, but I do know. So Our roommate, Ellen here has been working on Basically providing this because she and her colleagues recognized that the government really wasn't providing any guidance, national government, state, government, basically nobody had any clear guidance for what schools needed to do to reopen safely. And so, you know, properly, that should be the role of health agencies and these sorts of things, but it just wasn't available. And there were a lot of. Superintendents and administrators and teachers who were just confused as to what to do. And so she has been working with a group called pan fab which has a whole bunch of different things going on, but they basically have a small group of well-meaning scientists who have been looking through the COVID guidelines and speaking with epidemiologists and trying to figure out like what they can do to help schools give these guidelines to reopen. Which again is properly the job of the government, but in the meantime has sort of been taken up by sort of these well-meaning groups of people to try to help schools understand what they need to do to reopen safely. So it's been happening, but it hasn't really been happening from governmental agencies on the level that it should have from my opinion. And so I think that it's I would have hoped that these sorts of things would have come out sooner for sure. But I'm glad they're coming out now in time, really, for the, at least the, the spring semester, you know? And so it's, I think it's good now, now the CDC of course, is a regulatory agency. They, they don't have the power to make requirements in really any way they, they provide information. Yeah. And they provide guidelines that States and local jurisdictions are free to take up or to ignore. So whatever's being posted by the CDC is, is guidelines and are things that schools can. And I mean, I, I would generally recommend following largely, but also there's, there's a huge, huge, huge, huge, huge diversity of the different needs and the different People who are involved in different school districts the different resources available. And so absolutely school districts will have to be creative in how they how they do that and which sorts of things they find they're able to achieve in which they aren't. In the meantime there are groups like this one that Ellen has been involved in who who have been really doing active outreach to schools and trying to provide. Living breathing people who people who are involved in making these decisions can speak with. And so if, if any of you out there are involved in making these sorts of decisions for school districts and are trying to Wade through all of the evidence that's out there feel free to get in contact with me. I can help sort of direct to some of the information that's out there. And then yeah, and hopefully in time that evidence-based sort of provided by these centralized agencies will grow and grow and make schools safer of a whole.
Matt Boettger:That's great. And now could you, does the pan fab have a website? Yeah, it
Stephen Kissler:does. I can track it down for you and we'll put it in the show notes.
Matt Boettger:Good. All right. When you said pan fab, it's like, Oh, you can think of it like pandemic. Fabulous. No, it looks like he's a little weird, but okay, great. He'll she'll uh, Stephen will. Give us a link to put in the show notes. If you want more information feel free for now. Go to Matt, living in the real.com. Email me I'll forward that on to Stephen and you guys can get connected to get any information for you. Make those kinds of decisions on behalf of school. okay, so let's get into the vaccines because there is a lot of stuff that I talk about the vaccines. Yeah. There are some things I'm kind of mulling over in my head. Things are getting complicated for me. The, the first thing I always want to review again is this whole genetic testing and what's going on update. I read another great article from the guardian about this, about how we rank like 30th in the world for genetic tests, which is just mind-boggling to me, Steve. I mean, we're like on the cutting edge of technology, we're like kind of the forefront we're pioneers and, and maybe you can help unfold the complexity of this. I feel like we have technology, but I feel like we're not using it. And I don't know why we're not using it, how we got to this point. There was one small sentence that was said in this, and maybe just kind of infer the, the, the reason. And they said that the U S offered its scientists, no such budget and coordination. So is this simply just a money issue? That the government didn't fund it well enough. And that things like Portugal of all places are better than us in genetic surveillance because they had funding for where can you help me parse where we, how we got in this position.
Stephen Kissler:Yeah. I mean, so I'm, I'm not a genetic epidemiologist as, as much as a population level one, but I do have many colleagues who are sort of working in this space so I can give sort of my impressions as to what's going on. Even though I my expertise is not precisely in this area, but It seems to me like there's there's, as you say, there, there are budgetary issues for sure. And that oftentimes, you know, resources arise where, where funding is made available. And I think that it just hasn't really been as much of a priority for whatever reason. And I don't, I don't totally know why I think that There just, hasn't been a clear and present or for the ones who are making the funding decisions. There, hasn't been a clear and present need for this sort of thing. It is kind of a complex thing to communicate that like sequencing the genomes of viruses can tell you what, well, it can tell you all sorts of things. It can tell you where the virus emerged. It can tell you how much it's circulating. It can give you a sense of how many people are infected at any given time. It can help you monitor for variants that can do all sorts of things, but But it, it takes a fair amount of, of communication and background knowledge to really understand like what that link is and just how crucial this information can be. And so I think that for some of those reasons that money has just been sort of prioritized elsewhere. Furthermore you know, the United States is just a funny country because it, it just the way that it's structured, right. It's like, and this is part of the beauty of the U S which is that it is we have these grassroots. Systems and things that are growing up all over the place. And there's a lot of sort of local innovation and different States have jurisdiction over what they're doing and different hospitals sort of have their own ways of genome sequencing. And and so you end up having all of these different sorts of platforms, arising and different people sort of working on this problem independently, but there's not necessarily this very centralized coordination that you can have in. Other countries with other sorts of just sort of social structures in place. And that makes it very difficult because to, to get the maximum benefit out of the genome sequencing pathogens that we're doing, you really need everybody to be using similar platforms so that all of the sequencing can sort of be integrated with each other. And you need them sort of reporting to the same repository, using the same metadata, metadata, being the sorts of information that you. Include about the genome sequences that you're sequencing. And so all of this information can be standardized much more easily in other places than it can be in the United States, just by virtue of sort of how, how our country has, has evolved in a way how it's socially has evolved. And so, so there are big barriers in place that make it really difficult to achieve this on the same level that other countries have been able to. Now, I think that With this pandemic, it has really driven home the importance of this kind of information. And I think that we're going to move that direction. But it, it takes some time to really build up that infrastructure, to train people who are able to use it well, and we're getting there. But it's going to be slow going and we, we won't, we won't have it next week. Unfortunately.
Matt Boettger:Yeah, well, totally. I think you hit a great, a couple, a couple of really great points in the reason why I wanted to ask, well, I didn't even know the reason why I wanted to ask this guy. Honestly, we just confused. I didn't really know why we weren't or having this kind of availability of genetic research. And I've, I've heard a lot of times who's debt blame who's at fault and putting all of this lump on the previous administration, the president's on the administration for not funding it, which. I get it. I could totally see that. That is part of the problem, but I also think again, like most things, there's a level of complexity and that our very fabric by which we were, we were fabricated creates this difficult problem, you know? And so all the more reason why we need to, so going back to. Good old social justice ideologies of the principle of solidarity and the principle of subsidiarity, which sounds all technical. Just basically, to what extent do we fight for a common end? And then to what extent do we relinquish some of those common ends for, to preserve individual rights. And it's always a complicated thing and we go back and forth and we're seeing the ramifications of this right now, where, when we, when we have a really strong uphold in love for individual rights, which is wonderful, Some of the collateral damage is this right? A lack of coordinated standardization efforts that we need to reevaluate. And move forward, which I think is that kind of what you were saying, Stephen, that that's part of the negate renegotiation problem. Right? Totally. So I love it. I love it. Okay. Continue down along the line of the vaccines we realized here for a while now that here, particularly in an all over the world, that the vaccine rolled out has been in disarray. Good news though, that we, through the all 32 stadiums, uh, NFL Stephens had been, been, been offered to the government, basically to be used as Hughes vaccine vaccination sites. To to help expedite and increase the level of vaccinations to people. Some super excited about that. I saw Dr. Fowchee a couple updates the danger of thinking that because you're immune. That you do not need to get a vaccination, then encouraging those, even if you have had covered before to still get them. So we don't know right. How long the immunity lasts. We saw with Pfizer. Uh, you, Stephen, you're talking about a couple weeks about how effective it is and it's, it's, it's remarkably more effective than natural immunity. So that even if you have been infected, encouraged that if you're, if you're in that tier right to be, to be, to be vaccinated, Now I want to stop here with Johnson and Johnson. We didn't talk about this last week. We didn't get into it. So we never mentioned that Johnson and Johnson is a new vaccine has been approved. Now it comes with a 66% effective vaccine vaccination rate. So that's going to scare a lot of people and they're like, ah, man, I'm going to get in. I want to get Madonna. I'm going to get Pfizer. I want to throw it back to you, Stephen, just briefly about, is this something we should just like try to get a Pfizer or a Medina or where's this 66% mean? And how is it still really effective for us? Even if we get this one.
Stephen Kissler:Yeah. So the, the Johnson and Johnson vaccine has a couple of advantages. So as you say, it's that sort of like bottom line efficacy number is about 66%, but it seems to be just as effective in reducing hospitalizations and deaths as Pfizer and Madrona. And so I think that's really the key because that's, that's really what we're trying to avoid here. And so so that's, that's good. And I think that You know it's, it's still a very good vaccine and is one that seems to be very effective at reducing the severe outcomes, which is kind of what we're after. Of course. The other thing about it is that it is I think it's a one shot vaccine instead of two. So it makes it a lot logistically easier. It can be stored in standard refrigerators. And so that makes it the, the Johnson and Johnson vaccine is I mean, it's a good overall vaccine for sure. And I think the, the greatest benefit of it is that it it just opens up places to vaccination that couldn't get it otherwise. Either due to barriers of money or storage, or just the logistics of getting people in for two shots. Like the fact that we have a vaccine that is that effective, that is that much cheaper and that much easier to administer is game changing because, you know, the, the thing is like, absolutely like. I want a vaccine. Well, we all want a vaccine to protect ourselves. Right. But we're not going to be out of this until we have like a high level of vaccine coverage around the world, like everywhere, you know? And so that's, that's the real value of, of all of these vaccines and especially having multiple is that now we can Yeah, get vaccines to places that it would be harder to get them to, right. If they needed the sorts of technology and infrastructure, that's the art and the vaccines do. So it's sort of this two-fold approach of both getting, getting every individual person vaccinated, but also getting enough of the population vaccinated that we can really reduce the spread of COVID overall.
Matt Boettger:That's great. And just a really reiterate when, when Steve was saying that even though the 66% effective, from what I've read, it is a hundred percent effective from death. Like there has been no recording and, and, and really, really effective against hospitalization. Right. So so important really in the, in this. That's where we're going for. I'm like, I don't care if I get sniffles, like, that's fine. I don't care if I feel bad for a week, I just don't want to die. That's that's, that's kind of, that's what to, and all of these across the board prevent us. So it doesn't matter. Now I get there's ethical issues. I'm not going to get into with Johnson and Johnson versus Pfizer. That's a whole other area of discourse and really valid and really good. But for now that, you know, it's really good to hear that, that. That doesn't matter what you get, it prevents from what we don't want to have, and that is a death, but now let's get into complexity, the nuance of this, because first of all, like that's great. I'm on board. I'll take anything. But then we had this stupid thing called variant Stephen, and then they get cut and it makes everything much more complicated. So to throw a wrench in, I need you to respond back to this. So modern, right. Says Madonna's vaccine works against the new COVID-19 strains. We heard the same thing for Pfizer, not so with AstraZeneca. So this, now this all of a sudden, now I'm taking a step back and in my mind, my little feeble mind, Stephen, I'm trying to think what should I be doing here? Because my question is. The AstraZeneca is reported to offer minimal protection against the South African variant. So I'm in my mind. Okay. Well then maybe it's just whole RNA thing. This, the, the, the, that one is so good. It's able to just hit on everything. So I really want to get that as an insurance policy for future variants. Is it the type of vaccine that, that might. Make some vaccines better. And that this MRNs is just so good. It's like the X-Men of, of, of, of, of vaccinations. So what in light of this, what should we be doing with, with, with our decision making, with vaccines, help us out with that?
Stephen Kissler:Yeah. So with the, with the AstraZeneca vaccine, I think there's, there's something that we still need to continue to watch with it because and I need to, I need to get myself updated on this as well, but from what I, from what I saw, it said that the. The efficacy was very low against mild and moderate illness. And I think maybe even severe illness, but that was still not talking about hospitalization or death. And so it may well still be effective at preventing those for the South Africa variant, but it does seem to be quite a bit less effective at preventing the, the less, severe stages of illness. But we don't know yet, you know, it, it may, the, the variant might have sort of. Sidestepped all of that. And that could be you know, could it basically evaded this vaccine now? Yep. Are different types of vaccines better than others. It's, it's hard to say, especially because we've only had MRN vaccines for two months or so. And it's of course, an interaction between the vaccine and the pathogen too. So just because the MRN vaccines have been very good for COVID so far there's no guarantee that they will be that way for other pathogens either that said I think that. From what I know about the vaccines. There's no reason that any one platform would necessarily be better than any other in terms of a virus evolving around it. Okay. Other than the fact that you can update M RNA vaccines very quickly, so you can stay on top of the pathogens very well. But I think that in terms of just having a vaccine, that basically you can't evolve resistance around. I don't think we know how to do that yet. And so. That's one of the things that we'll have to keep paying attention to you. I think we could get lulled into a false sense of security that the Pfizer and the Madrona vaccines are sort of impervious to these kinds of things. But I think it's just one of those, not yet things that I think that it's absolutely COVID could still generate mutations that escape that unity as well. We know that I think it was a South Africa variant Yields slightly reduced effectiveness for the modern vaccine. So we know that it can at least take one step in that direction. So if that can happen, there's I, I think that it could happen all the way if it if it needed to. So really what I think this is all underlining is that, you know, again, vaccines are really important tools, but we, we gotta do everything we can to bring cases down because the more virus that's circulating, the more chances it has to evolve around the vaccines. So that's why we need rapid tests that we that's, why we needed to continue physical distancing that, you know, all of this stuff is so important and vaccines are just one really important tool. But if we want the vaccines to stay effective, all these other things still matter, too.
Matt Boettger:Okay. Great. So the moral of the story, the conclusion is, well you're when you're up, get the vaccine that's available and here's the other complexity of things. I saw another article we talked about before, Stephen, just about how now there's research being done as of recently, now that we have probably four or five different kinds of vaccines of the efficacy of giving one shot for the first dose, and then they get a hold of. A different shop for your second dose, whether you get a Pfizer one for your first dose and then a Johnson and Johnson one for your second dose. I have no idea how they're gonna do this, but have you heard anything updates on that at all? I just read that justice morning is some research being done. Any discussion among colleagues about that stuff?
Stephen Kissler:Yeah, I don't have any new information on that. I imagine some of the research is being done, but right now, absolutely the recommendation is to get the same, same shot for both, because that's the only thing that's been studied
Matt Boettger:so far. Yeah. Yep. Absolutely great. Couple of things just to, before we move on, but there is Medina asks FDA to allow five extra doses per COVID vaccine vial. I have no idea what that means, Stephen, but it must be like, You can squeeze out more stuff out of a vial and get more dosage. Yeah,
Stephen Kissler:I think that it would help with storage. You can store more in one fridge hopefully reduced costs of transport, of storage of just the vials themselves. You know, we're producing so many vaccines right now that even the little glass vials, you know, there, there could be like supply chain shortages for things like that. No, we're not thinking of that, but yeah. I think, you know, anything we can do to make that process a little bit more efficient. That's a good thing. Yeah.
Matt Boettger:All right. So you're looking for a new small business. Everyone go to the small glass vial and start making them cause you could make make make some money off that. Pfizer, Pfizer, X expects to cut COVID-19 vaccine production time by almost 50%. That's huge, great news. By the way, just to know that almost doubling the amount of vaccine can be produced by a Pfizer coming out really soon. We talked about mixing dosages. It's going to throw you a random question. Any updates on Sputnik five? We talked about it. We talked about it like months ago. And I here's my question, Steve, I'm just wondering, do you imagine that, will you, do you think Sputnik five would ever be distributed outside of Russia or is there even, is it going to be clamoring for it right now or is it not even talked about?
Stephen Kissler:Yeah, you know, I think, I think it actually has been administered. Okay. Somewhere outside of Russia, but I don't remember where I don't have many updates. I think that it finally got through, it's like equivalent of our our phase three trials and seems to be pretty effective as well. Greg relatively safe. So I think that that's, that's a good thing. But yeah, it's you're right. It's we sort of heard about it ages ago and then it's like, Oh, what happened? But yeah, but it's, they're still using
Matt Boettger:it, so. Okay, great. One thing before I get to my, my quick reflection, love to do it, but, uh, Stephen, have you heard about this? I read, I read this like the other day, and this was again about the, the MRN a future and that potentially a vaccine 3m RNA for, for Ms. Do you have you have you?
Stephen Kissler:Yeah. So they've recently about them RNA vaccines. They haven't been using them yet, but the M RNA is really interesting because there are all sorts of different health issues that that can be helped. By producing the right kinds of proteins in your body, basically. And MRN Ana is the language that tells your body what proteins to produce. And so by injecting RNA, just like we're doing for these vaccines, you can in theory, produce those proteins. And and that can help to address a whole host of different types of medical conditions that aren't just infectious disease related conditions. So that's something people are working on quite a bit now. One of the reasons why we have MRN vaccines for infectious diseases, but not other things is because for many of these other Diseases. You need to be able to keep producing there's proteins at a high level for long periods of time, which would require sort of consistent doses of MRNs because your body isn't producing that MRN itself with infectious diseases, you just need one little shot of MRN and your body goes haywire and it figures out, you know, what, what sorts of antibodies do we need to produce? And then it's the antibodies that give you the immunity for the future. So the MRN just needs to provide you with that template and then your body does. So there's a big gap still between. Dealing with infectious diseases and using MRN for some of these other diseases as well, but there's a lot of research going into it and that, and that research goes back for many years. And so there are still a lot of challenges to figure out sort of how to. How to give people enough MRNs to make these proteins, how to deliver it to the right places in the body, because it needs to be produced by the right cells and those proteins, do we need to be taken up by the right cells? There's a, there's a ton, a ton, a ton of challenges with us. But it's, it's really interesting therapeutic idea. And it's something that I think with the COVID vaccine research, there's been a lot more interest, hopefully, a lot more funding that will sort of help bring some of these things a little bit further along. So I think we're still a ways off from that kind of thing, but she's super cool.
Matt Boettger:Yeah, super fun, fun future ideas about all the technologies being developed around the pandemic. Okay. Well, that's really all my questions. I want to end this quick reflection that we were talking last week about Hugh and I and Mark about the struggles and just the craziness of life. And I realized, I think it was, I was numbing out and I wasn't really thinking. And then Mark and your guys reflections, made me really think about and as reflecting back. Okay. So seeing just the complexity of the conspiracy theories along with. The enormous psychological toll. It has placed on so many people, the suicide rates, domestic violence, depression, panic disorders, the financial destruction of so many people, the medical toll on people not wanting to go to the doctor. So all these things, children not be able to go to school. I mean, maintain social ties, the racial and gender disparities you know, seen an article just recently about, you know, women taking the blunt of the pandemic by being forced to pick their career over, over child care. And so just, just all this stuff that I think it's just good to, again, acknowledge publicly. This is not a simple fix. It's not just about lock downs and keeping COVID away from everyone at all. Costs and Stephens never advocate that we've never advocated. It's always the nuanced approach of trying to do both. But just realized feeling in this middle ground has been really like a struggle. Yeah. Cause I feel judged. I feel like, okay, I'm picking one side or another, you know, by, by, by advocating stronger measures for reducing numbers of COVID than I'm in just allowing people to commit suicide. And, and so I just, I I'm, I can imagine what you're feeling, Stephen, but I feel it on even on, on my own level. And it's been reflecting, this is. This is part of why I've been even I'm an introvert by the bed even more introverted lately. I'm just like, I'm going to keep it to my own bubble. I'm just going to, like, I feel a little bit of guilt and I don't know why I feel guilt because yeah. And then all of a sudden I remembered of a story. Now I want to keep this this long. But about 15 years ago of my best friends died on mountain taro in Colorado. His name was Tiffany. And at the time I was, I was going into the beginning of my ma. And I was at the time studying for those of you who are Christian, I've studied like the Providence of God. And so this, this complex reality of like predestination and free will do you know, it, God just dictate everything and you have no choice or do you have complete free will? And I remember being, having a Catholic past holding this middle ground of both, and I'm like, ah, you know, it's, it's kind of a, both and sharing that both and approach to her twin sister who was like struggling and really, and it was that holding that. Complex reality of both. And that bring me, they bring me constellation. They bring hope to other people. And it wasn't because I was like trying to hold a, some ideological, unrealistic tenant. I was really holding on to that. I believed to be really, really true. And it brought me a great sense of constellation and it really brought a lot of people around and together during a hard time of my best friend and her twin sister's death. So what does he have to say about what what's going on right now? I feel like that's kind of what's going on right now. There's like two tenets. I'm just like in the same way with Tiffany, there was a couple of tenants I was holding on to, to bring constellation, understand why this happened, understand why the purpose of this, how if we can find hope in this and kind of find healing and the same thing for there's like two great tenants I hold on to. Then make me realize that no holding this middle ground is the most important thing. And, and, and this is one reason why I mentioned the flu thing, Stephen, cause I'm like, that's really, I hold on to like scene how much the flu has gone down. Could you imagine what had been, if we didn't mask, we didn't do these things. How many more deaths, how many more suicides? Because of just of, of the fear of going outside. And then the other big tenant was way back in March. And the reason why I share this, because for me, I have to hold onto a couple of anchors to make me realize, okay, I'm on the right path. Right. And of course I have to adjust and shift with new information comes along, but way back in March, we saw those I think the, the information from, what was it open table about how, you know, a couple of weeks before the pandemic that people stopped going to restaurants before the, before the lockdowns even happened, showing that it wasn't necessarily a lockdown, it's a complexity of the situation of the fear of what's real. What's going on. And I just share this with you guys, because. I need a couple of things in my life to anchor me of what's true and what's real and going on one way, one extreme or the other, those aren't the real approaches. The real one is holding this really strong middle ground. And the difference is for me, has been with Tiffany with that death, it brought an increased sense of solidarity and closeness to people around me. Unfortunately, this both end has made me feel more alone. You know and, and and I'm not in, you know, not sure quite why. And, and the one thing I've learned about this is sometimes as I was wondering in my own head, Like, I'm always kind of every person I talk to they'll mention something about COVID and I'll go, Oh yeah. But not really. Oh yeah. But not really, you know, there's always a nuance approach. And so I'm constantly not in the circle of where we all agree on one thing. And this is, this is the complexity of it because not only is there truth, which is the both and approach, I also have to be considered of how I approach things. And I've realized wondering in my head, you know, I was worrying my head, like, am I just being like a Maverick that I just want to be that person who like, Oh yeah, but not, but not really. You idiot, you know, like this is how you really say things by being that person, or I'm actually trying to hold on to truth with sincerity. And I realized, okay, I'm really struggling to hold the middle ground at both end and feel okay with it and not feel guilty with one way or another. I feel like that part is true. The one thing I've realized even is that how I do it needs to be modified because how I do it oftentimes brings people further away from me and just an encouragement. It's, it's hard because when you're passionate about something, you can get a little emotional and it brings a bigger wedge in people's life. It doesn't mean that what you say. And what you're doing is not true. It's just, the approach is unreasonable. It needs to be done with charity and sincerity to bring people together. I don't know if this provides value to anyone who's listening, but this is the complexity that I'm dealing with realizing that both and can be lonely and need to hold on to the couple of tenants that show that this is the truth of what we need to hold on to. And by really advocating every week about the pandemic and measures that we need to take does not mean we're relegating. All the other things to the backseat, the suicides, the depression, women being forced out of their careers because they have to take care of young children that has nothing to do with that. It's that hard and difficult ground of both and, and seeing casualties on both sides. Right. But still doing the best pull the common. Good. That's good. Start you since. Any, any, any, any, any any anecdotes?
Stephen Kissler:No, I think that's great. I think there's you know, what that made me think of was the I watched this great videos this conversation about civil discourse that was, that was hosted by St Tom's up in Boulder. And it was great because this great scholar w what really spoke to me about what you were saying, and the entire conversation is really worth listening to, but one of the things that really struck me was just. The bearing of Cornell West and how he would always sort of compliment and affirm the other person who he was speaking with before he ever said anything about his own, you know, no matter who it was, no matter what the question was like, he would always like say, you know, like that was, you know, that was really insightful. And I learned something from what you just said, and I really appreciate what you had to say, and here's here, here's what I have to respond. And I think that was really powerful to me because I think it can be so easy to, you know, I also really Try to grapple with the truth and, and want to make sure that I'm grappling with the truth and community as well. But I think that too narrow of a focus on, on on just getting towards the right answer can, can make us forget the people that we're trying to get to the right answer with and can make those conversations really jagged and harsh and difficult in ways that they don't need to be. And I think really maintaining that proper ordering of, you know, the really the ultimate end are. Our people, right. And that's everything we're talking about. You know, we're trying to make sure that people stay alive and healthy from COVID. We're trying to make sure that they stay, you know, mentally and spiritually well throughout all of this. And, and that's the goal. And we're trying to do that on a societal level. And we're also trying to do that within our individual communities, with the people we interact with every day. And so there's a certain, you know, I, and I I'm accusing myself of this. There's a certain hypocrisy that can come with, you know, really trying to get these societal problems worked out, but then forgetting that, you know, we're speaking with another human being who also, you know, has had a really rough day and is struggling with their own mental and spiritual and physical problems. And if we don't attend to those firsts, we can never attend to the broader societal problems. So I've been thinking a lot about those things too, and I appreciate you sharing that. And so, yeah, I think I've been trying to communicate with people here, you know, with U2 about just like how to achieve that in our lives, because I think it's so important right now.
Matt Boettger:That's great. Thanks so much for San Stephen. I'll put that in the show notes. It was a great conversation. It really did change the way I think about things and it was phenomenal. So you have to watch it. I'll put it in the show notes and I think you just hit a hit a good point. Like before we talk about divides us. And this comes from the actual debate or not that it was a debate of the conversation. We have to really strive what connects us. And that's the first thing, like even Cornell West, the very end. We're just talking about like, come on, you can find something that you guys both have in common. Do you guys have a mama? Do you guys have a mama who loves you? Right. Start there. Right. Whatever it is, find that commonality and start with that bridge and build upon that. And I encourage everyone who's listening to the same thing to not start with the polemics. Right. But start with the connection. Cause more than anything, we're all starved for connection already. And so we don't need more polemics. Now we do need truth. We need to talk and dialogue, but let's start with pursuing, discovering what brings us together. So we get rid of the tribal mentality of like me against you, but that we're both. In for the same and the same common goal, Stephen, you just nailed it. We're here to support and love and bring people together and keep them healthy. So let's end on that note, find, discover the gift and the other person before he puts. What brings you in brings you in common with another, before you talk about what divides you, and then you can bring that truth with charity and love and compassion. Okay. Have a wonderful week. We'll see you next Monday. Take care. And bye-bye.