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Please Help Matt Honor Mark and Stephen for Helping Us Through This Pandemic
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!
Please Help Matt Honor Mark and Stephen for Helping Us Through This Pandemic
Things Discussed on Episode:
You are listening to the pandemic podcast. We equip you to live the most real life possible in the face of these crises. My name's Matt Boettger crime one. I'm joined with my good friend, Dr. Stephen Kistler. Now I really trust us that Dr. Mark Kissler still is alive. He hasn't been here for a while, but he's a lot of hospital duties, but we're always here with Stephen, which is so great. The, he is an epidemiologist at Harvard School of Public Health, and we're here to chat. How are you doing?
Stephen Kissler:Hey, I'm doing all right. How are you? Not
Matt Boettger:too shabby. I feel. Feel good because it's like past, mid, mid February, which for those of us in, in color in Colorado, at least from the K. All right. Let's just get Frank here. Like everybody has a different opinion about Colorado. It's wonderful. It's a great place. February sucks for me. I can just adjust it just so cool. It is rough. It's a rough time. So I know that we're over halfway through March down the horizon and there's some predictions. That we could have an early spring, which I'm excited about now, granted, but early spring, what do they mean by that? Because for those of you who have followed Colorado last summer, it was horrendous and really sad. And a lot of forest fires destroyed homes, even people's lives. You don't want that. I'm hoping for lots of precipitation in the form of rain. Rain not snow. So that's what I'm really, really looking forward to. So yeah. Oh yeah. One thing I wanted to mention, Stephen did this, Stephen dude, you've been a Twitter guy, but you haven't known about lists and now you know about lists. No, I know.
Stephen Kissler:And it's
Matt Boettger:yeah, they're great. Awesome. So Stephen's been awesome. He's congrat he made a little epidemiologist list on Twitter. So if you're a Twitter person I'll put it in the show notes where you can follow his recommendations. I've been doing it. It's awesome. It's fun to kind of look at it. See what's going on. The people he trusts and then can go find them in other places and subscribe to RSS feeds that kind of stuff. So check that in the show notes. Other things to be thinking about is leave a review. We love reviews, got another, a couple of ones that just are thankful for what we do, and we're thankful that we're able to do it. And I'm really thankful I get to hang out with Stephen and Mark. So if you, if you would feel the same way, please write a review you know, just give us whatever fair writing you think it is. It helps us kind of up the rankings. Let this be more available to more people. And if you wanna support us as little as$5 a month, it goes a long way. Ways, pandemic sorry, patrion.com/benjamin podcast, or just a one-time payment all in the show notes. Oh, Hey, this is big news to Stephen and that is next week is what it is. It's like our anniversary, Stephen and ours is the anniversary. We're not going to think that the pandemic, right. This is awesome. So isn't it crazy how time flies?
Stephen Kissler:It is pretty crazy. Yeah. I can't believe that. I remember. Yeah. Still getting that phone call from, from you suggesting this thing in the first place. And gosh boy, I can't believe
Matt Boettger:it's been a year. I know it has been a one wild ride. And so we're, we want to make this an important one, so please, please, please join us if you want to live. Or you can listen to podcasts. So we're going to stream live next Monday, early in the morning, and by seven, 15:00 AM mountain standard time. So you're in California. Sorry about that. But if you're going East a little bit more accessible, we'd love for you to join us. So it's gonna be a podcast, could be recorded. We're going to release it. There's going to be surprises that Stephen and Mark don't know about just going to be fun. And we're going to reflect for about an hour about the whole year what's been going on what we've learned from it, some fun surprises, and we're trying to make this stream available publicly. So usually it's behind those who support us. We're going to put it on the pandemic podcast, Facebook group, the public one. So check us out like. That group find it. We'll put it in the show notes, then you can join us and hang out and make comments and send good wishes to Stephen and Mark. We'll put them on the stream as well. And I'm going to try if I can put it on YouTube as well. Streaming cause some people aren't Facebook people, they're just like, ah, I don't want to be a Facebook groupie and I get it. I totally get it. So if you're a YouTuber. We'll see if we can stream it on that as well. So stay tuned in the show notes. Okay. I think that's all the good stuff. Okay. I have a question for you, Steve, and I didn't ask you off, off there. So let me know if this is totally blindsiding you. I got this information from some family members yesterday, and this happens, you know, misinformation, or maybe I'm the one who's misinformed. But two separate family members came to us in one way or another indirectly saying we heard the vaccine only lasts three months and I'm like, okay. Two separate family members. I don't know how they got his information. So I looked it all up. I couldn't find anything with even the phrase three months in it. Do you know anything about this whatsoever or a relationship to the three months?
Stephen Kissler:Yeah. You know, I haven't heard anything like that. Information going around I. W what my guess is, is that so early on when there were a lot of questions about reinfection from after you've been infected with like, actually. Properly infected with coronavirus. There was some speculation that the immunity on the last round three months as well, and that was based on basically studies where, where people would take blood and measure the amount of antibodies that you had. And they showed that that declined quite a bit over the level of three months. But that gets back into the conversations that we've had about B-cell immunity versus T-cell immunity. Where for these Corona viruses, usually your B cell immunity does decline pretty quickly, but it's, but it's your T cells that are giving you the long lasting response. And so in some ways it's like my guess is that it's just the immune system behaving as it should. And people are seeing it. That's a drop-off of one of the arms of the immune response, but that's what it does. The B-cell immunity always declines, no matter what the challenges, whether it's it's a vaccine or a virus or whatever And sometimes you sort of level out with different levels of B cells in your blood, depending on the pathogen. And it seems like for Corona viruses that, that drops off quite a bit, but the T cells are still there and those are harder to measure. And it seems there've actually been some recent studies that show that those T cell responses remained robust and people who have been vaccinated for at least as long as we've had the vaccine, which. Again, it's not that long at this point. Right. We've, we've only had it for a couple of months, so we can only really measure it out that far, but, but it still seems like it's, it's providing decent protection. And again, the other thing is like, what, what do we mean by protection as well? You know, there are different types of protection where maybe for the first few months, you're even, you know, six months a year, maybe you're completely protected from. Any type of disease, but maybe after that you're protected from severe disease, but you might get a cold of some sort. And so that's, you know, there's a whole spectrum here that we need to pay attention to. But from everything that I've seen that, that immunity ought to last at least three months. And I would guess
Matt Boettger:good. I assume that I was thinking, how do I. How do I reverse engineer this? How could they get it to first? I thought was maybe the whole, like misinformation of media where like, Hey, T-cells drop off for three months. Oh no, but not realizing that's normal or, or it could have been other, my other theory was it actually has been only three months since we've had the vaccine out. So it's like, Hey, so far so good. It's been three months, you know, I have no idea, but I I'll, you know what I tried to tell them is that. At least for what we know that natural immunity seems the lastly six months, if not longer. And the research seems to be that especially Pfizer and Medina boosts such an incredible response that it's pro it most likely surpasses natural immunity, which means, okay, so we've, we've got some good protection for awhile to match. Okay. Great. Just wanted to clear that up, make sure we're on the right path here and misinformation even a year after is still out there. So I'm glad we can still keep going to put some clarity to things let's not talk about COVID for about 10 minutes or let's do talk about COVID. But in relationship to this article I saw last week, I think it was maybe just over a week ago. Ebola has re-emerged in Africa. So of course now I've been doing this for a while. I see these articles go out and this is happening. This is happening. And so now I've said a little more, like instead of being reactionary, I'm like, is this sensationalism or is this a real thing? Well, I'm thankful I'm an epidemiologist my back pocket. So what's going on with Ebola in Africa. And what's the relationship between this and the w between COVID.
Stephen Kissler:Yeah. So, I mean, this is a very real thing. It's there is, there is an Ebola outbreak sort of centered in Guinea. Okay. At the moment there haven't been a huge number of detected cases so far. I think that as of last week it was, it was still just a handful. But it's still a concern because These outbreaks over the last decade or so have, have shown the ability to really spread widely and cause a lot of illness and a lot of deaths. So a brief history of Ebola over the last decade or so is I think it was in 2014 that there was sort of the first major outbreak of Ebola in West Africa which was really surprising because we had seen Ebola outbreaks in other parts of the continent. Before, but this was, this was pretty far away from where we had seen major outbreaks of Ebola before. And it was, it was the largest one that we've seen to date really difficult to get control of. Managed to though. And it really through the, the, the immense efforts and sacrifices of of the local health leaders really, you know, they were, they were the ones who managed to get control of the epidemic. And a Bulla is such a, such a complex illness because it has so many intersections between cultural practices since it's. One of the primary routes of transmission is through contact with. With dead bodies of people who have died from Ebola. So it it really made faith practices and burial practices difficult and dangerous. And so there's this really, you know, complex intersection between culture and illness and disease. And and so it was an incredibly difficult difficult time difficult epidemic. So they over time managed to get control of that epidemic and have basically eradicated it. And then there was another major Ebola outbreak. I think it was a couple of years back in the Democratic Republic of the Congo. My, my timeline is getting a little bit fuzzy because COVID has completely messed with my sense of time. So, so I'm trying to place exactly when this happened, but anyway I think not too long ago. That was also recently just declared over and now we're seeing it sort of rear its ugly head again. Yeah. And another part of the continent again. So important to pay attention to because this is you know, Ebola is, is really a severe illness and Cannes has shown that it has the ability to spread widely And and so, so, so worth paying attention to, but also a lot of reasons why I think that this is not something that is like something that we need to be. Mindful of, but well let me let me say sort of what I anticipate happening. So Ebola differs from COVID and a lot of really important ways. One of which is that it is unlike COVID, which you can spread before you show symptoms. Really Ebola is spread through very close, direct contact with the bodily fluids of an infected person. And they're by far the most transmissible after they're showing those symptoms that are pretty clear, Okay. So in one sense, it's, it's easier to manage that way. But that's not to say that it's easy in any means the reproduction number is not very high. It's a little above one as far as we know. But again, it, it requires relatively close contact with an infected and an infectious person. And so that was one of the things that really made COVID a pandemic illness very quickly was that people are able to spread it in the absence of it before they show symptoms. And that was, you know, I think that far and away above almost all other factors has made it so difficult to control. So in the 2014 Ebola outbreak in in the West African countries, we saw a couple of cases of Ebola outside of that part of the world, but not many. And that, and this is part of why is because it's while you know, while it can very much spread and, and clearly it has a propensity to cause major outbreaks as it did at that time. It's it's just a little bit easier to detect. And so that sort of helps prevent it from spilling over into different geographic locations like COVID did. And then in addition, and this, I think is the biggest thing is that with, with COVID, we, we were really caught unawares. You know, we, there, there was a thought that we might have a coronavirus pandemic, but we were really thinking about flu. We were really sort of You know, w we didn't have the testing capacity. There was just a lot. And, and it was a new virus. It was something that we hadn't seen before I bullet is something that we, as a world and particularly the countries in the African continent have dealt with a lot, and they've built up a lot of infrastructure in the meantime to prevent and to stop the spread of Ebola. There is And Ebola vaccine, there, there is a vaccine that is available and so that's being deployed and that's really helping to reduce cases as well. So there's just like a lot of knowledge, a lot of sort of local knowledge, a lot of You know, integration with with the local health authorities to try to prevent the spread of this illness. So while it is a concerning and emerging infectious disease, it's different on a lot of levels. And so absolutely something that I think that the countries that are being affected right now and need the support of the world right now because. It can spiral out of hand very quickly. But I think that it's just going to be quite a different sort of thing than COVID and I don't expect it to cause sort of this worldwide pandemic phenomenon.
Matt Boettger:It's so weird being, hearing you talk about this post COVID because you talked about how it's passed through saliva or like, you know, we're drinking. I'm like, Oh, this is nothing I have no great. It's it's, it's something big, but just such in a world of COVID where the spreads, I feel like at the drop of a hat and by just by ear, you feel like it's almost like Harry Potter ish by like, like just operates next week for, by someone just somehow just leeches onto you, you know? And then hearing this, like still serious, still needs to be taken and, and definitely really helping the local communities in Africa to get it under control, but just feels like okay. After COVID I feel okay. It's based what I'm saying is if there wasn't COVID I think I would, I would add a little bit of hair. See on the, on the back, on my, on my back right now. Now with this and like, Oh, okay. It's it's manageable. We can, we can set of control. So it's weird perspectives. But good. We'll keep you keep an eye on it. I had no idea there was a vaccine for Ebola. That's how out of it? Yeah, that's great. That's awesome. Well, heading back to COVID, you know, we, I think just this morning, I think we reached over 500 deaths of COVID here in the U S I just want to quick get an update of where you think we're at right now. What you're talking with your colleagues about. The spread, the strains, the U S I mean, rates continue to fall to my knowledge. It didn't check this morning. Things seem to be looking good. Is that kind of the temperature that you guys are kind of looking at as well over there in Harvard?
Stephen Kissler:Yeah. I mean, again, there's think you said it's just this very complex situation, right? Like cases are just plummeting at a rate that they haven't plummeted before. So there is a vaccine uptake is going up. So on the one hand, there's a lot of hope, but then you're right. We just like crossed this milestone. Half a million deaths and we have these new variants emerging, some of which are more contagious, some of which are able to escape some level of immunity. And so there's, there's like this really odd mix of like a lot of hope. I mean, I'm, I'm feeling a lot more hope. These last week or two than I've felt probably since the start of the pandemic, but also there's, there's this real concern too. So it's like this really weird mix of these intense sort of emotions and also just sort of like mentally trying to be prepared for whatever might come next. So, and, and that really, I think has sort of the pulse of, of many of my colleagues too, where we're, we're hopeful. We're sort of like cautiously, very optimistic about the direction things are heading. I bet again, you know, it's None of these, none of these victories are necessarily permanent. And as epidemiologists, it's kind of our job to always sort of be on guard for the next thing. And so we're trying to pay as much attention as we can to the variants. You know, they're, they're continuing to spread. We are having more cases of the. The which is the UK variant. That's been spreading in different places. And some have detected strains with our variants, with the mutations that can potentially escape from immunity. And again, it's like, it's probably not a complete escape from immunity. Chances are, if you've been infected before you have less likelihood of severe illness, but like it's, it's a complex story. Right. And it's, each of these is going to make it a little bit harder to get control. So yeah, we're hopeful. Generally the outlook looks good for the next little while, but. You know, it's there's there, there's still a lot that we need to pay attention to. And we're, we're not totally out of the woods yet,
Matt Boettger:you know, I have you seen like where the places where the variants are kind of surfacing or becoming more prevalent? Are we seeing any indicator that also we're seeing increases of infection in those local communities or. Has it still been at a place where yeah, it's still growing, but we haven't seen those communities grow disproportionately in their infections. Any, any
Stephen Kissler:pattern? Yeah. Right now it doesn't seem like the variants are causing Major spikes in new illnesses. So, so there was recently this paper, I think that we linked to in the last show notes, but I can't remember, but it was looking at the prevalence of this variant across different States and part of the issue. You know, we, we are, are doing a ton of genetic testing and so it, for many States, it's hard to get a sense of how much is there at all. But two of the States that are both doing a lot of testing and have really seen increases in the number of cases that are caused by the enter California and Florida, but that's measuring the proportion of tests that are due to that strain due to that variant. Sorry, I'm trying, I'm keep correcting myself because generally when we're thinking about strain, that's something that's like a lot more distantly related. We have like, A couple of different strains of Corona viruses, but that's like SARS one versus SARS two versus the ones that cause the common cold and these variants are, it's a more proper term to call it a variant because it's a very minor substitution. So I keep correcting myself, even though strain is the thing that I always sort of go back to. So that's, that's what I do. Anyway, these variants, so they're causing more and more on a per test basis. We're seeing a higher likelihood that you're going to be infected with versus one of the versus the old original. SARS cov two variant. But but so far we haven't seen like major spikes in the total number of cases. So even though it's making up a higher proportion of the cases, the total number of cases, generally in those places is either going down or staying flat now. Okay. There's no guarantee that that will continue. And of course, if, if the, if the variant is starting to. Make up a higher proportion than it's probably just a matter of time before it starts causing more and more cases. But of course, that's going to be counterbalanced by the fact that we're entering into the summer, by the fact that more and more people are getting vaccinated. So there's a lot of different sort of forces going on here, both keeping cases down. And so there's kind of a fight going on and it's just sort of a matter of time to see which of those forces wins out. Yep.
Matt Boettger:Okay, that's helpful. I'm just going to ask you the follow up question, but I think you answered that as well, but that's the fight that's going on among the vaccine. That's my own internal fight right now where we've talked about this week. I think the past two or three weeks where it's harder now, I think in some sense, because. There is a in at least in some areas, a much more lax approach and two, cause every case they're just plummeting. So it just feels like, it feels so weird. Like I'm wearing my mask, trying to be cautious. Then other people look at me like, what are you doing, man? Like, it's, it's you're we're on the way down. It's just, it's a weird spot. To be in, because you just don't know in three weeks, from now a month from now, it could be worse or it could be better. But I think this, as you said, over and over and over, and it's just the right thing, stay vigilant, not like hyperreactive or wearing 5,000 masks or your face where you got like a big, you know, dog nose, but it just do your normal thing and stay vigilant. And you know, we're, we're getting closer and closer to the summer and more vaccines rolling out. And it's great news. So keep hopeful. A couple other things here, just this, a couple of just pieces of information I read here for those of you who have asthma that I guess early on, there was a, there was a sense by which there was a fear that maybe COVID would have a pretty significant impact on those who suffer from asthma and a test came back or recess came back saying that looks about the same, whether you have asthma or not, the impact is the same. So good news for those people who were struggling with asthma right now, a couple of other things just to put on it. But just in the show notes for those of you who are looking in a mask and keeping mask, there was a great two articles. I put five places to buy in 95 mass. They're actually legit. And not like you can, you can, you can trust that. They're good. They're real masks. And then I found another article up in the show notes. It was really nice. Just the seven best disposable face masks. So I'll put that, I'll put that in the show notes as well. But going on to vaccines, a couple of things, information, awesome news, just a single shot of Pfizer's 85% effective, which is pretty phenomenal. I'm sure that puts a, puts a wrench in things maybe not. I know there's been a big. Like fight going back and forth about whether do we do both vaccines or we just do one census research. Stephen, I'm curious. Has there been any more information of like, Oh, 85% effective? Maybe we should just do one and let it the rest, or is it still kind of. You guys are still thinking of like the best alternative, the best option is still to remain committed to the double vaccine.
Stephen Kissler:Yeah. So the way that I've sort of interpreted that evidence is first that it's very good news. You know, we're, we're in a way, very fortunate that that a single dose is that effective. I would, I would say that the best thing to do is to continue on with the two dose series and the main thing. I mean, again From the very start sort of the way that I've been in my colleagues have been thinking about this, which is the way that many vaccines are, is that oftentimes a single dose of a vaccine is very effective, but the immunity doesn't last as long. So really the first dose is to sort of build up your immunity. And then the second is, is a booster. You know, we think about booster shots all the time. And that is to make sure that that immunity lasts. So as long as possible ideally longer than three months. And you know, I, and I think that that, that second shot is going to be the thing that is going to keep the immunity going for a longer period of time. So we really should be getting both doses as far as we know, you know, that's, that's the thing that has been studied. That's the thing that has most of the evidence behind it. There are ongoing trials that are looking at what happens. If a person just gets one dose and only gets one dose. And I think, you know, again, the good thing is that a single dose does seem to be pretty effective, but it's unlikely that that effectiveness will last as long as the effectiveness will last for the two doses. So two doses are probably important. But definitely good news that one gives you that level of protection, because that means that we're just getting closer and closer to you know, just preventing illness faster have to wait for that second dose to get some pretty immediate benefits from vaccination, which is a really good thing. Yeah,
Matt Boettger:A couple of things I saw here just to put on the, on the docket, the Pfizer vaccine does it need ultra cold storage? So that's a huge, I think big step. Trials continue for pregnant women just started for V for trials for that. So that's pretty pretty, I, this is crazy. This is crazy stuff. Thinking about like. I just realized how complicated vaccine testing is like, who's going to be the one that yeah, sure. I'm pregnant. Yeah. I'll, I'll, I'll, you know, quote, I'm gonna put it in quotations, risk my child for the sake of, I mean, the people that do this that's profound and they, they deserve some kind of award. I'm not quite sure. And then on top of that, I obviously didn't never thought about Stephen were kids and you have to go through these trials. And how does that work? I mean, they're not 18. They technically speaking. They don't, they don't get to say yes, but do you know, like, do you have any information back how that works? I'm sure there has to be some consent with a child. You just can't throw ownership by like, Hey, you're going son. I don't care what you think. How does that work? When it comes to the ethics of this? Yeah.
Stephen Kissler:It's, you know, that's, that's something that I should look into and maybe we can talk about more next time because I, I, I'm not sure how the ethics work on pediatric vaccine trials. There, there is some level of consent, but of course, like with some vaccines that need to be given when, you know, a child hasn't learned to speak yet, right. Like they, they nevertheless need to be tested in those populations. Right. And so of course requires the consent of the parent or guardian But it's, it's tricky. And, and, and that, that's part of why we haven't approved the vaccines in kids yet because the the, the, the difficulty and complexity of running the trials in those populations where consent is a lot murkier it's just really difficult. It takes a lot longer. It takes a lot more resources. And in many ways, fortunately, with COVID those populations, aren't the ones that are most effected. You know, if this, if the mortality curve was completely switched and this, you know, was really just mostly a severe illness for people under the age of 18. Yeah. You can bet that the vaccine trials would have been in those populations, but you know, it would have been a lot harder. So, yeah, I'll put in a
Matt Boettger:show notes. There was a, an article by O net archivist in CNN. There was just interviewing of a child who, who opted in to be one of the participants. And it was just amazing to hear him and his father talk about it and how they kind of negotiate and talked about the options and the risks and gave, gave the boy the opportunity. I mean, it wasn't forced to, and then he really wanted to be a part of it. So it was really cool. So I'll put that in the show notes for you. Remember that as well. Pfizer vaccine stops. COVID 19 spread is really study. I know we talked to before, but another one came up. I'm guessing this is more good information that, Hey, we're looking like it does help to prevent the spread. Once you get the vaccine, that kind of what, what the gist is.
Stephen Kissler:Yeah, that, that seems to be, which is great news and is, you know, not, not unexpected, although the number of like how, how much it reduces transmission. We were still not really sure about you know, there's as with everything, there's still some complexity, but, but the bottom line is that this is really good news. And so, you know, the re the reason this is coming out of. Israel. It was, of course, because they've they're the country with basically the highest vaccination rates to date. So they're the ones that can really study this in a rigorous way. And it does look like the Pfizer vaccine, which is they've primarily used the Pfizer vaccine in that country. It seems to be highly effective against blocking transmission. And so I think we can anticipate that the maternal vaccine is as well, and we'll have to continue these studies with the others. You know, just to make sure now again, okay. Variants, what are they going to do? We don't know, you know, they, they can cause infection. And so we can think about too. We can think about vaccines. There are different ways that they can prevent the spread of illness. Part of the question is, do they block me from getting infected or do they block me from. Spreading it or both, probably both, but to what extent the nuances there don't matter too much to individual people, but when we're thinking about how this is going to work on a population scale, that actually matters quite a bit into how the models end up behaving. So that's something that we're going to need a little bit more information about, but the key thing is that it looks like they're, you know, for whatever measure they were using for the reduction in transmission, it was like on the order of 90%, which is, gosh, Pretty good. Phenomenal.
Matt Boettger:And I want to talk more about that in just a second about, because I'm apparently up for my vaccine soon, which I had no idea I'm really excited about. I was kind of following Boulder County and their kind of recommendations and their tears, and I checked it again and I think it was like one B or to be some like that. It's still the winter phase, which is great. And it's the last one. And it said faith leaders and they're like, Oh my gosh, I I'm in that ballpark. So I think I wanna have the opportunity next week or two. So now it's in the forefront of my mind. So it's coming up. I'm not nervous at all. I'm like super excited. I mean, call me in. I'm really excited, but but I want to talk about what do we do once we get the vaccine what's considered okay. What's going to not okay. Before we do that and we'll do one another PSA just for people about vaccines. There've been more and more studies done and we see in a news of reactions happening deaths happening, you know, Shortly thereafter the vaccine, but just rest assured all the research is showing that the at least comes to the reactions. It's just follows the same statistic, a paradigm of any other vaccines, super, super rare. And none of the deaths, none of the deaths have been contributed, had been shown to be attributed from the vaccine itself. Again, when you have this many million of doses being given out a coincidence is going to happen. And not that you're going to default to that, right. We want to know what really happened. But rest assured is when encouraged people, when it's your turn. To just do this because for me, I mean, it started off just being, well, I want to be there for my mother-in-law. I wouldn't do it for my own for protecting other people. But now hearing about the variants and learning more about how with variants there's, they're there with, with less people in vaccine and there's more room for variants to surface. And then the last thing we want is to have a variant that just doesn't work. All with the vaccine. Right. And so then we'll quicker. We can get vaccinated the better it's going to be. So just wanted to put that out there. Let's let's talk about this now, Stephen, if you have anything to say about this, about just. I'm going to be vaccinated soon and other people are vaccinated. Is it a free ticket to, you know, I'm hearing these things like, Oh, you know, Val Fowchee saying we could be married to worry and mask through, you know, up and through 2022, when this doesn't make sense to me, like what, you know, what should we expect once we get a vaccine? What are, what is our license and where should we still be careful at?
Stephen Kissler:Yeah, it's, it's really complex. And I think that it's something that You know, we're, we're still working out, you know, as, as epidemiologists, as just members of society as a whole. And I think that it's a thing that You know, reasonable people can disagree to some extent on as well. You know, so I, I don't claim to have any like hard and fast rules for what one can and can't do when you have the vaccine, but I can sort of speak from from the place of, you know, what I, what I know about the vaccines and and maybe talk about the different axes that I'm considering this question on. So, of course, you know, we're getting this new information that the vaccines seem to be very effective at reducing transmission, which is great. As I said, we don't know the extent to which that's true for the variants. We don't know how long that lasts necessarily. And so especially if you've been vaccinated, but are around other people who may not have been vaccinated, it still makes a lot of sense to be wearing a mask, for example Again, because it helps just prevent you from spreading disease in case, you know, the vaccine wasn't particularly effective in you. If your body didn't Mount a good immune response, you know, vaccines are 95% effective, but that means that 5%, you know, you can still write like this, it's not a hundred. And and so and you also don't necessarily know the situation that the people around you, what sorts of co-morbidities they might have or who they might be taken care of. So from a sort of like a public perspective, I think it still makes a lot of sense until we really bring cases down. In the population to still sort of go about assuming that I could be infectious. Now, now that doesn't mean sort of be like, you know, the, that the vaccine doesn't do anything for you. You know, I, I do think that you can confidently I'd probably do a little bit more out of the house than you normally would. And you know, volunteer to I would hope, you know, like volunteering to help other people who don't have the vaccine yet, who might be having trouble getting groceries or getting medicines or things like that. Like this is another time to really help out the people who haven't gotten it yet, but who might really need it. And you know, like the vaccine, like it's. It's great. It's really effective. And, and, and as, as people are getting vaccinated, you know, I, I think that it is pretty safe to gather with people who have been vaccinated. And you know, if everybody in the room has been vaccinated, the risk of anybody getting severely ill is very, very low. So I think we could start going about those kinds of things, but yeah. It's important to do it, you know, again, sort of cautiously really, you know, just like at the beginning of the pandemic, really communicating about our different levels of risk, what everybody else wants, what their situation is, whether or not they've been vaccinated, what they're comfortable with and really trying to be mindful of that and consider it of that. Because again, like we said, last time, this is just a really complex time. And I think the best thing we can do is to just sort of be graceful and mindful of, of other people's. Preferences and risk tolerances and these kinds of things and, and negotiate it, but negotiate it in a loving way that sort of presumes each other's Goodwill as is the most important thing. The last thing I want to say here is too, is that I think that our, our role in society and the place in which we're being seen is really important as well. So for example, like you said, Matt, you're, you're a faith leader and I know many people who are teachers or who are doctors and they may have gotten the vaccine, but there's also, you know, as you know, Any sort of education or any sort of, you know, Mo modeling the behavior that you hope to see in others is really important. So even if you don't necessarily needs to be wearing a mask at all times, if you're in a position of authority, and if you're in trusted with the care of people who. Have not been vaccinated and who you expect and hope to be wearing masks and distancing, even out of a sense of just solidarity and modeling the right sort of behavior that you hope to model. I think that it makes a lot of sense to continue doing those things yourself and say like, look, I have this benefit of being vaccinated and in some areas of my life, That gives me certain freedoms that allows me to interact with people with less concerned. That allows me to have gatherings with friends. But when I'm here with you, when I'm having a conversation with my students, when I'm, you know, in my role as this person, who's responsible for the formation of, of other people. Yeah. I'm going to be with you. I'm not going to take advantage of this extra benefit that I have. And instead, I'm going to enter into this burden into the sacrifice that you're taking up willingly with you, and that tells you how much that I believe in you and your importance and your, you know, and, and what you're going through. And I really want to experience it with you, even if I have the option of not doing so. And I think that that's really important, especially for those of us who have authority on, on, on any level. And, and I think if we really think about it carefully, many of us do, even if it's in just our own families. But I think that that's another important thing to consider. Gosh,
Matt Boettger:that's, that's awesome. Stephen, that's a great way to end on this because that's exactly number one. When you get the vaccine, you don't have, it's not like on a, on a, on a sleeve. Or where people can see it. Right? So if you, you, you, yourself that benefits you and it benefits others, right? Hopefully we, we were getting better, better news about this, but people don't know this. And so if you're going out with strangers, I could easily, you know, there could be people out there I'm not vaccinated yet. And I could go. And somebody approaches me in confidence because they're vaccinated who, I don't know, just chats with me now. I'm nervous. I'm feeling little. So now it may affect my family now because they didn't tell me that they're vaccinated. So now we're going to like quarantine. So all these things happen. You don't know who it impacts. You don't know how they approach it. And so, you know, right away you were kind of showing some hesitation, like, yeah, like I get it. We're vaccine. This is really important. This is a really big news, but, but there's just so many caveats we don't know for sure. To what extent, how, you know. You could be the 5%. And not only that, but we don't know how exactly it transmits or doesn't transmit or on top of that, the variance, you know, six months from now, you might have a different message because maybe, you know, hopefully this never happens. Right. But maybe there's a variant that comes out of that. Doesn't affect over to. So now, now let's put that in the mix, right? So it's great news. It's awesome. News. I'm super excited. And then I think that last part helped me to realize that I'm still going to maintain my behavior. Not because. As some people who are close around me and people are people that I know think that I'm being forced to do something. It's some conspiracy. It's just, this is just another reason. Like, you know, they mock to like see vaccines and you still have to wear masks show. You know, it told you it's just some big political agenda to force you to like mindlessly do things. So that one day you'll mildly do something really, really stupid, which makes no sense to me whatsoever. But, but this is really. Real, and it is that principle of solidarity. What a great way to end on that note. I mean, that's just to be Houston general, right? Just good practice.
Stephen Kissler:I think so. Yeah. It's, you know, and I really want to emphasize it like the vaccine does it, it does give you certain freedoms, you know, it like it does allow you to. See people with less concern, you know, it's like it, and there are certain things, certain doors that the vaccine opens that you wouldn't likely have. Otherwise you don't have to wear masks probably as frequently. And, you know, amongst people who know your back, like it really does give you a lot of freedoms, but I think, you know, and this digs into a much deeper cultural issue, but like w with, with those freedoms comes a great deal of responsibility as well. And, and that's, I think that's the thing that we. That we need to pay attention to so enjoy, enjoy the freedoms, you know, and recognize them. And, and it it's great. Like it's great. You know, I, this is, this is what we've been working for the whole time is to, to, to open up these freedoms for people. Like that's, that's, that's been the whole, the whole goal this whole time. And so like, recognize that this is like a great, great gift and like, enjoy it. Like. And but use it, use it mindfully and and be aware of it. So, yeah.
Matt Boettger:Yeah. And to two quick things, one of the question, have you, you, that might, you might need to get an answer to, but number one, it does open freedom for me, because for example, when my mother-in-law gets a vaccine, it's an open door. I mean, once, I mean, once she gets a second round yeah. That's a clear open door for, even if I didn't have the vaccine that I I'm going to be able to see her and we're going to have the kids be with her. I mean, that's a huge opener that we can do safely. Now when I get the vaccine on top of that, just ups the ante. So there's tons of open doors happening at the same time. We're at a particular point in time by which we still have to be used some caution, which is my final question to you. And that, is there a particular number by which we can look at that one rates fall about below? We can start saying, okay, now we're, we've really got a grip on this. I know that I know early in April, We're talking about a number of cases per million or cases per thousand, that if we can generally get to this, we pretty much figured, like we got a good hold on. It. What's that, is there a number that we can aim towards or not
Stephen Kissler:really? Yeah. It's I mean, I think, I think so. I just don't know what it is yet, but that's a really good point and it's something we'll be, we'll be thinking about. I will probably conceptualize it in terms of, you know, relative risks. Like there are all sorts of risks, risky things that we do and engage in, but do so because there are other benefits that come along with those behaviors, whether it be getting into a car or. You know, what, what have you, like everything carries some level of risk. And so part of it is just sort of really trying to think through and say like, you know, what, what are the risks that, that COVID poses both to the individual and to the society. And once it reaches a level that's sort of on par with some of those other things, whereas the benefits sort of also match up with the benefits you can get then th then I think we can start thinking about that. So it's, it's an epidemiological consideration. It's also a social consideration. It's there are a lot of different levels to consider it here. But we should be able to get to a point where there's at least a certain sort of range of a target target set of numbers that that we can really start sort of relaxing some of these things.
Matt Boettger:And another big PSA is that it won't be like TSA. At the, at the, at the, at the airport where like you go there every time and they always announced, it's been recently, it changed to orange tickets always, or just never it never below. It's like, it's, it's like, it's, it's never not orange. Why do you tell me it's recently changed? Like, there's hope it's not good. It'd be TSA where you're permanently at the status of orange by which there's going to be a time by which w as it continues to ease. We see a wonderful future ahead of us. The vaccine is rolling out. I'm super excited. I'll report back when I get it, when I get it. My, my, get it scheduled. So we're pulling back then. Well, that's closest up. I'm excited for next week. Next Monday 7:15 AM. Mountain standard time. Join us live. As we stream it on as many broadcasts, we can, there's some fun things coming on. We're going to reflect with Stephen Marks. There's an, there's not going to be too much news on that one and less. There's something that big, that comes up that we have to talk about. That's going to be a time to reflect. Maybe I'll try to get a snippet from our first episode, throw it in there when we were young and green, not know we're doing it, we're just so much more mature now, but I think it's gonna be fun to play a couple episodes or like a couple of snippets of it, of when we're talking about the cases. Cause it's just such a radically different reality. We know. So that's going to be mind blowing and it's just show, put things in perspective of how things, how quickly things escalated in one year. So anyway, that's it for it. Have a wonderful week. We'll see you all next. Monday, 7:15 AM. If you wanna join us streaming, otherwise you can wait for it to come out shortly thereafter, have a wonderful, wonderful week and we will see you next Monday. Take care and bye-bye