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on all the various problems that we are encountering, the vaccines and all the different things and he gave a very enlightened depiction of of what's going on and description of, what's happening and what we are look forward to, but we're we're gonna encounter in and what can be done to really to mitigate all these issues are really enjoy talked to him and I hope you enjoy as well. Please

Welcome Nicholas Christophe will gain experience. You gotta discards. Lately I did so by October and during the month of October no drinking they're all start smoking cigars pointed to sober October work for Europe. Do it every year tonight's will reset it's interesting. Do not worry not. I have another friend of mine who stopped drinking altogether, and I he said that it was making him cranky when he was drinking and, of course, are extra calories agenda. I look,

impatiently, to him and thought I would love to do that, but at the same time, it's too hard to give up completely. So I enjoy a glass of wine with a meal that that I missed the most that that was the worst when I was having a stake in the sector like ice glass of red wine right now, but other than that, I don't drink much, I'm not much, but much of a boozer, although, when November kicks in I know I can drink again is usually a few days of access which is speaking on the subject of covert nineteen. The current pandemic weren't That's not a good thing. There's a lot of people out there destroying our immune systems. Drinking is a very funny video that I found on line of this gentleman who runs on his neighborhood, and he noticed that, during the lock down, he would run around his neighborhood and he would see the recyclable bins and they were just filled with empty alcohol. Container. She's like this is crazy. This is for the week like how much these people drink unjust vodka and wine, and

there's a lot of that. No one on young people have actually looked a little bit that alcohol consumption and it's a little bit like the toilet paper shore. a guy. You follow the whole time ever. Shortage thing will work. Happening is there's a shift in consumption. Your lot of drinking that was taking place in restaurants- and you know it at the bars- is now taking place at home. So I think it's like half in half like have to consumption in the past was at home, Half was out of the home, and now it's almost all at home, which is part of it, but I also think is you're suggesting the actual amount is going up to so so yes, it's you know it's contributing to weight, gain and other problems in our society. The toilet paper thing doesn't easy fixed for this folks. That way better, and I hate to do this to plug a sponsor, but it's a good sponsor the sponsor called touchy and till she may so the day attachment that disputes onto a regular toilet and it cleans your, but that only seventy nine bucks and it's it's fantastic? It cleans

but so much better than just toilet paper, and here it cuts. Your toilet paper concern, should have data like eighty five, I've. Ninety percent, because I just need a little bit patrol people to pack your but Dr Jerry, use one of those big day attachments well by Greece. There not uncommon dubbed the day so narrow in this. I why of course, I'm familiar with them, but we don't I have one here, but you can't, you should go You should get one tat, so much better. We may we may in fact use so, I can't believe we ve covered alcohol in the days. So let's talk about this, how did you what what made you decide to write a book under the current pandemic in the disease? Well, I mean for me it started, I was reading news reports in January by what was happening in China, but I wasn't paying ton of attention and then

have? These are chinese colleagues with whom I have been doing research for a long time and they contacted me, the middle of January we had been using phone data in China to study how earthquakes, for example, change you social interactions after an earthquake. Putting people call- and we could imagine that the first person who calls were important to you, for instance, in so we could use the phone data up studies. Social interactions, and so we decided to the phone data to study the pandemic and dumb and to study the movement of people China, I've how they might carry the virus with them, which started in MILAN in November, sometime and on end and then we noticed, or I signed the data that on January twenty for the Chinese were concerned with a virus that they basically deadened It is a social nuclear weapon and they put nine and thirty million people, almost a billion people your home confinement,

starting January. Twenty fourth I could see that in the data and that really gotten because your motion ceased people start moving in the whole country and that that really got my attention and as I got worried and it was clear to me that this was gonna, be a serious global pandemic, and so I began to redirect the Devotees of my laboratory at Yale to study mourn or about about what is happening with this virus, and we did a whole bunch of projects, some of which infringe did we can talk about? We release this app called who nada age you and a l, a who knowledge, which you can get thousands of people use it. Now. It's like it's like These four corona virus. It's it's, not a contact tracing out that looks backwards. It it crowd sources, information about who you are connected to things I study is networks and where you live and forecasts your rest, so people,

on the road from your reporting, a traffic jam or a cop, and you can exit the high when avoid that and people. Your friend, friends, friends are reporting a fever. It can ripple back through the network in feed information to all anonymous. It's it's anonymize, its it doesnt term. Doesn't bored who is having what anyway and incidentally, temporarily access is your contacts, it we don't copy the contacts it doesnt copy them. it makes it easier for you to identify all your social connections are anyway. So we did that We got a whole bunch of other stuff which maybe we'll talk about, and so in the month of May ray as we are doing all this work. I was getting more and more worried and and that our nation was in preparing, and so in March I started sending out some twitter through. It's like epidemiology, one or one like basic stuff and allow those trying to go viral and and people were so hungry for information about. It became clear to me in a factual in for me,

about what was happening and then Marge my editor, my love For mandatory little brown, a woman by the name of Tracy, Bihar contacted me and said: would you like to write a book, and I thought yes and my motivation was that I wanted to help the american public understand what we were facing and I was very worried that people weren't taking this seriously enough, and so so that's why I wrote the book. I wrote the book because I thought this is something I know about. This is something I care about a care about our country. I didn't see our leaders- is doing the things they needed to do, and I just wanted to help people understand what was happening in and what was likely to happen. What would you think should have been done that wasn't? usually like in the January the month of January. It's when, Everyone was alluded to the fact this was going on in China. The wider

new everyone knew, but we didn't really lock anything down to March. What do you think I should have been done? Will, first of all that I people like me I knew this was going to be a serious global pandemic for sure by the end of January and the president. We now know, unsurprisingly was brief even earlier right, I mean if the president was it didn't, have more information than me. Then there's something wrong: some wrong in our country and but certainly by the end of January, when China lockdown as we discussed we should it, be done immediately preparing our testing capacity manufacturing ppp. We should have, I think, begun. Incredibly important challenge of preparing the nation for the challenge we would face like gearing up for a kind of war. You don't we about to be invaded by the virus. So public messaging would have been really important to tell people. You know where we're facing a common threat we're gonna have to endure. Some sacrifice: we're going

have to work together to repel this threat. Here's some basic in for me about the nature of the threat. So all these things are ventilators, for example, also another in you know, sort of material that we needed on preparing our hospital systems, for example, lost several months in which we didn't. We didn't really prepare an honestly, I don't understand why our leadership failed us in this way meet responsible for that, but then there was a theirs and also an issue where the pandemic response team that was in place for the previous administration was disbanded and sort of reassigned crap I dont know. Yes, I don't know all the details about that. I know it wasn't just the Obama administration, they inherited the pandemic response from the bushes Ministration and the CIA has been identifying emergent the pandemics as a serious national security threat for a number of decades. Now is actually discussing the book and, of course, people like Bill gates have been worse

about this Tony found. She was writing about this stuff when you and I an elementary school, so so there's a lot of institutional knowledge about the existence and nature of these threats and adapt I don't I don't know why they weren't. We want better prepared when we saw what was happening in China. What could have been done differently I mean obviously manufacturing of p p and all those things that that absolutely should have happened, and that would have actually avoided a very unfortunate thing that happened. Where found she actually telling people, they don't have to worry

asks. Young later admitted the reason why did that is causing didn't, want people rushing to get masks and that would take masks away from the first responders. That's a very, very unfortunate thing that he did because that eroded people's confidence in in what he sang it it it it it lets. You know that their people that are in positions of power like himself or positions of influence that will lie for the better good, but still yeah, so let's not so the details of the value statement, I honestly don't know I haven't done deeply to know exactly what he said and when I can read Praise for use on basics, however, about mass wearing early on. I actually put it on my my instagram, because it was so crazy when you, saying it was an interview that he did on television and he would say for the general public, you know you don't have to wear mass is on helping you in whose accessing it might be bad because you'd be mess around with it and touch your fate. So

so initially was a little bit initially. There was ostensibly some confusion about whether it was advantageous to wear, masks or not, is clearly advantageous its advantageous to the where its advantageous to others it it reduces the this. These stress on the system by if everyone were to wear masks and just to be very, very clear, its neighbourly, a wearing mask is like driving the speed limit or not. Driving on the opposite side of the road and its there's now abundant evidence on the benefits of mass wearing and furthermore, and then come back to your foul key issue, the the if we were to all as a nation wear masks and adopt some other basic things. It would allow to keep our economy running better in our schools, open other words. We can't have everything, there's a there's: a deadly virus. That's a foot! so we're gonna have to grow up and be mature, do something there are and comfortable and unpleasant and may even seem silly, but if we do those things we can. We can avoid

doing other worse things like shutting down our economy, but anyway, I stopped me for a second there. The analysis of this actually kind of important when p or wear masks ears like this is common argument against. It is that the virus particles are so small if you're, breathing in air and it's getting through gaps, your mask, the virus is gonna get through, but the The impact of having a mask the positive impact is that you're. If there is a map, some virus in the air or virus coming from you, it's gonna, be greatly reduced act like especially an ideology that I've mask in other two parts to what you're saying, first of all, rotten water molecules our infinitesimally small and their money smaller than the pores on the fabric of your umbrella browse stops the rain. Why is that? Well, it's that the water molecules heard coming down. His molecules are coming down in droplets, so even

the virus is very small, much bigger than a water molecule, but still very small, and you are right that the virus itself could go through the fabric of amassed. That's not what's happening. Droplets are coming of your mouth or are coming from someone else towards you anymore ask, is extremely effective at stopping droplets citizen hasn't it shown that the virus is also aerosol. Now, yes, there's also aerosol transmission and we can talk the two of you? Yes, let's talk about that, but before we move to that lets, you stay one more sentence on the droplets, which is that when you exhale think about how, if you wanted to, if you had a fire hose at your house and the water was sprang out of the fire hose and you had to different strategies. First burst: in the water, from landing on us or of your house one strategy, b run around with buckets and try to catch the water? Is it was landing from this arc of the fire hose

there would be two like put a kink at the end of the fire hose and stop the water from coming out in the first is one of the reasons at master, so effective, even homemade, handmaid masks forget the and ninety five, which is what I wanted to come back to is that they are like plugging a fire hose or a garden hose at the opening, its much more effective than trying to have someone. swear mask, for example, so you're wearing a mask Furthermore, in the case of quota vires, one of the big problems is people dont know if their sick, this particular job is very nasty it. You can transmit. before you have symptoms. So one of the reasons- people to wear masses- they don't know their transmitting the disease, its very efficient to stop the viral drop the droplets before they leave their mouth and from spread the others and when you, where mass you also protect yourself from inhaling droplets of other people, ninety. Five are more medical, great mass, even even better than the cloth master you communal by on the internet, but those

gonna use those effectively, you have to seal them around your face and use the men and you don't really need to use them. Those I you can, if you have them, there's nothing wrong with it, but you also don't but the ones with valves those don't really help you do. The vow ones are kind of silly Arthur. Yes, it doesn't that defeats the whole purpose it can do it. You're still here but yes, these are all relative- is now on the aerosol thing. What you're talking about is some other things You exhale from your body are little dried particles of end of viruses. That are suspended in the air, and these can go further distance and there in fact evidence of aerosol transmission, which is different than droplets, but go through the air, but droplets are big and all to the ground, whereas it's like it's like raindrops versus little particles of dust that can float in the air

for instance, and so there is aerosol transmission and and the mass that we use, don't necessarily stop that you'd need like an end. Ninety five mass well fitted to stop that, but the mask still help so I dont think there is a really good argument. I mean I wish we didn't have to wear masks. I mean I am I not unpleasant, but all the unpleasant things we could choose from doing enough. The choices to a close, the schools in my local community, or do I have everyone wear masks to me? That's in! Oh, yes, where it's pretty straightforward, simple, there's a great video online that I saw this morning of a guy who held up a lighter and he used a bandanna for first and he blew through the bandanna and put out them back the lighter and then he put on a cloth mask and it was hard to blow through

he did it and put out the lack of any put on and ninety five and it didn't do a damn thing, but our a surgical mask just wiggled the flame. A little bit couldn't put it out so just shows the difference in quality the man. Yes, my doctor does not recommend bandanas, who saying don't wear that he's like please, it barely stops anything and if you want, if you gonna, where something please, where a mask and address ask yes, although it and I would say that something is better than nothing and the other things that one of the things I think he's gonna come up. Conversation and we Mysell tackle it. Now I was trying to think of like while I was trying to think of sort of general principles that are relevant hears. there is no in a time of a deadly congestion, contagion, Joe there's no life without risk and many people are used to this leads to thinking about risking their lives with many are not. I think what I would like people my is that there, the world has changed there is a new virus. That's entered our species, it's not going to go away.

It's gonna be with us forever and we have to personal, except that second, take steps to address it and third recognise that no single step is perfect. Even a vaccine is not perfect, so everything is shades of gray and degrees of rape. so, for example, even the fourteen day, quarantine rule, that's just a statistical distribution. Two point: five percent of people are still infectious after fourteen days, we just cut it off it. Today's because it will almost everyone can spread the virus anymore after forty days, but but not it's not true that no one can spread buyers, so there is still some risk or you can where mask and it reduces your wrist, but it doesn't limiting your risk, and so so pretty much. one thing we do is not perfect and theirs, and so we have to begin as a society and is as households or as individuals make decisions about what,

risks were willing to tolerate, and Jamie was brought brought something up this morning that people that had Sars sure it showed that they had immunity to covet nineteen, Jamie where we talk about earlier. Not the Airbus saying that I am. I misunderstood or Miss said that to you, but there are comparing immunity to Sars. They said that they are still carrying important immune cell seventeen years after recovery and they're, saying that might be the same sort of thing with corona virus that you might have immunity for a long time, but there have been people that have been reinforced. It is early, is three months and that correct yes, so this is again another complicated top so yes, we now have some evidence that some people can be re infected, but it's probably extremely rare. We don't know a hundred percent, but it is probably extremely rare and bars.

reason. Is that if you get covered and they test you and then three months later, you get covert again and they test you again. They found you, and these are ha. This person had it before it isn't immune, but there. The hundreds of thousands of people who also had covered, who are re, expose and didn't get infected, didn't get symptoms a second time, and so nobody tested them so you see we we only ascertain, we only see the ones that in fact do get reinvented. So you are right. There are happy now some cases proven with genetic testing that I've been an infected more than once, but we still think RARE the thing that Jamie was alluding to, as there are two parts to it. One is how long does the immunity? Last and honestly, we won no, the answer for sure until time passes, there's no way to be certain, but but we do believe that immunity will be sustained, will be reasonably sustained and further. Where I dont want listeners to confuse the difference between anti body levels declining and

being immune. So when you're bodies infected you mountain was a defence, a response produce it produce antibodies and for almost all in actions, those just decline, overtime and, in fact, with corona virus those those circulating, antibodies. Those proteins that attack the virus go downtown, close to zero up by about a year, let's say- and this was completely expected- there's nothing surprising about this by your body in the interim also begun to develop something called memory, immunity or t, sell immunity, and that's what protects you from re infection and we believe we have evidence for that people have sustained such t. Sell memory, immunity how long that last so Jimmy was saying with Sars one which struck us in two thousand three.

People can find evidence that even seventeen years later, you can mountain immune response, as your body remembers, that it fought off this thing seventeen years ago, an and one more thing, and that is all different than the question of cross immunity, which is also becoming now before me. The whole countries get enemy apology lesson here, which is that which is present, but you say I said, which is probably good when it's it's about time, that people recognise that in terms of pandemics, this is, I don't want to diminish the death or the suffering or anything, but it could have been far worse. I'm so glad you said that because because which, on the one hand, it is a bad germ in also roughly speaking, it'll kill about one percent of the people that Argive get it systematically. You get this disease, we have them

terms you got a one percent chance of death, it varies by age, and we come back to that too. If your interested, but as your saying it could have been so much worse, I mean there's, no God given reason this viruses and killing ten percent of us or fifty percent. Like the book on a plague and it, if you remember the movie contagion, I think them in the Moluccas. Agent had killed about a third of the people, but got it honestly, no reason that this week have been facing that situation. You know there's no necessary reason we're not facing that situation, so you're right it. It could be much worse and in fact, the two thousand and three corona virus killed about ten percent of the people that got symptoms from it. So is about ten times as deadly as the one

facing now. Why has there been so little discussion, especially from? Are our governments are leaders about methods to strengthen european system that has been particularly frustrating to me. There has been so little discussion about vitamin supplement station about changing your diet, about exercise keeping yourself healthy, making sure we get enough sleep, Loring Alcohol consumption, all these things that have been absolutely proven to boost your mute. System. Why has there been no not negating the use of masks or social distancing or of the other things that we nor effective? But why Has there been no discussion about boosting your immune system? I hope it is a really good question That's so you're right there. All these sort of healthy living things you can do from exercising getting better sleep, reducing straight stress, losing weight, reducing

alcohol and tobacco consumption. All of these things that in hand. The ability of your immune system to fight off infection, and that has not been part of the public health messaging campaign. I dont know the reason for that. It should be actually now that you mention it. We should be encouraging people to do that. have to say, however, that I dont want us to get into a situation in which is many very fit. People can get this german die and I dont an end and also people can be behaving well or poorly and get this germ and die, and and as a doctor, you know I'm very understanding of human beings frailties. You know we all are human. Wheat we or soft on the outside and we don't deserve to die of a jury anything else as far as I'm concerned, and so I do one has to say oh well Sancho. the bees or so, and so do you know

as a smoker, and so you are, they deserve their frank, now darling. I will not say that, but I know, but I know you're not On the one hand, I want to encourage good behaviour. On the other hand, I want to be careful not to suggest that, with that you weren't doing, but I'm just sort of clarifying the point. That is your fault. If you catch in dog, ass, right of origin, of course, yeah enabled her had. I think you and I think. I think people should be should prepare their bodies for the possibility of being infected but realize it there's no guaranteed. You know it's like those poor marathon runners that drop dead. You know having

run marathons our whole lives. You know it's just barely yeah that was Jim Fixes, a famous I wrote books on running and bill, Hicks Atta Hilarious, joke about him running and dying, yeah stats unfortunate, but that's probably some sort of cardio disease that he had. The there's there's ways that the government could have done it without shaming people that did get sick does there's the Munich. It wouldn't be taken much time to tell people a minute. I've had multiple health experts on this pod cast a talk about different methods of strength, immune system particularly supplement taken. Would vitamin d put it?

seems to be. In fact, she's talked about this as well seems to be particularly effective with a boost european system and also its a giant problem with people who are who wind up in the icy. You there's a recent study that show that eighty four percent of the people in the icy you with Cove id word deficient in vitamin c, and only four percent had sufficient levels and am shoot. Gusto, died. I haven't followed that particular literature, but you know as someone who loves the sun and it all I could strongly endorse up, get adequate son exposure for vitamin d alone yeah. But you know that the sun is the best way to get vitamin d for sure, but the way to get it if through the sun requires you to be in shorts and nothing else like a like our neanderthal running around all day. That's how we're designed. I mean it's like that's really what we're supposed to be doing. That

it's very unfortunate that we figured out houses me has kept us alive and kept us protected from pressure. there in the elements and all sorts of other things that would have killed us, but it severely. Diminished our ability to absorb vitamin d from the sun and vitamin d being not just divide, but also at maybe even possibly miss labelled as of item, it's really a hormone right. Well, I can be a precursor to hormones, yes, but I think that I boy. You wandered into an area that sort of trying to remember my medical school. Last time I thought about vitamin d synthesis and but my memories, it doesn't take much sun exposure per day for your by to produce adequate levels of vitamin d. I think an hour a day or something like that. But yes, in general, you're right, that is to say that a lot of ways. We live in the modern world, compromise our immune systems and their functioning

it is very simple that are actually getting their blood worked on. So even when you say an hour, a day gives sufficient levels how many these people are actually going an hour a day than getting blood worked on and finding out what the actual vitamin d levels in their blood are very few, that that's it's it's it. It's highlighting a weakness, in our understanding of our own bodies. See this. I mean this part. I would certainly agree with joy in the sense that as a nation. In a way we are put this exactly and once it we become softer. That's not exactly what I want to say is sort of like us. In a week, Yes, but you know we we want, or taken the two and in a way, that sort of what I am trying to talk a little bit about with respect to the pandemic as well, which is that we all wish that we didn't have to endure this unpleasant ray quality that this virus has now afflicting us. It's a little

but an end world tired. You know we all have Tobin fatigue, but it's a little bit like being in the dentist Sharon he's done to rude canals, and you know why many more road, your wanting any more route. Canals has nothing to do with whether you need the right. You know, unfortunately, this the reality that we're facing, and so what I really want in one I wanted to do. The book in Apollos era was deserve, help people to see the world for It really is now, which is that something big, as happened, something that doesn't happen, but every fifth Europe, hundred years, or so it's it's it's it and this in an and more importantly, this this way we ve been of the virus. Has forced us to live, which he'll, so alien and unnatural to us. In fact, this way it's not new, to our species, it just new to us, your life, This is outrageous how how can we have to do all of this stuff? But you know our ancestors. been dealing with this for thousands of years.

the first generation to have to do this. It is our time in the crucible- and I wouldn't I would hope for better for for us and in terms of crucibles, it's so small a mean again not to minimize the and the suffering, but I'm in the middle of reading Harare book homo ideas, and you know in it they beginning of it. He talks about of famine and plague for most of them. chapter and the just a sheer numbers of people have died in past plagues throughout human history, but before antibiotics and before we eyes and understood, but what viruses were mince horrific, but only where the Bonnac played would sweep through cities in ITALY and kill half the people like within a month, half dead more smallpox. When I went when the Europeans landed in enough in this caught in our continent, and they brought with them, old world diseases to the new world. The smallpox would widen

native american population. Ninety five percent of the people would die yeah and saying so as you, so we were very fortunate in terms as we said before, that this is the disease where we're dealing with. I think in many ways this is going to give us a much better understanding of what could happen and and give us a better better understanding of what we need to do something new comes along. Yes, I mean I I think that's right I mean I think, gun. I mean you, your kind of I'm actually glad that you're going there, because what I things I dont want. I don't want to be seen as dislike nihilistic. Do saying you know pessimistic I too late and sought to it. So you are bringing up the fact that actually to be another pandemic. Yes, and usually you

I say that if you look at the respiratory pandemics for the last three hundred years, the internet Emma intervals about ten to twenty years. It means we have a pandemic every ten or twenty years, but they're not deadly you so, for example, we had one in two thousand and nine the h one in one pandemic, most listeners might have a vague memory of hearing about it, but people didn't really pay much attention because it didn't kill many people. It was like a common cold, so we had a pandemic, but it wasn't very deadly that we have the two thousand and three previous corona virus Sars one pandemic it spread to about thirty countries, but for various reasons that pandemic extinguished, and we only at about eight thousand people worldwide who died of that. So we'd also serve forgotten that, serious pandemic, we had of influenza a virus, it's a different virus and grown of ours was nineteen, fifty seven. That was the second worst pandemic we ve had in a hundred years, and

previous leading killer, was, of course the nineteen eighteen, the so called spanish flu pandemic and the current pandemic we're. Having will be almost as bad as that in the sense that just to be clear to listeners, it's not gonna kill tens of millions like that pandemic killed it. We don't think, but the point is the current dynamic we have is the second worse than we have had in a hundred years. Worse than the fifty seven, which was the previous, second worst, so so it you know so so pandemics come every ten or twenty years there only really bad, let's every fifty four hundred years, but there's no The reason that we couldn't have another one, so you know- and in fact right now- there's surveillance systems in place in China. China, which monitor the emergence of new influenza strains, and it was just a paper published a couple of months ago,

suggesting there's a serious strain of influenza, bluing blooming a brewing. I'm sorry so, and I will see this one is a weird one right, whereas a lotta people get it in there s empty matic, I've ever had several friends, they got it and literally sperience, no, no symptoms there around people that had it they got it. They tested positive and as little as a mild headache or a slight call for a day, Jamie had it and he thought he had a saunas infection authority. Has our Jeez needs autos? This is our Jews kicking, it turns out, he was positive, but he was very fortunate. Is it was a very mild case? Do we know why, with some people get when some people get it? It's devastate, including young people? I have a young friends, twenty eight, he got it and he was really ill for two weeks.

Whereas some people get it and it's nothing. Yes, so we we have some sense of some of the reasons it varies, but not a huge understanding yet of the interpersonal variation, but I would like to go on a tangent based on that that lights. The ways in which these kind of protein manifestations of this disease, the fact that, with this condition, you and go from everything from having knows symptoms, two miles symptom, like Jamie too more serious symptoms like you're twenty eight year old friend to really severe symptoms to being hospitalized dying, writers incredible range of diseases that this particular virus can cause and in a way this is very unfortunate. For us because it makes it so much harder as a society to take the virus seriously and to combat it. Let me let me give you an analogy so

listeners to imagine that there are two worlds, I'm about to describe two different worlds in world a there, a thousand people and a virus infects. Ten people in this world makes them seriously ill and one person dies. So we would say that in this world, ten percent of the people that got sick died of the virus. That's world a in world, be there a thousand people the virus. In fact a hundred people, ninety of them get mine, the illness, ten of them once again get serious illness like in world day and one them dies again like in World Day, In this world in world, be a hundred people got sick and one died, so we might say one per cent of them died in world day. Ten percent of you will, I got sick died in world, be one percent of the people I got sick die

Now many people hearing about this might might think that it's better to be in world, be because you know it seems like the boat virus, less deadly, but that's a delusion is. If you stop Do you think about it? A little bit more clearly world be the same as world a plus. extra ninety people got mild illness. In other words, buddy right, you know right thinking, person should prefer to be in world be than to be in world ay in war. Build a turn out of a thousand people got seriously ill and one died and in world be that happened plus another. Ninety people got mildly, said so clearly, worse. The overall situation is worse in world be, and that is in fact the situation that we are facing. We in a like a world, be situation with his virus and the reason it's hard is that it all these extra people, those ninety, people who got mild illness make people take the disease more your casually,

Whereas in world a people might say, will not many people getting but when they get sick, ten percent of them die. While we should take this disease seriously, do you see what I'm saying I do see what you're saying so this is viruses very sneaking in that way? Yes, it's really like, if you one of the engineer of virus. That's going to spread the most that's kind of how you would do it have a affect so many people where they like. It was nothing and then some people were, you know, they're dead within a few days. Yes, also, as you pointed out earlier, it also has this property of being transmitted transmission. Well, when its asymptomatic suggested just to remind people. Hiv is like that you can have HIV, for years and not know it your spreading at your sexual partners and then kills you much later versus smallpox, which you can really spread smallpox before you have symptoms you, the pustules erupt on your body and that's when you become infectious, so there's a desert. There's a there's, no asymptomatic transmission!

a box, and there is an HIV and stars one from two thousand and three was more like smallpox. In other words, people didn't begin to transmit. the virus until they actually had symptoms from it, which is one of the reasons it was easier to control, because when people that's it terms we can isolate them, whereas with the Sars it we're facing now the Sars Clovy to covered nineteen people can transmit it when there were there not symptomatic, and in fact there is a lot of analyses that had been done that show about seventy. Five percent of the infections have been acquired from people who were asymptomatic, dissolve there's another issue as well that we can compare the smallpox and that you can develop a vaccine for smallpox that actually works for your whole life. You can't really do that with of it greatly don't know for sure. We don't know that sure. We I dont know that for sure I am hopeful that will be able to have a vaccine that has long term confers longer

immunity, but I dont think we know that either way for sure can you describe what's going on with these M Rna viruses and how they differ. Excuse me m, are vaccines and how they differ from a regular vaccine and what what's coming? on the pipe from Pfizer it that these are m or any vaccines it s rent in that it doesn't actually contain the virus, but it boosts your bodies ability to fight off the virus. Yes, so so there Many different ways of developing vaccines and the here. The general idea behind a vaccine is is that we want to give you a kind of an earth salts infection. We want to expose you make it as if you had been infected, but without the risk of getting the disease to trick you remove.

System into mounting an immune response, so that your bodies and prepared, if it gets the real infection to fight it off and are one of the simplest ways you can think about it is so called live. Attenuated virus is an old technology where you you take the virus to the laboratory, culture and hundreds of times and hope for mutations that weaken the viruses, ability to make you sick, but nevertheless keep the virus aid. to elicit an immune response, and then we give you that strain as a shot, and you have left a mild illness. You ve you develop antibodies and immunity and sustained, or you can have activated virus like going to the Chinese. The soccer, the sino vaccine that's enact was one of the first to start, which was it China is, is a live attenuated virus, so that is, oh, I'm sorry, I see live attenuate already, can't remember. But anyway, the sign a vaccine is a virus.

which day they take the virus. I'm sorry! I know it's not like the previous example. In this case, we take the buyers and we treat it lets say with heat or what the chemicals to kill the virus, but still have it. immune, organic and on that's another approach, and there are many other approaches, does and so or nine or ten different approaches, one of which is this MRI, nay idea and hear what is done is so, I'm sorry if I tell you about that, another approach might be to take. Take the rna from the corona virus that codes for a very important protein despite protein on the surface of the ground. buyers and insert that into a really benign virus. Let's say like a cold virus, for example. So we take this other species of ours? We do now equally engineer it so that we insert some materials. RNA into it. Lets say that forces that virus when it infects yourselves to give you will come

cold, but also to express this protein as if you had been infected with covered or carogne of our and then you mounted immune system to that immune response that protein and now your immune. So we gave you like a mild illness and we protected you a more serious one The M Rna viruses are vaccines are sort of like that. We enjoy you literally with with with our neighbours and the idea is that yourselves take up the rna and start me the protein, the alien protein that your body would have made like its. If we'd infected, you the real corona Vires, the real corner on a virus, as many people remember from high school biology, the virus can't we produce on its own it inserts its genetic material into, are cells, which then start producing the viral the virus itself, but now, in a sense, instead of giving you the whole virus, we give you a little part of it just some part of his genetic material, the M Rna, which

an ideal world. Does the same thing gets in Sir and yourselves, you start expressing this protein, which then your body attacks and you develop in immune response. and we are amazingly lucky that that our scientists have been able to develop not one but two different vaccines and will have many other vaccines using different modalities. I have no doubt that come out in the next year or two but the Madeira defies or vaccines were very lucky that they exist in that they are apparently quite effective, but does, but the story is not over and those are enough. You want to talk about that, but but it's good news but I do want people to get over optimistic either because you know it's my job to be a bit of a downer while the this is the this is the unfortunate narrative. The people keep saying the virus is killed,

thing. It's like the average immune system is ninety nine point, whatever percent effective in protecting you from the virus, meaning ninety nine point, whatever per cent of the people who get the virus survive, whereas now ninety nine percent of people over all survive, one percent will die of all people who are in fact that approximately and it you're older than seventy or eighty twenty percent will die. So why why, as the number that people keep talking about far less than that, why is the than the reported number of people to get the virus who actually wind up dying? It's it's! Not one percent were not we're not seeing percent nationwide in terms of people getting the virus, and I know we know the answer that question. I don't think there's any ambiguity scientifically, so so it so in order to, in order to really compute these numbers, it's not easy! You're right. We have to look at. if we have to have a way of ascertaining whose infected and then we

I have a way of ascertaining of those how many die and and and that's called the infection fatality rate and there was just a recent mega analysis, looking at very good data from around the world, multiple studies using different approaches that estimated that the infection fatality rate is between point five point, eight percent, and that something called the case. Vitality rate is the fraction of people who have symptoms who go when in fact it who die and that numbers about twice that so but half the people get the virus and have no symptoms at all. So if you get symptoms, you have a higher risk of death, and so you can doubles point five Two point: eight becomes one to one point: six percent of people who develop symptoms from the disease die, and there was another very good study that was just released a couple of weeks ago that estimated the infection vitality rate to be about one percent

So there's a lot of numbers, IFOR undoubted right, but this is when the gist is symptoms given either without symptoms. The infection, fatality rate is certainly not less than half a percent and could be as high as one percent. I would say: it's gonna be in that room, in the eyes of far the infection fatality right? Isn't there a large percentage of people that get it that don't have symptoms? Half about half? We think that's right of the people who get it done of symptoms, but you said ninety nine point: something percent arrival looked at it survive and that point something is is important, so I would say that if you- ninety nine point five percent of the people who get infected survive, I would say, could be, but it somewhere there are? No. I don't. I don't think I gave a number. I think I said none. I point something, but the boiling point being that Unfortunately, a lot of people saying this vaccine is ninety four percent effective or ninety per an effective yet would any ask you to that? What that means is that if you are

if it reduces your risk of death by that fraction, so, for example, in the vaccine trial in the Pfizer trial. These numbers are proximate, invalidate about forty three thousand people in the trial. Half of them got the vaccine. Half of them did not end in the people who got the vaccine nine people up tonight, let's say nine or ten got even though they were vaccinated, still got. Corona virus still had the disease. The vaccine was not perfect and in the people in the arm that did not get the vat vaccine, the other twenty thousand people, let's say ninety people abroad. really got corona by our, so what the vaccine did is. Is it reduce your probability of getting the disease from ninety out of twenty thousand people over the time window of the study to ten out of twenty thousand people, so that the point here is, that of the vaccine, is reducing your risk of getting sick.

Firstly, all of your infected and dumb, and it in its, not in your certainly better off. In other words, you would have had lets a one percent chance of dying before and now you have a point, one percent chance of dying ninety percent lower than that, because we ve given you the vaccine, I can do that exact, completely understand exactly what you're saying what I'm trying to say is: there's an unfortunate narrative or people are saying: I'm not going to take a vaccine, because the human immune system is more effective than the Axing see, that's not true, that's what I wanted to get out of you saying it. Yeah god I'm saying the vaccine away vaccines, vaccines work as it is enhances your your performance in all its like guide. It stimulates your immune system to make it even better at fighting them. The viruses there's no sense Would you could argue that an unchallenged emu

system is superior to challenged immune system. A system that has been you have been given, vaccine. So this is what's important to tell people right, because this narrative of ninety nine percent of the people who get it not Nine point: whatever your immune system is effective in fighting off this disease, whereas with the virus it's only ninety plus, whatever percent effective in print preventing the virus. So this is not at this. That's not a good narrative, correct that's right into the way to think about. It is just a pick. Some round where's. As you were saying, an enlightened and like like me, you sometimes usable virus. When you mean vaccine and he used the word vaccine media is on a farm. I neither I thought I saw knowing yeah but anyway, let's say for the sake of argument. You happen on vaccinated. You have a ninety nine percent chance of surviving. If you get infected right, you have to add to that. The benefit of the vaccine

in which is ninety percent, let's say effectiveness, so it will reduce your probability from ninety nine percent chance of surviving to ninety nine, point: nine percent Janni ass. Thank you. That's exactly what I wanted to get out of you there there that when, when you talk about the people there, took the vaccine, and now we know you, you have the data between the difference of the vaccine, the people together Pacino the people. They got the vaccine that still wound up getting cove id. Did they do health screens on these people and find out what co morbidity factors they may have had and see? If there is anything that would indicate that there's print were to particular risks. We don't know that yet those results haven't been released and also what we no, so we don't know the answer that, but we will know and also what don't know yet, as we we don't know how safe the vaccine is so first just to be very clear, both Pfizer daring to have released interim results and

We have every reason to believe that the final efficacy results will be about the same so as they complete the trial in the coming months. Do and more people get sick and both arms. We don't expect. Suddenly the vaccine not to work, I mean we ve gone to appoint. Words were pretty sure that the vaccine will be effective and um. not yet know the safety of the vaccine, is one thing we are nothing, we don't know, and we also don't know something else is very important for people to understand Since everyone needs to be an immunology now imagine that you're doing a trial and you're trying to see whether a vaccine works or not. You have to fine, what counts as works. What counts is an end point. So let me give you three possibilities. One mobility is we're going to measure. Does the vaccine prevent you from even getting infected, or does the vaccine say or do we say: that's he's not going to stop you from getting infected. The viruses to take root in your body, but the vaccine is gonna preventive. For making you seriously ill

or do we say actually the outcome we really care about his death. Does the virus reduce your probability of death, so it's possible that the vaccine, for example, might just illustrate. This point prevent you from getting seriously ill, but not reduce the probability of death, the words in the but in the fires or travel. I just described you with the night in the in the vaccine arm ten people got sick and in the non in the possible arm. Ninety people got sick. What if in both arms, one person died one out of the ten in the seen arm died and one the ninety in the in the other, I'm died. We would say that the vaccine was effective at lowering your probability of getting ill, which is great, but it had no effect on dying. That's

possible is possible that the vaccine will work at different phases of the illness process, and so the Pfizer trial reveal that there was a greatly reduced probability of people getting in fact Did the modern? A trial actually show that its vaccine reduce the probability of people getting seriously ill just great, but it might in fact have no effect on mortality. Still, we don't know. Furthermore, we also don't know whether this vaccine, even if it works, reduces it reduces, even if it works to reduce your probability of getting sick or dying whether it works to reduce. Your ability to infect other people, some, so me, may we ve heard vaccinating the population were reducing individual recipients, probability of getting sick, but they still can spread the disease. So so this is something else has not known. So we don't owe the safety. We don't know

which outcomes are really being affected, and we don't know if it affects infectiousness, and all of these things are things we will soon learn in the coming year, but we do not yet know them. So I just its event. Ass the news that we have a vaccine, but I just don't want people to get think it's a panacea. Is God please go, continue, not I'm just as one more thing, which is that which is that is that pulled out. Let me just remember recover what I was about to say about the vaccine and dumb. I forgot what I was gonna say, but go on you're gonna, say sorry nanos, my father said the problem with Skype COS What, though, is such that it is this a complicated topic in theirs? You're all I've been thinking about corona virus for the last ten months I mean they're, just so much stuff in my mind about this thing that oh I remember because I thought I was one of the talking about this, so I want people to also be

think about who? Should we give the vaccine to like what are the ethical and public health issues associated with? As we start producing the seem, you know. First will have a million doses well, who should get the first million doses it's pretty ethically. uncontroversial that the very first doses should go to People in the placebo arm of the trial. Those people took the risk of beings, experimental subjects they were randomly assigned to the placebo arm. They clearly should get first steps on the actual, effective brought. This now been shown to be effective because of their contributions. Ok, great then pretty uncontroversial is that the next group of people to get it should be: doctors, nurses, firemen, policemen, first responders, ambulance drivers, all of those people, healthcare workers, those people, because there

putting themselves in harm's way during a contagious disease to protect the rest of us. They should be next, ok, fine, but then who who's next after that in here it gets very tricky, both ethically and from a public health point of view, and let me give you one: an example of this. So on the one hand you might say we should vaccinate lets a vulnerable. Elderly people are people with chronic illnesses. They have the greatest chance of dying if they get infected should give the bat first, ten or twenty million doses should go to elderly people in nursing homes and there's a lot of compelling reason to do that, but it turns out that such individuals from a network science perspective are It was called the end of the transmission chain, it actually my make more sense and we might save more lives from a public health point of view. If we vaccinated working age people, people who are out about

because if I vaccinate you and I by virtue of making you immune, stop you from meeting the disease to other people since you're out about and seeing lots of other people, I might actually wind up saving more lives. Paradoxically, by vacillating the people at lowest. Risk. How do you have any legal and that that seems like a complicated one to explain? Yes, so that's it and in our nations gotta face this dilemma very soon, in fact, because when the initial, of course, we had? Three hundred million doses we wouldn't have to make these choices. We just give everyone the shadow wanted, and, incidentally, the cold chain requirements, for this is another topic no tangent on attention, but many rural parts of our country simply don't have the kind of refrigerators that are needed to stockpile. And administer these vaccines. The legislators are needed for these vaccines. Well, the up the fire, One needs a minus eighty refrigerator. I would do these are common like below below

dry, ice, cold and so on. Its own every pharmacy. You know your local, CBS or Walgreens doesn't have usually this type of refrigeration and it so you so you had plus all the trucks transporting it like from the moment that the vat scene is manufactured till the moment it's injected. It has to be most many vaccines on all vaccines have to be in what is known as the cold chain: They can never be de frosted and building the logistics to distribute the vaccine is a big big challenge. So not only do we have to invent a vaccine like we are, which is magnificent, that our nation is able to do that, but we have to manufacture it, which is not easy in all. We need a little glass vials we'd millions of them, and we need factories that can produce this particular kind of accede, etc. We need to distribute it like the cold chain, the refrigeration I mentioned and most important. We need to persuade people to accept the vaccine and

touches on what we were discussing earlier. Whether people will believe that the vaccine is useful in force. We have an anti that's population in our country and so on. So all of these challenges have to be overcome. So if we had three million doses of the vaccine is, would be less of a dilemma. initially we're not gonna. Have that we're gonna have some lower number of doses and those doses will be more easily administered in metropolitan areas that have the right refrigerators so we as a nation are gonna need to begin to think about this. But how do you know choose or distribute the vaccine. That's very complicated. Now that the difference between the Pfizer and the Madonna vaccine is what well, as I am told- and I'm no expert on this narrow topic- that the modern a vaccine actually doesn't require, as cold duration, for reasons that I dont understand since are both our vaccines, they bother encased in lipids. One of them requires a much colder temperature,

for distribution and the others. So the Medina one, I'm pretty sure is. The one that is is can Kanab doesn't require quite as colder refrigeration, which makes the logistics of distribution much easier. Do we know we will have any idea why I'm sure experts know that I don't know the answer to that. why, why does what is there? Anyone whose tried both again is there any better it in getting vaccinated with both vaccines. I doubt that because a very similar approach, but I can imagine that the time will come when might be some benefit in getting to complimentary vaccines. When we have developed still more approaches, we are talking about earlier when you can get and also that now it's also possible and We just don't know. The answers to these questions is also possible, so some signal infraction of people who die of Corona Vires die because of their own body

over response to their immune system is too to dramatic, to dramatically responds and its possible that that we may not want to give people multiple, dozens of different kinds of vaccines, because we might overcome their immune system in a way that actually harms them in some way, and so These things are all going to be are all going to be,

Lord: it out, you know in the coming year. We just I just don't want people to think it's over all simple, because it's it's not now Donald Trump. Seventy four he's overweight needs cheeseburgers every day, when a guy like that catches, Cove id and is fine in four days, people get very dismissive of it on for job right. What did he receive? What countrymen did he received and how different is it, then what the average person would receive if they got sick? So he he faced a very significant risk of death, and I think you got lucky so remember his doctors put em on deck Samantha zone. So so far we only have one proven drug. That lowers your risk of death if your seriously ill from covert and that's a very simple steer, I'd call decks a math. His own undone render severe has not been shown to lower mortality.

It has been shown to lower your length of possible stay, so there's some benefit to it, but it doesn't appear D lawyer, risk of death. What would end the difference between lowering your risk of hospitals day and lower your risk of death? Why would they let you out of the hospital if you hadn't Jones never get health improvements and Woody AIDS events, health impoundments, wins out again. Health improvements, SIG signify that your bodies, recovering better it's a mystery in its confusing and when the first round us of your trial was published a few months ago, it didn't show up a benefit for mortality, but it showed, but it showed a trend. It look like you would help and it makes like if its lowering your hospital duration, probably it's good for you and it also lorry risk of death. But then another trial came out much bigger trial as part of the think it was called this. a dirty consortium either, solidarity or the recovery. I can't remember right now: consortium out of England would show that actually room does of your had no benefit for mortality now how

I'd be imagined that imagine that You have a hundred people who are sick and in the group that gets from disappear. The only wind up, Spain spending an average of ten days in the hospital, but ten other people die. and in the other study the people that did not get rammed us a hundred people get sick and these, in an average of twelve days in a hospital. But again, ten of them die so The recipe are has lowered the hospital duration from twelve to ten days, but it has an effect of the probability of people dying, that's entirely possible, so there are many in fact would appear to have happened, and this was a study you said that was in England. Yes, it was a large study that was, I think, I'd I'd. I think the subjects were not just in England, it was organised by it a group of english scientists, either the solidarity or the recovery consortium- and I just don't remember right now that the name of it, but I want to go back to your question about the president. So

President was given deck Samantha Zone, and when that happened, I stated publicly that either president was sicker than they were telling us. So he was sufficiently said that they wanted to give him debts that is because giving Ex him at his own early in the course of the disease before your very sick, actually can harm you So you don't want to give it to someone at the beginning of their disease. You need to wait until nor sufficiently say and then it helps you so either he was sicker than they told us and so they were lying to us or he was we needed the decks about his, in which case you face a significant risk of death, so people in the truck files that show that the decks him at his own work so for your old, overweight people, men and men are much greater risk of dying than women of his condition hook.

the deck Samantha Zone. They had about a twenty percent chance of death, so I think the president actually faced twenty percent chance of death when he was at the hospital, which is a big risk of death, and I thinking you got lucky You know he survived. He was also given the this cocktail of of artificial. And bodies to the disease, which I think is another promising approach to treat. this condition. We dont yet have the results of the randomize controlled trials, but will so no soon, if those drugs no help. So this was an experimental treatment that they gave him. Yes, they gave him not the deck Samantha Zone. That was a well documented treatment right, but the analogue antibody cocktail was fairly the seal. The company of regeneration, was his golfing body or something I'm not exactly sure. So whatever was it seem to be very effective and then I will tell you that he went on a wild. Tweet storm seem like you, had a lot of energy or the decks and others on may have given them

steering I I wouldn't conclude that the body Katya was necessarily effective. We don't know. No, I didn't I didn't mean I meant only three. The overall treat whatever they gave him when he was in the hospital. The response was for a seventy four year old guy to be back in the campaign trail with this rigorous campaign that he was doing. four or five days later, President S active. Yes, I did not expect that at all and- and I, as I said, Thank you got lucky and I do think your death steroids I can give you love, can make it psychotic and a little manic actually- and I- and I think I mean yes can't really know from it. Dense. But to me he had a as a doctor. I am I looking at him. I thought this man has a little bit of a manic feel to him, but you know they take us against your rights and even that went away just from the twitter feed.

yeah I've medicine. That is how we always is. Well, I'm not an expert on Donald Trump Tweeds, but if you just look at some of those, you frank pick pick pick pick. Maybe he was always that way. But if you look at, if you look, some of the things he did like. I think the little having the secrets is dry them around. The hospital was a bit. You know it's. A bit manner You know that was like a very responsible thing to do: would expose people to rescue put his own health coming you and I, if you're, not where the hostile with carbon we told are our doctors. You know I just want to over drive around the block right now. Let me for they would they would say? No, you know that would not be you ok thing to do and waved to people right, yes, hilarious. Yes, I mean, I think I think one of the things, I make this argument in a arrow Other things is very interesting to me about about play

eggs earlier. You talked about how plagues or one of the four horsemen of the apocalypse is that that the that that lies and denial are like the squire of the horseman. They like follow right behind and it in any way. You would even say that lies in denial since David heard for thousands of years. Whenever there is an outbreak, people have always develop superstitions. They wanted to deny what's happening. There has been a lot of line, has been a lot of snake oil salesman in older just a lot of mendacity that are that follows the germ, so the germ of spreading through social connections and bullshit is spreading through social connections. and I think that we saw that even in the president, where he was frankly representing what was happening. We now know that he was told that it was going to a pandemic in December, but was saying always just a flu. Nothing's gonna happen, nothing's happened, he was lying and

and his whole hydroxide a clerk win story. There was no evidence that this drug would work, but you he was like a snake, all salesmen selling it, and you can even make the argument that that it is the perfection of our democracies, the fact that we have a democratic system that allows us the popular will to be reflected in the leaders that we elect, so that The people wish to be lie too. They will Lecter Liar cutting. Although I pause you for a second, there there's a lot of people that did believe that had dropsy cork when at the time had some positive bent, its, including my doctor, who, in other I gotTA, Donald Trump supporter. This is no evidence at all. There was some suggestions that, based on in vitro studies, that the drug might work, it was increased see to consider that it would work. I mean it wasn't. A crazy idea is a maybe this drug works, but there was no clinical evidence.

it worked. There was no randomized controlled trials, the giant and but isn't that also because there was no time for any randomize control trials because yes, as the initial stages of the the pandemic yeah. So so I'm not saying that it wasn't crazy to think that it might work. I say It does. Work is a different statement. I agree with you wholeheartedly that his endorsing of it as being some sort of a miracle cure was irresponsible s end, but that's also kind of what he does right like when he was sitting. Next to I'm sorry, what is her name Burke's when it? What was her name? Yes, yes, and he was saying, may really yeah. Maybe we can use some sort of internal disinfectant on people and all that create he's he's ripping like that. You know he's the guy that likes to have the answers. When he's. Given these speech relax people,

pay attention- and I thank you for that response is its that's that's how he usually is as a human being He gets to be seventy years. Old now also needs the present United States and is doing this now becomes a problem yeah. So this is what I would like to say so and I said not by saying you know it's a it's a reflection of the perfection of our democracy. we are able to get the public will and reflected in our leaders, and if the public will is to us said to have someone who tells you only good news and doesn't tell you bad news. We're gonna get that, but I don't think unless the leaders off the hook and acting before I explained that, let me just go back and say it's also true that many other leaders in other european nations, like in ITALY or in England, also flood this. So it's not the case. Only tromp singularly botched the response There were leaders in South Korea in New Zealand, even in Greece, you know who did it

had a successful response, but my point is where the United States of America I expect more of us. We have the cdc where the richest nation on earth, we know we, we. We have scientists and doctors. We have this it. We spent seventeen point seven percent of our GDP on healthcare that we have now security agency. We have everything, you would need to do better and I expect more from us. So I I absolutely do fault him for four flogging this, but I also think the american people need to take some responsibility. Anita sort of man up you, know and and recognise that the world has changed their some serious stuff, that's going on, and we have to do better in how we confront this threat. We can't be like children, pretending that it's not there or or fantasizing that it'll just miraculously go away. That's not a mature response and we

unfortunately, a long road ahead and we are not at the beginning of the end of this pandemic. We are just at the end of the day. justice at the stage a little bit. Here's what I think is going to happen. So it's great that the vaccine has been invented and will have several of them, but, as we discussed, are going to be some problems and challenges in in manufacturing it and distributing it in persuading large numbers of people to get it zone and that's gonna take time, let's say a year, so let's say the vaccine is approved in a couple of months. The beginning. when twenty one, I think we're gonna, spend all of twenty twenty one doing all that other stuff distributing the vaccine and so on. Meanwhile, the vice, still spreading and right now, probably about twelve percent of Americans, have been infected with a virus in the end for various calculations and reasons, probably about fifty percent need to be infected. The final attacks

Great problem needs to be about fifty percent before we reach this threshold, known as heard immunity, so we're about a quarter, the way there, let's say so. The virus is gonna, keep spreading, and while we're doing all that other stuff so either way. I think we get to twenty twenty two before we ve. heard immunity either, naturally, because the virus has finally attack that many people or artificially, because we immunized that many people. So at that point just to be clear: the viruses and gone it's still in our world and still circulating, but its epidemic thrust. Its epidemic capacity now has been neutered and we have devised a so called endemic, when we reached the herd immunity threshold, either by vaccines or naturally, that's twenty twenty two, let's say, but that just then we have overcome the biological and epidemiological impact of the virus, and until that time we're gonna be wearing masks. You're gonna be interment school closures. We're gonna have

physical distancing, there's gonna be problem gathering bands? You know hospitals, before periodically. This is good, the world wherein for the next year or so, and then we'll get to the point where, we have heard immunity one way or the other but then you see we have to recover from the psychology. All social and economic shock. Don't forget. Tens of millions of Americans are out of work, many smaller. does this have gone out of business. We have it sort of reshaping of our economy and all kinds of radical ways, and it's gonna take away for that to unwind also a lot of people be disabled by this condition. So far, we ve been talking about death, probably five times as many people will be sable, will have some form of long term, disability, renal card act, neurological or pulmonary. So if we have a lot to half a million Americans,

sure half a million Americans will die of his condition may as many as a million gonna in the end. By the time the pandemic is over, it's gonna be a number that range Whatever that number is about five times as many will be disabled, so, let's say half a million Americans die, we have two and a half million Americans with some form of disability. We're gonna have to cope with that as well. So if you look at the history of- epidemic disease, it's gonna, take a year or two to recover from that. So I think it's twenty twenty four before we really begin to enter the post pandemic period when life will return up in approximately two normal, with with some persistent changes in our society and I'll say one more thing and then I'll shut up. You look at the history, previous pandemics. What typically happens is during the time of the germ hitting the society. People get more religious, they

become more abstemious, they save money, they withdraw from other from social contact, Ebay, avoid risks, risk aversion increase, risk taking declines. All of these things happen and then, when that when finally, the epidemic is over, all those things reverse people relentlessly seek out social interactions. You know of speed events and night clubs in restaurants and political rallies people be sexual licentiousness goes up a spending. People's hearts spending money risk taking comes back one one person Neil Ferguson actually who kindly reviewed the book in the Times literary supplement. When he read this decision, Jenny goes, you know here is hoping that that this is a little like, so I think, come twenty twenty four twenty eight twenty twenty three, that we're gonna have like the roaring twenties again our society is going to really be unleashed from

from the shock that we are experiencing, I'm looking for that. One thing I gotta urge use. Please we hear every time you get excited and slap. Your table would get a loud bang out of your microphone. Ok, sorry what we talked about the economic issue. You briefly just touched on it. What do you think can be done to mitigate the economic impact and what what states. Do you think you're doing it right verses? What states you think you're doing wrong. It seems to me that one of the big problems that people are having with this pandemic is all the sudden governors and mayors have these powers that they never had before, and they don't seem to totally makes sense Like their allowing people to have mass protests- and there actually encourage them incur urging them but they're not allowing people to go to the gym their allowing people to do things like

Walmart Gerda target, but they don't want to go into restaurants, California's particularly restrictive and just day entered into. They went back to face purple whatever the fuck. That means whether their shouting everything down- and this is right after the governor got caught going to a restaurant with a bunch of other people, doing things that he specifically told people not to do. This is a problem. The people have with the power that government has now assumed and the real concern that many people have myself included. Is that were never going to see them? Give that up is that the powder there now to tell people to stay home. Don't work, shut down, school shut down, shut shutdown, restaurants that they're not gonna, let go people enjoy using power and its Firstly, if they have a legitimate, legitimate, good cause war like we do here in the pandemic,. So I share your concerns and I understood

what you're saying and their many components to what you just said. First of all, I want people to understand that even during the Bubonic play in England, when the government wasn't ordering restaurants to claw who's economy still collapsed. So we have to draw a distinction between what germ is doing to us and our economy and what it would have done. Regardless of what government did verse is what we are doing to ourselves in order to fight the virus. So I dont want people to think that, oh if the government was doing nothing our economy, It would be going great now I don't know, I don't have you with that either. I think the economy would still be fact but we'll get less fact. California is more fact than Austin. Texas is that's our act, Or it will, I believe you on that. I I don't know the presiding it was happening and ass a result, but I dont think that the economy would

certainly be less fucked. If you, if it, if its government took no action in fact that the principle, the ideal principle at least, is that by the government acting, we can protect the economy. So, for example, if the government were able to effectively force people to wear masks and if everyone warmer asks. We actually could maybe have a functioning economy. That seems to be the message that we should get out yeah, so so just to be clear. That idea, a world, I'm not saying that our government is working, but I'm in an ideal world. We as a people and together and say we're facing a common thread. Look if if, if we had enemy on are on our borders. If we being invaded by an army, you grabbing your gun and going to the frontier. It's useless right. You can't the army by yourself is solitary action is not adequate in the situation. Furthermore, everyone else on their own running to the frontier in a disorganized way also is not effective,

you need leaders, you need structured, unipolar, tunes. You need weapons, you need strategy, you need all that other stuff, that coordination to repel the invader and it's the same with this, we save our skins by working together to repulse the invader, in an ideal world. That's what government would do for us. It is an expression of the collective will for collective self preservation. So so I just wanted first, while draw a distinction between what the virus to do us versus what you're doing ourselves, which we seem to agree on now, the hypocrisy of our there's not come to the power issue. The hypocrisy is really worrisome to me and we talked this earlier. I think public messaging is a crucial part of battle. We had. I had a of us, so we have to people be honest with us and we have to have them because system. We can't say all this: what you need to do, but I'm going to the french laundry for different. You had not okay,

So I totally agree with that and that's why I want our leaders, for example, when they appear in public to wear masks. I dont think that you know a lot of the political politicians who are owing to public events, not wearing mass vice. President pants, for example, went to the sum invented the mail, When it everyone else's Massey wasn't mass, that's not the right message, in fact, and here's the other thing. Just this be clear, I know what's happening in north. in South Dakota right now been following a little bit and also in in. In Idaho in other parts of the northern part of our country. Right now,. it's in the nature of exponential growth to be deceived. Exponential growth is not an intuitive concept, so when experts say that shit is gonna hit the fan in a few weeks or it's really bad right, now the man in the street goes out or the woman in the street goes out and looked around us has nothing is happening so bad right now. What what are you talking about- and it seems like the what is lying, but what happens with it.

Potential growth. As you know, one becomes too becomes for becomes aid becomes. Sixteen, it looks like nothing has happened. Comes to become sixty four cases, or does this not so many deaths, it doesn't look so bad, but then it explodes right. Exponential growth, as we all learned in high school algebra and and that's the problem, and by that time, the time that explosion takes place it's too late, and this is why leadership is so important and why we as a people need to try to elect or in power individuals or honest with us, or not hypocrites who act according to their prescriptions and who tell us the plain truth: what is it we're facing, because we're gonna have to work together to get the best of this virus? What what is happening in South Dakota North Dakota? I not aware hospitals are at capacity and other and per capita. Think North Dakota has the highest per capita death rate of any place in it, world right now and base our rural and not a very populous state,

There are also pretty wide open right. They really did not force any restrictions at all, correct and and and on the one hand, I am not saying this important- I'm not saying that every car every play While there are some things that I think we need a national strategy for so, for example, inconsistent rules from place to lays can harm us. It's like designating one part of the swimming pool for pissing and just hoping for the best of meat that doesn't it doesnt work when there's a contagious disease. That's great sample guided. I wish it were mind. Is someone else came up with this, but anyway, but I'm so that's not the data we need have something of national strategy. We need some consistency. We can't have every little town. Having doing all this town is mass. The next door town is not mass, this town closeted schools, the other town, doesn't closet schools in this state and gatherings, but the adjoining state does not ban gatherings. We need some consistency. Having said that. However, it is also the case that different states are different. You know that

The population density New York City is completely different than the population density in Vermont or in North Dakota, and I can announce- and why people that live in rural states might say well, we have one advantage which they do have being less dense. The population density be lower it doesn't mean you can just count on that advantage and do nothing else, and this is this is something I wrote about it. The swiss cheese model, a pandemic control, so hygiene that every layer of defence is a piece of swiss cheese, for example, school closures or physical distances. or wearing masks or banning gatherings or or testing. For example, each one of those, is a layer of defence, but each of them is not perfect. I have little holes in them. You should have the intuition that, if you have just one layer of defence is imperfect their holes the virus can get through. But if you had another piece swiss cheese with holes are randomly positioned. Maybe there's only a couple of gaps left after that. Secondly,

this was cheese, were a couple of holes happened to line up, and then you out a third or fourth slice and by the fourth line of defence, there no holes left to penetrate all four layers of swiss cheese. This is what we need to do as a nation. Any one layer of defence is not enough. We need multiple layers, but the Good NEWS is, first, if we have enough layers, we necessarily need any more after that. So, for example, let's say we get a week where Mass we physical distance, we have, if we ban gatherings and we and we have testing. Maybe that means we don't have to close rules because they don't add anything else. Adding another piece of cheese to the as the fifth layer is not necessary. Furthermore, this is what happened at the White House relied on one layer which was testing they didn't have massing, they didn't physical, distancing, they dont we're just gonna, do testing its not enough, and it is obviously, though cause- I don't think they did. I don't think he was getting tested,

I don't think he was either honestly, but I have no inside knowledge. Why need to hear is when they asked him why, Last time you had a negative test. You asked me what Last time you had a negative test. Yesterday I get us every day. So, if if they're not asking him, if he's not answer That question there's only one reason does he doesn't want to lie because he knows other people know. So you know He's got an inner circle. That is a little that the little chatty Cathy talk a little bit and they're gonna die, random out, especially we doesn't when the election right. Yes, I think he wasn't getting tested. I think that's right. I think they probably had the idea that will test every one else comes in contact with the president, yet and they also by the way tests, are also not perfect member. We said: there's no life without risk. These are all probability distribution, so the tests are. Some tests are exceptionally good.

Not perfect. You get a false negative ways out of that. Using a rapid, antigen test. Correct is using the the test where they do in the nasal swab or the saliva test I dont know exactly what testing methodology was in use at the White House. But what I suspect happened is he got infected from someone else and then I think- and this is just rank speculation. I think he was the point source after that, because if you look at the network pattern of of who got the disease he's, including the person, the coastguard officer that was carrying the nuclear football who got infected by the way. This is just to be clear. It's. In my view, the height of your responsibility to be so lacks. The FAO that our leadership was infected, including even the person in the nuclear football? This is irresponsible, and he should we should by expect more from the white but anyway, the if you look at the pattern of people to map out the network of who got infected, I think he was. The common denominator

for a lot of the infections, and so I think he got it somehow he wasn't being tested. I speculators speculation, He spread into lots of other groups. It is so vaguely the president is a super. Spreader said. Yes, I think it's there's the data fit with the claim that the president was a super better. Yes near so clearly, that's a gigantic problem. Elon musk, apparently now has covered and one of things that he was talking about Us to TAT, came back positive and to test came back negative, and a lot of you are criticising him about this on twitter, complaining about it without researching the nature of these tests themselves and that the issue being that these tests are not that effective. If you have a very mild case,

of the virus or, if you barely have any in your system and that they might show positive and negative in the same day, I dont know the details of your. Must testing. I have to imagine that Elon Musk is good testing, so I was surprised eyes, by his description and I dont believe he released information on whether he was having pcr test The virus are antibody test for he did he would he released it? That is its rapid antigen test. so he wasn't getting pcr tests for the virus did didn't this particular time when he tested four times to negative into positive he's, pretty specific about it on twitter and that's when people criticise and those are all additives, those Raul antibody. Tesco, yes, I believe, a ninety nine percent sure, because he was actually then questioning the the effectiveness of pvc are now there's something though I wanted to discuss with you.

I got confused about it. Some old saying that, with pcr tests, when you get to a certain number of tests, then it becomes problematic. Correct, like an individual or an individual, having a certain number of pcr tests. There's no way I can think of that would be the case. I mean what the difference is that the pc art asked the pcr tests is a test of of saliva or or or or diesel, secretions for the virus, and typically after you recover you you dont shed the virus anymore. Now you can test positive for awhile afterwards, because you might still have some our name from the virus in your It's done but you're, not infectious, so you could test positive, but you can in fact any one else, but usually benign

a number of weeks you no longer test positive and that's done with the antibody test- is a test of your bodies response it a virus, the proteins at you produce to fight the virus were usually user. You take that from blood. but people have now developed, saliva antibody test, which is much more convenient and and though will be positive for a number of weeks or months as we were discussing earlier in two different kinds of and bodies, actually there more than do, but there's no color I GM and I e the idea, I'm spikes within two or three days and some test can detect that very. sensitive and the ideology almost immediately afterwards and you can use anti body task to detect, as your body was fighting off the virus. These are two different kinds of does deal the saliva test. This is something that I've heard of, but I've never seen implemented, what what is is there? A more effective version is saliva more effective than the nasal swab. Well,.

Just to be clear. The saliva tests could be the saliva test for the virus or saliva test for the antibodies. It is it's mine who gives wants us. There's two different want gather different their different things in their different ass. An endless alive is, of course, much easier for all of us that having blood drawn or having someone put at Youtube in our no so people are scrambling and have developed saliva test both for the virus and for the antibodies. just now, which is again great news. Incidentally, just to be clear to people. Why did the nation make a sacrifice of flattening the curve like? Why did we have the school closures in the lockdowns downs and all that stuff back in the spring. The reason we did it was to stop the progressive force of the virus like it's like a tidal wave was gonna, come ashore And we build breakers offshore so that the amplitude of the way would be due to still the water would come ashore, but it would come up shore more. Slowly than this huge wave hitting us

and the reason we did that was so that we could have our healthcare system begin to function, develop, discover the decks methods on works event, vaccines, invent tests, improve the tests, make the test easier for us to take. So all of these things have happened in the last nine months. This is why we did a sacrifice as we did last spring, and incidentally, this is why further sacrifices might be might be called from us. If we continue to be here, well, we might be able to spare a lot of deaths because then we'll have really good vaccines that have been shown to work will have more medicines to treat the sick. People Our hospitals won't be inundated. Doctors can take care of you better when the hospital is sixty percent, full Then, when the house, a hundred and twenty percent fall

they're not as exhausted the doctors, do want an exhausted doctor or wood with lack of supplies as worried that here, she's gonna get sick. Or do you want a well rested doktor with adequate supplies that is met really fit and ready to care for you. So all of these reasons we're flattening the curve back then and now, and so so these test, these miraculous test that we have for saliva, now have all been invented in the last couple of months. Jimmy did you find anything on the pc are nothing. Ok, I know I know I can imagine away joy cannon- in a way that the testing itself could be worse.

For you I'll, be all right, no nonsense out! No, no one saying that no, it was something saying that it becomes an effective. After a certain number of cycles here, here's another question: why do we have these ups wings and why do we have waves like what is the cause of waves? Is it people relaxing? Is it people gathering? going to bar seems to be particularly problematic right. What causing these waves is it that people get relaxed? So it's a lot of different things are doing it so that these distance of of a second wave right, I was completely unsurprising to anyone that studies, respiratory pandemics, I'm I'm unfamiliar with the respiratory pandemic in the last. Years that hasn't had multiple waves. Incidentally, I'm telling you now, maybe I'll, be back on the show in a year, they'll be a third wave a year from now.

Be a third way than actually probably a fourth wave to the amplitude of that way. If we have a back scene will be lower, but will still a blip up in cases a year from now Winder compare GIS eight months from now summer, so respiratory pandemics come in waves and they do that for a number of reasons. One has to do with Social and actions that the pattern of how people are at schools are open summertime schools are closed in in the fall, the school open and schools are of a place where lots of human beings me there are fifty million children in schools in three or four million adults teachers and janitors and others and capture workers at work in schools and awe and parents drop off their kids and pick him up and chat at the school. So there's a lot of social mixing that takes place in schools in the your time- people live differently, they move in doors, they have more close contact with each other's easier for restoring Benda mix pathogens. To spread I endorse and outdoors as everyone knows by now, so human being

for changes in the winter. And this is why, incidentally, the germ tippit he goes to the southern hemisphere for its winter while we're having summer and then comes back north when our winter comes. Furthermore, there's there's a physical and physiological reasons, so the dryness of the air and the coldness of the air may facilitate the disks, version of the virus, and Our bodies may are, systems, as you were discussing earlier, may function differently in the summer and in the winter. So, for a host of many reasons, it is very standard that respite Rare diseases. Have this galloping scientist Lloyd Old pattern, a higher in the way, during the lower in the summer. So there's nothing surprising about what's happening right now,

The one begun known is how bad with a pandemic be. Now will it be in the nineteen eighteen pandemic? There was the second wave was four times as deadly as the first way, and the question in many experts mines right now is: is this call the nineteen pandemic? This in a way that America is beginning to experience now, Willoughby as deadly as the first wave or more deadly and and and I fear that it will be more deadly- and you know over a thousand Americans are dying every day of this condition every single day day, today, and that number is likely to go up unless We really get our act together and even

we do get our act together. The it'll take about three weeks before we see that the deaths plot, towing and then beginning to decline, so so we're gonna have thousands and thousands of deaths like a battleship turning like even if we start to make the turn it's gonna. Take many miles before the battleship turns same. Is gonna happen here, and so I think you know we're gonna have it's, it's gonna be bad. Unfortunately, I think many many Americans are gonna die and again this is not diminishing. The impact of the disease or that the fact that it's a dangerous disease, but one of things that the CDC it said was that only six percent of the people who died from covert nineteen had only covert nineteen and that the

rest had an average of two point: six co, morbidity factors here, but a little bit. Let me as your question: if you have diabetes and you're driving on the highway you're in a car accident, what do we say? Killed you car accident, yeah, the car accident, will we all say. While you are diabetes, so you know we're not gonna, say the car killed you. So the fact that People- and, in fact, We are ultimately are gonna die rabies. Those are emailed and reverse that rightly people say the people of leukemia, who also had covered their listen, that as a covert death, but they really had leukemia anyway, they were probably likely going die jealous, impersonal, diabetes was probably gonna, die, either diabetes, but they got into a car accident. So my answer is, is that is I can answer this question, so my answer that the usual way we think of things that kill people we think of the proximate cause in Alexei. Let's say I had dug a chronic obstruct.

Pulmonary disease. Ride end stage renal disease and someone shot me: I'm just I was getting dialysis in someone's shot me doesn't mean that I was gonna die anyway, my renal disease. Therefore I wasn't murdered. I was murdered, that's what killed me right, but you, above violent actions versus diseases and co. Morbidity factors. It's I don't think, that's a fair comparison. Well, you know, I think or when I think it is fair, because let's say you have the same exact situation. Let's say you have cancer and you're getting chemotherapy and you're being treated for the cancer, and then you get infected with a with the pneumonia, I knew die of the pneumonia you wouldn't have died, but for the pneumonia in this case, the scenario putting to you is now. If you're gonna make it I you're making and I understand words coming from. I don't mean to dismiss it completely. You would Also, then have to apportion all deaths to have a fraction due to different causes. So you would say this person

had. I had had a diabetes and they also got corona virus, so we're gonna say it's fifty percent of the death, as do the diabetes and fifty percent, is due due to the corona Virus- and you could go, then it it if you, wanted to do that you could like for all causes of death, you could apportion them and that would risk in your rejecting multiple things, but it's not fair to just pick on grown a virus and say well. Actually people will have died of something else, so we're not account those that wasn't as not does not war saying what what people are saying is that the actual danger of the disease is is greatly exacerbated by the poor health Erica. That's true! This is what I'm getting at. Is it yeah yeah? That is true, but as a hundred percent true and and the coal more bidding greatly increase your risk of So that is true, and this is certainly one of the reasons why, Sweden, is having its own problems right now, but one of the reasons it wasn't really fair to hold up. Sweden

as a comparison for our strategies for the Swedes, her much help here that we are examining ever There is a completely different society. Yeah we're not, unfortunately, is healthy as the Swedes yeah. That is something that I feel like. We could have gotten into people's heads eight months ago and perhaps made a dent in the the impact of the virus. It's hard to tell people you have to be healthier. They don't want to listen, people have their habits and they have their vices and they have their behaviour patterns that they're just accustomed to, and it's very difficult to break people out of them. But some people would have listened somebody. Bull, especially terrified, faced with the possibility of either surviving a pandemic or not may have on something differently in its one of these frustrates we so much about not just the government response, but the media's response to this is that I dont see

Anybody out there saying you gotta, get healthier and it's a one year might save you, yes, I mean I, I agree completely with that an end. There are anecdotal story, I have some of them in the book of elderly B. Those who are whose fear getting this end one are not only a day, drawing socially and limiting their contacts, but they are trying to get fitter in other exercising more and trying to prepare their bodies for the possibility that they might get an infection and trying to optimize their chances. So I totally agree with that, but it's hard. It's hard to persuade people to to behave in a healthy way. It's always hard, let alone but you're, saying I think, erectly using look. It should be easier to motivate them to do it now, how well it might be hard, but it's not impossible and then there's been zero effort. Zero. Yes, it's almost like the like it's,

in a word: let's let us not try that and let's just shut down all the businesses that senior We need to be asked- and I guess so I think that's right. So this is where we're getting back to the sacrifices expected of us like if you want, if Americans were willing to work work together to like, let's say, if I may, to make us up unless they phronsie we were given a choice: either every American can whose ten pounds or ever arguments over way, which is like sixty six percent of Americans are overweight. Two thirds of them are more, are overweight everywhere American can lose ten pounds or we're gonna go businesses in our community. Actually, you know I mean I haven't other calculation we have to but you can imagine doing such a compilation and concluding that you're. Actually, that would be equivalent, and so we to tell people. You know this is your dilemma. Europe, you're, being call to action. You're, not you not being dropped, regional war, but you need to sacrifice you need to do your part and your part is you know this?

so I agree with you Joe. I mean I think I don't even think you're going to get them to be motivated that way, telling people they have to sacrifice and do your part people are fucking selfish. Tell him listen! This is going to save you. This is the thing that's going to make you healthy This is the thing is going to give you a better chance of survival, if you get infected, but there the wood for streets, a shit out of me, a person who spent most of my life thinking about health and fitness and wellness, as it has been zero impact, theirs, zero by the government. Zero impact on people's health in that regard, zero discussion of strengthening european says- and strategies and having health experts talk about proven strategies for boosting. Immune system? There's been no, yes, I think that should be the messaging, and I, I actually know some people that I can relay that to that may help the may influence the national.

sitting on this topic, actually sign when it? I made a note of this point, and I know- someone I can communicate this. Do what I know that you are viewed starting back national policy while thou be wonderful, because plenty of peer, reviewed studies on the impact of specific vitamins and nutrients on your immune system. Yeah. What else do you think we need to do that, we're not doing I think we are we talk about some of that already I mean you know. I think we need to get much better with testing. We need to get better with masking. We need to, unfortunately, avoid gatherings we need to be better with public messaging we need to prepare the nation a bit more to understand what we're facing. I, I think we do need more coordination. I dont think this the patchwork approach will work to these all the things I think we we should be doing in an

that messaging. Incidentally, I would second what you said, which is encouraging people to take better care of themselves, which is the thing to do anyway. So I think that that's already a pretty tall order, Joe I mean I don't know what more we can we are making heavy investments in in investing in technology and in science, which I think we do. I think we we do need to take our public health interests. After a bit more seriously, it sort of very on thing to spend money on another public health departments, but we need them When this, when they spend Amex struck, we didn't even have contact tracing capability. At the level we needed it's. You know it's very sort of bread and butter, a kind of public health, capabilities, but we compare to Asian trees. We didn't have that so so their number strategic investments as a nation we need to make all of which, incidentally, are peanuts compared to what's happening to us Larry Summers of former Treasury secretary former colleague of mine when I was at Harvard now I'm at Yale and at a colleague of his David Cutler

health economist at Harvard. They published a paper about a month or two ago which called that the corona virus to this sixteen trillion dollar virus sixteen trillion. Charges are vast sums of money and they estimated that the hit to our economy by the virus was eight trillion dollars. And that there was a further eight trillion dollar loss because of the DAS illnesses and disability from the virus. So our nation has suffered from them This virus took root in our society. It has suffered Sixteen trillion dollar loss. It's like thank having a big house that, just as burned to the ground, it's gone, you know it's just a big loss and and and that's that's what we're facing as a country ashes. and I just think we are back in repeating myself. I think we just need to confront that and deal with that

possibly as we can. I think one of the more you need things about America is that we have all these different states and we get to see all the different responses are. Different states have and that's one of the more confounding things about California's draconian methods, because it has really been effective there. There still massive infections and deaths and its it doesn't seem to have done that much particularly that right now with theirs. The giant waved their experiencing Florida is weird right cause for it is essentially said fuck it you can do whatever you want haven't they did they basically opened Everything live sporting events concerts restaurant? I haven't, I haven't track it at this level of detail, but I do want to emphasise that even if the governments as you can have live sporting events. Only certain many people still won't go so there is still

I'm very about Florida. I bet I said you're talking about Florida. I better go there that test, monkeys data test monkeys for America I mean people in florida- wild folk they'll do some wild stuff yeah. I right now, alligators I haven't, I haven't tracked every state and what every state is doing. I dont track it at that level. I definitely have an eye, and also, incidentally, I also don't look at cases by testing. I look at death because deaths are much less ambiguous, like testing numbers can go up and down because we test more yeah, we just more or less. This was sober. Deaths are much harder to fudge. So I monitor DAS. I have a sense of how many Americans have died on any given day and the cumulative toll of death, but I don't I didn't I an I'm paying attention. The different states like earlier we're talking about the Dakotas I haven't paid close attention to Florida. California

Lord, the governor had a press conferences want bring this up where he bringing up where you had different age groups, he had a chart and he was showing that we have to protect the most vulnerable, which is people particularly out older folks in obese folks. But it was basically saying for everyone else. This is not nearly as dangers, and now a lot of people got angry at him for this, and they said it was a responsible the way he was describing it but I'm pretty sure they're, basically opening up most things I mean they have Disney. world is open and a limited capacity their, whereas Disney Land California's completely shut down and has been since March? We here, but I have this. I have to make make a point here about this, and this goes back to our risk issue of our conversation about risk, so it is case that most young people, if infected with this disease, face a very small risk of death. In all, let's say you in your twenties, you ve like one.

three thousand chance of dying. If you get infected on average you're, sick or you have some other condition or whatever. Ok, your ire, but the truth of the matter is that young people face a low risk of death of all causes. Like I have kids in their twenties, I wouldn't want my kids to get sick and if they did get sick I would. I would take some solace in the fact that this particular pathogens seems too spare the young it needn't have been this way. Other pathogens kill the young spare the old, like Spanish, gigs yeah, like that's not the case here so I am. I do take us apparent some solace in the fact that you know my kids if sick would very likely to survive, but I would not say oh never mind if you get sick. That's not true! The risk of death is very low from all causes. So why would willingly accept an extra cause of death, especially one that does not offer any benefits is not like her driving a race card risking death, but you're having driving them,

scarf. Mozilla is getting floored as explanation, for that would be that they want to open up their economy because they think there is a danger in closing the economy. That is not discussed as often as the danger like enter in terms of the risk to human life, suicide, drug, addiction is a lot of factors in depressed in economy. Young poverty is deadly media losing their jobs. hundred percent. I totally agree- and this is why going back. I think first thing we have to do is we have to tell the difference between what part of the omg damages just due to the virus and what part is something we can do like we're doing to ourselves. We can affected because remember people are gonna, stop going out and shop shopping just as they know, there's a deadly virus out. So let's say for the sake of argument: fifty percent, circulation of human beings. That is reduced

that is, loss is because people themselves are making these decisions, so the economy is gonna tank just cause, people don't want to stop any more and that it has been happening for hundreds of years of would fight with the epidemics. So there's that part then there's the next part, which is things a weirdo by banning gatherings or closing restaurants or whatever now, if we're going to decide whether to do that are not your argument begins to have traction, because you can say look at what we can was down that part of the economy where contributing who poverty and suicide and drug use and depression, and all these other adverse effects. and then we have to engage in the very difficult and transparent as a society utilitarian calculus of saying are the lives we lose because of that more or less than the lives we save here. I agree that I think that we do need to be very clear.

hearted about it and do these calculations and publicize himself. The governor of Florida said I thought deeply about this and I have consulted experts and we ve done the calculus actions that we concluded that we're gonna have an extra hundred thousand desert thirty thousand deaths in Florida, because we are not closing the economy due to coded whereas if we close the economy, we would have saved those lives, but we would have lost some other number of lives and here's what I Furthermore, dear Floridians, because not slowing the spread of the virus. Some of you get sick, we'll go to your left the hospitals and will be turned away to die because our beds are full capacity and I am making a decision that we're gonna take those debts and we're gonna take them off alone, come on people being turned away at the hospital door and we're doing

because we don't want. We want to avoid these other. Does that would at least be honest, and you know I would respect that, but I don't see that that's what's happening. I dont think that deep thought is going into I dont think serious calculation is going into it and I certainly don't see governor saying we're going to keep our economy open, but the price of that will be these debts and when Why happens in a weaker in a month? I told you so that I dont see happen Well, that's that I say that if we can have our cake and eat it too, that is kind of political suicide. Right took to say that to decide where work calculating that a lot of you are going to die because of this decision, but the economy is going to do better No we're gonna see, fewer of you will die were calculated. Yes, you can do that or you might even to the calculation and say, look at sea, we Donna Calculation and we would lose forty thousand people do today? let me being tanked ah versus

thousand lives due to call it, and so I had to make the difficult decision as your governor to keep the two not issue. These stay at home orders to two, because this will result in more in saving lives or not say actually if we, if we, if I issued stay at home orders, we would prevent thirty thousand cover debts. if don't I stay at home orders, we would we woods. We would pay thirty thousand deaths from covered, but we would have twenty thousand deaths from the economy. I'm a mixing it all up now, because I'm moving too fast and I hope listers get the gist of it. The point is: is that their their lives on both sides of the ledger? And if you tell me

those lives and you decide. This is what you're gonna do. In your honest with people, I have less of a problem with that now Nicholas. If I gave you a magic wand- and I said you're the king, the world tell me what to do. If you could, if you could be the person you ve studied this obviously very deeply to write this book, probably more deeply the most. What do you think should be done? What step by step strategy to both preserve the economy and preserve them, maximum amount of people's health. I don't think we can fully preserves economy and I don't think we can prevent all deaths, so we To that both are going to suffer, I think we, into better as a nation by gleamed and jostling to to, implement. A variety of slices of swiss cheese, that we discussed earlier that, if we collectively implement mean we can protect more businesses and protect our schools are kids can go to school,

I'm, not saying that it's a hundred percent sure that we can do that. We might still have to close schools and close businesses, but if we did more testing more masking more physical distancing if we, if we limited gatherings. we had better messaging, so people said you know what I, if I dont have Thanksgiving gatherings gatherings than I can keep the business is open and keep the schools open I think it's just immature to think that we can just go about life as it was before, because our, world has changed, is just not the same. We have to accept this at least for a while. If we do those things, I think we and we and we have better messaging from our leaders. I think we can. We will emerge from this pandemic, as we will inevitably in a couple of years, because plagues always end, we are going to see the sight of this, we will urge with it relatively less relatively more unscathed. it is to say, with fewer deaths from the disease and fuel and less damage to our economy

but there's no way, unfortunately, to fully avoid death and, of course, struck of courses no way to avoid that we're in it right so, but would you instituted a nationwide mask mandate. I dont think legally, that's a lie but I think if the nation were able to do that, I think we would. We would greatly Do the transmission of this germ? We would save lives and minimize the other hardships that we had to implement. Yes, I think masks is the simplest thing I mean look I can just put on. I can put on this matter and if I do that thing and we all do that thing, we don't have to do other more difficult things. Why? Wouldn't we it's a simple and you can do, is to put on a mask and the second simple Then you can do is minimize. Your social interactions of these are much easier and distance that you keep from other people, for example, in my household. We we try to make a shopping list. shopping once a week is that of twice a week. I mean we're

having our social interactions word thinning out the crowds at the grocery store. We still by this about a groceries, we're just not buying it, we're not having as many as many crowds their meaning common sense basic things that we can do as a nation which, if we did, what actual our grocery stores in restaurants and other places too in old fare better. So I mean that's that's what I would. The men. Yes, one things that people really terrified about, particularly friends, live in New York City is that it's never coming back. There's a lot of my friends that are experiencing so many of their friends moving out see so many businesses go under the really terrified of that that New York City,

so big, and it's such a massive machine that to take out a giant chunk of it due to the pandemic, to have all these businesses go under to have all these apartments that available for lease all these businesses available for lease. I don't see any strategy on the table to bring that back. I don't see that being discussed. is this something you considered when you wrote the book yeah? I know I think those we'll come back. I mean, I think, the first of all We're seeing of exodus from cities to rural parts of the country that has been seen with every plague for thousands of years? Is nothing surprising about the fact that at times a plague people flee the cities but

The city is always come back, so I have no doubt if I were a very rich person and I would I would be buying Manhattan real estate in a year or two ago. Not now, that's why not now in a year or two well, I think it's still there go down for a while right, I mean people are still leaving the cities and the other takes a while for the marked declaring I'm no expert on Manhattan real estate. I made up that example: I'm not exactly giving thank you, because what the gist is clearly our accounts. These reshaping and people are moving into more rural parts. Ives Dolly we see rising house prices, rural parts, it in suburbs, also with a working from home people are beginning to realize you know, I can do my job from home. Why should I be the two bedroom apartment in in Philadelphia when I just as soon live on a big farm in rural Pennsylvania and do

a job from a distance, and I get much more space for myself in my family and so on. So so I think we're seeing that I think, but I do think the cities will come back because the intrinsic appeal of cities is so great. And they have always come back in the past. So eventually, I think the cities will return, but you know, but, alas, businesses are gonna, have gone out of business and will go out of business and in this is awful, and let's not forget in oh, I forgot. The unemployment figures may be. Jamie can Look up. I dont have em handy right now, but I like that, like thirty million, Europeans have lost their jobs and many people are unemployed and dumb let alone the loss of life and, in the end, as I said, we're not through with this yet, so I think you know. I think this is a big shot, a big big, the airline industry, the hospitality industry, you think which is something a lot of planes right now: the travel industry, an incident the travel industry is gonna take a while to recover, because now all of us have realised that I don't have to fly it all. I mean I think, doing

business face to face is not going to stop. I think there's something extremely important about face to face or business, and I hope next time you have me on the show I'll come down ass. It will see each other have a drink, I'll, be tolerable, a nicer experience, although this is great far as I'm concerned, but anyway, but Many many cases on the margin people say: why should I fly across the country? Lena sign is contractor, have some kind of a given member routine meeting skip it will not do it by sea I think that's gonna be persistent and that's gonna have an effect on our economy. I got him another job. I think there's gonna be a change in women insurgents or some of the gender dynamics, because so, if you look at the typical, like the stereotypical heterosexual, apple in this in this country, so there are, of course, homosexual couples. There are single family in a single head of household families.

No single mom single dad's, much less common raising their children. But if you but most households are our heterosexual couples the more stereotypical still typical that and earn more than women in the labour market now, the case or not all households or heterosexual, not all households as the manner more. The women but the predominant, The modal as we say, pattern is still that in our society. So when the market the economy is tanking, as it is many Schools are closing many fans. Please sit around the kitchen, able and their deciding how to cope, and they say while the man is making we're money. You know he should produce remain in the labour market and so many watch the kid. So the woman is gonna quit her lets a job that wasn't paying as much as the husband and and anyway, women might have, on average, a reference for being with her kids compared to men so and we should absolutely allow individual households and families to make their own decisions about how to manage their own lives, but when milk,

heads of families reached soon. or decisions? We might find that the that up the labour market, means that women have made over the last ten or twenty years might have been reversed by this pandemic. That is to say, a few years from now when we look at the labour where's participation of women, we might see it change landscape as a result of this virus, so they're all kinds of things that will persist. You know that the world will have changed in some ways working from home women's labour market participation at the travel industry. Cool it. You colleges, for example, lot of colleges I've gone to develop the infrastructure in the The bureaucracy for online learning I'm colleges will signal. We can actually offer an online degree much more easy. We would we were forced to do it. I'll cure insurance companies. Insurance companies use do not pay for it. Why did you have to?

are your doktor to get up a prescription refill? This is ridiculous. Its society But well now you know everyone moved people didn't want. Doctors didn't want to see patients for such silly things in one patients coming to hospitals and getting infected or infecting others, so we made in it corruption, and we should all you can. Doctors can reveal prescriptions without physically seeing the patient. You think that's gonna come back. I mean people. for two years they will have been easily getting the prescription reveal. The now know so. They're gonna be pursued. and changes in our society. From all of these things, one thinks it disturbs me is that the stimulus package that check that people got that twelve hundred, our Czech was one jack and I never had never repeated, and that was it it was. It was crazy, like it did, make any sense. I can't imagine they thought that that it really help people, especially over the long term, what what? If any effort has been put to try to increase that

and and try to send more checks out- and this is gonna- be a part of the response that the government has like gangs. Universal basic income idea really made so much sense during this pandemic like this is a real example when something like this is absolutely necessary. Yes, I think another example, and then I'll come back to that. Although I'm no expert in this topic is why health insurance is tied to your employment in this country and rightly makes no sense right. I dont want? If, if, if, if you lose your job and you can't get healthcare for a contagious disease, you're gonna be out about spreading this contagious disease ease or why are we don't have sickly policy for hourly workers that also doesn't make sense many hourly workers kept going to work when they were sick spreading the virus. This doesn't make any sense. We don't want that, so I think they're gonna be

changes in how we couple insurance to employment and sickly policies, because having a contagious disease illness, read some of the demands in the existing system now same Gozo, universal basic income. Now I am not an expert in this area, but I think that the way the government handled the way which is pumped out money- and I think that was also some corruption and like who got the money- I'm didn't track all this in detail. You may notice more than I do. I think we're gonna have to rethink, and I dont think we're done, unfortunately, with with them with restructuring and rethinking the unemployment benefits. I do think we're. Gonna have to do more to provide for people because all that stuff is about to end and I think people org eurozone a wave of mortgage foreclosures and other

the angel hardships that people are going to experience yeah now I agree with you: listen Nicholas next time we do this. I do hope we do it in parliament in person, but please tell people to have a copy of your books. You can hold it up. I do have a copy them Well then, I put on I hadda. I had it as is no matter and put on a mask, as this was swag, that my are that my a publisher semi, which I thought was really cool swags. I have a limited to five of those math. I wouldn't where what is the name Apollos airily comes from, It's a nice thing to finish on hold it. I could see the spelling of it Apollos arrow. Ok, yes, and it comes from a story at the beginning of the Iliad so the weeks. This was events three thousand years ago, so this that the Iliad which

homer story about the Trojan war describes. Events took place we thousand years ago in the book, begins with a plague. What happened is Greeks were laying siege to try and they were periodically going on raids and sacking vassal states of Troy and they would they would kill all the men, take all the treasure and enslave the women and children and bring them back to their camps and divide up the booty. So they had sat in nearby city and there was a maiden girl by the name of crisis who was given to Agamemnon that the principal king of the Greeks, as his prize and crisis is father. Crises was was a priest of APOLLO Apollo was the ancient Greek of healing and also of illness and disease, and so crises comes to the great care to ransom, his daughter, he brings a big treasure and he goes to Agamemnon Tent the king of all the Greeks, and he falls on his knees in a bag

and he says please release my daughter and not only does Agamemnon say it will not release the daughter, but he treats his An extremely rudely in front of the greek Army treat this priest is important. East and he says away with you. Not only will I know give you my daughter, but she will grow old in my house in my bed. You know basically working as a slave for me and if I see you lingering around the ships in, I will kill you any any does smashed the man and send him away. So the priest goes back down to the shore and he says a prayer he says to uphold If I have ever served you if I've ever given you sacrifices that have honoured you hear me now and come and punish the Greeks and the prayer instantly goes too the Olympics in APOLLO hears him. Paul always enraged, and he picks up his big on you like archery. He was also the God of Archery picks up his big silver bow and he comes flying through the air.

down among the ships that were and circling around the beach head and certainly, try any crouches among the ships and the in the region weeks thought of diseases as Apollos arrows, your invisible you're just stricken by an invisible arrow, and he it is among the ships and though, and in the end, the book goes. The story goes of Apollos arrows at the sitting of the Iliad goes first. He killed them hunting dogs and the horses, and then he began to kill the men. Now days through the army, go the arrows of the God and the funeral piles burnt day and night from the dead until finally Hara the queen of the gods, took pity on the Greeks because she saw them perishing and she was put into Achilles, is ear Achilles was another great king and warrior with spurs into his ear call the Greeks to muster returned the girl to the priest so that the plague will end and it turns out

then APOLLO either Memnon was forced to return return, this girl back to her father and he had to pay up a ransom, but he was his pride was so wounded that he then set into motion other events that ultimately lead that the last year of the warrant That makes a lot more sense cause. I was wondering I thought it was one word, a polish zero. That's what I thought, You were saying so like how is that spelled? We see we see the book now it's on the screen Nicholas. Thank you very much. Good luck with the sales yearbook. Thank you. very much writing it. Thank you very much for having such a reasonable and objective perspective on this, and I really appreciate very much to thank you for everything you do. Thank you for having me back and I look forward to this person in Austin in a year. Absolutely thank you. Take care of our other. Thank you. Friends were turned into the pot gas and thank you to express VP,

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