Kind: captions
Language: en
the following is a conversation with jay
baracaria professor of medicine health
policy and economics at stanford
university
please allow me to say a few words about
lockdowns and the blinding destructive
effects of arrogance on leadership
especially in the space of policy and
politics
jay barakaria is the co-author of the
now famous great barrington declaration
a one-page document that in october 2020
made a case against the effectiveness of
lockdowns
most of this podcast conversation is
about the ideas related to this document
and so let me say a few things here
about what troubles me
those who advocate for lockdowns as a
policy
often ignore the quiet suffering of
millions that it results in which
includes economic pain loss of jobs that
give meaning and pride in the face of
uncertainty the increase in suicide and
suicidal ideation and in general the
fear and anger that arises from the
powerlessness forced onto the populace
but the self-proclaimed elites and
experts
many folks whose job is unaffected by
the lockdowns talk down to the masses
about which path forward is right and
which is wrong
what troubles me most
is this very lack of empathy among the
policymakers for the common man
and in general for people unlike
themselves the landscape of suffering is
vast and must be fully considered in
calculating the response to the pandemic
with humility and with rigorous
open-minded scientific debate
jay and i talk about the email from
francis collins to anthony fauci that
called jay and his two co-authors
fringe epidemiologists and also called
for a devastating published takedown of
their ideas
these words from francis
broke my heart
i understand them i can even steel man
them
but nevertheless on balance they show to
me a failure of leadership
leadership in a pandemic is hard
which is why great leaders are
remembered by history
they are rare they stand out
and they give me hope
also this whole mess
inspires me on my small individual level
to do the right thing
in the face of conformity
despite the long odds
i talked to francis collins i talked to
albert burleigh pfizer ceo
i also talked and will continue to talk
with people like jay
and other dissenting voices that
challenge the mainstream narratives and
those in the seats of power
i hope to highlight both the strengths
and weaknesses in their ideas with
respect and empathy but also with guts
and skill
the skill part i hope to improve on over
time
and i do believe that conversation
and an open mind is the way out of this
and finally as i've said in the past i
value love
and integrity far far above money fame
and power
those latter three are all ephemeral
they slip through the fingers of anyone
who tries to hold on
and leave behind an empty shell of a
human being
i prefer to die a man who lived by
principles that nobody could shake and a
man who added a bit of love to the world
this is the lex friedman podcast to
support it please check out our sponsors
in the description and now here's my
conversation with jay batakaria
to our best understanding today how
deadly is coveted
do we have a good measure
for for this very question
so the the best evidence for covet the
deadline to covet comes from a whole
series of zero prevalent studies sierra
preference studies are these studies of
antibody prevalence in the population at
large
i was
part of the you know the very first set
of sierra problem studies one in santa
clara county one in l.a county and one
in the with major league baseball around
the u.s uh if i may just pause you for a
second
if people don't know what uh serology is
in cerro prevalence it does sound like
you say zero prevalence it's not it's
cerro and serology's antibodies so it's
it's a a survey that counts the number
of antibodies specifically
people that have antibodies
specific to kovaid which perhaps shows
an indication that they likely have had
cobit and therefore this is a way to
study how many people in the population
have been exposed to have had
exactly yeah exactly so the idea is that
uh
we don't know
exactly the number of people with cove
just by counting the people that are
there to present themselves with
symptoms of covid um covet has it turns
out a very wide range of symptoms
possible ranging from no symptoms at all
to this deadly viral pneumonia that's
killed so many people and the problem is
like in if you just count the number of
cases the people who have very few
symptoms so often don't show up for
testing we just don't they're outside of
the can of of public health
and so it's really hard to know that the
answer to your question without
understanding how many people are
infected because you you can probably
tell the number of deaths that's even
though there's some controversy over
that but uh that so that the numerators
is possible but the denominator is much
harder how much controversy is there
about the death we're gonna go on
million tangents is that okay we're
gonna i have a million questions so one
i love data so much
but i've like almost tuned out paying
attention to cover data because i feel
like i'm walking on shaky ground i don't
know who to trust
um maybe you can comment on different
sources of data different kinds of data
the death one that seems like a really
important one
can we trust the reported deaths
associated with covid or is it just a
giant messy thing that mixed up and then
there's this kind of stories about
hospitals being incentivized
uh to report a death as covert death so
uh uh there's some truth in some of that
let me just so
let me just talk about the incentive so
in the united states
we passed this cares act that was aimed
at
making sure hospital assistance didn't
go bankrupt in the early days the
pandemic
the couple things they did one was they
provided incentives to treat covet
patients
tens of thousands of dollars extra per
per covered patient
um and the other thing they did is they
they gave a 20 bump to medicare payments
for elderly patients who are treated
with covet the idea is that there's more
expensive to treat them i guess the
early days um so that did provide an
incentive to sort of have have a lot of
code patients in the hospital because
your financial
success of the hospital or at least not
by the lack of financial ruin depended
on having many covered patients the
other thing on the death certificates is
that reporting of deaths is a separate
issue i don't know that there's a
financial incentive there but there is
this sort of like complicated you know
when you fill out a death certificate
for a patient with a lot of conditions
uh like let's say a patient has diabetes
a patient that well that diabetes could
lead to
heart failure you know you have a heart
attack heart failure your lungs fill up
then you get covered and
what and you die so what do you what do
you write on the death certificate was
it cause it covered the killed you was
it the lungs filling up was it the the
heart heart failure was it the diabetes
it's really difficult to like
disentangle
um and i think a lot of a lot of times
what's happened is they people have like
erred on the side of signing is covet
now what's the evidence of this there's
been a couple of
of audits of death certificates in
places like santa clara county where i
live in alameda county
uh california where they they carefully
went through the death certificate said
okay is this reasonable to say this was
actually covered or is it was covered
incidental and they found that about 25
20 25 of the deaths were
more likely incidental than directly due
to covet
i i personally don't get too excited
about this i mean it's a philosophical
question right like ultimately
what kills you
it's which is an odd thing to say if you
if you're if you're not you're not in
medicine but like really it's it's a
it's almost always multifactorial it's
always always just the bus hits you the
bus hits you that you get a brain bleed
was the brain bleed that killed you
would it burst anyway i mean you know
the bus hits you killed you right the
way you die is a philosophical question
but it's also a sociological and
psychological question because it seems
like
every single person who's passed away
over the past couple of years kind of
the first question that comes to mind is
just was it not not just because you're
trying to be political but just in your
mind no i think there's a psychological
reason for this right so um
you know we have we spent uh the better
part of a at least a half century in the
united states not worried too much
about infectious diseases and we the
notion was we'd essentially conquered
them it was something that happens in
faraway places to other people
and that's true for much of the
developed world life expectancies were
going up
for you know decades and decades
and for the first time in living memory
we have a disease that can kill us
i mean i think we're effectively evolved
to fear that like the the panic centers
of our brain the lizard part of our
brain takes over
and our central focus has been avoiding
this one risk
um and so it's not surprising that but
people when they're filling out death
certificates or thinking about what what
led to the death
this most salient thing that's in the
front of everyone's brain would jump to
the top
and we can't ignore
this very deep psychological thing when
we consider
what people say on the internet what
people say to each other what people
write in scientific papers what
everything it feels like
when covid
has been
um
has been brought onto this world
everything changed in the way people
feel about each other just the way they
communicate with each other i think
the the level of emotion involved
i think it in many people it brought out
the worst in them
for sometimes short periods of time and
sometimes it was always therapeutic like
you were waiting to get out like the
darkest parts of you
just to say if you're angry at something
in this world i'm going to say it now
and um i think that's probably talking
to some deep primal thing that
um
fear we have for um
formalities of all different kinds and
then when that fear is aroused and all
the deepest emotions it's like a
freudian
uh psychotherapy session but across the
world something that uh psychologists
are gonna have a field day with for
generation trying to understand um i
mean i think that
i mean what you say is right but piled
on top of that is also this sort of
uh this impetus to empathy to empathize
compassion toward others
essentially militarized
right so i'm protecting you by by some
actions
and
uh those actions if i if i don't do them
if you don't do them well that months
must mean you don't just you you hate me
um it's created this like social tension
that i've never seen before and we and
we start have started we started we
looked at each other as if we were just
simply
sources of of germs
rather than people to get to know
people to enjoy people to get you know
to learn from um it it colored
basically almost every human interaction
for every every human on the planet
yeah the basic common humanity it's like
you can wear a mask you can stand far
away
but the
love you have for each other when you
look into each other's eyes that was
dissipating and
by region too i've experienced having
traveled quite a bit throughout this
time
it um it was really sad even people that
are really close together just the way
they stood the way they looked at each
other
and i it made me feel for a moment
um
that the fabric that connects all of us
is more fragile than i thought
i mean if you walk down the street or if
you ever if you did this during covet
i'm sure you had this experience where
you walk down the street if you're not
wearing a mask or even if you are
people will jump off the off the
sidewalk as you walk past them
as if your poison
even though the data are that covet
spreads you know indifferently outdoors
or if at all really at outdoors
but it's not simply a biological or
infectious disease phenomenon or
immunological it's it is a it is a it's
a
it is a change in the way humans treated
each other i hope hope temporary
i do want to say on the flip side of
that so i was
mostly in boston massachusetts when the
pandemic broke out i think that's where
i was yeah
and then i got came here to austin texas
to visit my now good friend joe rogan
and he was the first person
without pause this wasn't a political
statement this was anything just walk
toward me and give me a big hug
and say it's great to see you and i
can't tell you how great it felt because
i in that moment realized the absence of
that connection back in boston over just
a couple of over a couple of months and
um
it's we'll talk about it more but it's
tragic to think about
that distancing that dissolution of
common humanity at scale what what kind
of impact it has on society just
across the board political division
uh and just in the quiet of your own
mind in the privacy of your own home the
depression the sadness the loneliness
that leads to suicide
and forget suicide just
low key suffering yeah no i think that's
that's the suffering that isolation
we're not meant to live alone we're not
meant to live apart from one another
that's of course the ideology of
lockdown is to make people live apart
alone isolated so that we don't spread
diseases to each other right
but we're not actually designed as a
species to live that way
and that uh what you're describing i
think
if everyone's honest with themselves
have felt uh especially in places where
that where lockdowns have been sort of
very militantly enforced has felt deep
into their core
well i if i could just return to the
question of deaths he said that the data
isn't perfect because we need these kind
of serial prevalence surveys to
understand how many cases there were to
determine the rate of deaths
and we need to have a strong footing in
the number of deaths but if we assume
that the the
the number of deaths is approximately
correct
like what's your sense what kind of
statements
can we say about the deadliness of covet
against
across different demographics maybe not
in a political way or in the current way
but when history looks back
at this moment of time
50 years from now 100 years from now the
way we look at the
pandemic 100 years ago
what will they say about the deadliness
of code i mean i think the deadlines of
kova depends on not just the virus
itself but who who it infects
um so the probably the most important
thing about it about the deadlines of
covet is is this steep age gradient in
the mortality rate um so according to
these zero prevalence studies that that
that have been done now hundreds of them
um
mostly from before vaccination because
vaccination also reduces the mortality
risk of covid um the the sierra
prevalent studies suggest that
the risk of of death if you're say over
the age of 70
is
very high if you have five percent
if you get covered
if you're if you're under the age of 70
it's lower
0.05 but there's not a single sharp cut
off it's more like i have a rule of
thumb that i use um so if you're 50
say the infection fatality rate from
covalent is 0.2
according to the zero prevalence data
that means 99.8 survival
if you're 50 and for every seven years
of age above that double it every seven
years of age below that have it
so 57 year old have a 0.4
mortality a 64 year old would have a
point eight percent and so on and uh if
you have a severe chronic disease like
diabetes or if you're more morbidly
obese it's like adding seven seven years
to your life
and this is uh for unvaccinated folks
this is unvaccinated uh in the before
delta also
are there a lot of people that will be
listening to this with phds at the end
of their name that would disagree with
the 99.8 would you say so i think
there's some disagreement over this uh
and the disagreement
is about the quality of the zero
prevalence studies that were conducted
so as i said earlier i was the senior
investigator in three different sierra
problem studies and very early in the
epidemic
i view them as very high quality studies
um we we um in santa clara county what
we did is we used a a test kit
uh to uh that we obtained
from uh someone who was works in major
league baseball actually he ordered
these test kits very early in march 2020
that measures very accurately measures
antibody levels
antibodies in the in in the bloodstream
uh these test kits were eventually were
approved by the the head of eua by the
emergency use authorization by the fda
sort of shortly after we did this
and uh it had a very low false positive
rate false plot of means if you if you
uh if you don't have these coveted
antibodies in your bloodstream the cut
kit shows up positive anyways that that
turns out to happen about point five
percent of the time
um and uh based on studies a very large
number of studies looking at
blood from 2018 you try it against this
kit
and uh you know point five percent of
the time 2018 there shouldn't be any
bodies there so for to cover if it turns
positive as a false positive 0.5 of the
time
um and then you know like a false
negative rate about 10
12 something like that i don't remember
the exact number but the false positive
rate is the important thing there right
so you have a population in march 2020
or april 2020 with very low
fraction of patients having been exposed
to code you don't know how much but low
even a small false positive rate could
end up
biasing your study quite a bit
but there's a formula to adjust for that
you can adjust for the fourth spot rate
falls negative rate we did we did that
adjustment and those studies found in a
community population so leaving aside
people in nursing homes who have a
higher death rate from covid um the that
the death rate was point two percent in
santa clara county
and in l.a county across all these
groups in the community community
meaning just like regular yeah so like
that that's actually a real important
question too so uh the santa clara study
we did this facebook sampling scheme
um which is i mean not not the ideal
thing but just like it was very
difficult to get a random sample on and
during the you know during lockdown
um where we put out uh an ad on facebook
soliciting people to
volunteer for the study a randomly
selected set of people we were hoping to
get a random selection of people from
santa clara county but it tended to the
people who tend to volunteer were from
the richer parts of the county like i
had
stanford professors writing begging to
be in the study because they wanted
antibody levels so we did some
adjustment for that in la county we
hired a firm that had a pre-existing
representative sample of la county
um
so but it didn't include nursing homes
it didn't include people in jail things
like that didn't include the homeless
populations so it's it's representative
of a community dwelling population
both of those and there we found that
both in l.a county and santa clara
county in april 2020 something like 40
to 50 times more infections than cases
in both places
so for every case that had been reported
to the public health authorities we
found that you know you know 40 or 50
other infections people with antibodies
in their blood
that suggested that they'd had coveted
recovered so people were not reporting
or severe at least in those days under
reporting yeah i mean there was you know
there's testing problems there weren't
so many tests available people didn't
know a lot of a lot of them we asked a
set of questions about the symptoms
they've faced
and most of them said they faced no
symptoms or the most uh 30 40 of them
said face their no symptoms
and i mean even these days how many
people report that they get covered when
they get covered okay i'll have those
numbers
that point two percent has that
approximately held up over time that is
so if professor john ian edis who's a
colleague of mine at stanford uh is a
world expert in meta analysis probably
the most cited scientist on earth i
think uh at least living
he he did a a meta-analysis of now a
hundred or more of these cereal
prevalence studies
um and uh uh what he found was that that
point two percent is roughly the
worldwide number in fact i think he
cites this lower number 0.15 percent
as the median infection fatality rate
worldwide
so we did these studies and it generated
an enormous amount of blowback
by people who thought that the infection
rate is much higher
and there's some controversy over the
quality of some of the other studies
that that are done and so there are some
people who look at this same literature
and say well the the lower quality
studies tend to have lower ifrs
the higher quality studies how far oh
infection fatality right i apologize i
do this in lectures too
and i'm going to rudely interrupt you
and ask for uh for the basics sometimes
if it's okay no of course so these these
higher quality studies they say are tend
to produce higher but the problem is
that if you want a global eye infection
fatality rate you need to get
sierra problem studies from everywhere
even places that don't necessarily have
the infrastructure set up to produce
very very high quality studies
and in poor places in the world
this the the st that uh like places like
africa the infection fatality rate is
incredibly low
uh and in some richer places
like new york city the infection
fatality rate is is much higher
it's there's a range of ifrs not a
single number
this sometimes surprises people because
they think well it's a it's a virus it
should have the same properties no
matter where it goes
but the virus
kills or infects or hurts in interaction
with the host
and the properties of both the host and
the virus
combine to produce the the outcome but
you also mentioned the environment too
well it's i'm thinking mainly just about
the the person like if i'm gonna think
about it like the most simplest way to
think about it is age age is the single
most important risk factor
so older places are going to have a
higher ifr
than younger places africa three percent
of africa is over 65. so in some sense
it's not surprising that they have a low
infection fatality rate so that's one
way you would explain the difference
between africa and new york city in
terms of the fatality rate is the age
the average age yeah and especially in
the early days of the epidemic in new
york city
the
uh
older populations living in nursing
homes were differentially infected
based on because of policies that were
adopted right to send
coveted infected patients back to
nursing homes to keep hospitals empty
what do you mean by differentially
infected
the policy that you adopt determines who
is most exposed right that okay so
that's what the policy it's the person
that matters
i mean it's not like the virus just kind
of it doesn't care i mean the policy
determines the nature of the interaction
and there's also i mean there is some
contribution from the
environment different regions have
different proximity maybe of people
interacting or the dynamics of the way
they interact
like if you have a if you have
situations where there's lots of
intergenerational
uh interactions yeah then you have a
very different risk profile than if than
if you have societies that are where
generations are more separate from one
another
um
okay so let me just finish real fast
about this so you you have in new york
you have a population that was infected
in the early days that was
very likely going to die but had a much
higher likelihood of dying if infected
and so new york city had a higher ifr
especially in the early days than um
than um then like africa has had
um the other thing is treatment right so
the treatments that we adopted in the
early days the epidemic i think actually
may have exacerbated the risk of death
which do so like
using ventilators like the the over
reliance on ventilators is what i'm
primarily thinking of but i can think of
other things
um but that that uh also we've learned
over time how better to manage patients
with the disease
so you have those you have all those
things combined so that's that's where
the controversy over this over this
number is i mean
new york city
also it has a is a central hub for those
who tweet
and uh those who write powerful stories
and narratives in article form
and i remember those quite dramatic
stories about sort of doctors in the
hospitals and these kinds of things i
mean there's very serious very dramatic
very tragic deaths going on always in
hospitals those stories
um
a lot of loved ones losing each other on
a deathbed that's always tragic and you
can always write a hell of a good story
about that and you should about the loss
of loved ones but they were doing it
pretty pretty well i would say um over
this kind of dramatic deaths and so in
response to that it's very
unpleasant to hear even to consider the
possibility that
the death rate is not as high as you
might otherwise as you might feel yeah i
was surprised by the reaction
both by regular people and also the
scientific community in response to
those studies those early studies in
april of 2020 um uh to me they uh they
were there were studies i mean they're
they're the kinds of not exactly the
kinds of work i've worked on all my life
but it's kind of kind of like the kind
of you know like you you write a paper
and you get response responses from your
fellow scientists and you you know
change the paper to improve it uh you
have hopefully learned something from it
well but to push back it's just a study
but there's some studies and this is
kind of interesting because i've
received similar pushback on other
topics
there's
some studies that
if
wrong might have a wide ranging uh
detrimental effects on society so that's
that that's the way they would perceive
the studies if you say the death rate is
lower and you end up as you often do in
science realizing that nope that that
was there was a flaw in the way the
study was conducted or were just not
representative of a broader population
and then you realize the death rate is
much higher that might be very damaging
in in people's view uh so so that's
probably
where the scientific community sort of
just steal man the kind of response is
that's where they felt like you know
there's some findings where you better
be damn sure before you kind of report
them
yeah i mean we were pretty sure we were
right and it turns out we were right so
like when we so um
we released the the santa clara study
via this open open science process and
this uh server called med med archive
it's it's designed for releasing studies
have not yet been pre-reviewed in order
to garner comment from the from
scientists before peer review
the the la county study we went through
the traditional peer review process
and got it published in the journal of
american medical association sometime in
like uh july i think forget the date of
2020.
the santa clara study released in april
of 2020 in this you know sort of working
paper archive
the the reason was that we felt we had
an obligation we had a result that was
we thought was quite important
and we wanted to tell the scientific
community about it and also tell the
world about it
and it wasn't we wanted to get feedback
i mean that's part of the purpose of
sending it to these kinds of places
i think a lot of the problem is that
uh when people think about published
science they think of it as
automatically true and if it goes
through peer review it's automatically
true if it hasn't gone through peer
review it's not automatically true and
especially in medicine when we're not
used to having this at this access to
pre-peer-reviewed
work i mean in economics actually that's
quite normal you it takes years to get
something published so there's a very
active debate over or discussion about
papers before they're peer-reviewed in
this in this sort of working paper way
um much less normal or much much newer
in in medicine
and so i think part of that the
perception about what those that what
process happens in open science when you
release a study
that that got people confused and you're
right it was a very important result
because we had just locked the world
down in middle of march
with i think catastrophic results
and if the if that study was right if
our study was right that meant we'd made
a mistake
and not because the death rate was low
that's actually not the key thing there
the key thing is that we had adopted
these policies these test and trace
policies these policies these lockdown
policies aimed at suppressing the virus
level to close to zero that was
essentially the idea
if we can just get the virus to go away
we won't have to ever worry about it
again
the main problem with our result as far
as that strategy was concerned wasn't
the death rate it was the 40 to 50 times
more infections than cases it was the
two and a half percent or uh three
percent or four percent prevalence rate
that we identified
of the antibodies in the population if
that number is right it's too late the
virus is not going to go to zero
and no matter how much we test and trace
and isolate we're not going to get the
viral level down to zero
so we're going to have to
let the virus go through the entire
population in some way or something
normal well that we can talk about that
in a bit that's the great barrington
declaration you don't have to let the
virus go through the population you can
shield preferentially
the policy we chose was to shield
preferentially the the laptop class
the set of people who could work from
home
without losing their job
yeah and we did a very good job at
protecting them well let me um
take a small tangent we're gonna jump
around in time
which i think will be the best way to
tell the story so that was the beginning
yeah okay actually can i kind of go back
one more thing for that because that's
really important and i should have i
should have started with this
um what led me to do those studies
was a a paper that i had remembered
seeing from the h1n1 flu epidemic in
2009 this is this is where i've been
much less active in writing about that i
had written up like a paper or two about
that when in 2009
there there was actually this same
debate over the mortality rate
except it unfolded over the course of
three years two or three years
the early studies
of the mortality rate
in h1n1 counted the number of cases
in the denominator count the number of
deaths in the numerator cases meaning
people identified as having h1n1 showing
up the doctor
you know tested to have it um and the
early estimates of the h1n1 mortality
were like four percent three percent
really really high
over the course of a couple of more
years a whole bunch of zero prevalence
studies zero prevalence studies of h1n1
flu came out
and it turned out that there were
a hundred or more times of people
infected per case
and so the mortality rate was actually
something like 0.02
for h1n1 not the three three
like a hundredfold difference so this
made you think
okay it took us a couple of two to three
years to discover the truth behind the
actual infections
uh for a h1n1 and then
what's the truth here and can we get
there faster yeah and and there was it
spreads in a similar way as the as the
h1n1 fluid did i mean it's it's spreads
very solidization via you know so
person-to-person breathing kind of kind
of contact up um and maybe maybe some by
by foam eyes but it seems like that's
less likely now in any case it seemed
really important to me to speed up the
process of having those zero prevalence
studies
so that we can better understand who was
at risk
and what the right strategy ought to be
this might be a good place to kind of
compare influenza
the flu and covid in the context of the
discussion we just had which is
how deadly is coved so you mentioned
covet is a very particular kind of
steepness
where the x-axis is age
so
in that context could you maybe compare
influenza and kovid because a lot of
people
outside the folks who suggest that the
the lizards who run the world have
completely fabricated invented kovid
outside of those folks kind of the
natural
process by which you dismiss the threat
of covait to say well it's just like the
flu the flu is a very serious thing
actually um so
in that comparison
where does kovitz stand
yeah the flu is a very serious thing it
kills you know 50 60 000 people a year
something i found that order depending
on the the particular strain that goes
around uh that's in the united states
the primary difference to me are the
there's lots of differences but one of
the most salient differences is the age
gradient and mortality risk for the flu
so the flu is more deadly for two
children than covet is
there's no controversy about that
children thank god
have much less
uh severe
reactions to covet infection to than
that due to flu infections and rate of
fatalities fatality all of that i think
you mentioned um
i mean it's interesting to maybe also
comment on i think in another
conversation mentioned there's a u
shape
to the
to the flu curve
so meaning like there's actually quite a
large number of kids that die from flu
yeah i mean the 1918 flu the h1n1 flew
that the spanish flu in the us killed
millions of of of uh of younger people
and um that is not the case with covid
more than um
i'm going to get the number wrong but
something like 70 80 percent of the
deaths are people over the age of 60.
well we've talked about the fear the
whole time really
but my interaction with folks
now i want to have a family i want to
have kids but i don't have that real
firsthand experience but my interaction
with folks is at the core of fear
that folks had
is for their children
like
that
somehow you know i don't want to get
infected because of the kids like
because god forbid something happens to
the kids and i think
that obviously that makes a lot of sense
this kind of
the kids come first no matter what
that's number one priority but in for
this particular virus
that reasoning was um
not grounded in data it seems like or
that emotion and feeling yeah it was not
grounded it wasn't at the same time this
is way more deadly than the flu just
overall and especially to older people
yes
right so the numbers when when the story
is
all said and done
the covet would take
many more lives yeah
so i mean 0.2 is sounds like a small
number but it's not a small number
worldwide what do you think that number
will be
by the you know that's not that's not
like but would we cross i think it's in
the united states it's uh
the way the desk currently reports like
800 000 something like that do you think
we'll cross a million seems likely
yeah do you think it's something that
might continue with different variants
what well i i think um so we can talk
about the end state of cover the end
state of covet is it's here forever
i think that there is good evidence of
immunity after infection
such that you're protected both against
reinfection and also against severe
disease upon reinfection
so the second time you get it it's not
true for everyone but for many people
the second time you get it will be
milder much milder than the first time
you get it with the long tail like uh
that lasts for a long time yeah so just
there's studies that uh that follow of
course people who are infected for a
year
and the reinfection rate is something
like somewhere between point three and
one percent yeah um and like a pretty
fantastic study italy's found that
there's there was one in sweden i think
there's a few studies that found there's
some similar things um and the
reinfections
tend to produce much mild disease much
less likely end up in the hospital much
less likely to die um so what the end
state of covid is it's circulating the
population forever and you get it
multiple times
yeah
and and then there's
i think studies and discussions like the
the best protection would be to get it
and then also to get vaccinated and then
a lot of people push back against that
for the obvious reasons from both sides
because somehow this the discourse has
become less scientific and more
political well i think you wanna like
the first time you meet it is going to
be the most deadly for you
and so the first time you meet it is
wise to be vaccinated the vaccine
reduces severe disease
yeah well we'll talk about the vaccine
because i want to make sure i address it
carefully
and properly in full context
um
but yes sort of uh to add to the context
a lot of the fascinating discussions
we're having is um in the early days of
covid and now for people who are
unvaccinated that's where the
interesting story is
the policy story the sociology
sociological story and so on but
let me go to something really
fascinating just because of the people
involved the human beings evolved and
because of how deeply i care about
science and also kindness respect and
love and human things
francis collins wrote a letter in
october 2020
to anthony fauci anything somebody else
i have um
the letter oh it's not a letter email i
apologize
uh hi tony and cliff
c
gb declaration.org
this proposal
this is the great barrington declaration
that you're a co-author on this proposal
from the three fringe epidemiologists
who met with the secretary seem to be
getting a lot of attention and even a
co-signature from nobel prize winner
mike levitt at stanford
there needs to be a quick and
devastating published takedown
of its premises
i don't see anything like that online
yet is it underway question mark francis
francis collins director of the nih
somebody i talked to on this podcast
recently
okay
a million questions i want to ask but
first how did that make you feel when
you first
saw this uh email come to uh
uh too light which when when when did it
come to light uh this week actually i
think or last week okay so this is
because of freedom of information yeah
which by the way
sort of um
maybe because i do want to add positive
stuff on the on the side of francis here
um
boy when i see stuff like that i wonder
if all my emails leaked
how much embarrassing stuff like i think
i'm a good person
but i don't
i haven't read my old emails maybe i'm
pretty sure sometimes later i could be
an asshole
well i mean look he's a christian and
i'm a christian i'm supposed to forgive
right i mean i think
he was looking at this
great barrington declaration as a
political problem to be solved
as opposed to a serious alternative
approach to the epidemic
so maybe we'll talk about in more detail
but just for in case people are not
familiar great barrington declaration
was
was was the document
that you co-authored
that basically argues against this idea
of lock down as a solution to covid and
you propose another solution that we'll
talk about but the point is
it's not
that dramatic of a document
it is just a document that criticizes
one policy solution that was but it was
the policy solution that had been put
forward by
dr collins and by tony fauci
and a few other few other science not i
mean i think a relatively small number
of scientists and epidemiologists in
charge of
the advice given to governments
worldwide
and it was a challenge to that policy
that said that look there there is an
alternate path that that the path we've
chosen this path of lock down with an
aim to suppress the virus to zero
effectively i mean that was unstated um
cannot work and is causing catastrophic
harm to
large numbers of poor and vulnerable
people worldwide
we put this out in october 4th i think
of 2020
and
it went viral i mean i've never actually
been involved with anything like like
this where i just put the document on
the web
and tens of thousands of doctors signed
on hundreds of thousands of regular
people signed on
it it really struck a accord of uh
people because i think even by october
of 2020 people had this sense that there
was something really wrong
with the coveted policy that we've been
following
and they were looking for
reasonable people to give an alternative
i mean we're not arguing that covet
doesn't isn't a serious thing i mean it
is a very serious thing this is why we
we had a policy that aimed at addressing
it
um
we were but we were saying that the
policy we're following is not the right
one
so how does a democratic
uh government deal with that challenge
uh so to me that you asked me how i felt
i was actually frankly just i was i i
suspected there had been some email
exchanges like that not necessarily from
francis collins
around the government around this
time i mean i felt the full brunt of a
propaganda campaign
almost immediately after we published it
where newspapers mischaracterized it in
all in the same the same way over and
over and over again
and sought to
characterize me as sort of of a as a
sort of a marginal fringe figure or
whatnot and me and sinatra grouped uh
martin culdor for the tens of thousands
of other people that signed it
i felt the brunt of that
all year long
so to see this in black and white in you
know with the handwriting essentially if
i mean the the metaphorical handwriting
of francis collins was actually frankly
a disappointment because i i've looked
up to him for years
yeah i've looked up them as well
i um
i mean i look for the the best in people
and
i still look up to him
what troubles me is several things
the reason i said about the
the asshole emails that i send late at
night
is um
i can understand this email
it's fear it's panic not being sure
the fringe three fringe epidemiologists
plus mike levitt who won a nobel prize i
mean but using fringe
maybe in my private thoughts i have said
things like that about others
like a little bit too unkind like you
don't really mean it
now add to that
he
recently this week whatever
uh
double down on the fringe
this is really troubling to me
that like i can excuse this email but
to see the arrogance there
i that francis honestly i mean
broke my heart a little bit there this
was an opportunity to like especially at
this stage
to say
just like i told him um
to say i was wrong to use those words in
that email
i was i was wrong to not be open to
ideas
i still believe that this is not like
say
like actually argue with the with the
proposed with the policy of the proposed
uh solution also
the devastating publish take devastating
takedown
devastating takedown as you say
somebody who's sitting
on billions of dollars that they're
giving to
scientists
some of whom are often not their best
human beings because they're fighting
with each other over money not being
cognizant of the fact that you're
challenging the integrity you're
corrupting the integrity of scientists
by allocating the money
you're now playing with that
by saying devastating takedown
where do you think the published
takedown will come from
it will come from those scientists to
whom you're giving money what kind of
example would they give to the academic
community that thrives on freedom like
this this is
i believe francis collins is a great man
one of the things i was troubled by is
the negative response to him from people
that don't understand the positive
impact that nih has had on society how
many people has helped but this is
exactly the so he's not just a scientist
he's not just a bureaucrat who
distributes money he's also a scientific
leader
that in the time in difficult times we
live in is supposed to inspire us with
trust with love with the freedom of
thought he's supposed to you know those
fringe epidemiologists those are the
heroes of science when you look at the
long arc of history we love those people
we love ideas even when they get proven
wrong that's what always that attracted
me to science like some somebody like
the the lone voice saying oh no the the
the moon of jupiter does move
yeah i mean you know but the funny thing
is you know galileo is saying something
truly revolutionary we were saying
that what we proposed in the great
britain declaration was actually just
the old pandemic plan
it wasn't anything really
fundamentally novel
in fact there were
plans like this that
lockdown scientists had written in late
february early march of 2020. so we were
not saying anything radical we were just
calling for a debate
effectively over the existing lockdown
policy
um and this is a disappointment a really
truly a big disappointment because
by doing this
you were absolutely right lex he sent a
signal
to so many other scientists to just stay
silent even if you had reservations
yeah devastating takedown the people you
know how many people wrote to me
privately like stanford mit
how amazing
the conversation with francis collins
was
there's a kind of admiration because
okay how do i put it um
a lot of people
get into science because they want to
help the world
they get excited by the ideas and they
and they they really are working hard to
help in whatever the discipline is and
then there is sources of funding
which help you do help at a larger scale
so you admire those the people that uh
um
are distributing the money because
they're often
at least on the surface are really also
good people oftentimes they're great
scientists so like it's amazing i that's
why i'm sort of um
like sometimes people from outside think
academia is broken some kind of way no
it's it's a beautiful thing it's a it's
really is a beautiful thing and that's
why it's so deeply heartbreaking where
this person
um
is um i don't think this is malevolence
i think he's just incompetence of
communication
twice i think there's there's also
arrogance at the bottom of it too so
like but you know all of us have
arrogance yeah there's a particular kind
of arrogance right so here it's it's of
the same kind of arrogance that you see
when tony fauci gets on tv and says that
uh that if you criticize me you're not
simply criticizing a man you're
criticizing science itself right right
that is at the heart also of this email
this so the certainty
that the policies that they were
recommending collins and fauci were
recommending to the president of the
united states were right not just right
but right so so far right that any
challenge whatsoever to it is dangerous
um and i think that that is really the
heart of that email it's it's um it's
this idea that
my position is unchallengeable
not to be to be complete to be as
charitable as i can be to this you know
i believe they thought that i believe
they some of them still think that that
that there was only one true policy
possible in response to copenhagen every
other policy was immoral
and if you if you come from that
position then you write an email like
that you go on tv you say effectively
right i mean that that is that is what
happens when you have this sort of
unchallengeable arrogance that the
policy you're following is correct
um i mean when we wrote the great bank
declaration
what i was hoping for
was a discussion
about how to protect the vulnerable i
mean that was the key idea to me in the
whole thing was
better protection of the older
population who really at really serious
risk if infected with covid and we had
been doing a very poor job i thought to
date in many places in protecting the
vulnerable
and what i wanted was a discussion by
local public health
about better methods better policies to
protect the vulnerable
so when when i was when we were met with
instead a series of essentially
propagandist lies about it so they for
instance i kept hearing from reporters
in in those days why do you want to let
the virus rip let it rip let it rip the
words let it rip
does not appear in the great barrington
declaration
the goal isn't to let the virus rip um
the goal is to protect the vulnerable
to let society go as you know open
schools and do other things that it
functions as best it can in the midst of
a terrible pandemic yes
but not let the virus rip
where no the most vulnerable are
protected the goal was to protect the
vulnerable so why let it rip because it
was a propaganda term to hit the fear
centers of people's brains oh these
people are immoral they just want to let
the virus go through society and hurt
everybody that was that was that was the
idea this it was a way to preclude a
discussion and preclude a debate about
the existing policy
so i've uh
this is an app called clubhouse
um i've gone back on it recently
uh to practice russian unrelated for for
a few big russian conversations coming
up anyway it's a great way to talk to
regular people in russian but i also
there was a i was i was nervous i was
preparing for a pfizer ceo conversation
and there was a vaccine room and so i
joined it
and there's a there's a pro science room
as they they these are like scientists
that were calling each other pro science
it the whole thing was like theater to
me i mean i haven't thoroughly
researched but looking at the resume
they were like
pretty solid um
researchers and doctors
and they were mocking
everybody
who was at all i mean it doesn't matter
what they stood for but they were just
mocking people and the arrogance was
overwhelming i had to shut off
because i couldn't handle that human
beings can be like this to each other
and then i i went back to just a double
check is this really how many people are
here is this theater and then i uh asked
to come on stage on clubhouse to make a
couple comments and then as i open my
mouth and say thank you so much you know
this is this is a great room sort of the
usual civil politeness all that kind of
stuff
and
i said i'm worried that
the kind of arrogance with which
things are being discussed here
will further divide us not
unite us and and before
i said even the united further divide us
i was thrown off stage now this isn't
why i mentioned platform but like i am
like uh lex friedman mit
uh also which is something those people
seem to sometimes care about the
followers and stuff like that like did
you just do that and then they said
enough of that nonsense
enough of that nonsense they said to me
enough of that nonsense
somebody who is obviously interviewed
francis collins
is uh uh the pfizer ceo uh you're
bringing a potential epidemiologist also
so just yeah exactly but this broke my
heart the arrog