Hello everyone, and welcome to Talk Nerdy. Today is Monday, November thirteenth,
twenty twenty three, and I'm the host of the show, Kara Santa
Maria, and as always, I do want to thank those of you who
make Talk Nerdy possible. Remember, Talk Nerdy is and will always be one
hundred percent free to download, and in order to make that possible, I
do rely on the support of listeners just like you. It's been a while,
I think since I've given a full shout out to the patrons because I've
been traveling so much since finishing my PhD and sort of readjusting before coming back
home for good and starting my post doc. So I do want to make
sure that I give an appropriate shout out to my top page trends this week.
They include Daniel Lang, David J. E. Smith, Mary Neva,
Brian Holden, David Compton, Gabrielle f Hadmio, Joe Wilkinson, Pasqually
Gelati, and Ulrica Hagman. Thank you all, so so so much.
I do want to also let you know that this episode may be slightly noisier
than usual. I'm staying with a friend in Los Angeles. There's a bit
of street noise behind me and my interviewe, doctor Jonathan Howard, is in
New York, as you'll hear, and there's quite a bit of street noise
behind him as well, So this is quite a city episode, but hopefully
you can look past that. So yeah, I have a great one for
you this week. It's an important topic, especially given that there is a
new COVID vaccine available now. So I have the opportunity to speak with doctor
Jonathan Howard. He is an associate professor of neurology and psychiatry at NYU's langon
Health, and he's also the chief of Neurology at Bellevue. He writes often
for science based medicine. He's quite prolific on social media, sort of debunking
pseudoscience and offering evidence based, accurate, science based medicine information. And he
has a new book available. It's called We Want Them Infected. How the
failed quest for her immunity led doctors to embrace the anti vaccine movement and blinded
Americans to the threat of COVID. So, without further ado, here he
is doctor Jonathan Howard. Well, Jonathan, thank you so much for joining
me today. Thanks so much for having me, I sure appreciate it.
So we are going to be talking about your new book, We Want Them
Infected, And really what we're going to be focusing on is I guess some
of the difficulties early on in navigating the sort of commentary or the conversation around
COVID, what maybe fueled some already existing anti vax rhetoric, what really confused
a lot of consumers, And where things are now, what the role physicians
have and sort of affecting change here. I mean, I think that this
is timely because even though your book came out, you know, several months
ago, there's a new vaccine out right now, and you see the whole
kind of conversation coming back and just reiterating every time a new vaccine is released.
Yeah, no, absolutely, an uptake for this new vaccine is horrible,
and I'm worried we're going to pay a price for it this winter.
We'll see. Yeah, So why don't you tell me early on? I
mean, like right here at the top, because I think the title is
a really bold title, we want Them Infected? Where did that come from?
And what are you communicating there? Yeah? So the title comes from
a quote by a doctor by the name of doctor Paul Alexander, who was
an epidemiologist and official in the US Department of Health and Human Services during the
Trumpet administration, and on July fourth, twenty twenty, before anyone had been
vaccinated, he wrote an email which said, infants, kids, teams,
young people, young adults, middle age, with no conditions, etc.
Have zero to little risk, so we use them to develop HERD. We
want them infected. So, while doctors like myself were treating and dealing with
overwhelming COVID outbreaks in the spring of twenty twenty and a little bit less so
in the summer of New York City in twenty twenty, there were a large
number of doctors who were working at cross currents with us. We were trying
to limit COVID infections and these doctors were trying to do the opposite. And
these doctors did not treat COVID patients for the most part, but they had
a plan to purposefully infect young people with COVID, with the idea being that
once enough young people were infected, HERD immunity would arrive and the virus would
go away. So it was this idea of getting rid of the virus by
spreading the virus as widely as possible didn't work out. So well. Yeah,
so I guess an important question, and I don't know how answerable this
question is would be, you know, was this sort of plan, I
don't know if you could call it a plan, but was this mentality a
simply misguided or was it actually I don't know what's the I'm trying to think
of just the right word for this, like not so much intentionally nefarious,
but maybe neglectful, maybe not really taking into account all of the available evidence.
Because obviously we think about when I was a child, we didn't have
a chicken pox vaccine, there was no vera cello vaccine, and that's what
we did. We counted on herd immunity. But people got really really sick,
Like it wasn't healthy to do this thing that people used to do,
which was like send kids to chicken pox parties so that they would intentionally get
sick. Yeah. So, first of all, it was a formal plan
to purposely infect people, and that was written up and published on October fourth,
twenty twenty. It was called the Great Barrington Declaration. I'm sure we'll
talk more about that, but the authors of this had already met with President
Trump in the summer of twenty twenty, and the next day, on October
fifth, twenty twenty, they were invited to the White House to meet with
Alexander Azar and they later went on to advise Ron DeSantis, amongst other people.
So it's interesting that you bring up the examples of chicken box because my
mom took me to a chicken pox party when I was a kid. Not
you really this a lot of thoughts. So when is it ethical to purposefully
expose a child to a viral disease? I think four criteria have to be
met, and two of them are met by COVID. So the first one
is that you just can't avoid the virus the rest of your life, which
is going to be true of COVID, right A newborn today can't hope to
dodge COVID. That is number one. Number two, the virus has to
be milder for children than for adults, which is true chicken pox and obviously
true of COVID as well, with the exception of babies. Babies have a
very high risk. The third feature which COVID does not meet is that but
chicken pox does, is that one infection leads to permanent immunity. And the
fourth feature which chicken pox met at the time my mom exposed me but does
not meet today and COVID also does not meet today, is there has to
be no vaccine for it. So I think my mom was relatively ethical to
expose me to chicken pox in the nineteen seventies. It wasn't entirely risk free,
and I'm at risk for shingles now children, my vaccinated children aren't going
to be at risk for shingles. But under those very narrow circumstances, I
think it can be ethical to expose a child to a viral disease. Now,
the plan to purposefully infect children and young adults and young people, let
me just state that case under the best terms possible. So the idea behind
it was formulated actually very early in the pandemic, as early as March twenty
twenty, and it was based on this idea, which is true of COVID,
that young people have much less risk than older people. And the idea,
which I've alluded to already is that once a certain amount of the population
was immune, heard immunity would arrive older people who had been in theory sheltering
in place and living at home for a few months, would be able to
emerge into a world world where everyone had immunity to COVID and the virus sort
of went away. Again. A lot of this was based on faith,
faith that one infection led to permanent immunity, and that it wouldn't there would
be not enough virus circulating in the community to that herd immunity would arrive essentially,
which obviously didn't happen. So obviously, you know, we can look
back after the fact with hindsight and say, you know, clearly that was
misguided at best. But at the time, yes, COVID was new,
but SARS type viruses were not new. Like we knew about SARS, we
knew about mers, and we even knew about coronaviruses, the forms of coronaviruses
that caused, for example, some proportion of the common cold. So I'm
just curious, based on you know, immunologists, epidemiologists, virologists, best
available assumption, why did they think that a single infection would cause extended immunity.
I don't know. It was a little bit of an article of faith,
I think, and even early in the pandemic in the summer of twenty
twenty, there were doctors on Twitter essentially sort of saying that, no,
it's unlikely that one infection is going to lead to permanent immunity. So this
was all a little bit of an article of faith about a brand new virus.
Here you go, I found it. There was a Twitter thread by
a doctor Chad Pettit or Petit from July twenty fourth, twenty twenty, which
he said, herd immunity requires that individuals who have been infected to develop a
long lasting immunity. We don't know how long immunity lasts after infection with stars
Cove two. If we use other coronavirus as evidence, it doesn't as guidance.
It doesn't look good. Typically, the immunity that individuals develop after infection
lasts about a year or two. This will become important. So a lot
of arawogists were sort of signaling alarm bells that immunity might not last very long
time, and unfortunately they turned out to be right for both the virus and
the vaccine. And I should say, you said one thing about we got
immunity, we got hurt immunity to chicken pox, just a slight correction there.
Humanity has never gotten heard immunity to a virus without a vaccine, so
that's like what we were aiming for, but that didn't happen, correct,
And this is because newborns don't derive with natural immunity. So this is what
would used to happen with measles before the vaccine is you would see the number
of cases every year would go way up and down. It sort of looked
like a sawtooth. A new crop of unimmune babies would be born, they
would all get infected, and the cases would fall the next year until a
new crop of babies sort of arrived. Not that babies arrive in batches,
but whatever, But yeah, I mean that makes sense. The idea here
is that obviously, if anybody in the community is carrying it, the babies
are just like completely vulnerable to it. But if the community is fully vaccinated,
or at least vaccinated above a certain point, then you're not going to
see this kind of I guess the vulnerability is still there, but it's not
as readily vulnerable like kids are. They're just less of a chance for a
kid to get infected if like all the kids at school are vaccinated correct.
And that's the state that we have now for measles and for chicken box.
And there's still there are still occasional outbreaks where you have pockets of under vaccinated
groups who cluster together. But an average newborn baby. Babies don't receive the
measles vaccine until they're one years old. But an average baby can lead a
typical baby life and not expect to get infected with measles, which is not
the case with COVID and probably will never be the case with COVID. And
let me just say, you know one thing about all of the doctors who
formulated this plan, they really underestimated COVID. At the beginning. In March
and April of twenty twenty, they wrote editorials in stat News and The Wall
Street Journal predicting that COVID would kill less around twenty to forty thousand Americans,
And as the death toll piled up, they didn't revise their initial predictions unfortunately.
Instead, a lot of them started spreading what became basically QAnon, means
that people were dying with COVID, not of COVID, that it was just
old people who were dying anyway, that death certificates couldn't be trusted, or
even worse, that it was doctors who killed patients through the inappropriate use of
ventilators. So these ideas that became gospel amongst the right wing science denial US
originated from doctors at Stanford, Harvard and UCSF and Johns Hopkins some of our
top universities, which is really sort of astonishing. You know, I'm curious,
like just to kind of go back a little bit to the timeline and
this question that again I don't even know really how informative this question is,
but of whether this rhetoric or this intentionality was misguided or sort of like neglectful.
How far were we from the vaccine at the point where there's this massive
public health crisis and these individuals are saying, like, how do we put
a lid on this? Early on, We've got social distancing, we've got
education about you know, hand washing and proper hygiene, but like, other
than that, what the hell can we do? Yeah, there wasn't much
to do in the spring of twenty twenty, and no one knew how quickly
we would develop a vaccine that was by far the pandemics maybe the only sort
of happy surprise of the pandemic, and really, I think the greatest medical
achievement of my lifetime. To be fair to these doctors, they were worried
about the consequences, and they were right to be worried about the consequences of
prolonged school closures and prolonged lockdowns on people's mental health in businesses. For example,
I always take great care to recognize that I was sheltered from the worst
consequences of lockdowns. My kids had remote schooling for a year and a half
they were teenagers, which was not ideal, but I was never lonely.
I worked throughout the pandemic. I never had to worry about a mispaycheck.
So I was very fortunate and very protected from the worst harms of lockdowns,
and I always take great pains to recognize that. But again, rather than
recognize that they had underestimated COVID, they started spreading these conspiracy theories, and
they underestimated COVID. I think it was a little bit worse than that,
because they underestimated in ways that were mathematically impossible. So let me give you
an example of this, and I will name names for the first time.
A doctor who takes up a large chunk of the book. Doctor John Ianides,
who I imagine most of your listeners have heard of. He's maybe not
exactly a household name, but he is one of America's most famous scientists,
and he is extremely respected guru of evidence based medicine, and I had written
favorably about him and some of my previous work. Seems like a very nice
guy, but regardless. On April ninth, twenty twenty, he gave an
interview to The Washington Post where he said he predicted that about forty thousand Americans
would die of COVID this season, whatever this season meant. By that date,
about twenty thousand Americans had already died, and two thousand Americans were dying
daily, So unless COVID essentially vanished that instant, his prediction would be falsified.
And indeed, eight days later, COVID's death told exceeded forty thousand people.
But rather than say oops, I underestimated COVID, as a lot of
people did at the beginning, in good faith, and they admitted air again,
he started spreading these conspiracy theories that it really wasn't COVID that was killing
people, it was just old people who were dying anyway when you happen to
swab their nose and find stars Cove two in their nose. So and that
had a very damaging effect. So you know, I'm super curious because in
my mind I have this sort of division and maybe this is fair, maybe
this is unfair, sort of between like the Anthony Faucis of the world and
then the physician that you just mentioned. So we know that the way that
science works. We know that the way the public health works is that we
operate with limited information, and we make the best decisions we can based on
resourcing, based on available evidence, based on all of these different sort of
variables, and then as new information comes in, we iterate and new messaging
comes out. And so I almost see like, and maybe I'm oversimplifying it,
but these two camps, the camps of the self correcting. Hey,
guys, this is how science works. And I know it's hard to follow
because I said this thing last week and now I'm saying something different this week.
But we've got to all stay together on this and keep moving forward based
on what we're learning and the sort of very I think American ideal of like
what I said before, stands, I'm going to double down on it.
If the new sort of information doesn't seem to match, I'm going to retrofit
it to match and come up with a new narrative so that I don't have
to have ever been wrong. And I think that this is like a big
departure that I saw in the sort of bifurcation of public health messaging. Do
you think that's a fair characterization? Oh? Absolutely, And I make this
very explicit at certain points in the book. So I quote, for example,
doctor Paul Offitt, who, again probably most of your listeners have heard
of, one of America's most eminent vaccine experts, and he predicted on March
second, twenty twenty, that COVID would cause less than quote one tenth of
the damage that influenza causes every year in the United States. He immediately,
I mean not immediately, but within a few weeks acknowledged his air, saying,
if you're going to be wrong, be wrong in front of millions of
people. Make a complete ass of yourself. So let me read a quote
from my book. My aim is not to correct quotations from doctors who made
good faith airs in the middle of a rapidly changing pandemic, only to later
recognize their mistakes. The doctors I discussed haven't just minimized COVID in an air
and tweet are two The airs and omissions I will describe are not isolated events.
And I should say my book has all of my errors in it.
I try to hold myself to the same standards that I hold others. But
these were doctors who from day one said COVID was over and was nothing to
worry about, and repeated that every month of the pandemic, whether new variants
were coming, they said, don't worry about new variants. They said,
now is not the time to panic, Now is not the time to fear,
et cetera. Again, because they wanted them infected. I think once
you grasp that reality that they wanted us young healthy people to get COVID,
all of their statements make a lot of sense. Yeah. So, like
when I mentioned Fauci before, would you put him in the same campus?
Off it? Best as I can tell, Yeah, I mean he has
made some goofs. He initially told people not to wear masks, and I
think he later regretted that comment, and he has probably spoken more and more
publicly about COVID than anyone else, and so the idea that he would get
everything right is going to be zero percent, especially because this was everyone's first
pandemic. The virus has changed a ton, the vaccines have changed a ton.
I mean think about it. The world's leading virus expert, if he
fell into a coma on New Year's twenty twenty and awoke today, would be
useless at anything with regards to COVID. And you could even say that.
Let's say you knew everything there was to know about COVID during twenty twenty,
during the first year, and then you fell asleep into a coma and awoke
today, you would be useless today. You would know nothing about Delta,
you would know nothing about omicron. You would think the vaccines were ninety five
percent defective, and unfortunately that wasn't the case. So yeah, anyone who
comments publicly is going to make some mistakes. But I really think the measure
of a scientist is exactly what you say that people who acknowledge their errors,
they speak in a humble fashion and they don't become attached to their ideas.
A lot of the doctors who I write about reacted, they couldn't separate themselves
from their ideas, So if you criticize their ideas, they would say,
oh, you're attacking me, you're trying to silence me, you're trying to
suppress me. They were very good at the victim complex. Yeah, and
so you know, I think the one thing that we haven't kind of dived
into yet, which is such an important part of this, is the behavior
change that these expert views enabled or affected. So I think that there's sort
of again different camps when it comes to you know, I mentioned the bifurcation
of that scientific view of like, you know, adjusting advice and adjusting information
based on available evidence and doubling down and saying I've never been wrong, which
is very political but also very American. But there's also this kind of I
guess, maybe not so much a bifurcation, but a categorization of the sort
of experts who are propagating misinformation, disinformation, pseudoscience, and then the sort
of non experts who are also doing the same thing, and very often there
is an agenda involved. But regardless, I think that it's hard as a
consumer when you see a physician or an epidemiologist giving bad health information to know
the difference between what's evidence based and what's not. When that person's also supposed
to be an authority figure. It's very hard. And all of the doctors
who I talk about mixed good advice with bad advice. So I've been studying
the anti vaccine movement for a decade, and I've always been fascinated by anti
vaccine doctors. A doctor who I trained with here at NYU, a woman
by the name of doctor Kelly Brogan, morphed into one of America's most outspoken
anti vaccine doctors. This was in twenty ten or so. However, she
was not particularly influential, I think during the pandemic because people could tell that
she was, you know, kind of on the fringe, so she would
She's a germ theory deniaist. She doesn't believe HIV causes AIDS. She doesn't
believe Star's Cove two killed people. She thought people were dying of an epidemic
of fear. I mean, really sort of out their stuff. The doctors
who I discussed mix good advice with bad advice, so they would say things
which are true that for elderly people in nursing homes and for people with underlying
conditions, they have to be very very very careful not to get COVID.
It's can wipe out those those populations, but for everyone else, it's just
the cold. You probably won't even know that you're going to get infected.
So I think that confused people quite a bit. And they can speak in
scientific jargon. They're intered the way you're going to introduce me with all of
my credentials and so and so's and a professor of this and that at Stanford
and Harvard and UCSF. And they appeared on Fox News, the Washington Post,
the Wall Street Journal, the Atlantic Magazine seemed, you know, talking
very professional, wearing suits and ties, and so the general public was very
confused by all of this. Yeah, So I mean, how maybe you
can help us, because I think for a lot of people who haven't been
like deep in it, like we've heard stories. We sort of know about
certain reactions, Like you hear about, let's say, the far out there
sort of anti vax conspiracy theories about how like I don't know, there's like
a chip in the virus, like you know, you get like the extra
kind of out there. But then you also hear the conversations about like myocarditis,
or you hear the conversations about like mass sell reactions like maybe you can
help us understand a little bit, what were some of the conspiracies, What
are some of the conspiracies that have sort of persisted, and like, how
do we separate fact from fiction here? You know what's floating out there?
Yeah, so there's a lot that's very hard to say it. And these
days, myself, especially the way Elon Musk is running Twitter, I have
a hard time separating fat from fiction myself sometimes. So I think maybe a
better question would be our way to reframe the question. You know, how
can you know when to trust someone? I think the first thing is that
they tend to speak a lot on very narrow topics. So, for example,
you know what expertise do I bring to the table? I think I
bring two things. Number one is I worked throughout the pandemic. I saw
what COVID could do with my own eyes. I saw how it could overwhelm
hospitals. I saw that, yes, most people who died of COVID were
older people, but not all. I learned that some survivors of COVID could
be devastated. So it wasn't like you died or were fine. So that's
number one, and the number two is my decade long interest in the anti
vaccine movement. So I was really able to tell to see how arguments that
were previously made against the HPV vaccine or the MMR vaccine were repurposed for the
COVID vaccine. And we can talk about that with regards to my ocarditis in
a second. Whereas and admit air. So I in my book, on
my blog on science based medicine. On social media, whenever I goof,
my initial reactions will say no, I didn't goof. But when I've been
shown to make a mistake, I hope. I'm not always successful, but
I try to acknowledge the air and do so very publicly. In contrast,
as we've said, the doctors who I discuss have a very hard time admitting
air, and they claim to be experts on every aspect of the pandemic,
on transmission, on math, on ventilation, on the effects of school closures,
on everything, and everything seems to fit their preconceived narrative. They'll never
share information that undermines their idea that COVID is harmless for children and they don't
need the vaccine. Against it for example. Yeah, Yeah, it's gosh,
it's there's just such a c of rhetoric out there, and it's so
unfortunate that some of it is presented in that very kind of classic pseudoscientific way,
which is like I love the term pseudoscience right, like bad science or
wrong science or not quite science, because I do feel like there's always in
like good good pseudoscience, if I can say that I'm putting air quotes on
it, like a kernel of truth, there's always like a little bit of
like legitimate science, like encasing the the inaccuracies. And so it is really
difficult for individual consumers to make good decisions because to me, at least,
and maybe it's because I'm practiced in the skeptic community, the obvious bunk is
obvious, but the less obvious bunk is where that in between areas like really
really nefarious. And I think if you talk to any average American at least
on the street and you maybe gave them a quiz about COVID information, a
fair amount of misinformation would be mixed in with accurate information. Yeah, and
that's a perfect segue to talk about vaccine side effects. In vaccine myocarditis.
So one of the things that I that the book tries to do, like
I said, is really show how old anti vaccine arguments were repurposed. So
you mentioned that the vaccine can cause myocarditis, which is true. That is
not a pseudoscience. So let's talk about that a little bit. So vaccine
myocarditis usually occurs in young men between the of twelve to twenty five after their
second vaccine dose. The exact rate of vaccine myocarditis isn't clear. There's about
thirty studies from around the country, around the world that show some pretty different
rates. But I think about one in ten thousand is a reasonable estimate of
how often it occurs. So it's rare, but not zero. And then
what about the severity of it. So with this, there is universal agreement
that nearly everyone, upwards of ninety five percent of people have a mild case,
meaning they spend a day or two in the hospital and they go home
feeling fine. That's not one hundred percent. And there have been some cases
of deaths around the world. I'm not aware of any in the United States
from the vaccine, at least the mRNA vaccines. And you know, we
have to be humble about the potential of long term consequences. So I don't
want to minimize this vaccine myocarditis. But there were certain doctors who spoke about
this, and I mean this very literally, as a fate worse than death.
So there was one doctor who wrote an article in December twenty twenty,
after about five thousand young adults had died of COVID. He said, young
adults should not live in fear of COVID. Their risk of death is very
small. Fear of death, you know, is not a good reason to
avoid COVID, and he gave all the statistics. Oh, your risk of
dying is one point zero zero or point zero zero zero zero one percent.
Fine, Okay. Six months later he wrote an article saying vaccine myocarditis should
be respected. So here's this doctor saying, don't fear death from COVID,
but fear vaccine myocarditis. And this was extremely common that doctors spoke about vaccine
side effects as a fate worse than death. And to give you an example
of how ridiculous this was, there were several studies that took blood samples of
children after they had been vaccinated and found that a small number of them had
vada trapponin, which is a marker of cardiac injury, even though they had
no symptoms of myocarditis. So listen, maybe that's a big deal, maybe
it isn't, who knows. But they treated that as a fate worse than
death. So they would say, you know, the risk of a child
dying of COVID is much less than suicide, much less than drowning in car
crashes, which isn't exactly true, but they would minimize literal death that way.
But they would treat an abnormal lab value in a child who feels fine
as a potential marker of some catastrophe. And again, these were not the
Kelly Brogans of the world. These were not the German theory deniers. These
were doctors from UCSF and Stanford and Harvord writing in mainstream publications, and myocarditis
wasn't sort of the only one, right, Like I almost feel like I
was seeing a theme where almost every time there would be rhetoric around some sort
of vacu seeing side effect, so gian barret for example, or some sort
of immune overreaction like a massed sell issue or something like that, that the
actual virus the actual COVID virus was significantly a significantly higher risk factor than for
those things than the vaccine itself. Yeah, I think this has to do
with the fact that people tend to feel worse about problems that we feel we
cause, rather than rice that we fail to prevent. So a naturalistic fallacy.
And you can just sort of think about it this way. If you
found if you looked in your pocket and found that a twenty dollars bill had
vanished, you would feel much worse if someone had stolen that money than it
if it had just fallen out of your pocket. And so there's this idea
that when the vaccine causes a problem, it's the equivalent of someone stealing the
money, Whereas if the virus causes a problem, even if it's a much
bigger problem, even if a thousand dollars thought out of your pocket, you
feel not as bad because it's natural. It's just how things are, that's
how kind of it's meant to be, et cetera. So, yes,
anything, atas amongst a certain class of doctors, anything the virus could do
was minimized, again, including literal death, and everything the vaccine did was
blown up way out of proportion, And again, this is exactly what anti
vaxxers did with measles before the pandemic. So you can read an article from
twenty nineteen from an anti vaccine blog minimizing measles, and they would say things
like, before the MMR vaccine in the nineteen sixties, measles only killed four
hundred children per year, which is both true and a lot of children to
die every year from a vaccine preventable disease. And they would go on to
say, more children died of you know, asthma, more children died of
this or that, which again is true, but not a good reason to
let four hundred children die of measles every year. And then fast forward to
twenty twenty one and you would read doctors making that exact same argument about COVID.
Only five hundred children died of COVID this year more children died of XYZ.
So the exact same language, the exact same arguments. Do you think
that there's a bias? And maybe this only applies to the first several months
sort of when our hands were a little bit tied, when we were watching
this horrific public health tragedy unfold and feeling this sort of wave coming at us
that we were a bit impotent to do anything about. Do you think that
there's sort of a bias, especially among experts, especially among those with a
voice to I don't want to say minimize the risk, but to I don't
know how to put this. Reduce like a fear that panic might be worse
than the viral rus itself. Like did we see that early on? I
don't know if we well, we saw doctors saying that. I don't know
if that actually happened, but yeah, there's a whole chapter of the book
which is devoted to just this. Doctors again mocking anyone who tried to avoid
the virus, saying that there was a panic. They even current, They
even turned coin new phrases coronaphobia, for example, about people who are too
terrified of COVID. And again this echoes pre pandemic arguments and language that anti
vaxxers would make against measles. They would say, oh, every tendre's and
measles up break, Oh people are panicking. Oh there's such a fear.
But fear is good at times, it's certainly unpleasant, But graveyards are full
of fearless people. A lot of people live their lives without fear of COVID,
and they're not here to tell us this story. And I think a
lot of the doctors who use that rhetoric, you know, sort of what
motivated them. That's one of the questions you're kind to ask me early,
early on. I think a lot of these doctors got famous and made careers
out of being a little contrary and being a little different, And there's value
in that. We need people to think outside the box. And of course
the best example of this this pandemic is Karina Coreco. I'm going to butcher
her name. I always do that the scientists who just won the Nobel Prize,
and boy she deserved it for her work on the mRNA vaccines. So
we need people to think outside the box. But these guys just couldn't turn
that off. So when everyone else was saying COVID is going to be very
dangerous, it's going to be horrible, they couldn't not be different. They
just had to be different. So I predict that if everyone else was minimizing
COVID, they would have said, COVID is a big deal. We need
to we need to worry about it. So you do think that there was
sort of a contrarian bent there. Absolutely, absolutely, Again that's what I
think motivates people like Kelly Brogan, Andrew Wakefield, Cherry Tenpenny, all of
these sort of famous names in the anti vaccine world from before the pandemic is
whatever mainstream medicine says they have to be against, and they will call that
thinking for themselves. And I think that that infected a lot of other doctors
during the pandemic. But sometimes the majority is right sometimes, you know.
So when the majority said COVID is something to be feared, and when the
vaccines arrived and they said, you know, everyone eligible should get vaccinated,
including children, the majority was right. So I mean, I think it's
an important question and something that I know you talk about in your book early
on, and we sort of skipped over, but I would love to maybe
hear just a little bit, you know, about your experience. I mean,
you were there on the front lines, you were at NYU, you
were seeing individuals who were coming in back when this virus was pretty mysterious,
back before we had appropriate treatments available, and like, you know, you're
not just speaking from as a person who has dug deep into the literature.
But you're speaking as a person who was at the bedside of people who were
actively dying from this disease. So I'm just curious, you know, what
it was like for you personally being there on those front lines. Yeah.
So I always described my COVID experience as I don't think I did a lot,
but I saw a lot. And my COVID experience was pretty much every
New York doctor will say the exact same thing. It was very intense in
the spring of twenty twenty, but not much after that. So during April
in May of twenty twenty, our hospitals were taken over by COVID. There
was nothing else in the hospital other than COVID. Where I worked were located
in Midtown Manhattan, relatively well off area. Our emergency room was never wus.
Some of the scenes that took place in Queens and Brooklyn of you know,
essentially people dying in the parking lot, we never had. But those
hospitals transferred their patients to Bellevue, So we had about fifty to sixty new
arrivals every single day. And are ICEEU there's usually one patient per room.
There were two patients per room and every available clinical area was devoted to the
care of COVID patients. We had gynecologists caring for men, we had pediatricians
caring for seniors. We had nurses come from all over the country, So
I heard a lot of Southern accents. I grew up in the South,
and you know, a lot of accents reminded me of home, and so
it was very different that way. And I saw more people die in the
spring of twenty twenty than I probably my entire career. One thing about COVID
in New York City was the sounds. So everyone heard, and you could
probably hear through the microphone. There's some some signs, some sirens wailing through
the you know, wailing through the windows, but the streets were totally empty
other than just siren after siren after siren. And inside the hospital it was
you know, code blue to this room, code blue to this room,
code blue to that tomb uh that that pager usually goes off once per day
at Bellevue, and it was going off every every five to ten minutes,
And it was a It was a very tragic time, but it was also
kind of an inspiring time. People stood on their balconies and cheered for us,
and they you know, sent us all sorts of food and nice cards,
which was which was, which was appreciated. But there wasn't anything to
do for these patients, right. So a lot of our patients, as
I said, they came from other hospitals, and they came doctors were desperate
to try everything. So they all were on a hydroxychloro queen and as if
the omayas and these sort of hail married treatments. One rule that I had
is that, because I eventually ended up running a COVID team during May of
twenty twenty, I said, none of our patients are going to be on
experimental treatments unless they're clearly dying and you have nothing left to lose. So
I stopped all of those treatments. But you know, it was a horrible
time. I would leave work every day at six or seven, and I
would come back the next morning, and half of the patients so I left
the day before had died or been transferred to the ICU overnight. So I
just to repeat, I saw more death during that time than I had my
entire career. And eventually those scenes played out at pretty much every hospital in
the country. I don't think any hospital was spared those sort of scenes of
mass death. There were these giant refrigerated trucks behind the hospital and used to
store all the bodies. Some hospitals needed forklifts to move bodies into these.
And there's a movement now to deny that this ever happened. They will say,
you know, emergency rooms in New York City were empty, which was
true for my emergency room. Very few people came in through our emergency room
here at Bellevue, but again we had patients transferred from every other city throughout
the hospital, or every other hospital throughout the city. Excuse me, so
obviously you had never seen anything like it, And I'm just curious when you
sort of started to do a lot of deep, more like journalistic work into
documenting the different conversations that were had on social media, the different rhetoric that
we saw both in sort of the public arena, like you know, official
messaging from the White House and from different organizations within the US government, and
also just individual people speaking out on social media or on their blogs. Did
you get the feeling that a lot of the people who were intentionally pedaling let's
say, disinformation as opposed to misinformation, right, so misinformation getting it wrong,
which happens, and hopefully sometimes iterating disinformation agenda driven intentionally, you know,
having spreading incorrect or pseudoscientific content. So did you get the feeling that
those who are sort of peddling disinformation weren't there, that they just like didn't
have this frontline experience, or do you think some of them had it and
they still were pushing this information. So I think very few people who saw
what COVID could do with their own eyes ended up spreading disinformation, And that
takes a specific kind of maliciousness where for the most part, you're not going
to wind up on their front lines in the first place, because you have
to get through medical school or nursing school, are respiratory tech school in order
to have been on the front lines. And so I think the malevolent types,
that the pure disinformation types, were very unlikely to have ever treated COVID
patients. And I will say their campaign against the COVID vaccine, this was
unearthed later by journalists, began in February twenty twenty, even before the first
person had died in the United States of COVID. They were already getting ramped
up. In terms of the doctors who I speak about, again, yeah,
very few of them treated COVID patients. And that shows, that really
shows, because they say things that no one who treated COVID patients would have
said, such as, these were just old people who were about to die
of natural causes anyway when they happened to contract COVID, or you're not really
sure that COVID killed these patients, or that hospitals were overwhelmed by people who
were afraid they had COVID and they were just the worried. Well, so
they said things all the time that no doctor who treated COVID patients would say.
And I'll say it took me a while before I sort of realized,
oh my gosh, these guys don't know what they're talking about, because I
fell biased to or I felt prey to the exact same things that I was
talking about. That they spoke with great confidence, they had amazing credentials,
They were I thought, entirely trustworthy people. So when these guys were saying
in April twenty twenty, in May twenty twenty that COVID is on its way
out, that we think we're approaching herd immunity that were past the peak,
that the virus was much more widespread than we already thought, and that half
of the country they didn't quite say half, but you know, large numbers
of people had already been infected without us even knowing it. I believed it,
or I had no reason to doubt it. It was really only when
the dust had settled and I went back and started rereading what people were saying
at the start of the pandemic that I was like, oh, my gosh,
these guys were just kind of making it up from the comfort of their
couch. Yeah, And so, you know, I think that a lot
of us saw the panic, the fear, the confusion in the early days
when the vaccine was first released. Then we saw that people were getting vaccinated,
and that the virus was changing, and that even though the virus continues
to to mutate, that the the death toll has significantly dropped, the severity
of the of the outcomes of of getting sick has changed because of a lot
of things. Because we are getting vaccinated, because we do have things like
packs livid and different medications available, because we aren't overtaxing our emergency you know
rooms, our hospital systems. But I'm cure, you know, how do
you think things are netting out now? Like? What do you see is
the COVID landscape today versus how it was during the sort of I don't know,
the intensity of it all early on. Yeah, obviously is nothing like
it was in April of twenty twenty. And you know, perhaps the saddest
reason that is is because vulnerable people have already died. There's a terminus and
epidemiology collde mortality displacement, which is, you know, the virus has already
sort of killed all the people that is going to kill, Although that's not
entirely true. I think at this point in the pandemic, I don't have
I don't know if anyone does has a really good sense of what what the
virus is doing with the actual numbers are. I read that around one thousand
people are dying of COVID per week here in the United States, which is
much less than previously when two to three thousand people were dying per day,
but you know, not an insignificant number of people. Well, and I
think maybe at this point in the pandemic it can be hard to tell if
someone is truly a COVID death. Meaning let's say, at fifty year old
gets COVID and two months later has a heart attack. Was COVID to blame
for that? It can be a little bit hard to tell. And I
think at this point in the pandemic, we're worried not a lot as much
about death as much as we are about disability and long COVID. And I
think that people like myself who were kind of shell shocked from the mass death
have maybe not paid as much attention to long COVID as possible because it's sort
of like, well, you're not dead, so right, It's like a
triage bias, right, and now we're seeing like, yeah, really intense
to I have a friend who has this like horrific long COVID, Like I
guess it's a I don't remember what it's called. It's a bunch of letters,
but it's like a mass cell reaction where her body just has these like
horrific immune attacks and it's made her so incredibly sick, disabled, and it's
just I cannot imagine living that way. Yeah. No, I know some
people who've had to quit medicine for that reason. Not many, not many,
but definitely some, And so I think the harms are a little bit
more invisible now because you know, these people are probably sequestered at home,
right, They're not out in the community interacting with us telling us how sick
they are. I know, a lot of them look healthy, right,
So it can be hard to see and it's impossible to see invisible disability for
example. So, and I think we have to be humble about the potential
for unknown consequences of repeat infections. You know, if a newborn is born
today and they're infected ten times by the time they go off to college,
what is that going to do. I mean, most kids will hopefully be
fine, but hope is not a plan and time will tell. Yeah,
So I'm curious, you know, for those who are listening to the show
who are like, oh, okay, my vaccine card's pretty full. You
know, I personally, because I was working in a hospital setting, I'm
into my second vaccine card. We have this new vaccine that's available now in
the winter of twenty twenty three that you can get alongside your flu vaccine that
is an adjusted vaccine. You know, it's intending to sort of keep up
with these mutations. But for those who are sort of weary or who are
not weary but weary, like are like, I've been shot so many times.
I've had the virus, you know, multiple times, Like I'm good,
right, Like, tell us why it's important that we keep up with
a vaccine schedule. So so far, I'm unaware of a vaccine dose that
hasn't helped on average. This is especially true for older and vulnerable people.
But people have a very strange attitude toward vaccines that they don't have towards other
aspects of their health. Right, Like, if I told you I'm not
going to the dentist because I've gone for the past ten years, you would
say that that's crazy, right, Or why do I need to go to
the gym? I worked out, you know for the past five months.
You know, people recognize that certain health practices in order to be successful,
need to be maintained. And I would say that getting a vaccine is much
easier than going to the dentist or going to the gym routinely. Even though
vaccines, none of us enjoy the actual process of getting vaccinated. We get
a sore arm and some of us feel pretty rotten the next day. And
at this point we don't have a ton of evidence that this new vaccine is
going to be beneficial, and I think a lot of the doctors who I
write about use that to their advantage. They will say, where's the randomized,
double blind, pacebo controlled study showing that you need these sorts of boosters.
But this is what happens, as we've learned, in a pandemic,
is that you have to make decisions in real time without the luxury of the
best, highest quality of evidence. For example, had we done a randomized
controlled trial of the booster last year in twenty twenty two, we would have
known in twenty twenty three, after the wave had already subsided, exactly what
to do. So you have to make decisions with incomplete information. In choosing
not to get a vaccine is a decision, even though, as we discussed,
it's not often perceived that way. So listen. So, if someone
has had six vaccines already, they've been infected four times, what is the
benefit of an additional vaccine? Now? I don't really know, but I
think that on app just to repeat myself, there has not been a vaccine
dose that I'm aware of that hasn't been shown to be of some benefit to
at least some people, and I think it's not super duper hard. Probably
the hardest part actually is getting an appointment and finding available vaccine. The VACS
role has been horrific, but if your local drug store has it. I
live across the street from about three of them here in New York City.
I just went across there and got a vaccine and my arm hurt that for
the next day. It was not a big deal, right, you know,
it's I worry sometimes that it's it's about more than just the how do
I put this? So I just finished my PhD, as you know,
and I am in between my internship and my postdoc, which means that I
am one of the you know, many many Americans who sort of in between
health insurance. Open enrollment has started. I'm getting I'm gearing up to get
my sort of Obamacare to cover me until I start my postdoc. But I
went down to like my local pharmacy and said, hey, I just want
to get a flu and a COVID vaccine, and he was like, without
insurance, it's going to be like two hundred and fifty dollars for both of
those, and I was like, my mind was blown, Like you know,
they all advertise free flu shot, but then in the fine print it's
like with your insurance. And it used to be that COVID vaccines were covered,
that we had government you know, money set aside to ensure public health.
But I guess that that has now dried up. So I think that
sometimes sadly, this this move towards vaccination and public health and wanting to do
the right thing is squashed by finances. Yeah, no, you're absolutely right.
And I'm halfway done with an article for Science Based Medicine where I talk
about this, and I discuss how vaccine advocates like myself have focused exclusively on
the science rather than on the economics of vaccines. And Fizer, even though
they got oodles of public money to develop this vaccine or charged doing what companies
do, they're charging as much as they can for it. And I was
always kind of mystified why vaccine advocates were called pharmacie. Obviously this has earned
you know, pharma gazillion dollars. You know, it was the number one
best selling drug last year, but I was mystified this. But because vaccines
traditionally save a lot of money by keeping people out of the hospital. But
these drug companies, you know, they make people feel like they just want
to extract every penny from everyone's wallet and by charging as much as possible,
which they do. And I think vaccine advocates like myself have been kind of
too silent on this, which is why we are called pharmaciew. So hopefully
I will publish that article once I get all the sentences in the correct order
and say, yeah, I think this has been a problem that skeptics and
vaccine advocates have not spoken out as much about the economics of vaccines and the
fact that a lot of people, Yeah, two hundred bucks is a huge
amount of money for a lot of people, and I don't blame someone for
skipping the vaccine when they can use that two hundred dollars to pay rent or
buy groceries. Yeah, and it's the calculus is really difficult. Like you
said, I need to eat now, I may or may not get sick,
you know, And I think people often think that way, like it's
so clear to us that, like, the way you're not going to get
sick is to prevent yourself from getting sick. But a lot of people are
willing to or sometimes are forced to take that kind of gamble or you'll see
you know, I think the mentality and maybe it's important for you to help
answer this of individuals who are like, well, the last time I got
vaccinated, I got sick anyway, right, so why should I get vaccinated?
Like, how do you answer your patients when they come and they ask
that question. Yeah, So the main disease that I treat actually as multiple
sclerosis, and with one exception, all of the MS drugs are designed to
prevent bad things from happening. So I have this whole sort of speech that
I give, which is to say that these medications, and this is true
of vaccines, are like an like an invisible suit of armor. If you
were in a fight, that would be weird. But let's say someone cuts
you and then you put on your invisible suit of armor. That suit of
armor would not feel good. It would not heal the cut that was already
there, but it would protect you from future sword blows. And if you're
in the middle of a sword fight, you would notice the armor protecting yourself.
But the good that the vaccine does is invisible. So let's say you
saw someone who gets vaccinated and they get COVID and they don't get hospitalized and
they don't die. You can tell that person there's a perhaps a chance we'll
never know for sure that it was the vaccine that made your illness much milder
than it was. So that's how I tried to say it. Or it's
kind of like a seat belt, right. If I was driving from New
York City to Boston this week, I would probably be fine if I chose
to make that ride without a seatbelt, But wearing a seatbelt just puts the
odds of a healthy, safe trip in my favor. Obviously. It's the
benefits of a seatbelt are playing for all to see, whereas the good that
a vaccine does is invisible. So I think that's why you have a hard
sell. Yeah, And I think the other question that is sort of the
obvious follow up, and maybe the last question that I've got for today,
is what's the difference in protection between vaccine immunity and natural immunity. So for
individuals who are either both vaccinated and have had the virus several times, or
those who are vaccinated and who have never been sick, or those who have
been sick a bunch of times, but haven't really been vaccinated that many times,
Like, how do you, as a physician think about that calculus and
you know how we can be best protected? Yeah, so everyone uses the
phrase natural immunity myself as well, but we should know that the immunity induced
by vaccines is completely natural, right, the immune responsor trigger, don't worry,
I use an well. I mean so I tend to think about them
in pretty similar terms that if you're vaccinated or you're getting over a COVID infection,
you likely have very good protection, but for a relatively short period of
time. So I think that future generations will just get used to their annual
COVID shot the way we're used to an annual flu shot. Are We're used
to going to the dentist every year. We're used to doing many things on
an annual basis, And I hope that the COVID shot becomes normalized in that
way, because, as I've said, every dose so far has been shown
to help keep people alive and out of the hospital. Again, it's much
more beneficial for people who are older and have underlying risk, but there's some
benefit for younger people as well, and the risks are so low. The
risk of myocarditis from the boosters. There's like one out of one hundred thousand.
I mean, it's extremely low. So it's just a question. You're
kind of a gambler, right, where's the downside? A sore arm and
maybe feeling sick for a day, that's the best I've got. Goot the
downside. And even if that I found, and maybe this is anecdotal,
I don't know, but that each booster that I've gotten, my reaction like
that feeling of being ill, because I was quite ill from the second dose
of the first shot, and then each subsequent booster I would get ill,
but it was like less and less and less, to the extent that my
very last booster, I think I felt sick for like an hour, which
was amazing compared to how, oh my god, I was sick for like
a whole weekend during the first vaccine. Yeah no, me too. My
last booster, I noticed nothing. So if there's some potential benefit and there's
virtually no downside, I say, why not? Right if someone was going
to hand me a free lottery ticket, I'd say it's probably going to be
worthless, but hey, why not? So Okay, I know I said
that was gonna be my last question, but I have another follow up.
What are the odds do you think, like, what is it looking like
for having some sort of multi valent shot in the future where we don't have
to get two jabs for flu in covid but we get an all in one
vaccine. Oh, I will plead the fifth on that. I don't know
the exact answer to that. Are you hopeful? Maybe I'm What I'm really
hopeful about is a pan coronavirus vaccine, so like a cold kind of resistance
as well, or a sterilizing vaccine kind of like we have for measles,
meaning that you can't get infected and you can't pass it on. So something
that really induces immunity not just deep in your lungs, but in your sinus
passages as well. That's what I'm really sort of hoping for, and it's
a reason to try to avoid COVID infections for now. I think I'm not
the most careful person on the planet, that's for sure, but I'm more
careful than most people. Just got done flying and I wore a mask on
the airplane, and I'm hopeful that in a few years we'll have much better
vaccines available. Time will tell, so you know, before we before we
sign off. I'm just curious. Obviously there's so much to cover, There's
so much in your book. Is there anything that we didn't discuss that you
feel like it would be really important to bring up? I would just say,
you know what, what can we do about all of this? And
I think I've been a little bit dismayed at my own profession. Ninety nine
percent of US doctors behaved admirably. We rushed in to treat COVID patients fearlessly,
and decent number of us paid for that with our lives. But I
think when it comes to misinformation, there's just this sort of attitude of I
think David Gorsky called it shruggies, meaning people to sort of, eh,
whatever, some doctor says something, You know, what am I going to
do about it? And I think that you know, we all need to
do what you do on The Skeptics Guide to the Universe and on this podcast,
which is not to sign once anyone, not to try to get anyone
fired, but just to speak up about gross misinformation and say this is not
acceptable. And I do think the tide is turning a little bit that way
in that certain doctors are receiving pushback for spreading misinformation that they didn't used to,
and we just need to say this is unacceptable for our profession any more
than it's acceptable for a firefighter to start a fire. Yeah. Yeah,
good points all around. So everybody, the book is so, I have
it queued up here. I want to read the full subtitle the book is
we Want Them Infected. How the failed quest for herd immunity led doctors to
embrace the anti vaccine movement and blinded Americans to the threat of COVID by doctor
Jonathan Howard. Jonathan, thank you so much for spending time with us today.
Oh my pleasure. Thank you so much for having me. I sture
appreciate it. Kara and everyone listening, thank you for coming back week after
week. I'm really looking forward to the next time we all get together to
talk to Ernie