All Your Coronavirus Questions Answered: Michael Greger, MD | Rich Roll Podcast

hey everybody welcome to the podcast my guest today is dr. Michael Greger making his fourth appearance on the show most people know Michael as a nutrition expert he's the man behind such best-selling books as how not to die and how not to diet as well as the founder of nutritionfacts.org less well-known is the fact that earlier in his medical career Michael worked in public health with focus on infectious diseases and he is a guy who's been sounding the pandemic alarm for well over a decade at this point on that note he recently released a new book it's called how to survive a pandemic and the focus of today's conversation is on all things coronavirus what causes pandemics what can be done to prevent future pandemics the current state of affairs and what we should all be mindful about right now when it comes to self-care and looking after others this one is packed with so much solid grounded information I think you guys are going to love it if you enjoy the content that we work hard to put out every single week do me a solid hit that subscribe button and with that I give you one of my very favorite people the great dr. Michael Greger [Music] back in the house ready they're rich and roll so good to see you I feel like I just saw you but it was a little while ago I wasn't the world was very different pandemic John it's all out the window what's super interesting about you is that we all know and love you as this nutrition specialist expert the man behind nutritionfacts.org but actually you earlier in your career had this whole path in public health specializing in emerging infectious diseases and you've been shouting from the mountaintops about pandemics for over a decade so here we are and suddenly that book that you wrote back in 2006 is more relevant than ever you've got this new book out so I can't wait to just roll up our sleeves and get into what exactly is going on right now well yeah I mean the first half of my professional life was all emerging infectious diseases in fact I mean that's most of my scientific publications that's how I got an old broad that's how I got on you know all that I mean that that was really that was and no one was listening right I mean yeah yeah in fact the whole public health community was warning people about the coming pandemic no one listened I was like alright um you know I'll have it let me let me default to the leading cause of death every single year from from 1919 to 2019 for the last hundred years always realize in the back of my mind well you know the reason that heart disease wasn't the leading killer for last 101 years because in 1918 there was a pen am i blue right the next ones coming and when it comes alright then I'll find them maybe when people listen um I'll be able to delve back and that's how I was able to you know scribe to write a book in such a short time was because the researchers done and it was just a matter of you know throwing together a few chapters on that on the current situation right and you know well the first book was really focused on bird flu right do you think if at that time people really perked up and paid attention that that would have shifted your whole career trajectory you would have stayed in that field I think so yeah I mean because I mean it's as critically important today as it was back then in fact the leading candidate according to the CDC of the next pandemic after Kovan is a bird flu virus by the name of h7 and 9mm which is a hundred times deadlier then covered 19 is that the one with fifty percent no it only has a forty percent right we're telling you it's so h5n1 I'm was higher but has has dwindled as h7n9 has taken to the forefront of a global spread so that's the leading candidate although h5n1 still may be waiting in the wings of chickens of course my 879 seems to be the most likely and so instead of one 250 people dying at 200 times deadlier 40% and so you know as devastating as co19 has been to lives and livelihoods around the world you know uh you know imagine a pandemic you know that you know the every other person right so the well so you know uh you know 1918 I had a two percent fatality rate mm-hmm and so yeah but imagine a pandemic where billions are infected but forty percent people right and that was and that was the last time a bird flu virus jump directly to humans and tiered pandemic it caused the deadliest plague in history the 1918 riot and so it's you know you know it's it's just uh it's just a matter of time and so but there so the good news is there's some we can do about it mmm you know just like closing down live animal markets and you know the wild animal trade will reduce the risk of future coronavirus pandemics reforming the way we raise domestic animals for food may help forestall the next well that's a good place to start you know the very root cause of what's leading to these pandemics that you know ultimately are an inevitability so let's start there I mean we're all kind of familiar with what triggered kovat with the pangolins i guess that's the reigning theory of the moment - how this began but there's a larger issue at play here which is the institutionalization of animal agriculture and how we're creating you know on a systemic basis the breeding ground for the next pandemic and the next pandemic and you know perhaps much more virulent strains of a virus that are gonna be far more deadly here over the last few decades human pathogens have emerged at a rate unheard of in human history and as we emerged from where mostly from animals so you know HIV it's been traced back to the butchering of primates and the bushmeat trade in Africa mad cow disease it was because we turned you know cows into carnivores and cannibals SARS in cove at 19 and traced back to these exotic live animal markets but you know our last pandemic swine flu in 2009 arose not from some backwater wet market in Asia but was largely made in the USA right here on industrial Pig operations in the United States now thankfully so when I'm full only killed about a half million people but the next time we might not be so looking well just came out that last week this new story about pigs in China and and a couple slaughterhouse workers getting sick yeah this is very alarming so it's actually yeah it's actually a new mutation oh that very swine flu virus this durable hybrid mutant which contains genes from both human Pig and avian flu z' that was new enough to the human immune system that was able to to spread around the globe and is still with us to this day as a seasonal flu but but all it has to do is you know change enough to kind of overwhelm the pre-existing immunity but but yeah so so but we happen to pick the two species that are that are vulnerable to the virus the only known virus on the planet capable infecting billions of people within months of time and that's influenza and so most species actually or don't get the flu very few species so it's pigs and it's Birds Anakin's - or chickens or something chickens yeah no it's a chickens emerges in waterfowl um but in fact as a waterborne innocuous aquatic virus and only travels to the lungs when placed in a land-based predator estriol bird like chickens and how would the duck and a chicken ever get together a live animal markets its awareness to pack them both together and once the virus finds itself in the guts of a chicken it no longer has the luxury of easy waterborne spread where chickens aren't paddling around in the pond also it's a fecal oral route in ducks and waterfowl as it existed for millions of years before we domesticated ducks once it finds a way into a chicken it needs to mutate or die it has to find a new way to travel and on does that by changing to an airborne virus actually infects the lungs and that makes it that much more risky for terrestrial mammals such as ourselves so what yeah it goes into you know chickens as this harmless virus comes out as the flu uh-huh and what is it specifically about kay foes animal agriculture that's fomenting this is it just the crowded conditions is it the way that they're you know immersed in their fecal matter is it the way that they're fed are treated like what are the contributing factors all the buffs and when we take thousands of animals oh I mean Cremonese you know filthy football-field-sized sheds till I beat to beat course not just now to top their own waste it's just a breeding ground for disease right it's not just the sheer numbers the overcrowding but the you know the stress crippling their immune systems the ammonia from the decomposing waste burning their lungs the lack of fresh air like a sunlight put all these factors together well you have is kind of the super storm kind of environment for the emergence of spread of this perfect storm environment the emergence part of super strains of influenza tragically we don't tend to shore up the levees until after disaster strikes and the bottom line is it's not worth risking the lives of millions people for the sake of Cheaper chicken mm-hmm and I suspect that when you have so many of these animals in these types of conditions that that then creates a situation in which you're kind of exacerbating the potential for mutation right because if it's getting spread amongst that population then there's an exponential amount of it and so it's replicating more rapidly it's like crowding a thousand pigs in an elevator right one of them sneezes like what do you expect would happen it's really the perfect if you want if you were a mad scientist and wanted to breed a deadly uh you know flu virus this is exactly the kind of conditions where you do in fact they actually do these so-called serial transmission studies in a lab where when you want to make a pathogen more deadly more lethal more virulent what you do is you pass it from animal to animal normally virulence is a control there's a there's a there's a there's kind of a balancing act a teeter-totter between virulence and transmissibility if the that's why in its natural state influenza is completely harmless ducks never get sick no waterfowl get sick because a dead duck can't fly that virus wants to get to the next lake how does it do that by completely being an oculist harmless no symptoms the duck doesn't even know it has it and just multiplies in the intestinal wall and and goes on okay but only when forced into environment where there's no cost to the virus to get very odd I mean the the virus would like to give me very more violent the more virulence is the more can produce titers of virus you have a huge viral load but it has to be really really quiet about it because it might not spread as far but as soon as you remove that restriction remove that constraint when a virus can knock you like a two-by-four and still transmit to the other because you're so backed up something right now because even immobilize hosts can spread when that happens then there's no limit to how virulent the virus came together and that's what we had in the trenches of World War one which is where we think the 1918 virus emerged from the trenches and basically from the virus's standpoint those same trench warfare conditions exist today in every industrial chicken shed in every industrial egg operation confined crowded stress but by the billions not just Millions that's fascinating yeah I never thought about it in those terms normally yes the virus would not want the host to perish because then the virus perishes but when there's a population of you know hundreds of thousands of these animals what's one dead animal if it can jump to the next one and continue to populate so there's an evolutionary advantage there's a selection pressure to get even more violent to kill the animal quicker to make this violent hacking cough I mean to each other and so it just ratchets up but only in those kind of rare circumstances and either in the lab where you can literally dose an animal you you stick a needle down their throat and then um and then you can take take their lung so you grind them up into blender and you stick that needle down another animal but you do that you do that ten times you can and you don't take harmless virus turned into a lethal virus kills 100 percent of the animals because which virus is selected for when there's guaranteed transmission to the next one the one that that out can beats the others mm-hmm right otherwise normally it would you know if if in the millions of years where influenza existed naturally if some crazy mutant strain came up that was more it would instantly be selected against and die there with that animal because it's just not gonna spread much farther I just created this system to create you know virulent particularly virulent pandemic so or we may always have pandemics but there's a difference between a pandemic with a point for case fatality rate one 250 people died and something like like so called category 5 pandemic that's the CDC's has a pandemic severity index similar to those like hurricanes severity index with categories one through five and a category 5 pandemic starts at 2 percent mortality so 19 is there's only been one category 5 pandemic of 1918 and that's but that's just where category 5 starts at 2% Wow and so covitz kovetz uh - right no kovetz point 4 oh ok what a category what category is it in so oh so so that makes it a category 1 pandemic right now we are in a category 1 pandemic which is less Academy sorry category 2 bitten having point yeah under point 5 mmm so we are category 2 pandemic and and never before has there been flu viruses with a fatality rate on order of something like Ebola or untreated HIV I'm so you have 2 worst of my something like the common cold a respiratory virus easily transmitted infecting a significant percentage of the population within months and a virus with just unprecedented lethality with h5n1 8 7 and 9 and 10 other bird flu viruses that have emerged completely unknown in the last few decades ever since we started exporting or Tyson model of industrial poultry production to South Asia it's terrifying it's absolutely terrifying what what determines the jump to humans how does that work because we're you know we hear about these wet markets in Asia and that's really about one species to another species and then a subsequent jump to humans right right and so right for the there's been three deadly coronavirus outbreaks SARS MERS denkova 19 and they all seem to have a fall it seemed to involve this transitional species starting and in bats the reservoir species just like for influenza it's ducks and waterfowl house I think but yeah but the virus is so far removed from something that can affect humans there has never been a single reported kind of human clinical infection from adopt virus I mean they all all influenza viruses where I'm from duck there's one case of someone cleaning out a duck bar and got a piece of straw in there I get a little conjunctivitis little pink eye it's the worst a duck virus has ever been able to do only through these land-based terrestrial birds like quail and chicken um is the virus able to mutate into the flu that a respiratory pathogen that can infect humans and pigs another can a land-based mammals so in coronaviruses bats are the original and the reason why bats and ducks are I have these heard viruses is because they congregate in massive in this huge herd some root bat roost in colonies can be half million mm-hmm bats together and only under those kind of circumstances can you get a can you get a viral pathogen able to infect large populations because normally if there's just small colonies of various animals everyone gets immune to the virus the virus dies so that you don't have so you can't really have kind of a herd virus but when you have these massive colonies of hundreds of thousands of ducks are bats they can develop they can start basically an infection on one side go all the way to the other side of the population and then this one loses immunity back and forth and it can exist so in bats we have this corona viruses but it takes but people aren't getting affected directly from bats there's an intermediate species kind of halfway between kind of stepping-stone species between bats and people in the case of SARS it was this cat-like creature called the civet cat raising these live animal markets the case of MERS the Middle East respiratory syndrome viruses camels bats - camels - people at a desk of a nineteen leaving candidate for the intermediate species as these penguins these scaly anteater type creatures again I'm in these a live animal markets where you can get this kind of confluence of unusual species that you've never really get together in nature and can create these viruses with mm-hmm and what is the degree of difficulty for you know the virus that's you know being harbored in the chicken farms the pig farms - jumping to human it's like what are we looking at in terms of you know we've had swine flus etc we've never seen a true pandemic emanate out of factory farming yet I mean you're painting a thousand nine so that 2009 was our first factory farm pandemic we just got lucky that was there is a narrative that that came out of China though but did that actually come out of United States was actually factory farms or was the or sorry there out of eighteen so influenza viruses influenza virus has an segmented genome there are eight genes I mean six out of the eight came from a triple mutant hybrid this was a never before described bird swine human virus a virus with genes from all three species that arose in North America I mean in fact the first the double hybrid first was discovered in this factory farm gestation crate facility of pregnant pigs in in Newton Grove North Carolina um very rapidly this triple hybrid mutant spread throughout North America and then we exported it to Mexico we exported it around the world um where it mixed with a Eurasian swine so to create the pandemic Wow about six out of eight of the the pandemic virus came was birthed in here in North America well given that factory farming is essentially how you know most Americans are getting their food and the prospect that this is a breeding ground for future pandemics what do we do I mean is there a solution short of eradicating this entire system you know I want to talk about Cory Booker and and Elizabeth Warren's new bill that they just proposed to a rat I'm not sure exactly what the details are the the farm system reform act and what's packed into that but you know what is the path forward what is the solution to this knowing that we can't flick a switch and end factory farming overnight how do we get on on you know the right side of history with this so well important to realize that the public health community has been has a consensus so the American Public Health Association which is the largest and oldest Association of public health professionals in the world came out over a decade ago calling for moratorium on factory farms no more factory farming so the public health community has recognized the risk and has been shouting from the rooftops and no one's been listening so this is I mean this is this is what the public health community understands to be the rest not only for the emergence of antibiotic resistant bacteria but because of the threat of pandemic flu both from production and from pig production and certainly there are things we can do to reduce the risk so for example we have there studies showing that just providing straw bedding for pigs so they don't have the immunosuppressive stress of lying on bare concrete their whole lives it significantly reduces swine flu transmission rates the Pew Commission on industrial farm animal production came out specifically against these extreme confinement practices like the gestation crates for pregnant pigs these kind of veal crate like boxes that are more pigs pregnant pigs have kept for four months at a time and specifically because of the human health risk of putting animals under these kind of conditions right and so you know these are the the animals needles social distancing frankly they could use for anything wrong at this point but if we really want to eliminate this threat we really have to accelerate the movement away from animal agriculture towards plant-based milks plant-based meats plant spaces egg products and for those of you thinking that such a move is a pipe dream have you looked at a dairy case lately right major US dairy companies declaring bankruptcy because of crashing fluid milk cells because of this preponderance of new consumer choices and we're seeing that same kind of increase in consumer choices in the meat aisle as well and ironically who is leading this charge in innovating us out of this precarious situation Tyson Perdue Smithfield Hormel jbs the largest meat packers in the world all right now have a plant-based um meat products hmm how now jbs the largest me backer in the world just came out with their own line a blend base you know Smithfield is partnering with KFC in China to put plant-based chicken nuggets on the menu I mean these are so this isn't like the Topher keys of gift for some vegetarian niche product right they are recognizing particularly with the the pressures on them on the you know the source chain that this pandemic has shown it's more profitable it's your less labor cost less food safety issues I mean all down on down the risk of the externalities of business as usual they see the writing on the wall and they're rearranging themselves as protein companies rather than meat companies and so that so they're the ones that that are really leading the charge in terms of putting these these products into the hands of kind of you know regular you know regular consumers and now from a personal health standpoint you know be better if they just eat some black beans but from a pandemic threat standpoint zero risk yeah I think it's it's imperative that these companies pivot and evolve they're just responding to market pressure and consumer demand they see that this is the direction that people are moving in they understand that they're gonna quickly become antiquated unless they diversify their product line and it's working and that's why they're doing it right we all hear about the beyond meets and the impossible foods but it is interesting that these stalwart you know gigantic conglomerates that have been around forever are also waking up to this reality and making these pivot shifts yeah the question is are we gonna do it fast enough well I mean the clock is ticking I mean that's why and but if they're so what we needed is some kind of kick in the pants some kind of dress rehearsal some kind of fire drill to wake us out of our complacency right uh-huh and to really rethink the food system and if frankly if this doesn't do it right that's it fun I don't know if it is it well but I mean you would hope it would unite us it would really take something like this serious enough to really get people to rethink ways in where did this come from what can we prevent future much potentially worse threats down the road but now the idea of upend em it's not some just you know something on policy papers and people been yelling about in the side literature now it's real life yeah and so and we can and and we can see what kind of viruses are in the pipeline and realize it look even more innovative approaches I mean for those out there who are like you can you can yank that pork chop from my cold dead hands is the cultivated meat revolution the thought that look which Winston Churchill wrote in this 1932 Popular Mechanics article you know will we will escape the absurdity in fifty years of growing a whole chicken just to get a wing or a breast or whatever well now that we're making real meat with animal cells we write with muscle cells right why make why make a skeleton why make all that stuff here and eat and again from a personal standpoint right meat is meat hmm I'm certainly from a food safety standpoint to be safer I mean there's do you don't have to worry about intestinal pathogens like e.coli Salmonella when you're making meat without intestines ready don't have to cook the crap out of meat it's there's no crab to begin with right and just like you don't have to worry about brewing up new respiratory viruses when they're you're making meat without the lungs right and so that may that that's another route to to escape us from this sort of Damocles dangling over us which hopefully finally people will recognize yeah well a year ago the Booker Warren bill would have seemed preposterous but here we are the world is very different people are paying attention to this in a new and different way we all saw the news articles when the meat producers were putting out you know ads about or there were articles coming out about the supply chain problems and the threat to the workers and there was this sort of conversation around should these people go back to work should they not I was looking at videos of some of these slaughterhouse workers who are basically putting themselves in harm's way and frustrated that the meat packer employers were not enforcing some level of social distance or kind of health standards to protect its workforce like this is you know also about those workers who are you know in peril as a all of this and I think it is good that we are talking about these things what do you know what the the Booker Warren bill is proposing so it's real it's proposing reforms like the elimination of some extreme confinement practice we etchant would help I mean so anything um you know reducing broiler stocking density mm-hmm [Music] you know with in terms of meat type birds I mean and we can show in laboratory settings you double the space per bird and you can dramatically drop influenza transmission rates in these birds and so I mean look you know anything all right the situation is so dire anything is better to do and this is the time to have this opportunity and look right now is the last ever at this point the last thing we need to do is prop up the meat industry even for the current pandemic I mean look at the comorbidities the underlying health risk factors increasing one's risk of couple 19 severity and death type 2 diabetes heart disease obesity high blood pressure all of which can be prevented arrested or even reversed with a healthy enough plant-based diet I mean look you don't even have to be obese just being overweight put at a BMI of 28 puts you at the nearly six times the risk of a severe course of cover 19 so that's being about 175 pounds at the average average American height it's nearly six times the risk of a severe course you know the average BMI in the United States twenty-nine so being skinnier than the average American could still leave you with so much excess body fat that put you in nearly six times the risk Wow um and yet so you know so so this is the time to you know if you're ever going to start a exercise program or stress reduction or get your sleep schedule right or you know reduce stress or start eating healthy this is the time let's take advantage for those of us who are privileged enough not have to have to be out on the front line to you know clean up our act and not only protect us against the current infectious disease set but from chronic disease threats in the future I want to get into some of those practices but before we do that I want to talk about where we're at right now we're looking at the potential of thousand new cases a day we I think we're at 40,000 as of yesterday you know anybody who's looked at any of these graphs is seeing this you know spike upward that's relative you know it's pretty alarming clearly we've done a poor job at containing this it's been you know a political disaster a public health disaster where what is your sense of where we're at how we've handled this and what we should be doing not just a poor job but the poorest job I'm in the world over so you look at I mean you don't have to go you know dig up you know South Korea and Singapore and Australia you know and you know these things look the look at Europe for example about the similar population as the u.s. Western Europe and they had they they they they they they you know got caught unawares just like everybody and had the spike but came back down they truly have a wave right we're talking about is there gonna be second wave the first wave in the nights are still in a West way we're still in the first wave and so if you look at the pandemic the the epidemic curves around the world they go up they come down even with comparable population sizes except the United States which continues to rage on but you know you look at you know Japan where you know oh my god they had 10 deaths or you know Australia a hundred deaths a the milestone they reached a hundred death and I say yeah they have 10 times smaller population yeah we have a thousand times more deaths I mean you know yeah um and so when you hear all South Korea they're having problems again oh they had to you know they had five cases somewhere in there coming um and you know my concern is not just these deep red states you know like Arizona and Florida but look what's happening in California and I think it's because California's never saw what New Yorkers saw I mean they never saw the hospital's overrun right because we caught it early enough in California the first state to really take action that it worked - good and so people didn't see the hospital's overrun people didn't see you know doctors have to make triage decisions as to who gets the ventilator and who doesn't and so there was this complacency that and this kind of black and white thinking like we're just back to business as the post is still taking precautions particularly for those who are elderly particularly those with these underlying risk factors who are still at great risk right and once the protest began the floodgates open it's very hard to put that back in the bottle right although you know now that were weeks out well thankfully we did not see the uptick that was suspected by many I mean we think it's because of of being outdoors I'm so in 1918 a lot of the transmission was actually driven by these war bonds marches on where they got people together during the pandemic to raise money for World War one and was and and that was implicated a lot of spread so even outdoors but now with the current virus whatever the transmission it really does seem the high-risk is enclosed indoor poorly ventilated crowded spaces for extended periods of time that's where these so-called super spreader events are happening that's where you can get you know sixty percent of people walking out of a bar and we're later coming down infected whereas despite the crowded conditions outdoors you have once you're outside you have the ultimate ventilation one little air current and you're you know any little respiratory droplets or aerosol that gets you know that you exploit with you breathing if you're chanting even if you're yelling even if you're hacking because of teargas these are I mean these are conditions billed for the bars you you know with all you need is a little breeze and we did not see that kind of right thankfully it seems that we're every week we're learning a little bit more and we're having to figure out you know how to dismiss what we thought was previously correct you know we were disinfecting all our groceries and we don't do that anymore and I thought are we supposed to be doing that should we be doing that or am I just being lazy you know wearing masks of course is a given but I think it would be helpful to just point people in the right direction in terms of you know just kind of piggybacking on what you just said what are the most of two things that we should be doing what are some of the things that we're doing that perhaps we don't need to I just don't know where that demarcation line is there's a lot and I'm trying to educate myself and I'm still confused you know I know that I need to wear masks I've watched videos of of where you can see how it impedes the expectoration of your breath but you know if somebody's smoking a cigarette you know hundred yards away from me I can smell it so if I'm smelling that does that mean that if that person is infected that I'm potentially breathing that too like it's it's very confusing even for somebody who's actively trying to get to the best practices right so right even the most conscientious among us are still having difficulty separating kind of the wheat from the chaff and knowing what do we know what we really don't know and so I think early on when we really didn't know the transmission characteristics this virus no all past pandemics have been influenza pandemics and we know so much about influenza it was easy for us to know okay we know exactly how it's spread we know exactly how to clamp it down but this is a new virus and so we really didn't know the transmission characteristics and so something like the surface disinfection of anything coming into the house I mean anything early on that was a legitimate act because we just didn't know how much it so called for my transmission to doorknobs and light switches and toilet flushes and gas pump handles we didn't know how much was contacting you know then touching our mucous membranes eyes nose mouth before disinfecting our hands now we know that is that is not the primary means of transmission and so and now that we had enough time where people have been isolated in home and their only contact with the outside world wars the delivered groceries and delivered food and there we have not seen validated cases um even among people that aren't taking any special precautions okay so now we can breathe a sigh of relief and we can and we can take in this information realize okay now we we know what to prioritize in life in terms of reducing our risk and what's the priority distance distance distance that's really I mean there's this really overinflated reliance on masks that give us a false sense of security remember that masks are not to protect us the masks are to protect other people from us right it reduces those respiratory droplets that come out of our mouths with conversational speech are just normal exhalation and and the thing about this virus as well as influenza you may Kate come contagious before you start showing symptoms and so days after being exposed to this virus you can feel perfectly fine look perfectly for an MB exhaling virus with every breath and that's why if you don't know who's infected and who's not that's where the social distancing coming and without sufficient testing you don't know who's infected there's nothing she just have to try to keep everybody away from everyone else that's what the social distancing measures were implemented for and still the most important thing we can do to protect ourselves is I mean it's like that's the good news like you cannot get the virus if the virus cannot get to you and how do we get the virus from other people so reducing as much as possible or contacts outs of our outside of our household and if we have to have contacts outside of our household it's for a short time in as well-ventilated area as possible particularly for those that are vulnerable or for those who come in contact with those vulnerable and so and so there's this gradations of risk there's a riskiest behavior there's the riskiest populations and then all the way down to you know maintaining a sense of social cohesion but I mean you realize you know as bad as cup of 19 has been right we still the grocery stores are still being restocked we still have electricity we still have clean drinking water um doctors are still showing up to work you have a pandemic with something like a 7 & 9 h5n1 when case fatality rates like literally a flip of a coin whether or not you die from this virus then you could imagine how much worse this situation could be that's why it's so yeah it would be straight-up apocalyptic if that was going on right now and you hear stories like I just read a story the other day about a super spreader event a wedding in India and I think 90 people contracted the virus as a result of attending that event but there isn't some situation in which every worker at Ralph's suddenly in the hospital mm-hmm which is interesting kind of around people all day they're wearing masks but you know I haven't heard of any grocery workers at least on at scale contracting the disease so we care these doors but I guess they're all wearing masks so we're still trying to understand what's behind the super spreading event so some of them like this this famous choral group where 80% of those unlike God infected in one choral singing session anything oh well not only indoors in one room but they're you know they're there they're there they're spewing virus out into the air and so that would that would that would make sense that that would be and then you look at the meatpacking plants where it's so loud you have to talk really loud shout into people's ear then they're so packed tight um and it's and it's chilly which actually may play a role in enhancing my viral stability and the prisons are now becoming hot spots again that just makes sense and so we can explain a lot of these but there may be characteristics of certain people or certain strains of the virus that do in kind of whatever situation that would have been in could you know lead to mass infection and imagine being the bride and groom of that right inviting people I mean or any kind of function right I mean we really need to think before we have that you know before we bring over people to the house party yeah yeah and just we should think you know God what if our what if we heard whatever some of one of our dearest friends right or our family so you know we just read this is the Newton what Americans want what they want when they won't know and this is this is we're seeing a little evidence of that we this is the wake-up call yes I mean it's really and it's not going away anytime soon all right I mean I talk about in the book written months ago that you know that there's no reason we should expect that this should go away in the summer the other quart of irises don't they blah blah blah and here it is continue to rage on during their in the hot summer months and so and so the only way to stop pandemic is through herd immunity having a certain portion of the populace mewn to the virus an infection can only burn through a population if there are enough susceptible individuals for viral sparks to jump for one person to the next immune individuals who can't get or transmit the virus act as fire brakes to slow the spread or like control rods and in a nuclear reaction to break the chains of transmission now ideally this herd immunity is achieved through massive vaccinations right vaccines are way to to use like fire to fight fire you use the virus to fight the virus by generating the benefits of infection immunity without generating the risks with disease and death ah not without a vaccine then herd immunities only achieve the hard way through mass infection hmm but looking at the characteristics of the virus we have now we suspect herd immunity will be achieved when 60 or 70 percent of the population is infected when there's that many people who are immune this is assuming that we have some kind of at least short-term immunity one sixty or seventy percent of the population is unable to get or transmit this virus then the 30 to 40 percent who are completely susceptible are protected by everybody else and the VAR stops right pandemic ends and so the goal particular if you're older particularly if you're if you're sick um any of these underlying risk factors you want to end up in the third and forty percent we're at the end of all this the pandemic is over and you never got infected you never were at risk right that's the goal and hopefully we were able to get that through vaccines but you we need to realize reality check vaccines historically taken 11 years that's the average and has a 94 percent failure rate meaning 94 percent never made the market um now that this is a totally different situation we have literally a hundred and fifty candidate vaccines in the pipeline so the whole world is jumping on this so we should certainly see an accelerated timeline but you know you have to test enough people to ensure sufficient safety and so we should not expect to have a war whole vaccine the general population till 2nd - mm second yeah it's a long way off and herd immunity is a long way off short of that what would have to happen I mean so we're about five to eight percent 5de percent of Americans have been affected so far now I'm at now unfortunately some of the some of the early data on immunity it's possible that um immunity to this virus may be short-lived so we're seeing that a lot with coronaviruses there's other coronaviruses for which um you come back months later I'm so with like common cold coronaviruses forty five weeks so four to five weeks of immunity and then you're just as susceptible again so it's possible we get into a flu vaccine kind of suits in all right where you'd have to get vaccinated every year to maintain immunity to this virus but some of the early data suggests that some of the people that got infected early may now I'm starting to become susceptible again based on the level of have so-called neutralizing antibodies in their blood the ones that really target kind of the the receptor mechanism of this virus we have yet to test what's happening to their t-cells is IC to memory immune systems in the body the antibodies and the t-cells both can retain memory of infectious exposure in main to gave that lasting immunity so far we've tested antibodies and they've been disappointing may only last weeks in terms of infection so then herd immunity is much more difficult to achieve but we we have yet to really see what's happening with these memory t-cells maybe they will give us the and that's what we saw with SARS SARS antibody levels went down they had some memory T's thankfully we eradicated SARS from the planet and how could we get rid of that deadly coronavirus and we're having such problems with this one because with that one you only became infectious after you started showing symptoms in fact peak infectivity was ten days after you started coughing coffee for ten days later you're spreading it ah put up fever monitors and every boy's ear who started I mean still with 8,000 people got infected and killed about 10% killed about 800 people but we could stop it we didn't know that we could have a corona virus where we'd have the loo like infectivity during incubation period infectious before show symptoms and that's that's what that's why we're in this situation all right right well it would seem important to be able to answer that question about whether we can contract it again critic long that is right for yes for vaccines for everything so have it you know there was this talk of having an immunity passport right proving I have Randi I'm and of course the concern if that gave you some kind of perks you had better jobs or whatever people would infect themselves like I have like Quranic parties too and then you could get the little immunity path but if we really don't have lasting immunity they don't last for a few months um then what is what does it even mean to have gotten the virus um if you can get to get a few months later yeah we've been doing antibody testing here and with regularity people are disappointed to find out that they didn't have it everybody you know thinks oh in February I had a you know I was sick so I probably had it sniffles one of these right um but and and it's possible that having an asymptomatic case like you test positive but you never really or you had a mild case symptoms you actually may even get less immunity from that and it really may take because it kind of passed under your immune system radar and you just said and that that your body was able to squash it so quickly that your body didn't have to mount much response at all right and so it considers it such kind of my alumni are gonna worry about mounting this constant like right now your your bone marrow is pumping out anti chickenpox vaccine uh antibodies right now and will for the rest of your life if you had chicken pox is child's and most everybody has and your body's wasting lots of energy every single day making chicken pox making v measles making anti and it's a lot of generates a lot and in fact immune cells expend more energy than your heart cells which are pumping every single day these are huge they're literally buddy probably got millions of antibodies every minute it's just these little you know I mean there but that's because that was our one of our primary threats to our existence on this planet historically throughout evolution were the infectious disease threat because bacteria and viruses multiply so much quicker than we do and so we had it was this back and forth you know they'd get a little better our immune systems would you know catch up but they've got a few billion year head start on us uh-huh evolutionarily and so that's why we use our brains to develop technology to be able to squash it and vaccines are the technology that allowed us to for example eliminate smallpox from the planet Earth literally hundreds of millions of people used to die because of a disease that is now gone from the face of the earth septons from bio warfare labs and and and you know with 1976 I think last case never phone thanks to vaccines so anyone says you know questions vaccines you know we we there was probably the greatest public health victory of all time was the elimination of smallpox there is no longer a disease and that was thanks to vaccination and so we should we should we should hope and pray we have a safe and effective vaccine for this in the future on on the subject of herd immunity what do you make of Sweden's o strategy well you can ask what they made it it and they they now realize it was a mistake and they have some of the highest infection and death rates in in Europe in fact around the world and so they they but but but if we like we're looking at that at a discrete point on the timeline to three years from now if we're still grappling with this in a in a you know in a material way and they're not you know I feel like you know are we able to really evaluate the merits or demerits of that strategy right now well even even in the most infected so even in Stockholm which I think has the highest I'm a post infection brace they were still minute twenty five percent hmm so they're raging now and so they are still fine now we're much farther from a herd immunity situation but the point is to keep the disease and to have had low enough rate until we achieve that until that on a level of firm unity is achieved I mean that has to happen kind of across the board unless you completely closed off your borders like they were able to do very successfully in New Zealand so if Trump called you up in the middle of this podcast and said Gregor I'm get you in the White House tell me what to do what what you know if you're in charge if you're sitting in Falchi situation all right now what's the what's the problem well first of all I said look I'm in a rich role podcast wait until we're done but when I have a moment well it's really putting the experts back in charge so I mean in any other circumstance the CDC would have been leading this charge I mean they've been effectively silenced right um and the same thing with I mean it was like this is Rand Paul told told Falchi he was not being optimistic and not for the muzzle be I mean and and so when when we don't have the experts in charge I mean this is this is this is and this is not just happened in the US I happen to a certain extent in in Brazil in in in UK in a number of places where they can't have these kind of this kind of autocratic response instead of listening to the two experts who have been spent you know their lives doing this and so there are good sources of information I don't want to put a plug in for the Center for infectious disease research and policy at the University of Minnesota Michael osterholm has a weekly broadcast um so it is one of the sanest voice has been doing this work for 45 years I remember when I was doing my work I'm in this you know 20 years ago I mean he was a leading you know leading the charge way back then and was you know with HIV on down the road and so it's people like him and Falchi who have this is they've spent their entire lives studying this and so then to have pandemic preparedness you know documents going back when I was writing about this and that and you know I was kind of late to the game 14 years ago or so you know we had I mean you know and but then we had all this this you know these plans and there's threw it out the window we just didn't follow what we needed to do and and part I mean it's very difficult politically because if it doesn't if you're not if it doesn't look like you're overreacting they you're not doing enough frankly because we have oh it's the mathematics of exponential spread during a pen and now in retrospect we know oh when we had one case we had 10,000 then we had you know and so you're always late to the game but it always looks like your your your your you know you know Chicken Little because uh there's only a few cases you know what I mean you know let's not write that's not you know the impact of the economy is such and this was a certainly a new virus I mean so they're sure for early missteps there's you know I you know very few places around the world we're ahead of the curve and the ones that were like Hong Kong Singapore South Korea they had recently suffered deadly coronavirus outbreak so Cora South Korean 2015 had this MERS outbreak some businessman came back from from the Middle East and started spreading and so they had this testing and tracing public health infrastructure intact the other country suffered recent SARS outbreak right so they had experienced this firsthand on their soil their populace was ready they were understood the risks and we're ready to do whatever the experts were told was necessary and said they were able to jump ahead of the curve and you get on this you start these social distancing measures two days three days early and you have this mathematical modeling modeling suggesting you could literally you know prevent millions of cases in the long run if you know a week earlier you did this a few days earlier did this and that's because once it spreads out of control it's very hard to kind of put the put the lid back on right I think that's what we're experiencing now I mean the difference being that there wasn't that kind of popular will because the SARS and the MERS like we knew about them but they didn't really land on our shores in a meaningful way right right in fact right SARS never did so I'm sorry said Canada never actually made it into the States um and so right we said we didn't have that the history but we certainly had experts who spent their whole lives preparing for that situation in fact I was part of these we there were you know these governmental drills where we all got together all we have these you know sick chickens in Maryland and then what's going to happen and what kind of decisions we have to make and there was all this kind of you know wartime game planning for you know you know departments and but you know it just it's just not the window hmm and so okay so early missteps right we you can forgive around the world for countries that have not had a recent history but then right but now even even a few months ago we were far enough in to realize the situation we were in and had to take it much more seriously yeah there was this sense of what we just have to lock down for you know ten days or we just have to do this and it's gonna be very temporary and like and all the scientists are looking at each other saying like what world do you live in right but having said the messaging is so confusing and it's not cohesive and there is no sense that there's a real plan so we kind of did that for a while and then we kind of tiptoed out and then suddenly we're protesting in the streets and now we're like are well now we see the spikes but are we gonna go back home and nobody's really you know taking the reins to articulate in a clear cohesive manner what the steps are that we all have to get on board with in order to get on top of this so I just feel like it's just gonna it's gonna run its course and people are gonna do what they're gonna do right now short of some you know catastrophic spike that's going to get people to wake up again cuz getting them to go sequester in place after the many months of you know what we've been experiencing I think is gonna be very difficult yeah yeah but I mean that cement but that's if you can the fewer people you come in contact with supporting on time outs I mean and the farther you can be away in the more event I mean that's just you know now having said that if you are under the age 50 none of these comorbid conditions but the chances of you dying from this virus one in a thousand right I mean we are talking about a in the scheme of things a wimpy viruses are category too bad dammit um ah but you know we should all be you know well informed as to what's risky what's not risky what can we do to reduce our risks should we have to come at act act and then the you know you know it's great well setting aside the comorbidity factors you know if you're not obese have high blood pressure heart disease etc if you're not in a nursing home you are in a much better position to combat this should you come into contact with it but we've all heard the stories of young fit people who have either perished or gotten so tremendously ill that they're having trouble recovering so let's talk a little bit about this narrative that it's just like the flu or it's just a little bit more serious than the flu like what is the difference between the flu like as we kind of understand it as Americans versus the experience of contracting this disease and what happens to your body when you have it yeah so I mean so for those in the public health community even saying something is as bad as the flu as a way to minimize it doesn't it for infectious disease folks flu is a scourge that kills tens of thousands Americans every you know every year and and you know unfortunately the annual backs flu vaccine is not very effective between 30 to 50 percent decreased risk which hey better nothing but you know we're gonna able to really put a put a lid on this virus come surging back every year and it's been the leading cause of death that's where I have a chapter on it and how not to die because one of the leading causes of death ma you know this low respiratory tract infections or no pneumonia primarily caused by influenza and so but this is but a bad flu year has a point one a case fatality rate one a thousand people getting it um whereas for a cup of 19 we're looking at point four now so at least four times worse and of course it depends on on what age group you fall in but that's kind of all across the board unfortunately here in the United States even without taking obesity into account over age 50 most Americans actually have some comorbid condition I think their high blood pressure or heart disease or diabetes and so yeah and so you know all these these lifestyle medicine pushes to enhance you know to to increase our resistance against chronic disease sometime for in the future now is helping us right right now and so you know this message to you know better take care of ourselves some family has never been more kind of there isn't enough discussion about what we can do to buttress our immunity or you know make sure that our immune response is intact and healthy and a corollary to that is also I think there's this idea that we want our immune system to be as robust as possible but is it possible that it can become too robust yeah that's the irony here so we have amazing studies showing the simple foods can boost one's immune function so I have videos nutrition facts the door talking about randomized double-blind placebo-controlled trials showing that for example broccoli sprouts can reduce viral loads for influenza decrease virus induced inflammation boost antiviral natural killer cell activity but this isn't the flu unlike other common viruses corona viruses do not have not been shown to cause more severe disease in immunocompromised people those with HIV those are on chemotherapy or anything they're vulnerable to other infections not to coronavirus infections including kovat 19:08 a second how does that make any sense because it's your own immune system that's the primary driver of lung damage during infection during the second week of infections during the infection the second week of symptomatic and infection with Cova 19 the virus can trigger what's called a cytokine storm which is like an autoimmune reaction I'm where your body ovary acts and in attacking the virus in your attacking virus your lungs get caught in the crossfire and in you know burning down the village in order to save it we may not make it through that process so while I'm certainly in favor of common you know common sense generalized you know advice to stay healthy such as sufficient sleep and staying active and reducing stress staying connected I'll be a you know remotely with friends and families eating healthy but I would not you know take a specific sub go out of your way to take a specific supplement or dismissive food to boost some element of your immune system until we know more hmm about this virus because potentially we could be doing more harm when we're well-intentioned and trying to do good I've been hammering the broccoli sprouts and also vitamin D we're hearing a lot about vitamin D so what are your thoughts on that so so there are a number of of vitamins and minerals that are critical for optimal immune function vitamin D is one of them vitamin C zinc selenium but there's no evidence to suggest that super enormo levels have any benefit so you need sufficient for functioning immune system so all the studies that show for example zinc improves heart outcomes for disease so you give zinc to children with pneumonia significantly decrease mortality rates randomized placebo-controlled trials zinc verses sugar pills to children with pneumonia those given the zinc significantly less likely to die but where is every single one of these studies been done sub-saharan Africa Ecuador places where there is micronutrient deficiencies so if you find a deficient population not getting enough zinc giving them zinc can get bring them up to mute but if you have someone with functioning immune system um with adding zinc do anybody do any good if you're if you're having enough if you have enough vitamin C have enough slate desert there's no evidence that having higher levels so having said that vitamin D deficiency is rampant is rampant even in you know the the problems that's shining example of this is there is a study of skateboarding teens in Hawaii right and you just imagine them shirtless all day right and they even they had these high rates why is that um well it's because we evolved running around naked in Equatorial Africa um being baked in the Sun all day long and so if you want to know what normal vitamin D levels are you measure people who work outside all day long I mean that's what that's kind of a natural level of vitamin D and so we were never meant to have these winters and inside and wear clothes and all these things that cut down on the natural vitamin D production and so for people that don't get sufficient midday sir particularly those with darker skins particularly were older particularly those with more body fat a may need to supplement with vitamin D and so I would recommend 2,000 and ashy units a day for those who get insufficient some that's what I do because I'm inside all day I got my D levels tested once before I supplemented and I had the D levels of an institutionalized elder like these people who are like nursing homes and literally never got outside that was me in front of my laptop or mr. nutrition I just never got I got work to do I got a book to write what do you mean and so right so in fact 2000 was enough for me so 2,000 would get most people from the general level up to optimal right um but for me who got no son I had more so a couple questions on that it's not about mega dosing it's about just making sure that you're not deficient but I think it's probably safe to presume that there's a good chance you are deficient because so many people are short of getting a blood test to determine that if you are depleted or deficient how long does it take to restore you know that balance is that happen quickly or is it a fact so rapidly that you can actually randomize people with infection to vitamin D while they have the infection and improve disease outcomes um and so that's good you increase their levels Walt lay on the wall I mean so literally within the days your immune systems like come on people we need some vitamin D right now right and so right so so very rapidly were you able to improve and the same thing with these think stones right they gave them to kids not before they got infected to see how they if they got infected how they do literally they were already sick gave them zinc and then a few days later they were live or dead whether or not they could sing so another problem with zinc is he there isn't even a blood test so you couldn't get tested for xing sufficiency if you want to but if you are so but if you were eating a nutrient-rich diet right which is well where all vitamins and minerals come from with only two exceptions it's just from the ground and so you know you know and and bye-bye eating by eating them implants ah ma I mean that's where the car that's where we should get um I dealing with the two exceptions of vitamin D the sunshine vitamin vitamin b12 which made by microorganisms which blanket the earth but we now chlorinate our water supply don't don't get a lot of b12 in our water don't get a lot of cholera either that's a good thing we have a nice sanitary system but again because the way we lived in a modern world like with vitamin D because we live in a modern world we have to yeah sure we get a regular liable source of vitamin b12 what other what other foods should we be mindful of making sure that we're getting that our nutrient rich and the way that we want our needed given oh but so fruits vegetables legumes the same litany right beans lentils chickpeas split peas whole grains nuts the seeds herbs and spices mushrooms real food grows out of the ground feels not factories a nice thing you know it's not its experience the basic stuff right this is where I get tired of talking about this uh oh my god well I mean it's but it's even more relevant now and if and if people are gonna start eating healthy now because they don't want to die from the virus and and my my secret plan is for them not to get breast cancer in ten years and I don't get died of a heart attack look whatever it takes for them right I would appeal the vanity tell people helps with acne I mean anything to get people to eat healthy because I know it's gonna save their lives later on and so maybe this will have the side benefit of starting some healthy habits they're gonna stick with them and thanks to the pandemic are not going to you know croak in ten years right stroke what about viral load we hear a lot about viral load right you you touched on it a little bit ago that that you know we want to avoid these you know endure kind of hotspot settings where we're in close proximity to each other but I'm not sure I fully understand the like the idea is that you could potentially come into contact with the virus but if it's in a passing way if it's not you know in one of those cloistered kind of settings that perhaps you're not going to contract the disease that's your smoker fifty foot away right we have this sense that one one viral particle we get exposed to the virus and all sudden we get infected and you must realize that even if someone with active tuberculosis coughs in your face the chances of you getting tuberculosis like one two hundred really because you have an immune system now if you have HIV or it's some yeah impaired that's what your immune system is for we we were built to fight off invaders right and so only under certain circumstances when we have sufficient it's called the viral load when there's sufficient so you pick a pathogen and there's an average viral load for coli bacteria one e.coli bacteria the odds that that's going to trigger infection even though they multiply like crazy or one Salmonella no it's it's you need you need a sufficient dose that's why um like pasteurization that's not about sterilizing milk cooking it's not about sterilizing the meat I mean it's about reducing the the number of infections sold that is below the infectious load and so when it comes to respiratory pathogen it's not that you you have to prevent yourself from breathing in one particle ads you have to reach a sufficient number of infectious particles and whether that's a thousand whether that's ten thousand we unfortunately don't know yet with kovat 19 but we do know it for other respiratory pathogens and you can I mean you could dose it out and how do you do it well they do the stage of the influence with a young healthy people that are really low likelihood of suffering and they little drip it in their nose so they drip a thousand of the nose and see how many percentage of 100 people drip two thousand and their nose they drip ten thousand right and you can find out exactly how much so we don't have that data yet because we have a new virus but we always know that I mean otherwise the the disease was spread even more happen than this so it is on intensity of exposure and at plus duration of exposure so everyone's freaked out about elevators right but how long are you in that elevator right it's so it's if you have someone in your home who is infected and you have a studio apartment and they're not in their own room and they're hacking away and they yes they have us they have a cloth face covering and they're we're trying to wipe down all the doorknobs and we have those windows open and the exhaust fan on the stove going and in the bathroom going you have an air purifier and like you were trying to do the best to maintain ventilation you're living with that virus for long period of time in and and that that puts you in extremely high risk is these crowded settings um and in fact they do they now we have these beautiful studies where you know we've traced everyone back to one of these restaurant events and use and they have the the little map of all the tables where all the people are the tables and here is the index case and everybody over here got it no one even sitting next to them over here got it why because the airflow is going this way right here's the air vent here's the air bed everybody got it this way and the person sitting three feet away on the other hand didn't get it is because these little tiny these are like little dust motes that you see when the sun's rays come in they just kind of float around but one little teeny breath we just you know blow them to one end of the room or the other hmm um and so it's butts just being in this cloud of little dust motes breathe in one breathe in two three than three and it's and so when you look at these contact tracing apps and contact tracing protocols they're asking who have you been close to that's the intensity under six feet and for more than fifteen minutes we've been close to they so the so is less than a minute that is that random or is that calculated is there a scientific basis without fifteen minutes okay window not scientific basis for Cova nineteen because we don't know right we don't know the parameters yet but so that's based on other respiratory pathogens so basically all this modeling has to do we have other respiratory passage we have common cold viruses we have influenza viruses and so we have other data from viruses we think transmitted very similarly based on the data we have so far so based on that you know we're not even going to call on the phone someone you spoke with directly face-to-face for ten minutes two days ago and now you're in the hospital there that they aren't even so that likelihood that they're a minute threshold but so fifty minutes and they had to be close so a fifteen minutes you spent all hours but you were outside on the porch with someone who's eight feet away from you not even go call em hmm then what about well look we're seeing a clampdown now on indoor dining a lot of restaurants and you know in California at least they're closing some of open they're closing back down there's you know every state is different but airplanes seem like a bad idea recycle there we're seeing these Airlines announced that you know they're not going to restrict their seating you just were on a plane I mean that just seems like the worst idea so there's uh there's it's safer than being in a similarly confined space just because of the they actually HEPA filtered through the air system so you actually should have those that you can imagine being in a plane not wanting that recycled air in your face no that's exactly what you want your face you should open all three of those nozzles if you're not sitting next someone point them all towards you you have this wave of air pushing past your nose for someone someone walks there's a few does that air cause that air recycle those completely recycle so somebody in the back is coughing and it kids through through HEPA filter which is not a perfect filter but it does filter out the majority of the type of droplets we think are carrying this virus and so you have this semi purified air blow fishing everything else of wooshing everything else away now that is not a I would not consider that a low risk scenario um but look when you gonna be on the rich roll podcast you take you run the cost-benefit you showed up man I appreciate that taking that risk what about what about masks okay so you go out in the world you see all variety of masks from the guy with a who's got the bandana around his neck covering his mouth but not his nose you've got cloth masks like this you got the n95 like how important is it to have a high quality mask i what should we be thinking about when we're making that decision about what kind of mask so the only mask actually designed to protect the user the wearer are these n95 masks which were specifically designed for that purpose they filter their they filtered the air coming in hmm and so that is what's being recommended for medic personnel and but those that's not something you just you know that it has to be something has to be fitted to your face actually go through a fitting process in the hospital to make sure you have the right size for your face you can't even have a day of beard growth so everybody with any facial hair covering that that area is completely I mean that it breaks the seal this is a meant to be an airtight seal and the material has this electrostatic charge that traps these microscopic little floating particles I'm such that you can wear it with just someone coughing active TB germs um and and been very effective for copa90 now of course you can infect yourself taking it on and off and you know you can you can you there can be an inadequate seal for whatever reason um you really shouldn't use it's meant to be disposable now we don't have enough even for medical professionals and some that we have to reuse the mass and we don't have enough data to show how many times you can reuse it now saga you can get and what kind of protection I'm still existing can you reuse it after you decontaminate it on and on and that's why so no one is recommending n95 masks for the public not because they don't work but because we don't have enough to go around now that's not our fault right that is a failure of the national stockpile we should have had n 95s for for for all medical professionals as have other countries and in fact other countries have provided you know surgical masks for their entire populace for free and so now surgical masks are meant to protect others from the wear so that's why surgeons wear them so they're not breathing germs into an open surgical wound that's at least the theory although there's only been two randomized controlled trials and there's actually no drop in infectious raids during surgery surgeons wearing masks versus not wearing that I don't want so even surgical masks are of questionable utility for cutting down on disease transmission and the cloth face coverings there's no data to suggest that they're useful certainly during 1918 they were found not to be successful the the benefit so the my concerns is false insecurity mm-hmm the critical factor of getting affected is distance distance distance lightens the time and distance and so if you but if you feel invulnerable or you feel lower risk because you have that mask on and you would go places you would not normally go or you would stay longer or be closer to people than you normally would that's how a mask could actually increase your risk of rise all indirect ways it could decrease risk of infection the people really need to be using like the surgical masks at the cloth face hurting or people are actively hacking coughing actively symptomatic there I mean they are spewing out virus like crazy they really need to be wearing masks if you go outside no one's wearing a mask and you know you're infected and you have a fever and you're coughing but you need to know the drugstore you live alone you need to go outside and no one else is wearing a mask the social cost but no one you know of putting on a mask and flagging I'm infected um you can imagine how people might not do that whereas if by law or by decree or by social contract everyone's wearing a mask you are more likely being symptomatic to wear a mask and protect others um and so that's a way how masks could really help even if it doesn't necessarily cut much down on the asymptomatic transmission which is what we're hoping we're hoping that those tiny little respiratory droplets that we spew out of her mouth during normal conversational speak we're gonna trap some of those with a cloth face covering do we have data showing that's the case we do not and so when the CDC came out and said we changed our minds a base on the new data or based on the latest science we are we are going to recommend everyone wear cloth face coverings and you say well you go to the CDC website what's this new science they cite the national national institute of medicine um and you go there you say what did they do and they came out said master probably a good idea based on what date but they're very clear say we have no data showing that they actually work theoretically it could cut down on some of this transmission again not not helping the wearer but helping other people from the wear if they're infected not even knowing it but um but this but my biggest concern false sense of security I have something called my face so I can go to the grocery store twice as many times as I did before and I don't have to exactly stay as far away from other people as I you know that's how masks could be part yeah I think of it much like it's basically a a tool for social distancing like it's sort of buying you a foot or two right like instead of making sure that I'm you know six feet apart maybe I can be five feet apart but it's not doing anything more than that is that or or you could imagine it working even better the presence of masks reminding people you're during a pandemic it looks weird walking around like cashiers people are on the street it's amazing how quickly we normalized to it not I don't think now I just yeah I think of it's normal right I mean it's funny when you look at these 19 so I was at the National Archives when I was writing the book and doing talks about it and going through and seeing all that you know major baseball you know back in the 1918 everyone's wearing masks and the spectators it just looks so weird to have people with you know billy clubs and mass son but now right it's amazing how quickly but if it reminds you first sample wearing wearing gloves on your hands and the reason say was no point in wearing gloves on your hands in public because you can just as easily infect you know rub your eye with your gloves as with your hands and so you have to wash your hands gloved or not but if having bright pink gloves on your hands well as you go up yeah you know I mean if that reminds you and you just look down and it feels weird and it's awkward and you're everyone's looking at you because you got breaking it if that keeps you mindful of the position of your hands that could be a good thing that could cut down on rates of it you're just because you're not you know it's not business as usual if masks make it not business as usual I mean it's just a little you know it's constant reminder oh maybe I should be a little more careful in this situation or not go somewhere then that could help testing testing testing we need more testing testing is the way that we're gonna get on top of this when should we get tested what kind of test should we take there's all kinds of tests out there what are these tests telling us about how we're responding to this problem right like I think like oh testing testing testing I've gotten in a my bi test a couple times I've been negative I haven't had the full swab test you know do you wait until you're symptomatic like when is the appropriate time to explore that and I don't go yes so testing testing testing only makes sense if it depends what you're going to do with those results and so testing is critical to know what's happening with the virus and without that information then you're flying blind so you want to know if some kind of stay at home mortar actually helped or not you want to know be able to trade with these protests would that lead to a big spike or not it's still so early on we're gathering data regarding gathering intel on our enemy and so without testing we're completely flying blind and we just don't know how far are we away from a herd immunity what's helping what's not helping what are those super spreader events how can we avoid those what kind of you know occupations what kind of restaurants are good bad you know we don't know that if we don't have it sufficient tests and so we have been and so the countries that have done the best I'm so South Korea for example they were ramping up to test literally within 10 days and thousands of tests a day we weren't testing at all at that point and it's interesting they actually had that we had our first cases on the same day South Korea in the US and you look at our curves I mean it's completely vanquished it and we're still raging on so what are you gonna do with that testing and so so basic what's called SERO prevalence testing you just want to know you want to do random sampling um as part of an experimental set up to in various areas of the country on a consistent basis to know what's happening with the virus where and so we can gauge that against our hospital capacity how many been relators we have in that county how many you know how many ICU beds and then we can make these decisions do we open do we close or window should we be pumping the brakes on this kind of social assisting obviously we won't want is little as possible we want to be able to have as much freedom of movement and continue the you know vitality the country's much as possible until unless we're gonna start running out of beds right until I mean that's the whole point of flattening the curve you're not necessarily reducing the number of people that are gon die we're gonna get sick you're spreading them out you're just we know this many people are gonna die but if they all die but if they all come in the hospital this week then more gonna die then if they come out over the next ten weeks now it's possible if we slow it to the extent that we hit a vaccine aha that's the game changer so we can slow things down enough then then that slowing flattening the curve strategy then does indeed result in fewer deaths overall because ah then we finally have a method to stop the virus without getting people infected and so so they're there there's a there certainly in place for testing in terms of individual testing right now there isn't sufficient tests available and this goes back to having enough swabs enough reagents on it and now we're dealing with this with a future vaccine we don't enough glass vials in the world to even put the vaccines in so then then if you're gonna use one if you're gonna stick needles into one vial instead of having single-use files and you have to add preservatives adds another safety issue and I mean it I mean so basic and of course public health community has been shouting about this forever I have this in my book fourteen years ago the supply chains are not sufficient to have enough mass to have enough PPE to have enough of the basics we need so that's we're running into the testing and so it's like mass what are the best mass Oh within ninety five so I'll shoot at should everyone have an n95 no we can't because we need them for the frontline workers even even surgical mass which are better than cloth mass we're telling people not to use those because we don't have enough for the medical workers and so that's right you know DIY making it home with a with a sweatshirt even though we don't have data showing that's necessarily I'm as effective as people think it is um it's so Sammy was testing what we like we want weekly testing for everyone in the country right then then we can rub but we don't have that capacity so who should get tested um it is people that are coming in contact with vulnerable individuals that is the highest so people working in a nursing home we want that staff tested um because one case in that just can explode right right um so people in you know prisons that haven't already been overrun like San Quentin um I you know it's kind of at that point it's almost too late what we're seeing in some of these but it's those kind of high risks in ours these are the people we want regularly tested so we could pull them out of circulation X it's ironic actually goes back to the porn industry and HIV that's how the porn industry is work right here was a deadly virus and there was yet there was an industry where you had to continually put yourself at risk to be an Ender so what do they do they instituted a mandatory testing I forget exactly how quick how frequently need to get tests and you could not work unless you come back with a negative test and you would be out of work they'd figure it out the interval right like it was every two weeks or they had whatever was right and so they could they could constantly and so that's what we need and so that's we should let the porn industry that they they're always out front these technological breakthroughs that the whole concept of testing tracing actually came from the STD world I mean that's what you know you have a case of gonorrhea huh we need to find everyone you slept with recently and we need an honest they call them on the phone and say someone you've been with recently had gonorrhea you need to go get tested so you don't then spread it to everybody else that's the concept of content of testing tracing it's so much more difficult now with this respiratory virus because it's spread so much quicker and so you can imagine how many people have you you know had this kind of 15-minute window and in close proximity in the last and you're like well I just went to this wedding right and then all of a sudden you can imagine how olson one wedding just makes this explosive number of contacts whereas if you have been trying to distance as much as possible as far as possible from as many people as possible it's like who've been with off there's just been one you know one or two we could contact those people think again we can imagine how you can right but yeah even I mean we need a hundred thousand workers and it's and the problem is and then you call people up and you say someone you've come in contact with in the next few day in the last few days has tested positive so you should quarantine for 14 days who wants to get that phone call right okay you get that phone call what are you gonna do with that information is not no fault of your own you're going on your own business someone tells you and now you've got to lose to two weeks of work well obviously you should be compensated for those two weeks of work and there's ways you can make it easier but you can imagine even in the best case scenario where it all works we're all testing people you can still imagine how difficult this to kind of put the rabbit back in that what about some of these nonvaccine drug protocols that we're hearing about I just read that the USA acquired the entire stock of REM des aveer what's going on yeah all of this yeah well I mean that's yeah I mean that's that's that's the US health care system right so yeah so this company comes out of this drug has no drug cocktail to date that in pervious studies actually shown to decrease mortality I mean so that's the best thing I mean that that should be the standard I mean um yeah so what REM disappear has shown to do is decrease the number of days in the hospital so number days that you're sick and look if you're sick with this virus sure give me some of that cuts a couple days but does it actually help people live through this fire that that's the that should becomes a treat like one aspect like like alleviate some of the symptoms of the disease as we doing but it's um it seems to be slowing the virus down such that your immune system can get a can get a can get a-- i say you know and similarly there's a there's a drug called oseltamivir or Tamiflu for influenza just very similar thing does not actually decrease mortality from influenza but may save a day or two off of hospitalization of a severe course certainly still give the drug but whether or not the government should be spending bill giving billions of dollars to big pharma to buy these drugs so they're selling these the remm disappear for $3,000 a course I mean so and but if it's not actually showing to saving lives couldn't that 1.5 billion dollars be spread in a way where we could you know and so there's there's you know I mean we just need to I mean it's possible that before vaccine we will have an effective treatment by effective treatment we actually reduces the risk of death we do not have that yet we do have a decreasing number of the even though we have an increasing number of cases in the u.s. deaths have gone down and flattened and largely that's because younger people are becoming affected now as soon as the kind of relaxation so just think people getting in bars and younger populations are getting so the cases are scouring but mortality is still staying relatively low and though in large part that's younger younger population is getting affected what are some of the wrongheaded kind of ideas that you see percolating around like in the new cycle you read oh you know we should do this we should do that or and you just think why you know this is not right like all we need to do is this like I'm trying to give people you know just some really tacit advice that yeah I mean it alleviates some of the confusion I mean look in the nutrition space we know of just a crazy ideological frenzy by which people attached on to crazy ideas right and defend them at all cost and the confirmation bias but I have never seen the kind of crazy that I've seen in response to so now I have a whole series of cover 19 videos I'm gonna switch the research team to be working on on so we have like serious 17 videos or something and the responses now I put up a video saying broccolis good i get the trolls come out i mean that you know it does not take much but but it's not a whole new level now cuz you hit up you hit a nerve with it right so i am a china operative one moment and you know whatever yeah yeah the the bill gates 5g you know soros axis and and that and and i think a lot of that comes from just this terrible crisis communication at the highest level I mean yeah I mean you never to weaponize misinformation and create division because this is something that should not be politicized and it's been unbelievably politicized to a level that I think surprises every I mean that's kind of a consistent message so not much surprise the public health community who the whole time could write just a big carry a big I told you so sign all day long every day but that's something that really has surprise and look there's always been scapegoating for so you know the you know the so-called Spanish flu of 1918 one reason called the Spanish flu was because that was a neutral country and so it was the only one that didn't have censoring the news and so everyone out the US like we don't have any flow you know the Germans we don't have any flow so them and it just got out of course in Spain they called the French flow and you know I mean and there's always scapegoating of Jews during during you know horrible epidemics there's always been this kind of nasty something about crises like this they kind of bring out the worst in people as well as the best of people but yeah but this this is certainly at a level under and so that just makes it even more important to get information from you know decent sources and I think we have this there's this like well look you do your research I'll do my research kind of thing like like like as if like what exactly is your research like you do your google is that guy in his mom's basement to that guy who spent his entire life studying so this really shows the you know look I'm I'm I I'm as opposed to as anyone this kind of i-told-you-so because I'm an authority I mean we've seen where that has gotten us in trouble but we should when someone says I'm an authority you say show me your sources like you weren't born with this information how did you come across this and and argue to me why this really is the best and any expert worth their salt should be able to say this is how I arrived that here's the data here's the science that shows that this is the right course of action and but I mean that should be that for whether you're talking about nutrition whether to show me the day where did you get this from did you get it from your tinfoil hat friend someone told you at the gym or you know some check out a magazine telling you this or did it actually have some basis I mean if any decision to be made based on science based on the best available balance of evidence it's something that affects the health and well-being of yourself and your family I mean that I mean that should have a different bar of evidence than an Amazon review for a new toaster like I mean that's like the in that case opinions of total strangers could be useful for you oh you liked it because oh okay thank you right but we've gotten to this culture of just like Oh random strangers have ideas that are useful to me and then and and somehow translate that and well yeah we've we've arrived at this moment where for whatever reason we've developed this profound distrust of experts and that's highly problematic in terms of seeing our way forward as a society not just experts in science but experts across the board and you know a wide variety of disciplines in their defense in the in the defense of that is experts have done a terrible job I mean so the Corporal this is a [ __ ] show so you're giving people plenty of reason to distrust the right and historically I mean it was there was the the tobacco industry that weaponized first weaponized science and it is the tobacco industry textbook that has been used by every corporate entity from then on we're talking about the sugar industry weather type it's all about they realize that policy is being made but based on the science and so you you control the science you control the mess and so there was the backhoe Research Institute they funded millions of dollars paid off the AMA and so when the AMA says smoking moderation is good for you on balance not just neutral but actually smoking is good for you most doctors smoke so and now we say trust the experts right Robin you understand why yeah wait a second the experts are saying that coca-cola was good for me and that's because of this corporate takeover over science evidence-based medicine etc etc and so there is good reason to be skeptical when these decisions are made where there's industry stakes by the billions so something like should we get mammograms okay that should seem like a simple question of the science when there's a billion dollar industry then you need to you need to not just take the experts word for it but really dig into the signs right if it's a question where there really is no you know climate change when there's a billion dollar industry on one side of the issue you always have to question until you see what the best available balance of evidence is and so the industry so you can see how that that skepticism a big pharma completely based in I mean I'm so in fact the Tamiflu Fiasco who stands to benefit in 2006 in my book on pending preparedness and Preppers Bay way back then I talked about the wonders of this drug Tamiflu and how you should you know talk to your doctor about getting you a prescription of of this drug because there were 11 randomized control trials that showed that a significantly decreased mortality and morbidity from it saved lives from the flu and and so the science in the peer-reviewed literature was absolutely dead unclear Roche one of the biggest drug companies in the in the world had they of course funded them all 11 studies but that's what drug companies do kind of the only industry we put in charge with their own self-regulation but I mean but this wasn't some fly-by-night company this is you know company's been around okay and so then so here I am writing the update right for how to survive a pandemic so I'm looking at template chapters I what's what's been happening daily flu lately right in 2009 with swine flu the group of scientists Cochrane Collaboration kind of the gold standard evidence-based medicine well let's review what's happening in Tamiflu because with swine flu there were the government's were making billions of dollars of purchases of this drug for their national stockpiles and some some pediatrician in Japan said she said oh there's these 11 trials can we see the data please I went to broach and said let's see the date of the levant rose if you say there's lemon trials I'll show that reduce and Bruce refuses to give him the data hmm it's like whoa wait a second now at the time way back when it was still early we just believed I'm okay but now when they were making big purses okay and they knew every moment they could delay recently releasing the data they could get billions more in sales every year they really billions more in sales and it took some years and so it was only I think till 2014 until they find they were forced from national pressure international pressures at scientific community to release the data and guess what it showed the opposite zero benefit in terms of mortality but they had made this calculus they were gonna bring in so many billions of dollars that they were going to just flat-out lie to the governments of the world and say they had this pandemic this drug that's gonna save people from pandemic flu and just raped in bed and they knew it was based on a total lie but and it was this one little pediatricians like we'd you see the data just like and that's what started it all we finally know it was all it was a sham and it works just like this REM does a barrage it shortens the period but it doesn't actually result immoral in live saved and so now it's referred to as the Tamiflu flu Fiasco that was modern-day big pharma pandemic drug screwing the populace screwing tax payers screwing government's the world over and so you say I don't believe big farm I'm skeptical about vaccines that's a legitimate right that's a legitimate place to be coming from right we want the skepticism but that skepticism shouldn't be I'm not gonna let Bill Gates you know yeah I have whatever Bill Gates is doing but I it should be he makes it hard I want to know the data trust I want to see so you write your about you you heard par dr. Greger are mired in the data the average person is scrolling through their Twitter feed just trying to make sense of the world right you mentioned osterholm yeah like who are the people that we can you know safely pay attention to and feel confident that we're getting the right message who are those people in science and who are those people in the media who are delivering this information like who is the measured person where we can turn on the television and not have to be you know cocking our head every time they say something and just have some level of confidence that we're getting the truth yeah so there's actually been a number of journalists that have been really stellar when it comes to this and so statin news is probably the source so that's the source I could so statins so this is stat news news is kind of a medical news source that has prided itself on having a really evidence-based balanced analysis so they've probably been the done the best work not saying everything they've put out is right on the message but they've really done some of the best reporting to date and and in terms of scientific entities CID wrap Center for infectious disease research and policy at the University of Minnesota Johns Hopkins School of Public Health um as a website puts out some excellent information um ah and so in this way so you don't have to um even me look even ah we're so right now there are 800 articles in the peer-reviewed scientific literature coming out every day 800 every day and that's not talking about preprints all the stuff in the pipeline just being published every day so even I can't stay on top of that and so even I have to rely on on this kind of collective group effort of let's all go through these 800 pages every day papers every day and really pick out what's gonna be a kind of changing in terms of practicality what is this new information um that's reliable and that's where these these these important you know expert sources and and the CDC despite some flubs early on with testing and despite the the kind of wishy-washy mask recommendation has has put out some consistent good is there anybody just in mainstream media like I feel like Sanjay Gupta has been pretty measured and how he's communicating around this I mean I don't you know who do you think is yes I've not been following the instream who's in the mainstream in this journal right my journals and in this and the scientists and so right unfortunately now there are people with PhDs and MDS of into the name and they think all of a sudden that they're infectious disease experts or or you know aerosol experts or you know occupational safety I mean there are people who spend their whole lives figure out transmission of disease and just because you have an MD does mean you're an expert in this at all then just keep spouting nonsense about all sorts of things and put out mathematical models that you know they're computer scientists and they suggest that they're modeling it says do this as opposed to this where they really don't have expertise in that particular area so even you know just trust the experts yeah I mean that's not just noise potentials it's like right I mean but it's people but there are career you know scientists that this is what they've done their entire lives like lost their home and they've been through it all right and they've and and you know there are a few that have this this past record of not taking the easy road of not just going along with everyone so for example osterholm is famous for coming out and questioning the efficacy of flu vaccines and so until like 2011 they this this very influential landmark paper in The Lancet saying that you know flu a we topped the flu vaccine but it's actually based on kind of crappy testing such that if you actually use better testing it really only works you know 30 50 percent of the time and in terms of decreasing was 30 percent now still in favor of flu vaccines he gets it every year but you know we we need better flu vaccines we need to communicate to the public what the truth is and we need to do better and we just keep convincing ourselves we're actually doing better than we are we're you know that was incredibly controversial at the time and now it's just it's just understood and it's kind of part of thing but I mean we can look back in history those who are Mavericks and really stuck to the sides against the political winds um and and and and you can always go to to know they're not gonna give you the comfortable message they're not going to give you the message they're not going to give you a message that they have more certainty that that they that there really is and they're gonna say they don't saw is a good sick it's a good I don't know I'm not an expert this but let me you know show you know the point you in the direction of an expert in this yeah I mean I and this is the time right if there's any other issues any less important but this is the time we really need the best information um and and it's it's really even right even for me frost presumably but I mean we know the craziness and the minute but it has reached a level it's in its and it's and it's a white division right it is a whole new thing like oh I yeah I was I was with you doctor burger but now you are one of the lizard people who's gonna you know well it's a function of this intersecting with a lot of other issues that's tapping into you know a repressed rage that's just underneath the surface like we've all seen the videos of people you know losing it and target or you know Trader Joe's on the whole mask thing and how the mask thing has been politicized and and it's concerning you know because this shouldn't be a political issue we should all be on the same page in terms of how we're navigating this this is the common interest of our society behind right I mean this is the time to just be extra kind and extra and to rely I mean this should wake us up to the plight of our essential workers who have basically been 100 percent bottom ARF's our society and ignored and even now ignored are they giving hazard pay for being the wall this is the bigger conversation about how we're structured when we realize that our essential workers are you know these people who are getting paid less than everybody else to perform these things that are required to keep her the gears of our society moving we need to reform how we're treating these people so this could be the I mean so it is this an opportunity this is the opportunity although yeah but but it's yet it's bringing the best and worst and I'm afraid at this point the worst is overtaking there was some beautiful best at the beginning the clapping for the health care workers and I mean on the singing oh but yeah but though they ends and and yeah there's a half-life on that stuff but I remain optimistic and we're gonna land this plane I think I think you know listen get your sleep eat your veggies make sure you're getting enough vitamin D b12 whatever it is like what else like what are the simple things like wear your mask in public where are you masking public sign of respect right because I am keeping you safe that's what the math says I care about you and if there's one thing we need right now in society is more messages I care about my fellow human being mm that's a good place to end it I think I love you my friend thank you so much ah come back anytime I think we should do a check in every six months well the at the rate that you're cranking these books out you're gonna you're gonna be back here in next month the book is called how to survive a pandemic it's out now in audio book and an e-book right the workers coming out when in the fall August 16th on August 16th oh yeah soon amazing man so pick it up Amazon oh it's on your is it you get it was honoring your website we doing cool thank you all right [Music] [Music]

Channel: Rich Roll

Views: 239,046

Keywords: rich roll, rich roll podcast, self-improvement podcasts, education podcasts, health podcasts, wellness podcasts, mindset podcast, vegan podcasts, plant-based nutrition, Michael Greger how to survive a pandemic, michael greger, how to survive a pandemic, pandemic podcast, coronavirus podcast, covid podcast, vitamin d for covid, zinc for covid, herd immunity podcast, should i wear a mask, should i social distance, zoonotic disease, zoonotic diseases, bird flu, h7n9

Id: 97HiavAClUk

Length: 108min 38sec (6518 seconds)

Published: Mon Jul 13 2020