Ask Dr. Drew - Dr. Peter Hotez – Nobel Peace Prize Nominee for COVID-19 Vaccine Research – Ask Dr. Drew – Episode 71

Episode Date: February 4, 2022

Dr. Peter Hotez is co-director of the Center for Vaccine Development at Texas Children’s Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine. Dr. Peter J. Hotez, MD, PhD and his partner Dr. Maria Elena Bottazzi were recently nominated for a Nobel Peace Prize for their work to develop a low-cost COVID-19 vaccine. Dr. Hotez is involved in the development of CORBEVAX, which has been dubbed “the world’s vaccine.”  It uses traditional recombinant protein based technology that will enable its production at large scales, making it widely accessible to inoculate the global population. Find more from Dr. Hotez at: https://peterhotez.org  https://twitter.com/peterhotez  Read Dr. Peter Hotez's book “Preventing the Next Pandemic: Valid Diplomacy in a Time of Anti-science.” Ask Dr. Drew is produced by Kaleb Nation ( https://kalebnation.com) and Susan Pinsky (https://twitter.com/FirstLadyOfLove). SPONSORS • REFRAME – Since the beginning of the pandemic, nearly 1 in 5 Americans has reported consuming an unhealthy amount of alcohol, but only 10% of them are actually getting the help they need. Reframe is a neuroscience-based smartphone app that helps users cut back or quit drinking alcohol. Use the code DRDREW for 25% off your first month or annual subscription at https://drdrew.com/reframe • BLUE MICS – After more than 30 years in broadcasting, Dr. Drew’s iconic voice has reached pristine clarity through Blue Microphones. But you don’t need a fancy studio to sound great with Blue’s lineup: ranging from high-quality USB mics like the Yeti, to studio-grade XLR mics like Dr. Drew’s Blueberry. Find your best sound at https://drdrew.com/blue  • HYDRALYTE – “In my opinion, the best oral rehydration product on the market.” Dr. Drew recommends Hydralyte’s easy-to-use packets of fast-absorbing electrolytes. Learn more about Hydralyte and use DRDREW25 at checkout for a special discount at https://drdrew.com/hydralyte  • ELGATO – Every week, Dr. Drew broadcasts live shows from his home studio under soft, clean lighting from Elgato’s Key Lights. From the control room, the producers manage Dr. Drew’s streams with a Stream Deck XL, and ingest HD video with a Camlink 4K. Add a professional touch to your streams or Zoom calls with Elgato. See how Elgato’s lights transformed Dr. Drew’s set: https://drdrew.com/sponsors/elgato/  THE SHOW: For over 30 years, Dr. Drew Pinsky has taken calls from all corners of the globe, answering thousands of questions from teens and young adults. To millions, he is a beacon of truth, integrity, fairness, and common sense. Now, after decades of hosting Loveline and multiple hit TV shows – including Celebrity Rehab, Teen Mom OG, Lifechangers, and more – Dr. Drew is opening his phone lines to the world by streaming LIVE from his home studio in California. On Ask Dr. Drew, no question is too extreme or embarrassing because the Dr. has heard it all. Don’t hold in your deepest, darkest questions any longer. Ask Dr. Drew and get real answers today. This show is not a substitute for medical advice, diagnosis, or treatment. All information exchanged during participation in this program, including interactions with DrDrew.com and any affiliated websites, are intended for educational and/or entertainment purposes only. Learn more about your ad choices. Visit megaphone.fm/adchoices

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contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Thank you all for being here today. Very important guest. I want to get right to this. We have him for about 40 minutes or so. Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children's Hospital, dean of the National School of Tropical Medicine at Baylor College, trained as a pediatrician. Dr. Hotez is also involved in the development of

Corbovax, which is an interesting new vaccine therapy that we will begin to talk about. And at the time we are conducting this interview live, it's a very auspicious day. Our laws as it pertains to substances are draconian and bizarre. The psychopath started this. He was an alcoholic because of social media and pornography, PTSD, love addiction, fentanyl and heroin.

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Dr. Hotez, welcome to the program. I believe a Nobel Prize has at least been discussed in your future. Well, let's see. I got nominated for it along with my science partner for the last 20 years, Dr. Patatsi. So we'll see. I don't exactly know how it all works, but it was certainly unexpected and very exciting. Congratulations. Very few people can make said claim. So I have admired your evenness and approach to the mess we've been in for the last couple of

years from the very beginning. I know you've been out there on the media all along and you're trained as a pediatrician. Is that correct? Did you practice pediatrics for a while? Yeah, I was a, Dr. Drew, I was an MD, PhD at Rockefeller and Cornell in New York, then did, interested in developing vaccines. So I did pediatric and pediatric infectious disease training. And I'm a professor of pediatrics and molecular virology, although I've stopped seeing patients, but the focus on the lab. Okay. And so the reason I asked about the patients is I feel like people with clinical judgment have been sort of left out of the, I don't know, the ability to express themselves or policy setting.

You know, it's been like, for instance, here in Los Angeles, our public health director is a sociologist, and she's been making very, very strange sort of commitments that have been very harmful from a medical standpoint. Do you share my concerns that the patient physician decision-making has been left out of this pandemic? And it's not just decision-making, it's how you talk to people. One of the things you learn when you're a resident and a physician in practice is you learn how to deliver bad news and you learn how to be empathic and be supportive and being able to express things a certain way. Too often, I think we have lost that because let's

face it, there's not been a lot of good news these last two years. And the other thing that I try to do is be very authentic and honest with my emotions. I mean, I've actually cried a couple of times on CNN or MSNBC. And I said, oh my God, I can't believe I'm crying. And then you realize that people respond to it because they want to know that you're not just some abstract talking head, that you really feel passionately you care about what you're saying. And no question that being a pediatrician, especially in an acute care setting, because

back when I attended pediatrics, it was in Pediatric Infectious Disease Council. So pretty sick kids, you know, immunocompromised kids, kids with HIV AIDS or hematology oncology patients. So I think that's served me well, like it does you. And I think, well, but I think our peers generally are here because we care. And it's actually the most caring, and people unfortunately don't understand or believe this but the most the most caring um group in in the medical world is it are the the the professionals on the ground so it'd be the physicians the nurses

now we have physician extenders in the mix a little too but these people are there and doing that work because they care profoundly about what they're doing. And they're the ones really protecting and representing. And when we get left out of the conversation, it's very, very concerning to me. You know, I was, I get what you're tilting at. Go ahead. Just to make that one point, you know, I mean, I still remember when I was a resident of the pediatric intensive care patients I took care of, or especially the kids who died. And imagine now being a healthcare professional, a nurse, or a respiratory therapist, or a doc in an ICU setting in a big hospital where COVID is striking and taking care of dead and dying patients all the time for two years. It's unimaginable the kind of emotional toll that must take.

Well, actually, that was a little mysterious to me because I worked in intensive care medicine for many years. Eighty to ninety percent of the people we treated did not go home. And when they did go home, they went home to horrible chronic disease. And so ICU nurses and doctors are exquisitely attuned to the death and dying phenomenon. And so I had to go into the units and go, why is this different? And they had trouble articulating it, actually. Most of them said, because there's too many young people coming in that don't go out. And that's a change. That's the new thing. In pediatrics, you guys, that's why I could never be a pediatrician. I just couldn't do it. Seeing children, I just can't do it. I take my breath away.

Yeah. Definitely God's worth. It takes my breath away. But I want to make the point, though, that both of us worked in HIV and AIDS for many years. And we learned how to shape behaviors around infectious disease. That illness really taught. That was a pandemic with a 100% fatality rate. Not a 1%, a 100%.

And we learned how to talk to people and to shape their behavior. It was not through shaming and mandates. What happened to us? Why did we suddenly go from something that we know how to do and works to something that was so very, very different? Well, I think the dynamics are a bit different in that this is a highly contagious respiratory pathogen. And when you have an infection with a reproductive number that's as high as the COVID-19 virus is the SARS-2 coronavirus, the more dependent you become on vaccination strategies. And I think that's the game changer as opposed to HIV-AIDS,

which has its own unique mechanisms of transmission. So I think that- Okay, wait, wait. I want to make sure I hear you. Yeah. I want to make sure I hear you because that's actually a profound thing. So you're saying with HIV and AIDS, we had treatments, but really our problem was behavior. We needed to change behavior. And now we need to deploy vaccine. That's the mandate. And deploying vaccine therapies is different, has behavioral elements to it, but different than shaping behavior per se. A little bit.

Well, it's also converged a little bit more now with HIV AIDS because, of course, we have good antiretroviral drugs and that, as you know, is lowering viral loads and having more of a preventive approach. But when you have a highly, I mean, the only way you were going to eradicate smallpox was to vaccinate, right? And I still think the only way we're going to eradicate or eliminate or definitely get COVID under control is vaccinate, especially vaccinated low and middle income country populations. Otherwise, this is going to continue to haunt us. And so, and I'm assuming your point is that we will get more and awful variants potentially

because of all the viral replication. Well, I mean, Mother Nature's telling us what she's going to do. We got the Delta variant out of an unvaccinated population out of India at the beginning of last year, and then Omicron out of an unvaccinated population in southern Africa towards the end of last year. So the message is, as long as we refuse to vaccinate the African continent, Southeast Asia and Latin America, she's going to, Mother Nature's going to continue to hurl new serious variants of concern at us. And once we get through this Omicron wave, I'm not confident we're going to have much natural immunity from Omicron. I think it's going to behave more like upper respiratory coronavirus short-term protection. We're going to be vulnerable again. And that's why I'm pushing so hard on the White House, the Biden administration to step up vaccinating, helping to vaccinate low and

middle-income countries in the World Health Organization. And hopefully our vaccine will have a role in that. Now, let's go to the vaccines. The vaccines have a decay in their efficacy as well. Particularly, I've noticed the boosters. I mean, they are very effective initially, and then it seems like it's kind of, you know, eight, 10 weeks out, it's not the same. Are you worried that we're going to have to go through, if to the extent that we deploy mRNA vaccines, are you worried we're going to have to go through

just constant updating and revaccination? So this is my big concern, because I don't know if you were listening to the kinds of things I was saying up until a couple of months ago, you know, I was one of the first to say this is a three-dose vaccine. And that's because giving the first two doses close together, we know what happens when we do this for pediatric vaccinations, do a series of primary immunizations, and then you need to wait six months to a year and boost, and then you get long-lasting, durable protection.

And so for the longest time, I've been saying since January last year, I said, it's not one and done, two and done, it'll be three and done. And what was unique about what I was saying as one of the first to say, this is a three-dose vaccine, for me, the disappointment is that I would have thought after the third immunization, this would have held up for a while, that we wouldn't have to boost again for five, six, maybe 10 years, certainly not like what we're seeing now. So we are seeing this kind of short term duration of protective immunity, at least against symptomatic illness that's only holding up a few months. And so the debate with my colleagues is,

is it simply because of the Omicron variant that is so different that the virus neutralizing antibodies aren't holding up, or is there an issue with mRNA vaccines that the durability is not so long lasting? And so that's, to me, that's going to be one of the big questions moving forward for the country in terms of adopting a long-term strategy for vaccination. Do we stay exclusively with the mRNA approach or do we branch out? Would it be possible that one of the errors we made was the one month duration between Vax1 and

Vax2. Perhaps if we waited three months, as many European countries have done, we might get more protracted immunity. Do you believe that? Well, I think that may in fact be true. But in defense of the policy that when these vaccines were first rolled out, I think the loss of life was just catastrophic, especially in some of the nursing homes. And I think the whole clinical trial plan was to stop the deaths and to move as quickly as we can to fully vaccinate the human population. So I don't have a problem with the fact that the first two doses were given three or four weeks apart, depending if it was Pfizer or Moderna. But I think the mistake was in how that was messaged and not making it clear to the American people that,

hang on, we will likely need a third immunization at some point down the line. We can't tell you whether it's going to be six months or a year, but don't be surprised if that. And I think if we had done that and set expectations accordingly, I think it would have helped because we got into this terrible situation where only about a quarter of the U.S. population wound up getting that third immunization. And the declining protection against Omicron after two doses is pretty significant. It's, yeah, I have learned in this pandemic pandemic we're having something bleed in here i mean is that on is that your clubhouse is somebody on your clubhouse maybe it is somebody has yes whoever that is yourself yes you're right go to the audience um uh one of the things i have learned in this pandemic,

and it's the point you're making here about our messaging, is that it has seemed to me that one of the grave and tragic errors is certainty and hubris, or at least displaying certainty and hubris. That has not been, it's not aged well. It's not aged well, and it's not scientific. It's never scientific to me well so you know one of the things that i've noticed about the way i talk when i'm on the cable news channels that's a bit different is i do go i explain my assumptions i go into some level of complexity like we just did just right now you know why we why i always thought we needed

a third dose and i think the mistake that I'm hearing from the federal, U S federal agency, CDC, and as they don't do that, they don't provide their underlying assumptions and the, and there's still this old fashioned way of communicating. Like you have to talk to the American people, like they're in the fourth grade or sixth grade.

And I found it's not true. I find that I find that. I think you do that. You do that really well as well. I mean, I think Dr. Hotez, I find that, and I think you do that. You do that really well as well. I mean, I think you're talking to them like they're adults. Yeah, that's what we learned during HIV and AIDS was you be completely transparent, give them the thinking and give them maybe some humor and music to kind of help soften the message and then, and then let them be adults and be, you know. Talk to them like adults. I mean, I talk to them like colleagues, right?

And the thing that I think our health communicators haven't realized is the American people are willing to tolerate a surprising level of complexity if their lives depend on it. And uncertainty. Yeah, and uncertainty. Yeah. Well, but we know that from dealing with patients. I mean, that's how we don't ever hide things from our patients. We may have to tell them multiple times to get them to really fully understand things. But it's not about a shell game or saying you can't handle the truth, which is what it feels like i think what may have happened was i think what happened

you know in some ways we've got you know two parts of the country one part that's all in on whatever medical interventions are recommended hey doc just tell me what to do to protect me and my family all in yeah and then there's another segment of the country that's no matter what they say they're not going to do and i think they tried to converge that with one voice and it wound up coming out like baby talk that was unsatisfying to both. That's very true. That's really funny. So one of the things you were talking about very early in the pandemic, I believe it was you, and please correct me if I'm remembering this wrong, but you started, you do talk about your thinking as you're being interviewed. And one of the things I heard you saying was, I don't know, this is a new technology. It's probably good.

But what's wrong with the adenovirus vectors? What's wrong with using something, a more traditional platform? And that struck deep with me. I actually ended up taking Johnson & Johnson just kind of, you know, because it was early. And I thought, all right, did I hear you correctly, first of all? Was that your thinking at the time? Well, what I meant was, you know, in some ways, both the adenoviruses also knew because we've never given it to large populations before as well. And so one of the things that I pushed really hard for was to balance out the portfolio of Operation Warp Speed with some of the newer technologies, which

were very exciting. And you could rapidly immunize a new population, an immunologically naive population very quickly. But in the long run, you don't know what's going to work out the best and balance it out with some old school vaccines like our recombinant protein vaccine, which is made in yeast. It's a vegan vaccine. It's the same technology used to make the recombinant protein vaccine, which is made in yeast. It's a vegan vaccine. It's the same technology used to make the recombinant hepatitis B vaccine that parents have been giving to their kids for decades and people understand it and trust it. And I think if

they'd balanced out the portfolio a bit more, it wouldn't have gotten us into so much trouble. Certainly that's true on the global scale because you can't make mrna and adenovirus vaccines at this level and yeah and by the way you know all the weird and by the way i got the i got the pfizer biotech vaccine and i'm grateful for it and it yeah may have saved my life and my whole family my whole family got it too it yeah it's just still down to me i was like i just want to go one vaccine and i remember not toast to hotas talking about that all right just go get johnson johnson i i didn't really care i i. I just was in a hurry to get vaccinated. And there's a long story of me getting sick trying to get the vaccine. But tell us more about it. It's Corbovax. Is that how you pronounce it? So at our Texas Children's Center for Vaccine Development,

we use more traditional technologies because we mostly make vaccines for parasitic diseases for the poor. So schistosomiasis vaccine, Chagas disease vaccines. And about 10 years ago, we got approached by a coronavirus group that said, we really need your help making coronavirus vaccines because nobody cared about those either. And they were orphaned. And so we did what we always did, which is use our traditional platform technology. It worked really well for SARS and MERS. And then when the COVID-19 sequence came along, we flipped it around and made that COVID-19 vaccine. And now we've licensed it to four developing country vaccine manufacturers. They call themselves that, the Developing Country

Vaccine Manufacturers Network, Biologically in India, BioPharma in Indonesia, and in SEPTA in Bangladesh. And Patrick Sung Chung from the LA area has created Immunity Bio for Southern Africa. No patent, no strings attached. And now BioE, the first one we provided to, we helped in the co-development, has now produced 250 million doses and it just got released for emergency use authorization in India. And so we're kind of off to the races because the great thing about this vaccine, there's no limit to the amount you can make. Simpler technology, one of the best safety profiles, one of the least expensive of all the COVID-19 vaccines,

simple refrigeration that's been given to kids for decades. So when you go down the checklist, it checks a lot of boxes for global health. So we hope this really starts to make a difference. I have, and congratulations, I'm sure it will. But I've also, when I run into vaccine hesitancy, there's sort of no talking people out of their concerns about mRNA vaccines. But very often I'll have people say, oh, I would take Novavax. When's that coming out? I'll take a protein vaccine. And I suspect it'd be the same as it pertains to Corvavax. What about distributing it on a limited... or any U.S. industrial partner to have it made available in the U.S., which is too bad because I think it could help close that vaccine hesitancy gap for some people. Yeah, it absolutely would. And at least there's no doubt that it would.

And you could just distribute it on sort of a limited basis for motivated people because there's actually within the anti-vax crowd, there are motivated people. People want a vaccine. They just don't want that vaccine. Yeah. It comes in all and uh i'm hoping novavax there is this yeah yeah i'm hoping novavax fills some of that that that gap um is there that to me is this is all sort of there's parts of this epidemic that have been sort of scandalous to me

and i've just added another thing to the list which is the fact that you can't find a U.S. partner for a really good-looking vaccine. I don't understand that. Am I missing something? Well, the market's flooded, right? I mean, there's no financial incentive for a pharma company to go into that space because they don't see a sufficient market to justify the investment.

There is, though. There's a buyer of last resort. There's a buyer of last resort. The U.S. government could buy a bunch and that would motivate the manufacturer and then they can distribute it. Because the other one, my second scandal, is that they bought all the Paxilvit

and the Molnupiravir and you can't get it. I'm desperate for it all the time with my patients and you can't get it because they do touch an awful job at distributing, but that's scandal number two. But why not them buy your vaccine? I mean, the vaccine that might win a Nobel Peace Prize, they're not in the market for. Come on. Well, maybe I need to bring you to my next meeting with the U.S. government. It's not like we haven't been trying, but in the meantime, we're trying to focus on where we can make some gains. And right now, it's the low- and middle-income countries of Africa, Asia, and Latin America.

At least we can do that. Which is great. And necessary, of course. And by the way, I didn't mention that Peter has a book, Preventing the Next Pandemic, Valid Diplomacy in a Time of Anti-Science. You can also find more at PeterHotez, H-O-T-E-Z.org, and Twitter at Peter Hotez. And I do not want to in any way take the winds out of the sails

of going to the countries that don't have vaccine. That is my lingering concern, is that something's going to emerge where there's massive replication and we could have done something about it. Well, the point is with our vaccine, there's no limit to the amount you can scale, right? It's not like mRNA where there are limits to the amount you can make, at least until you figure it out later on. Right now, you can hit the ground running. And so there's no, it doesn't have to be a zero-sum game, I think, with our vaccine.

I'm going to complete my list of what I feel have been scandals. And you're now on the list with lack of funding for something that sounds like a no-brainer. But scandal two being the distribution of antivirals. That first few months of the pandemic, we were kind of locked out of Operation Warp Speed. We got a little bit of money from NIH, not much, about $400,000, which helped us. But and there's a, in Houston's a very philanthropic environment and Texas children's hospital in Baylor supported us a lot. So, so, and then it worked out well, but it was, uh, it was, uh, you know, it was a tough time because, you know, giving bad news on the cable news networks and then you get off your interview and then you're out, uh, as I call it, snoring for science, um, trying to raise some funds. And, uh, that's really funny. I have been down there. My interaction with the medical community in Houston has been through the Menninger's Institute and again, astonished at the support that they get from the Houston community. So, so I know that it's a that it's a great medical sort of community, city. But my third piece of my scandal, the one, two, three scandals were the distribution of antivirals,

funding for your vaccine now, and then the fact that physicians froze in the early parts of the pandemic and didn't do anything for their patients except said, go home and come back when you're sicker. And I understand it was a very confusing time, but the scandal part for me was it felt like, well, what I think I was seeing was that many of our colleagues are now employees, and they became scared of their employer and scared of running afoul of them by doing their job and just sort of froze. That's scandalous to me. That's scandalous. Well, a couple of things. First of all, with regards to the Paxlovid,

I'm sad to learn that it's still not available. I'm hoping that will change very soon because that has the ability to make a big difference. I think, you know, in the beginning of the pandemic, you know, when it hit the US, I think people thought it was going to be more like the original SARS and they you know in terms of when respiratory support I don't think people understood that it was you know it was a cardiovascular disease as

much as in a neurologic disease as much as anything else and so so the I feel very very bad for my colleagues in New York who had to learn that the hard way when that first big wave hit in March and April. And New York was really caught totally off guard in part because the Centers for Disease Control missed the entry of the virus from Europe and let it incubate for weeks before anybody picked it up. That was just a horrible, scary time. Yes, I agree with you and completely unanticipated. But I got to say, that group, the New York medical community, in terms of their responsiveness and their improvisation, was rather extraordinary, even though they were hit with something they didn't understand.

And within a week, I heard them talking about cytokine activation, something that I didn't know. They already understood this was part of the story. That was remarkable, remarkable. Well, it was the blood clots and the fact that they were getting coronary artery thrombotic events and strokes. And I think that took everybody by surprise. And so they had to learn pretty quickly to put them on anticoagulants and then the steroids. And you're right, the fact that they called an audible and they were able to make that adjustment quickly, they saved a lot of lives, no question about it. Yeah, so it's interesting.

So I should balance my scandals list with the behavior of our peers in the hospitalist population, the inpatient side was extraordinarily responsive. It was sort of the entry level, the entrance to the medical world that really was sort of disappointing to me. Explain to people, just so we're sure they all understand what we're talking about, what we talk about as a neurological endovascular polysystem disease rather than just this respiratory problem. Well, I think what you saw was the activation of clotting pathways. So you had this virus,

unlike the original SARS back in the early 2000s, this one was causing blood clots to form in your blood vessels. And that was a major reason why you had a lot of difficulty oxygenating patients. And so people were coming in to the emergency room looking reasonably well and wound up having oxygen saturation rates that were incredibly low. And that took time to figure out. And the fact that so many of the EMTs were being called because the patient had been seemingly well and then deteriorated so quickly and was basically moribund by the time the EMTs arrived. So understanding the importance of oxygen monitoring, I think that was a critical early mid-course adjustment. Yeah.

And even within the sort of larger vessel intravascular coagulation, I'm convinced, you know, I had bad COVID the first go around. And I think there's a lot of microvascular, there's something going on with endothelial activation above and beyond clotting. Well, that we know. But also, one of the most striking findings that I saw were in the long COVID patients.

So the UK health system, national health system, has a biobank of MRIs. So basically any patient in the NHS that got an MRI it's cataloged and what they were able to do is bring those individuals that was all they had 40,000 brain scans pre pandemic and were able to bring them back after kovat and that you know that's a story that has really not been fully told which is that so many patients have gray matter brain degeneration and evidence on their scans of cognitive decline that resemble people that should be much older. And so that to me is one of the real reasons that I'm so concerned about getting COVID is, yes, I don't want to get hospitalized or be in an ICU, but I also don't

want to get COVID. I don't want to get gray matter brain degeneration. And I still have a lot of things I want to do in life. And no, I understand. And I definitely had a whiff of it. Yeah. Well, I kept telling people, I feel like I've been hit in the head. Like it felt like a major head trauma. That's exactly what I've never had major head trauma, but I just imagine that's what this feels like. And I got over and I had long COVID, I had long everything and i got over a lot of my long fog by learning new languages i just went right at it and started really and it cleared rather quickly with with use yeah isn't that interesting um so uh we have to go in just a couple minutes i just want to but i think the point is going to be we're going to need a generation of neuropsychologists to really understand all of the long-term impact.

And so even when we get past this pandemic, it will still haunt us for a while. You know, speaking of Menninger, Dr. Menninger, when he was still alive and practicing, he was practicing in the end of the 19-teens and the early 1920s. And he was on the record at that moment saying that he believed most of the psychiatric and neuropsychiatric problems he was seeing was the result of the 1918 flu. And he documented multiple, multiple psychiatric symptoms, including psychotic disorders, which now have been reported with this one. it's very very interesting well you know the other interesting side note to this is you know all the things we're learning about the mechanisms of long covid in terms of in mental health in terms of auto antibodies and microglial activation as I'm

looking at this I'm boy, I bet this is going to help us understand things like chronic fatigue syndrome or fibromyalgia. This is going to give us now new tools to really understand the basis of this. Yeah, 100%. I'm working with multiple different groups on this. We have one group that's looking at non-classical monocytes who don't go through their normal apoptotic cycle and have persistent spike protein within their cytoplasm. And they are migrating into the central nervous system where they don't belong and are correlating highly with long COVID. So, again, we're getting into the depths and some certain VEGF and other cytokines that remain elevated. I mean, this is, I worked in a psychiatric hospital when lots of people came in with chronic fatigue and the psychiatrist did very strange things to them to try to treat it

because it's disabling. It's very disabling. But this is going to give us a window. Now we're going to get at it. We're going to get at it. Yeah. I agree. It's an exciting time to be a neuroscientist.

No question. So I know you have to leave us. And again, I want to say congratulations on the Nobel Prize nomination. It's got about 15 minutes. Well, I want to end with a couple of questions that may take a minute to answer. One is, what did we get right? What did we get right? As we do a little postmortem on where we've been, are there things that we can do in parallel rather than dragging it out years. So I think we may have some new opportunities to now accelerate how we move new interventions from discovery into the clinic, even outside of infectious diseases. I think that's going to be extremely useful. I also think it shows that when people are willing to throw money at problems, it can make a difference. On the other hand, I think there are some lessons learned that still really worry me. I mean,

why was there this epic fail at the Centers for Disease Control? Why did we miss the entry of the virus from Europe? Why didn't we figure out a way to create a national public health response? Why did we miss the boat on genomic sequencing? And why can't we measure vaccine effectiveness? And clearly all of this transcends administrations. And the CDC is supposed to be the premier public health agency. So how do we fix that and make it the premier agency again? I think that's going to be an important lesson learned. And also the fact that we still have no commitment to global health and we still think that the US is kind of walled off from the rest of the world and I think that's a lesson learned as well. So there were some good things.

I think we also saw this with America's view of scientists. On the one hand, I think the American people appreciated hearing from scientists, and that was a real privilege for me. On the other hand, the anti-vaccine aggression, that's been scary. I mean, we've had 200,000 unvaccinated Americans over the last seven months needlessly lose their lives to COVID because they refused to get vaccinated. vaccinated and trying to understand the forces behind that and how we got to that very dark place where people didn't trust the government or science or and outright refused to take something that would have saved their lives. And I think that's going to haunt us for a long time. I think you pointed at it already. It was with that messaging where, you know, you can't handle the truth. I'm going to treat you like a four-year-old.

That was a grave, grave, grave. And they're continuing it. It seems like they can, they're not turning back from that. Occasionally, occasionally they'll, they'll sort of say something like, yeah, we wonder if this is the case. And people, people grab to it. Like, like people that are hungry, they, they, they want them to tell them what they're thinking. And yet, you also had this issue. You also had this issue where, you know, members of Congress, you know, openly disparaging vaccines and saying they're political instruments of control. That was very damaging. And some of the conservative news outlets at night, you know, did a lot of damage. And so we're also dealing with the consequences of that as well.

Just back to the mRNA really quickly, do you have any concerns about the side effects that are flying around a little bit? Because I started thinking, let me frame it a little differently, because I started thinking, gosh, you know, when I, before mRNA vaccines, if I saw an episode of myocarditis, that was a major problem. That is like serious illness. And that person may get cardiomyopathy down the line, could have an arrhythmia. We toss around myocarditis. No big deal, just myocarditis. Myocarditis is a very serious medical illness.

Do you have any concerns about that? It's, you know, one per 3,500 now in adolescent males, and it's mild, and it does seem to be reversible and all that good stuff, but does it worry you at all? Well, also the numbers are still a bit over the map too. I'm hearing one in 10,000, and that does make a difference. But I think it does worry me, but what also worries me is the extent of cardiovascular disease in people who get COVID-19 with even higher rates of myocarditis and not just myocarditis, but thrombotic events and strokes and myocardial infarctions. I think those are the kinds of things that I always try to keep that in perspective as well, that yes, there are uncommon side effects, but on balance, there's no question getting vaccinated is still going to save your life. And how you frame that, I think, is really important because look at the consequences to come back to that again I mean 200 000 Americans

could be here today no there's no doubt if if you're over if you're over 50 that that risk reward clearly shakes out but if you're yeah well even even among some even among young people you know we're seeing a lot of you know you know 20 30. know, but at the rate of, I understand, but in older folks, it's in 5%, 1%, and in 19-year-olds, it's 0.00013. And, you know, and the vaccine is 0.002 myocarditis. So it's like, how do you, I don't know. I can't, I'm glad I'm not making that decision.

I always tell people to talk to their pediatrician because it's a hard one for me. You're taking a healthy person and making them sick for something that may not make them sick. So I don't know. You know, I guess we'll agree to disagree on this one, but I think it's really important that young people get vaccinated because we are seeing so many young adults go into the

hospital, not only from cardiovascular disease, but neurologic injury. We are seeing a significant number of people who are losing their lives. And no question, when you look at the risk versus benefits of getting vaccinated, even for a young person, it overwhelmingly comes out in the side of getting vaccinated. We've lost too many young people in this country. And again, the consequences of long COVID. And this is not a time in your life when you're 25 or 30 and maybe signing up your first mortgage or trying to go to graduate school or starting a family. This is not the time in your life you want to be neurologically debilitated from long COVID. And then what the last question would be, what keeps you up at night?

What keeps me up at night is we're not going to vaccinate the world and we're going to continue to be buffeted by COVID-19 variants. And the tolerance of the American people for taking preventive measures is going down pretty significantly by the day. And so that's going to set us up for more political instability in the country if we can't finally get rid of COVID-19. That's clearly a big one. The other are going to be the long-term consequences of long COVID in populations and suddenly realizing that all of the horrors that we've just been through may be the beginning of something even bigger.

I think that's a big one. And then I'm also worried about all the anti-vaccine activities, whether that spills over into other childhood vaccinations and parents start questioning the need to vaccinate against their kids or cervical cancer so so so yeah that that no doubt is going to happen unfortunately i think you can tell i'm a warrior but you're a warrior you have you have a you have a here you know we really differ and it's just right here well first of all you're seeing kids i'm seeing adults. So that gives us a little different sort of risk-reward diathesis in our head.

And the other is I have a positive bias and you have a negative bias. You're a little negative. You're a warrior. And I want to cheer on and conquer. Let's get this thing. On the other hand, I've devoted my life to something called neglected diseases. So I do have some optimism. That's right. For the

underdog, though. Back to the people to worry about. Listen, it has been a monumental privilege to have you here, and we appreciate it so much. It's been a privilege for me to speak with you, and I appreciate that opportunity. Look forward to staying in touch because

we'll see how this thing goes and please let me go make noise in washington on your behalf i think that's scandalous scandalous that they are not helping you fund this thing or at least helping put the structure in place where somebody else can help you find it just seems insane to me that they're not doing that and that's again somebody somebody's judgment is off as you're we were talking about the cdc's failures somebody doesn't have really like keen judgment i don't i don't know what's going on there or maybe the bureaucracy has gotten too cumbersome where people with judgment i think government agencies just take on a life of their own sometime unfortunately yeah i think that's it i think that's right come back soon that's dr hotas's next book preventing think that's right. Come back soon. That's Dr. Hotis' next book, Preventing the Next Pandemic.

Susan? Come back soon. Please, we hope so. Especially don't let the idiots get you down. Yeah, don't let the negativity and all. You're an important voice and you should be treated as such. And thank you for the new vaccine. That's a major deal.

And thank you so much and go to your next interview. Thank you. All the best to you yes sir thank you too bye-bye uh all right so let us we've got the clubhouse still going i'm watching you guys on restream i'm sorry i've not been very attentive there it's been kind of exciting for me to talk to dr hotas um whether you had another interview yeah he has another interview to go to but i can now take your uh let's see wait a second here one percent chance of external is serious can't say one to one percent uh i'm not quite sure what you're saying jill i think i understand what you're

getting at it's a little more complicated than that what you're saying there i think um and uh what i'm gonna do is take a little break and then come back and maybe take a couple calls off uh covet a couple calls off. COVID calls. COVID calls off of Clubhouse. We'll be right back. Let's talk about our friends at Hydrolyte. I can't say enough about Hydrolyte.

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ready-to-drink bottles at the walmart next to the pharmacy or as always you can find it by visiting hydrolite.com slash dr drew that is h-y-d-r-a-l-Y-T-E.com slash Dr. Drew. And be sure to use that code DrDrew25 at checkout for a special discount. Oh, my dog Rex just came in here, leaned his head in, and just threw up all over the place. And so Susan is having to clean it all up. He just looked in like, hi, how are you guys? I want to show you something. In the wings here, I've got Dr. Bruce Heishober,

Dr. Bruce from the corolla world i'm seeing if i can get bruce up to uh come on up here and give us his thoughts he was listening quietly during dr hotas's presentation i'm wondering what he's thinking dr bruce and don't forget to get your dr drew bobblehead oh yeah susan wanted me to point this out it's coming up vd's coming get your bobblehead somebody said dr drew dot com slash shop there it is so that's susan's masterpiece with the help of alana and her husband i think dr bruce is not there you are okay i don't think dr bruce figuring out technology is always a fun fun part yeah let's uh you can do it bruce just just unmute yourself in the

meantime i've got chuck chuck here people have their hands up and give them a chance to come here uh chuck joe is dr bruce there you are hey bruce how you doing good so am i is your doctor h is gone no it's just you and me he had to go talk to the surgeon general yeah he had talked to surgeon general okay he hang out it's uh dr bruce heishober he is you know from our work over at corolla's world he's been listening quietly I'm going to go talk to the Surgeon General. Yeah, he had talked to the Surgeon General. Okay. Hang on. It's Dr. Bruce Heishober. He is from our work over at Corolla's World. He's been listening quietly while I talk to Dr. Hotez. Weekly Infusion, the podcast that we used to do.

I'm a failed podcaster. Let's face it, Susan. No, no, no. I'm just lazy. Dax reminds me. I forget the Dr. Spaz part, but yes, Dr. Spaz. You got to come back soon. So what's going on?

What was your concern? Okay. So while I was going to ask him, you know, whether it's logistic or heuristic, it just seems like if I've just had COVID, even if I'm vaccinated, I just have COVID two weeks ago, say, and then I'm mandated to get a booster next week. Just the way I think as a physician, well, maybe it'd be better to wait a few weeks or a couple months. Of course. Right. But that's not what's happening. People that have had COVID and then they're going to get fired if they don't get the vaccine.

I know. I think what he would say is bureaucracies are a problem, which is sort of what he and I were agreeing on, that bureaucracies are not set up to respond to the needs of this present moment at all. And that's one of the lessons in all this. You know what? I just told you this the other day. I went to a restaurant and I just had COVID, but I've also had three vaccines. But I asked the girl at the front, she goes, oh, can I see your vaccine card? And I said, what if I just had COVID and I could prove that and I haven't had the vaccine? Because a lot of people have had COVID. They don't want to get the vaccine because they just had

COVID. It's even crazier, Susan. She goes, you could sit outside. And I was like, oh, come on. It's even crazier. They don't ask you if you have COVID. You could have active COVID and walk in. I know. And no one asks you, do you have COVID? That's the craziness. I had that opportunity too in New York to go out, but they would have asked me for my vaccine, not if I had COVID. Right, that's right. Oh, it's crazy. So I have a patient last week I'm talking to her.

She goes, well, I want to take my kid up to family reunion in Sacramento, but the pediatrician said my one-year-old should not go because people are crazy and anti-vaxxers up there. They don't get vaccinated. There's a more virulent strain probably that's going to occur. Don't go. And I went, what?

So I called the chief of PEDS and he said, that's insane. He said that the prevalence up there is 20%. Riverside County is 53%. So some of the, even doctors, some of the- Well, what I'm noticing is this is the death of math. And this is how humans do, no, is how humans do poorly with probability risk. So you heard me talk to Dr. Hotez where I said, well, you're taking a healthy 19-year-old, and you have a 0.00013 chance, 0.8 chance of getting him sick or 0.2 chance getting him sick versus a 0.0013 chance of getting covid and getting seriously ill um you

know i don't know how to make that decision he's like oh i've seen too much horrible things and i thought oh my goodness you know we we're really biased we we got to really pay attention to our biases because he he dr hotez is very worried about long COVID. I'm not very worried about long COVID. I had long COVID. And he's extremely worried about that. Now, it's not unjust. He's not wrong. It's just his bias takes him to over amplify that risk.

Maybe he's right. I don't think so. Because everybody I've seen with long COVID recovers with no neurological sequelae. Well, might we see dementia in 10 years? We might, but we also might see cardiomyopathy from the myocarditis in 10 years. I don't know how to, these are really, really hard decisions. And so the point being, I was listening to Peter Atiyah's podcast, which I cannot recommend strong enough.

He was talking to Monica Gandhi and Vinay Prasad, my favorite people. And he said, you you know i was asked to adjudicate in a family squabble around the vaccine there was a 35 year old son and he just didn't want to get the vaccine and so they asked me to help convince him and he came in and the parents were going ape they were going nuts on their son and finally attia said what do you think your son's risk of death is from COVID if he gets it? Oh, it's 50%. And I thought, oh, my God.

See, this is the problem. People are not given the right information to be able to understand the relative risks of these things. And so because it's all been hysteria, people are all over the place. And I don't blame them because they've not been given the right information. But plus, it's undermined the physician's ability to give that information and reason with the place. And I don't blame them because they've not been given the right information. But plus, it's undermined the physician's ability to give that information and reason with the patient. The other thing I was going to ask him is,

I hate that you mentioned hydroxychloroquine, but it was an example of bureaucracy. I was going to say, it's a zinc ionophore, right? We literally can't talk about it because we'll get kicked off YouTube. We probably will anyway. Okay, so example.

You can find us on Twitch, and you can find us on Facebook, and you can find us on Twitter, and you can find us on Rumble, everybody. You'll get kicked off of YouTube. Isn't this amazing? What country are we in? Okay, so let me, as an attorney, rephrase my question as a plaintiff's attorney. Please. The use of azithromycin is based on its mild antiviral effect, but mostly it's anti-inflammatory effect, right? True.

So nobody squeals about azithromycin, which is, to me, more insane than that other thing we can't talk about. Correct. Way less utility. Doxycycline, colchicine, but don't mention those other things. So, and to me, it's just, I want to sit down with a patient. It's like, you're queuing on, you got the jab doc, what's wrong with you? You're crazy. You're going to, you know, you're going to start. And then on the other end, you have the other extreme and it's just,

can I be a doctor? And just as a, as a, our friend, Dr. Z dog says the COVIDians and the COVIDiots, we have two camps, COVIDians and COVIDiots. And no one really has the right information because there's been a massive public health failure of providing it. Think how good we were with HIV and AIDS, how people came to understand that so quickly. We were really good at it. Why didn't we do it again now? I'll go to my grave asking that question. It'll be on my tombstone.

Why didn't we do it the way we knew how to do it right? Why did we, and Dr. Hotez said, oh, it's because it's a respiratory pathogen. It was more of an emergency. I was like, I get it. But still, we could have adjusted course at any point. But you know what? It's like religion.

It's like, you know, you can be religious and have your free thoughts, but just don't try to sell it to me. Oh, but Susan, when you're religious, there are people that are sinners, that are dirty, and that, you know, if you have COVID, you're dirty, or you must have been a sinner to get it. Our brain does weird things when we get into religious thinking. And you're right. It is religious thinking, but it has had untoward effect. And that's why I just rather keep in the realm of cognitive distortions.

We need to watch our distortions. We need to watch our cognitive biases. We have to understand our brains don't, they're not perfect instruments. They work on the influence of biases. We have to watch our biases. My bias is a positive bias. I have to watch it. I have to police it or I'll think too positively and not worry enough about the downsides. I have found that as a good way to go through life. I wouldn't want to go the other way, but I understand from an evolutionary perspective, we need both forces at work to get the best outcome. Right, Bruce? Wow. You lost me as usual, Drew. You're way beyond me. No, please. You're so deep. I'm dazed now. I don't know what to think. That is just yours and Susan's ADD.

I know. You'll understand. I know, exactly. I was saying something very simple. It's like blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah. And then he'll ask me a question. I'll go, what? All right, Bruce. I got to take some more calls here, but thank you for being around for this. Everything good with you?

Want to talk about anything else before I let you go? No, no, no. I was going to tell you, I got another Craydon person, if you haven't done that podcast yet, a COO of a company that's got a very good story so about tell me thumbnail it so so somebody that was he's basically he runs a 22 million dollar company and he had uh somebody recommended crate him for his pain and uh he got horribly addicted to it and it's just the ignorance about it so anyway i'll send you his information but no thanks, thanks a lot. Dr. Spaz, everybody. There he is. All right. Let me try again with Chuck. Chuck is not there anymore. Let me see if I can get him off the audience. Hold on.

Chuck got bored. I think that's you, Chuck. Chuck. There we go. Yes. We'll invite you to speak again. Sorry about that. No, he's still there. Chuck. Here you go. Hey, can you hear me? I hear you now. Oh, great. Yeah. I forgot I had to raise my hand again. It's okay. I was looking for you. It's all good.

Thanks. So there was a lot of discussion about why the approach from the government and some of the disinformation. I want to ask this. Do you think that there's maybe a plausible reason? I don't know if this is true or not. That's why I'm asking the question. For an emergency use authorization, doesn't that require that there can't be an alternative therapy? I believe that is true, but I think it really technically is alternative therapy. Now, I may be wrong on this. I'll look at the restream. You guys can straighten me out if I'm wrong.

I think it has to be alternative therapies in that that class in that particular approach to treatment so in other words you could have you could have treatments but there might be something superior with a different technology or a different biology attached to it that they will approve you for i think that's the that's the nuance that people get kind of screwed up about, but I don't know for sure. Yeah. So, I mean, that's what I was just trying to look for. And then, you know, because I, you know, I think it's important to have conversation about it. Oh, yeah. I think if you got in the room with the right people that had a fair conversation, if that is the case, then we need to fix that.

If that's really the case, because in war and pandemic, we're battling against this to try to save lives. You want as many tools in your toolkit to address a problem. Hear, hear. Listen, and the insanity of all, I naturally, I think this is why Joe Rogan is in trouble right now because he has that same kind of instinct I have, which is when people have been silenced,

why? I want to hear what they have to say. Let me talk to them. I'll talk to both sides. I'll talk to everybody. I'm just interested in expanding my fund of knowledge, but I'm automatically drawn

to people that are silenced because i'm not going to get to hear it otherwise and i i don't know it could be an important opinion could be bullshit i don't know but you're right there should be they should be like there's always been in science and medicine it's what it has always been and why this was different is just that's scandal number four i'm putting that scandal on my on my on my list of scandals i believe it's all people driven i mean when it all comes down to it uh it's it's not a company that makes the company it's the people that make the course of course so what do we do what do we got wrong what are we getting wrong or is there something i i started thinking about

the notion that we'd become histrionic we become hysterical that our personalities have been infected with this histrionic quality which i'm not sure that's right that's something i've been thinking about what do you think i i i i really just think it's it's it's an evolution of the discourse. You see that and the lack of credible information. I think you could always even – throughout my life, I've tried to say to other people, you could take a perfectly sane person, a great person. You take out their pillars of success and take their financial, take their ability to have a place, a dwelling, a home. And you can turn that person into a criminal. Well, I think if I could reframe that, I think you're right.

I would put it at there's no telling. There's no telling how somebody is going to behave when you pull all the everything. It's the same as if you drop them in the middle of the ocean there's no telling of how far they'd go to survive and i think you're that you're saying the same thing i'm saying actually that's exactly what i'm saying we we because of the circumstances whatever's going on in our internal constructs right now turned us into hysterics now maybe that's the way it always happens i don't think so i think it's something to the fourth turning or the present moment or something. And, you know, as such, I think we need to really have some very smart people thinking very, very carefully about what just happened. Chuck, thanks for the comment. I'm going to wrap things up. We thank Dr. Peter Hotez for being with us. Ask Dr. Drew is produced by Caleb Nation and Susan Pinsky. As a reminder, the discussions here are not a substitute for medical care, diagnosis, or treatment. This show is intended for educational

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