Ask Dr. Drew - Teen COVID-19 Vaccination: Dr. Vinay Prasad on the Risks to Public Trust – Ask Dr. Drew – Episode 68

Episode Date: January 24, 2022

Dr. Vinay Prasad is a hematologist-oncologist who has concerns about the CDC's all-or-nothing approach to teen COVID-19 vaccinations – a policy he believes could cause catastrophic damage to trust in vaccines. Dr. Vinay Prasad, MD MPH is a practicing hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco. He studies cancer drugs, health policy, clinical trials and better decision making. Clinically, Dr. Prasad cares for patients with a wide range of benign hematologic and malignant conditions. Website: https://Vinayakkprasad.com  Twitter: https://twitter.com/VPrasadMDMPH  Podcast: Plenary Session [This episode originally aired on November 30, 2021] Ask Dr. Drew is produced by Kaleb Nation ( https://kalebnation.com) and Susan Pinsky (https://twitter.com/FirstLadyOfLove). SPONSORS • 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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please 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. Welcome, everybody. I want to get right to it. Dr. Vinay Prasad is somebody I've been wanting to speak to for a little while. He's a practicing hematologist, oncologist, associate professor in the Department of Epidemiology, Biostats, University of California, San Francisco. He studies cancer medication, clinical trials, better decision-making in medicine. He also cares for a wide range of hematological patients.

Dr. Prasad's podcast is called Plenary Sessions. I cannot recommend it strongly enough, particularly if you have any interest in health care. 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. Ridiculous. I'm a doctor for f***ing sake.

Where the hell do you think I learned that? I'm just saying, you go to treatment before you kill people. I am a clinician. I observe things about these chemicals. Let's just deal with what's real. We used to get these calls on Loveline all the time, educate adolescents and to prevent and to treat. If you have trouble, you can't stop, and you want to help stop it, I can help. I got a lot to say. I got a lot more to say. Let's talk about our friends at Hydrolyte.

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It's gluten-free, dairy-free, caffeine-free, non-GMO, and even vegan. Hydrolyte Plus Immunity is also now available in ready-to-drink bottles at the Walmart, next to the pharmacy, or as always, you can find it by visiting hydrolyte.com slash drdrew. That is H-Y-D-R-A-L-Y-T-E dot com slash drdrew. And be sure to use that code DRDrew25 at checkout for a special discount. Dr. Vinay Prasad, thank you for joining us. It's great to be back.

Yes, great to have you again. So I don't know if I remember if I told you last time, but I found plenary sessions well before the current circumstances we all find ourselves in. And I loved it. And I loved it because not all of our peers know how to read medical literature, penetrate the analysis, whether or not the study design was good, whether the statistical analysis was appropriate, whether the conclusions and assumptions were appropriate, and then contextualize it within the rest of the landscape of the literature on the topic in question. You're uncanny at doing that. So it didn't surprise me that when we got into our present mess, you would have something to say about it because it didn't look to me like people were using

very penetrative analysis of the risks and rewards of the present moment. And we sort of talked about this last time you were here, and you were starting to get your feet wet with writing articles about, let's just call it what it is, the insanity of the decision-making around public health policy in the last year and a half or two years. And you've kept going. And I thank you for that. Most recently, you've been taking on vaccine mandates, I would say. That's probably the best way, I think, to characterize what you've been talking about. You want to tiptoe into that for us? Well, I guess there are many parts to it, but I think you're right in the sense that

I've always been somebody who likes to read the literature critically. And so when I see a paper, I don't take it at face value. I want to dive into it. Let's talk about vaccine mandates. I think we have several categories of vaccine mandates. We have workplace vaccine mandates directly pushed by the administration. We have mandates that go through OSHA. We'll see about the legality of that, but that's affecting many people.

We also have school mandates that have started. We have a mandate in Los Angeles for children above the age of 12 that they need two doses, I think, by the end of the year, or they won't be able to attend in-person school. So that's a different type of mandate. And I guess I've commented to some degree about each of these mandates, but if I could just for a minute, I'll talk about the school mandate. I think the school mandate is a tough mandate in the sense that there is a clear downside from having this mandate, which is that there are going to be some kids who you're going to push out of school. And I happen to think that now is not a moment we want to push kids out of school. Now is a moment where we want to

account for all the kids who've been missing. And as you know, there are many children who have been out of school for over a year, no one's been in touch with those kids. I think that's the priority, bring them back. And then down the road, we can talk about mandates, the Los Angeles decision is unique. It mandates it under the auspices of the emergency use authorization for 12 to 15, which is not a formal biological license agreement, not a formal approval.

And so I think it's a tough mandate. And so I'm happy to talk about school mandates. I'm happy to talk about workplace mandates, but there's a bunch of mandates in place. Well, yeah, the one issue you've raised is, of course, that of young males and myocarditis, and which is a real you know it's one per 5 000 let's say just for the sake of argument uh and the people that want to sort of sideline that side effect say well it's mild and reversible which which is true thus far when you start mandating vaccines of millions of kids you're going to get some more severe cases and

you're going to get some bad outcomes. My fear, I don't know if this is what your fear is, that in doing so, two things have happened. The government has superseded the physician decision-making, the patient physician decision-making, the thing that you and I value perhaps most above all else, you and I sit down with a patient and go together, we're going to make a decision based on the best risk reward, motivational state you're in, risk tolerance, the actuality of whether or not it's something that you should be subjecting yourself to it, the benefits you're likely to get. You and I and the patient, we sit down and we go through this carefully.

We don't just walk in and go take it which is what the government is doing now they've they've gotten they've superseded they've they've ruined well they've i don't know it ruins the right word they've taken away the physician patient relationship and decision making and are doing it all by fiat and mandate to, the biggest downside of doing that is you're going to get some problems and then vaccines generally are going to be resisted because of the mandate itself. It's going to be a more widespread problem with vaccine resistance. Do you agree with that? Yes, I think that's the worry. And you've made a number of excellent points here.

I'll just hit on some of them. The commissioner, the former commissioner of the FDA, Scott Gottlieb, has said that he thinks to some degree these kinds of choices, especially around kids and adolescents, they need to be between the parents, the kid, and the doctor. That's really the right place you want to have these discussions. Every kid is different. Some kid had COVID and recovered from COVID. If you're a 12-year-old boy and you've had COVID and recovered from COVID, do you necessarily need two doses of the mRNA vaccine?

Could you get by with one dose? If you're a healthy 12-year-old boy, could you space the doses further apart, as some countries in Europe are doing, to try to lower the risk of myocarditis? These are different strategies. But that LA mandate, not only you got to get two doses, they're not happy with one dose, you got to get two doses. Even if you're a 12-year-old boy, 13-year-old boy old boy, 14 year old boy, they have to be within a certain time period. And that time period give a lot of flexibility for doctors and pediatricians to make choices that are individualized, perhaps spreading the doses further

apart, which is a strategy that's being attempted in Europe. So I agree with you that these sorts of mandates do encroach upon a sacred space, which is the doctor-patient space, which is that space. And I think they're particularly egregious when you use it as a requirement to go to in-person school. Now, we know in-person school has massive benefits to the kids who attend over the kids who don't attend in-person school. And remote education is no substitute. The last thing, Dr. Drew, I got to point out is that, you know, many people are rightly concerned about policies that actually create outcomes that vary by race, and they call it structural racism, they call it a structurally racist policy. This policy

would do that because, in fact, in the state of California, the highest rate of vaccination in that age group is in Asian kids at 92 percent, white kids, 87 percent and black kids in the high 60 percentage. So it will have a different impact based on the race of the child. And so that, to me, is also problematic with the mandate. Yeah, right. There's explicit racism in all the mandates, whether it's not allowing somebody to—see, people step back from that and go, well, they're choosing it, so how is it racist? They're not choosing it. The African-American population has been poorly served by the medical system across the last hundred years, and therefore we have failed them by not building the proper trust in a medical education. That's not their fault. That's our fault. And so we would expect them to be resistant.

Now we're not letting them into restaurants. We're keeping them away from schools. Their kids are already distressed, and we're going to make them more distressed by this. I can't understand why that's not a national outrage. I absolutely agree with you. Now, if you want to talk about the next part of your question, which is vaccine mandates for employment, for going into restaurants, these also have unintended consequences. So one thing it is, where are the displaced people going?

Are they all going to their house and sitting in their house? Or are they having meetups on their own, meetups among people who've been pushed out of these communal public venues. And if so, that may be driving spread. The next thing I think people forget about is that I think you already see it, there's going to be a backlash in the votes, there's going to be a backlash politically against political entities that they felt impose this mandate on them. And those political that political backlash is real, and it will have consequences for real people on policy down the road. So the mandate is not just about the, did you bump up the percentage point from 62 to 64 percent, and you can pop the champagne then, but you also have to acknowledge that there are many downstream consequences of it that you're not capturing in that metric. Yeah, I agree with everything you're saying.

I think you've put out a couple articles recently sort of specifying this how was the reception of that i think the reception is good um you know it's it's threading a tight needle it's tight needle so what's the name i guess um right now we're in a climate that's extremely polarized on this issue and there have always been some people who are steadfastly opposed to all reasonable vaccination. And I don't support those people. There are also a growing group of people who are steadfastly in support of every single booster you can get in perpetuity. You don't need to show me any data. Just give me the booster. I'm also not there

either. I like to recommend vaccines when they have clear evidence. Benefits outweigh harms for the people getting them. And so that's why I strike this nuanced position. I think it's different if you're a 12-year-old boy who had COVID and you recovered, versus you're an 87-year-old person who has never had COVID and maybe you're in an assisted living facility. That's a very different choice. And so we can acknowledge those differences. That's always been the practice of medicine. That is the basic practice of medicine. And I sort of telegraphed this at my beginning opening comments. And I think you and I talked a little bit about this last time, but I still, every time I interview a peer, I just have to ask these same questions, which is, what happened? I mean, why? What happened to the risk reward sort of mandate? You're required to make a risk-reward analysis.

And from the beginning of this pandemic, there seems to have been no risk-reward diathesis. They've done things that have harmed people massively, pretended it didn't, didn't learn from it, continue to sort of focus on the same drum, beat of the same drum. I'm just astonished. I don't understand what's happening. Now, people have begun to say out loud, I've begun to talk to some of the experts that were there during the decision-making

who have said things like, and I said, well, why, what did you, what were you thinking? And they're saying now, well, it was a panic. We were panicked. Okay, all right, well, why still? Why are we adjusting to that? Why aren't you learning? You were in a panic.

You didn't have all the information. I get it. You made a bad decision. Why are you standing by that decision and continuing to bang the drum for bad policy? It's that we can be more nuanced about this now. We have a toolbox. We know a lot of things we can do that won't be so harmful to people. Why the insistence? Do you have any idea? Yeah, I mean, I think you're right that some of the most harmful policies we did early on is lockdown slash shelter in place. That's a policy that the implications go to every domain of life. It's not just healthcare. It disrupts everything, the economy, people's livelihoods, everything. School closure is the

other big intervention, and it has many consequences. You don't even know all the consequences. It's never been done like this at this scale for so long. So you're right. All of these things are blunt force tools. It's performing a surgery with an ax and not a scalpel. They're very crude tools. Now, why did we jump aboard? Why do we stifle dissent?

Why is everyone, you know, sort of the mainstream media has a certain narrative about it. Twitter has a certain narrative. And I think it's in part because it's been politicized that for whatever reason, one political side is the side of more masks, mask younger kids and have mask mandates in school and mandatory vaccine policies. The other political party has gone the other direction on these issues. It didn't have to be that way. The parties could have split these issues differently. But once it gets politicized in this environment, it's going to naturally pull towards more

extremes. I think the other reason is panic, you see that around the new variant that has been announced, sequenced by South Africa, you see sort of immediate panic and why is panic so powerful? I mean, we live in an environment where panic, anxiety, rage, outrage, these are the emotions that drive everything. They drive the masthead of the New York Times, they drive Twitter, they drive Facebook. The New York Times is responding

to what they're seeing on Twitter and Facebook. And so these emotions have always garnered attention. And in this current moment in time where attention is the commodity, it's natural that everything gets pushed in that direction. I think the failure is that you expect scientists and public policy experts to be able to take a step back, take a deep breath and say, you know what? What is the right rational calculation?

How should I think about this risk in terms of risks we always accept in our day-to-day lives? Let's put this in context. But you don't see a lot of that. So I agree with your premise. Yeah, it's very very strange and um i i think not only do we have a collective anxiety disorder i i think we've become histrionic because so much of the rigidity of what's the thinking has become delusional it's become like massive like like

mass delusional sort of sweeps across the population periodically where you it begs no alternative it's like talking to a patient with a psychotic illness it's really weird uh so somehow we became kind of delusional and as such you're not going to be reading scientific literature very carefully you're going to be looking at it within the context of your delusional system i agree with you i mean i'll give you one clear example of that the only explanation explanation. You look at a town like Palo Alto, a lot of smart people in Palo Alto, it's the town that Stanford University is based out of.

It's a really expensive place to be. And if you look at that school district, they mandated that the kids wear masks outside at recess. So this combines a lot of things, you know, cloth masking, which we have evidence from a cluster randomized trial in Bangladesh, it didn't really work. Nobody thinks that they work outside.

Nobody thinks kids are at highest risk. And you put it all together in the smartest, quote unquote, smartest place in America. What explains that, Dr. Drew? And I think you're on to something. There might be a collective anxiety, collective delusion about this issue in that place. And that's the only explanation I see. That and political polarization. It's extremely left of center. Right. The sort of derangement syndromes that people have on both

sides, frankly. And I think the best example, I don't know if you saw this study, there's a sort of a brief review or a brief sort of anecdote of somebody that went out and looked on Stanford campus, students riding riding bikes students in motion percent wearing mask versus percent wearing helmet 20 helmet 60 mask zero utility from the mask and really putting themselves in harm's way without the helmet i saw one commenter say about that study that i guess if you wear a mask and not wear a helmet, there's no point in protecting a brain that's not working. So I guess I see that, you know, that is a problem. Those are Stanford students. Those are Stanford students. Those are the best brains, supposedly. They are the best brains. Look how even the best brains can be swept up in, I think,

I think the point is clear. The helmet, mile for mile, the helmet's a better bet than the mask outside. No doubt about it. Why are the smartest people making making this error the smartest people making this error because they're not using their brain they're thinking from a different place and that place is tribalism visibility virtue signaling all the things that we hate about the modern world and yeah and conclusion reasoning from conclusion also they've decided this is their point of view and then they draw draw back speaking of that i i'm a little also mystified. Again, I'm just all day shaking my head. I'm either disgusted or confused. That's how I spend my days. This is on the confusion scale. Mask analysis, we have two controlled studies. We have two essentially RCTs,

which is the Bangladesh and the Denmark study. I remember the excitement that the Denmark study was going to be published. I remember it. There was a buzz about it. And then all of a sudden, NEGM passes. Then all of a sudden, JAMA passes.

Then all of a sudden, it finally gets published in Annals. And it's an okay study. It's a decent study. It's not a bad study. It shouldn't have been passed up by the New England Journal. And it said something.

And yet it and the Bangladesh study get continually destroyed differently than we normally criticize studies. When I hear you on plenary sessions analyzing a study, you're raising assumptions and issues and looking at details in the analysis. And then often stepping back and saying, but still, this can be relied upon as a reasonable conclusion. I just see only you have no idea how bad this is. You have to be a statistician to understand how terrible it is. And I just don't see it. So that's my confusion. We have two studies that tell us that masks are about 15, 20% efficacious, and people want to destroy those studies. Where do you come in on that? And explain to me why?

Okay, I think you're making a great point. I guess here's how I come in on it. I think we have to remember for most of this pandemic in the United States, what was the mask that the mandates have made you wear? What's the mask we're making people wear in San Francisco right now or Los Angeles? I would say throughout most of this pandemic, we've asked people to wear a cloth mask. We just said any mask. We're not demanding to wear a surgical mask. To my knowledge, the only government that ever mandated a surgical mask was Germany. Every other municipality or state used a cloth mask. And I think it is clear from the Bangladesh cluster randomized control trial, we're talking 300,000 people, we're talking 600 villages. I think it is clear that cloth masks had absolutely no reduction in the rate of SARS

CoV-2 spread in the Bangladesh study. So one thing to say right off the bat is we recommended the wrong mask. Now, is it possible wearing a higher quality mask and n95 is the magic thing? Sure, but the n95 has never been studied in a cluster randomized trial. In the same Bangladesh study, we have evidence that the surgical mask was a winner, as you say, 11 percentage point reduction. That's not nothing, but it's also not 80%, which is what the CDC director tweeted and said it was. The CDC director, I hope, would know the right answer, but is tweeting 80%. Where did she get that? I've not seen that anywhere. I think

what she's looking at is sort of outbreaks in schools or something. There have been some weird sort of observational studies in schools where there's an outbreak or something. Is that what she was looking at? It was just the most bizarre statement of all time. I'm thinking the Pima County, the Maricopa County CDC study. Even that study, which is very much flawed, I don't think it even found that big of benefit. I mean, I think she's looking at a study of a double-masked mannequin in a chamber. I mean, that's the only thing I can think she's looking at, a double-masked mannequin in a chamber,

which is not a real-world study. But let me put it this way. Okay, so she says it's 80%. There's another analysis in the British Medical Journal. It said it was 53% that also use very low-quality studies. I saw that. One of the criticisms of the Danish study, DanMask, that study that you're referring to, that randomized trial, was the authors tried to find a 50% benefit. Or what we say in science, the study was powered to detect a 50% benefit. Now, some people said that, well, nobody thought it was 50%. We thought it was about 10%, 20%. And you don't have a big enough study to find that benefit.

But what I point out here is that both these things can't be true. If you believe the CDC director, if you believe the BMJ, then Dan mask had adequate power and it doesn't have that effect. Or you don't believe them, in which case you got a bigger problem because your CDC director doesn't appear to know what the efficacy of masking is, which is, I think, a big catastrophic problem. Right. You don't get to say 53 percent and not 20 percent. You don't get to do that because once they're two they're based upon two different sets of analysis and assumption you you can you can you can say well maybe the 20 is correct and maybe the 53 is correct or maybe it's somewhere in between i i it could be still not 80 not even close and people behave as though not wearing a mask is is like

shooting a gun into a crowd it's the the weirdest, weirdest thing for me to see. Very strange. Okay. What's occupying you going forward? What kinds of things are you going to be writing about? Are you still focusing on vaccines? I guess, yes. I mean, why?

Because they make me. I mean, do I want to focus on this? But as you saw yesterday, they said a few things. We don't know anything about the new variant. We don't know if if it transmits more we don't know if it's more lethal we acknowledge that's a true thing they don't know anything at the same time we're changing the recommendation and anyone over the age of 18 no longer you can get a booster you should get a booster that's an interesting claim when you didn't know anything about the new variant so you're you're upgrading claim. And the reason that troubles me, Dr. Drew, is we can all imagine there's this 20-year-old boy out there,

and he's already gotten two doses of Moderna. And this boy is healthy, not in health care, just a healthy average kid. And now the CDC is saying, you need to go back and get a 50-microgram dose of Moderna, a booster shot, which is the half dose in Moderna. And I guess my point here is that there will be a non-zero rate of myocarditis from that. I know that from some Israeli population data. I don't know if that 20-year-old boy is going to get any

benefit from having done that. And that to me is a problem. It's a gamble. They're pushing it a little bit too much. Boosters is reasonable if you bring the evidence first and then you make the decision i think it's a problem if you make the decision as you say and then you try to look for evidence and that's what they did with the booster dialogue at least for healthy young people for older people people with literally morbidities suppressed they may need the booster sure yes yes i i i do actually think it is a net positive that Omicron has got people who are on the fence going ahead and getting vaccinated or getting boosted, particularly if they have significant risk. That is a net positive as far as I'm concerned. at least once a show go i block my head block my thought just my thinking just blocks all of a sudden it's a post-covid phenomenon i've had um well let me bring up this thing i was going to bring up which which was there was a study i think was it israel or new zealand or something that showed uh excess death in the this was flying around last couple of days excess death in the

vaccinated populations you see that little graph that showed there was a sort of separation. Okay. It's a very poor study. It's controlled for age only. Age only. They didn't look under the hood and look at whether there's anything else going on in the end vaccinated or the vaccinated. And just off the top of my head can predict that in the vaccinated group, you're going to people have people with more medical problems. That's why they got vaccinated.

You're going to have people who may have delayed. We have both groups, people who delayed their treatments for all kinds of things. That's going to start becoming an issue now. So I, I think, I guess what I'm trying to say is that. Drew,

is that the chart from yesterday's show? Yes. Yes. Same chart. You want to put that up? Yeah. Yeah. You'll see it in just a second. I'd preside. It's a, what i'm trying to say is that drew is that the chart from yesterday's show yes yes same chart you want to put that up yeah yeah you'll see it uh just a second i'd preside it's uh it's a you just see a separation between the vaccine and unvaccinated but it's a there it is and this was in where was this i can read where that uh doesn't say uh i think it was like new zealand or something but but anyway it was flying around all over the place yesterday and uh i guess i just thought wow

you know this is this is the nature of my thoughts are yeah my thoughts are you know what you're doing is you're comparing the risk of death among somebody who had a reason to go get the vaccine against somebody who didn't have a reason to get it. And if I would imagine that if you're living in a community, for instance, you're living in a nursing home, it might even be a mandate in the nursing home that everyone who works here is going to get, or everyone who lives at this nursing home has to get this shot. And so you're going to bias it to where it's sicker people are getting vaccinated either first or getting vaccinated at all. These kinds of comparisons are not very useful. Similarly, you could make a same graph saying that, you know, schools in Pima and Maricopa County that had mask mandates for kids had less COVID spread than schools that didn't. Well, I would

tell you that there's other differences between those schools. They're much more likely to vote for Biden than to vote for Trump. They're much more likely to have that higher vaccination rates at home, et cetera. It may not be the mask. And so that's a classic confounding problem. But I will say the way to look at excess deaths would be to look a meta-analysis of the randomized control trials. And there, I think the answer is wouldn't be able to do it actually, because at this point, everyone's been crossed over. So I think this is a question that, you know, will be quite difficult to answer. But I wouldn't let it dissuade anyone from getting the shot. I know now the comment I was going to make, which was what you had said about making a mandate and then collecting the data. Nowhere in either of our careers have we ever, ever applied a treatment that had no evidence

for utility when wait for the utility. I mean, we might in extraordinary circumstances, I guess, but we would spell that out. You know, we would say, I'm sorry, we had nothing else to do. I have an idea. We're going to try something that's different than this mandate for something that has not been proven to be efficacious. I agree with you. I would say that as a general rule in medicine, there are places and times where you can debut something, try something without firm evidence. And those tend to be when people are really sick. And when you also counsel them about the uncertainty. We very rarely debut uncertain things

on healthy populations because we know healthy people have much less to gain and a lot more to lose. And so it is unusual to start moving ahead of data when you're talking about healthy young people who really, you know, they got nothing wrong with them. And that's a much harsher phenomenon to come to terms with. I'm expecting three bad outcomes before people go nuts. And, you know, to say making a healthy kid sick, that is a really hard thing to see. But let's get off that for a second. I'm dead.

Yeah, I know. couple of the questions. I know one thing. How will people know about those bad outcomes, Dr. Drew, because my understanding is that now even truthful personal stories of bad outcomes are being censored by technology companies. So, I mean, I think we can all have the debate around whether or not incorrect information should be censored and under what circumstances. And I think we need to think about those policies. But now there are people who believe that truthful information can be censored.

And that, to me, I think is deeply problematic. Oh, my God, is it ever. Dr. John Campbell, a British nurse who's an academic, interviewed a kid from here who had myocarditis. I think he had pericarditis. And they just discussed his clinical course that kid was crushed in social media for speaking about his medical condition it was I want to interview that kid I put the word out like please let me talk to you and support you because that is nonsense you're I just want to say one more thing you made a good point which is that most of it is mild and And I think that is true. Thank goodness.

You know, also most people who get SARS-CoV-2, they actually don't get sick and die. So, I mean, but these comparisons can be misleading because it's not about what happens to most people. It's also about the distribution. And idiosyncratic adverse events like myocarditis will have a distribution. There will be a very few kids who get very, very sick from it. And already we've seen that in New England Journal publications. There's a kid very sick requiring, I think, external support for cardiac support. And so it will have that distribution. That doesn't mean it should be taken lightly.

I think any condition after a vaccination that requires you be hospitalized is something to be taken quite seriously. And be transparent about. The fact that they're being so clandestine is what's creating so much of the resistance. taken quite seriously. And be transparent about. The fact that they're being so clandestine is what's creating so much of the resistance. But how do you feel about Omicron? Want to go on the record with anything there?

I've been careful not to say much about it because I'm an old fashioned person who likes to see information before I make up my mind. I guess that the truth is people don't know a lot, but I will say one thing that I think is telling, which is by the time you institute travel bans, it's probably already on your shores. And so travel bans are something that causes a great deal of grief to people, separating people, separating families, making it very difficult to do things. I'm not necessarily sure they change pandemic trajectories.

And I'll say one more thing. The particular type of travel ban people love to use these days is not a travel ban starting this moment, it's a travel ban starting a few days from now. That's the travel ban. If you have a travel ban starting a few days from now, what you actually do is you make everyone rush to the airport right now and try to get on the next flight and so you actually lead to a crowding situation right so i wish these people would think about this a little bit more before they react yeah yeah again there there is the risk lack of risk reward thought process i bought stock in united that's really funny so i i'm going to go on the record a little

bit and say i'm gonna go on the record and say um i i believe what the physicians are saying there, that we probably have fairly widespread Omicron and their hospitalization and death rate continues to decline. And to be fair, the only confounding issue that needs to be sorted out is whether it's gotten into old people or not yet. And if it's getting into old people and the death rate's not going up, I'm not worried about this thing. Now, it may create a little vaccine issue along the way here, and we might want to address that, which I'm sure we will. And that's that. In the meantime, we have antivirals coming. Any thoughts on that? The 13 to 10 today, Moldupiravir was given the go-ahead for EUA, which I am delighted about. I hope they get

as quickly on to Paxlovid. They are moving forward, it looks like. I guess I would say, I guess I agree that the more options, the better, sure, in this disease. I guess I think this is a product that also may increase viral mutation rates. And so it's got to be used really carefully. And so I think it's probably not going to be the kind of product that people are just prescribing for you to have it at supply at home just in case you need it. It's probably going to be the kind of product that are given out very carefully. But I think the reason we get excited about treatments and vaccines is because the alternative of putting society in lockdown, I think, is an untenable alternative.

And at this point, it's got no political traction, it really cannot be offered. And I think Dr. Fauci was asked about it this week. He says all options are on the table. But I do suspect that realistically, this option is politically no longer on the table. I don't think the American people would tolerate it again. And so we need to think about these other things. Yeah. The back here in California, we had this red, green, yellow, orange lockdown. It was all made-up numbers. Never was we going to achieve green or orange, ever, ever. It was just all fantasy.

And so hopefully they're not living in fantasy anymore. Back to the Merck and the Paxlovid, I think the Molnupiravir is going to be used as the exposure drug. You know what I mean? Like a household exposure kind of thing. To me, it feels like where it fits. And the Paxlovid are going to be used as the exposure drug you know what i mean like if household exposure kind of thing that to me it feels like where it fits and the packs of it are going to be if you get sick i think what do you think i think that's uh that's that's that's uh interesting i mean i guess i don't know the answer i don't know which one will be used where i do know that we're seeing data on uh monoclonal antibodies suggesting that if this variant were to spread they believe the antibody

may not have as much affinity as for prior strains so something else will be needed yeah and this may be something that fills that role but uh i'll i'll wait uh i'll wait some studies let's hope so yeah oh oh my god i'm i'm pretty excited about that but but um do you have any somebody's asking me do you have any issue do you have any thoughts about the fact that 10 people dissented on the EUA for moldy pyruvirate? That seemed like a lot to me. It was 13 to 10. I was sort of surprised by that. Yes.

I guess I would say that that tells you, I think, to some degree that people are a little bit more equivocal about this product but i will say we've done this analysis that if you look across many drug advisory committee meetings um there are often split votes and in such cases the fda often does vote to approve the product and make it available but split votes are not unusual interesting oh interesting and and the pax of it i assume is coming soon and i heard the Regeneron people are going to look at some changes in the monoclonal antibodies. So, you know, we will be in pretty good shape when we have this toolkit sort of put together. I think we'll have other vaccines coming. I mean, there's a lot going on now.

There need be no panic, it seems to me. And we might even get Dr. Oz in the Senate. I saw that. He's running for Pennsylvania Senate. That's amazing. Okay, listen, I promised you 3.30. We in the Senate. I saw that. He's running for Pennsylvania Senate. That's amazing. Okay, listen, I promised you 3.30. We're right there. I think I got to pretty much everything that was on my mind, and I just appreciate you being reasonable and being persistent.

Are our public health colleagues listening? Are they responding? I mean, much of what you push out is sort of interrogatory. And I wonder if they have a response and if we can learn something or maybe help them adjust their thinking and maybe they can learn something. But I'd love to know, there's a lot of whys that you're asking and are they answering? I would say I do think we have some fragmentation in science broadly. I think that there are different camps and there is a camp that's still stuck in the mindset that COVID zero is the goal. And if I were to say what I would say, the single big take home point is that you've been saying all along is that when you think about COVID, when you think about public health response, you got to think about the totality of human health and human experience. That's more than just one thing. So we got to think about the virus. Yes. But we got to think about mental health. We got to think about people working. We got to think about heart

disease. We got to think about cancer. We can't put everything else on the back burner year after year. And so once you accept that and you accept the second fact, which I think is the virus is here to stay, it's never going to go away. It is always going to be with us intertwined with human beings, even for a thousand years. Imagine that. And so as long as that's the case, you need policies that are, have a light touch that try to protect the most vulnerable people, but also allow the rest of society, vaccinated people, younger people to get on back with their lives. And I think that is the part that public health experts need to hear the most. And just because you're a public health expert doesn't mean you're the expert in every domain in life. And so they do need, I think, the body politic to help them see everything. I agree. A lot of them aren't even physicians, which is astonishing news to me. But

thank you so much. You can follow. We'll leave it at that. You go to dr prasad's website v-i-n-a-y oh ak prasad is that right ak ak prasad yeah ak ak prasad is the website and twitter is v prasad p-r-a-s-a-d mdmph and of course that plenary session podcast you will not be disappointed i think if you google his name you'll find him yeah it's probably easier too many people stealing my handle stealing my hand i gotta use all these letters in there okay well keep uh keep fighting the good fight it's just a pleasure to talk with you and i i i cheer you on from the sideline as i listen to your pods and read your articles and uh just uh don't stop don't stop they. They need the clarity and they need the thinking. You have the, you know, you've earned the position to be able to take these points of view and you

should be taken very, very seriously. And I just hope that people are listening. So thank you so much and I'll let you go. Thanks for having me. Take care now, Dr. Prasad. You betcha. What we will do is we will take a little break and then I'll come back with our clubhouse friends, see what kind of questions you guys have there. If I can handle them, I can. Dr. Prasad had to run off, so we'll let him go. We'll take a little break, be right back after this. I want to give a shout out to our good friends at Blue Mics.

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Trust me. To take your audio to the next level, go to drdrew.com slash blue. That is drdrew.com slash B-L-U-E. Those of you on Clubhouse who are listening to us spout off. No, the mics were off. It was fine. Oh, okay. I turned them off.

Okay. But we were talking about my friend Bertt kreischer and uh paulina came in she just did leanne's podcast right go to wife of the party if you want to hear it see another good podcast with paulina exactly exactly wife of the wife of the party i guess burt came in and they talked about food right birth has an issue lately his uh his food alcohol. Don't we all? Yeah. Like, don't we all just have an issue occasionally? Like, I'm fat right now for me, but I'm tired of being on a diet all the time and trying to lose five pounds. And then I lose it, and then I get all wrinkly, and I have to get fillers. And then I'd rather be fat and then maybe have some fat sucked out of me where I don't

want it, so I don't have to lose the weight. Your face won't sag susan pinsky all right let me get to some uh calls here over at thanks my boobs bigger over at um shoot um sorry okay uh hold on here raise your hand if you want to ask questions because now it's all you boo yeah i'm trying to get to the questioners here. Let's get Bebe back. She'll raise our spirits. Remember Bebe?

Bebe! Yes! Dr. Drew! How are you? I am your number one fan. And Susan, you're gorgeous. You're gorgeous the way you are. I've never had the opportunity to meet you.

Thank you. You just stay fabulous. Did I tell you that Bebe would raise your spirits? I told you she would raise your spirits, and here we are. But you have turned me on to Dr. Pr Thank you. You just stay fabulous. Did I tell you that BB would raise your spirits? I told you she would raise your spirits. You have turned me on to Dr. Prasad. I now sit at home. I work from home and I listen to plenary sessions. I tried to listen to his podcast on pancreatic cancer, but I was so excited when it came across my phone that you were talking to him. But just two very quick questions and a comment. The first question is, you always speak of an Adatex score, your own. If I live on the East Coast, is there some way I am able to get an Adatex score?

I have been vaccinated, and i don't believe to the best of my knowledge that i have ever displayed any covid symptoms so you want to know have i have i it would be a hard thing to tease out of a lot this data but you if you how long ago do you think you would have had it if you had it oh i i have no idea that's why i was wondering am i eligible i looked on their website yeah obviously i live on um i live in pennsylvania so i don't know whether what's your what's your vote for dr oz or what's your zip code he's a pretty good guy i i can vouch for his character he's a and his intellect i i i without i beyond reproach, the guy is an amazing human being. Okay, then I'll vote for him.

And you do not get to be the head of cardiovascular surgery at Columbia Presbyterian as a slouch. And he runs a business well. That is the highest order intellect. I mean, look at how long he's had that television show. Like, that's amazing. You know? Then I will jump on board. And if Dr. Drew tells me to help campaign for him, I will do that.

Just know he's a great person. I don't know what his political views are. We'll see. We'll see what he shows up with. What's your zip code? 15108. And did you look around for a testing site near you? Well, I just went out to their main

website and and i was i was actually been meaning to call them because i wasn't sure how do i need a script so here it is not yet available within a 50 mile radius of your area so it's not yet available there keep keep me posted all right and and here's the thing uh you're not going to learn that much from it so editing is a company i worked for for a year. I no longer work with them. I was put on a research protocol with them where they are following my Additix score and it's been very interesting. high-level antibodies across the board, the binding domain, the nuclear capsid protein, the spike protein. I had antibodies to everything of all types. It was just all over the place, and high neutralizing antibodies. It started to decay, not badly, but it started falling down. I took the Johnson & Johnson vaccine, and of course, the spike stuff went up, which was great. Even my neutralizing antibodies went up a little bit then they started

falling again and then they went up again and so i think i might have been re-exposed which is very interesting that my neutralizing antibodies are up pretty high so that's kind of fun and interesting so it's interesting to to look at these profiles but they haven't been standardized yet so you you can only tell them about mine oh susan's i i had a hunch that she needed a booster they wanted to test her because much like you bb they were wondering about looking at somebody like that that may have had it but probably didn't but had a booster i had the two vaccines i had a hunch that she needed to be boosted and she did her neutralizing antibodies were in the toilet she had some spike antibodies but really but really not what made me comfortable.

So I was really glad that she got boosted before we went to Europe. Just, I have friends that say, well, I went to LabCorp and I got tested. And I'm like, well, what does that mean? That's kind of a yes, no test. And all you really are going to learn is that you've been vaccinated.

That's really all you're going to learn. And so, I mean, it's a quantitative test in some settings to some degree, but again, these things aren't standardized yet. So we don't really know how to interpret them. So they're all sort of on a hunch, but if you don't have the neutralizing antibody results, which is really becoming the thing that's most standard, I'd say the thing that people are looking at the most consistently, you don't really have that, I don't think, in the LabCorp test. Okay, thank you. You're not going to learn too much no matter what, so you're good.

I was the one, I have the healthy 17-year-old daughter, and I was just trying to find out the best time to get her vaccinated to get the most bang for my buck on the vaccine. Now, this is the one i've had my daughter vaccinated against hepe happy hpb i was all on board with vaccines but much like you say when all this hit i didn't know who to trust and when i hear people like you speaking dr persaud speaking he had a fabulous talk with the dr pershing who does this for like you all give me the clinical information and Adam Corolla gives me the courage and the humor. I was going to say Corolla gives you the clinical information.

He just keeps me from when I listen to him. He just brings my stress level down. Just listening to his humor, just listening to him saying, don't be afraid, go out there. And just my last comment, please keep podcasting as the variants come out. Please keep having these fabulous guests like Dr. Prasad, you know, speaking about the antivirals. And you're where I go to get my information. And Susan, you're fabulous. Dr. Drew, you're fabulous. Dr. Drew,

you're fabulous. And I will now be quiet. Okay. You don't think he's asked the same questions over and over too much. This is Susan's complaint. She goes, you keep going over the doctors, all the same.

But as, as a lay person that I have now turned off any mainstream media. Yeah. And when the, when the variant hit, and this is why I raised my hand again, I went out and I looked up, has Dr. Drew commented? Has Dr. Prasad commented? And then there's that gentleman, his name is Z-Dog?

Yeah, he's great. We should get him back, Susan. We've had him on your radio too. We should get him back, Susan. We've had him on your board, too. We should get him back. And so I go look. So maybe to you that thank you for tolerating us lay people. But when something like that hits the mainstream media, I'm like, I'm not listening to them. I'm going to wait until somebody such as these folks speak and these are who I'm going to listen to. Well, that's good news for you and probably the public generally, which is what has upset me most during the whole thing has been the media's panic mongering and then the medical

community sort of freezing in place and silencing dissent and that kind of stuff, which was silly. So good. You shouldn't be listening to that. You should have some resources. ZDogg is great. Vernee Prasad is great. Alex Berenson can be wrong, but he's not afraid to be wrong, but he's raising important issues. Steve Kirsch, too.

Steve Kirsch, we worry about some of his conclusions. But the other thing I noticed for myself is I have a bias. It was clear to me I have a bias when Omicron came out. My bias is immediately to say, please don't panic. That's always my bias. And I did. Yeah. And people do. And then you buy stocks.

And then they go back up. But I noticed I have a bias that way. That's why I panic. And I came out and said, but listen'm doing i have my own self critique is i came out pretty quick with don't panic before i really knew whether we shouldn't and i thought oh that's a you gotta be careful yeah but please keep as this evolves please keep speaking on it yes and then at adam corolla gives us a dose of humor and I can manage another day. We went out to dinner with him on Sunday night. Susan.

Yes. I think he should run for president. Did we have fun? No, I have just too. Well, let's hear what Susan has to say. We haven't talked about it. We had a good time. We ran into the.

Dubros. The Dubros too. Terry and Heather Dubros. It's so funny. I said, text, you know, Heather and he emailed her and she didn't get the message. He goes, let's meet for dinner. And we literally were in tables right next to each other. They sat us down next to the Dubros.

I'm like, wow, weird. And they look good. You didn't see what I did. I walked over to their table, not because I realized it was them. I was looking through the window to where their table usually is. And I was trying to look

and I just saw the corner of my eye. I was like, I think it's Heather Dubrow that's sitting there. And so lo and behold. So that was fun saw the corner of my eye. I was like, I think it's Heather Dubrow there sitting there. And so, lo and behold. So that was fun. And Adam enjoyed meeting them, and that was good. And we discovered the three stages of Adam drinking, which was a new insight. What was the first one?

I remember the second one was loud, and the third one was teddy bear. He got cozy, yeah. That was the third one. It was cute. I would pay money just to observe that. She was right she was absolutely right that that it was uh that it was loud then passive and and uh a happier version yeah cozy version of him yeah all right baby good to talk to you thank you thank you i appreciate it all right bye-bye all right i have a quick question that's based on that as well yes

so whenever you remember my wife was, it was about the testing. So my wife, remember she was sick last week for like 10 days and we got tested. We did our COVID test and all that. That was before they announced this new variant. Well, so did the test that I take then, will that still be able to detect all of the different variants that may be coming out in the future or happening right now? So if it said I didn't have COVID, then at least up till now. We're good for now. Yeah, we are good for now.

And there's certain ways, certain tested, there's a dropout of a certain protein that affects the way the tests are read, but it wouldn't affect your yes or no kind of question. So the no is still no. Okay. Although, as you know, I'm still, I'm a little bit skeptical and Susan's super skeptical of time course testing. In other words, you know, my own personal experience was I didn't, I didn't turn positive until I'd been sick for four days.

Right. And some people are sick, get a test positive early, then go negative, then go positive. Some are positive early, some are positive late. So it's a weird illness in terms of the detection of the antigen. So just FYI. And is there a difference there between like, I went and got the quick test. It was like a 15 minute result versus a different test that may have taken, I think they said a few days to get the results back. Is one better that detectives? Right. The PCR, yeah, PCR is a little more accurate. Also gets more false positives, but PCR of any type is more accurate, generally speaking.

I was hoping. I was hoping. Let's put it this way. You're not going to get false negatives. You're not going to get a false negative from PCR. Good. George, what's happening? Hey, can you hear me?

I do. Hey, so I think it was last week, the headlines about the Merck drug not being as effective as originally described. Yes. What is, can you unpack that a little bit? And are we going to see that same thing with the Pfizer one? I don't believe you're going to see it with the Pfizer drug. They, I, somebody explained it to me. Well, the main thing that falls out of it is that there were no deaths in the Merck-treated group.

No deaths. And that was the main finding, that whether or not you could keep people out of the hospital, not as effective as preventing death. Okay? So that was the main thing. The other thing was they were studying very sick people. And so people are speculating that if you get people on this medicine earlier, you may see more capacity to keep people out of the hospital. Does that make sense?

Yes, that makes perfect sense, actually. Yeah. And of course, as usual, you know, when you do studies like this on new drugs, you're using sick populations. That's just the way we do things. But no deaths, no deaths in a sick population. That's a good thing. Good to know.

Yep. Thank you, George. You bet. I'm still messing around here with calls, everybody. Thank you for having a little bit of technical stuff. Okay, let me get Eric, who talked to us before. Whoops, Eric, I did not do that properly. Now I did it. Eric, come on up here.

And again, you're all screaming. There you are. Yep. Hey, Dr. Drew. Eric, what's happening? Hey, great interview today. I'm glad I was able to jump on. Yeah, as you were going through the interview, I had a question pop into my head about the Stanford situation

that you brought up with the bike helmets and all that yeah um how much of of the um the mask wearing as opposed to the bike helmets do you think is social pressure because that's the first thing that jumped into my head uh it's a hundred percent and venae sort of said that it's said it's politics, it's virtue signaling. It's 100%. Because these are smart kids, and there's no COVID transmission outdoors. That's it. They know that. I mean, it just doesn't happen.

There's still the benefit, then, of, well, I guess, not the adverse effect of not being cast out of the tribe, not being the one seen as doing something different. It's just easier to put the mask on rather than avoid a scowl from someone on the street so everyone just kind of does it. I think that's correct. You see that. I've only seen that in California. Yeah.

I see that. Like, you go around New York, people do not wear masks in the street. They don't. I see it walking around outside my office every day. In New York? I'm not sure. In Pasadena. Like, you go around New York, people do not wear masks in the street. They don't. I see it walking around outside my office every day. In New York? In Pasadena. Oh, yeah. Yeah, yeah.

In Pasadena, it's in California. Not in Orange County, interestingly. Orange County, you have to look. You won't find a mask anywhere. And Orange County has a lower incidence of COVID than L.A. County. Okay. Okay. Mask mandates. And people are just more sane in certain areas. lower incidence of COVID than LA County. Okay. Okay.

Mask mandates. And they do, people are just more sane in certain areas. And yeah, I was in Pasadena. I was, I went running down by the Arroyo and an older gentleman was on the show. I was sharing the sidewalk with him.

I was running. I was not walking fast. I was running past. He was passing me on the sidewalk he recoiled from me as though i swung at him with my fist it was unbelievable right it was like okay so so that level of reaction feels insane to me but i i would say that the average person is just, I just want to avoid conflict. I wouldn't call that insanity. That's why I wear masks. Early on in the pandemic,

I thought I was very diligent with the mask, and then I got COVID. It didn't make any difference. And now I've been more, because I'm all protective, vaccinated. It's just virtue signaling in this town. I'll just do it. I'm fine.

I wear it under my chin. Well, yeah. Until I go inside so that people know I have a lot of virtue signaling, but I think most people just conflict avoidance. It's just, I agree. That's me, Eric.

You're an MFT. What do you think about my theory with that? I like conflict. Wow. You know, Jason Ellis brought that Jason Ella. I did Jason Ellis's podcast today and he brought that up. Susan. He did that. I like conflict. He said You know, Jason Ellis brought that. I did Jason Ellis' podcast today, and he brought that up, Susan. He did?

That I like conflict? He said he's afraid of you. Jason Ellis is an MMA fighter. So is Nadav, and so is Annie. And he's afraid of Susan Fancy. I'm trying to soften up a little bit. And I said, wow. I said, Jason, I was really, I guess recently i became kind of sort of aware of your um edge uh what should we call it your your is it aggression or is it what is it what do we call it your sternness something something

about her makes men like a mean old grandma yeah it makes men men particularly women don't seem to complain about you so much but but i became aware of that through the your mom's house guys so when jason brought it up i said all right you know i didn't i was not aware of it i'm always really nice to him on the phone i always say you're always very nice and i always text him i love him somehow you're you're something i think yeah you're intimidating well that's a better word women something. Intimidating. I think he treats women poorly. No, he treats Katie like she's made out of gold. Yeah, but I mean, it's the sexual thing that they

have that sort of the way they treat women sexually, like your mom's house and this guy. And I think people meet me and they're like, oh, that's Dr. Drew's wife. We can't do the same thing to her. Oh, we can't screw with her. And I also am part of the business,

so it's kind of hard. It's like, is she going to go all Me Too on me? You know, what's going on? Oh, my God. That's the last thing you would ever do. I don't. I'm like, come on, hit me. Let's go.

Yeah. That's not the usual, I guess. I'm at that age now. I'm like, oh, yeah, I miss being sexually harassed all the time. But it's just, I think they're like, they see me as almost like you're. No, I don't think it's me. I don't think so. Because none of them bring that up.

This is who's afraid of Susan. They don't. Yeah, there he is. That's Jason. This guy. Yeah, this guy's afraid of Susan Minsky. I didn't know that, but I appreciate that. Yeah, it's pretty good. That's Jason. This guy. Yeah, this guy's afraid of Susan Bansky. I didn't know that, but I appreciate that. Yeah, it's pretty good.

I appreciate that. I thought it struck me. But, Eric, what do you think about my theory about the histrionification, that we've all become histrionic and taken a move in that direction? But I don't know a lot about histrionic disorders. I've been reading about it. I can't figure out. I always assumed it'd be something to be set up before age five, but it feels like there's kind of a circumstantial component to it.

I get, I mean, I wonder social media feels like a factor there getting just more, it's rewarded more than I think it ever has been before. Whereas I imagine historically it would just be something everyone would want to avoid the rare cases where someone would be histrionic but now that's being reinforced you're just seeing the tide so maybe it's just a behavioral piece just strictly i mean it's well and and is there something about it that people in leadership would have never been in leadership prior, but now because of the way things are rewarded, there's more of kind of a top-down, trickle-down effect? I'm just kind of brainstorming off the top of my head thinking about it. But I imagine a lot of these people I see in leadership who seem to be acting histrionic, and it would never have been tolerated before.

But now there's echo chambers that might be reinforcing that. Interesting. Yeah, it's interesting. I don't know. I mean, I definitely think that is a phenomenon that is happening in one way or another. Now, whether that's an actual histrionic diagnosis or just no no i don't mean behavioral pattern i just think if it were strictly hysteria i wouldn't expect the rigidity of the thinking and the kind of delusionality that's what that's why i keep thinking it's more of the disorder but it doesn't

mean you've got a diagnosable condition it's just it's just yeah yeah yeah well i like i like what you're saying that it's reinforced and it's a behavioral piece and maybe it's just something that lies dormant well and then even just the conflict avoidant thing too i think a lot of people out of fear of looking like an outsider will say something or at least support someone who is acting that way whereas before it would just be like avoided if not shut down yep i think you're right all right thank you i don't know i think we've all been brainwashed. I mean, when we saw that little girl on a scooter going down Arroyo Parkway, like on a busy street, on a scooter without a helmet and wearing a mask. Right. I mean, I saw it with my own eyes.

And it actually made me laugh because it was so stupid. You know what I mean? It's like, that is so stupid. She's going to get hit by a car. She's going to die. Yep. Yep. I agree.

Josh. I was pointing that out in the first place. I didn't realize she had a mask on. I go, what is this girl doing on a scooter without a helmet? And then I pointed out the mask. And mask. Josh, what's up? Hey, Dr. Drew.

I just wanted to talk about what you think is sort of racist policy. I mean, we know that, you know, minority people, they tend not to get vaccinated. And when there's these vaccine mandates or when people are, you know, forcing you to get a vaccine to see a show or whatever, that looks like racism. But I would change the language a little bit and i would call that something um it's not my word but white privilege yeah white supremacy kind of thing yeah well not not white supremacy just just the privilege that white people get for being white yeah that's that that some people like frederick douglas would call that white people get for being white. Yeah, some people, like Frederick Douglass

would call that white supremacy. And people unfortunately get hung up on skinheads as though that's white supremacy. No, no, no, no. White supremacy just means you have a white perspective above others

and that you can't help it sometimes because that's your upbringing, it's your orientation, it's your culture. And yeah, I think that's exactly right. It's like they don't, the people that have made these policies that disproportionately discriminate against certain populations do not think about or seem to get why those populations are resistant.

Again, Dr. Prasad agreed with me, It's our profession that created that. And we need to focus on overcoming that distrust, not segregating people for not getting a vaccine. That's an insane policy. But we're doing it. We're doing it. And I don't understand why there's not more outrage from it. I don't get it. Yeah, I mean, I want to tie this into a new kind of spiritual awakening or something, because it could just be the end of what we consider to be white privilege. I mean, that would be unbelievable if we could just do that. So to your point, I have been saying that there's a lot of unpleasantness about what's going on these days, but there will be some good things coming out of this.

The question just becomes how much, you know, how much conflict, as somebody like we were talking earlier, like I prefer the avoidance of conflict, but how much conflict are we going to have? How much discomfort are we going to have before we get to an equilibrium where we are? It's an old sort of idea that Hegel, GWF Hegel, allegedly put forward, which was that history moves in these – he didn't really think about pendulum things. He called it a thesis, an antithesis, and then a synthesis, that things come together in some sort of synthetic way, taking both poles into account and come out better as a result of that.

Now, it doesn't mean there can't be a lot of pain along the way to sort of get to that point. So to your point, I think you're right. I think you are right. This is, I forget your name. He's in Japan. Randy. Hi, Randy. How are you doing?

Good morning from here. So good morning to everyone. He's in Japan. Randy. Hi, Randy. How are you doing? Good morning from here. Good morning to everyone. Good morning, sir. Susan, I'd like to apologize. I hit you up on the DMs. I wanted to follow up on the last time I think I listened to Dr. Drew and your son had COVID. How was he going through that?

Wait, was that the last time we talked to you? What? On my DM? Which you had, like Instagram or Twitter? I think the back channel on this clubhouse when it first came out. Oh, yeah. Oh, yeah. I have that. I have that.

Yeah, sorry. I've responded, right? I can't remember. I don't believe so. I'm sorry. So he was sick with me. He was the only one that got COVID. This was in December last year. It's been a year. Yeah. It was sick with me. He was the only one that got COVID. This was in December last year.

It's been a year. Yeah, it was the last holiday. How are you? Yeah, how's Japan? What's going on there? I'm doing well. You've probably seen in the news that the cases here have gone down quite radically. Yeah, somebody told me this.

Somebody just today told me that Japan had stringent lockdowns. Is that true? Very true. Lockdowns not in the respect of the, what would you say? Travel restriction lockdowns, yes. Okay, but they didn't make you shelter in your house. They didn't make the kids stay home from school. They didn't close all businesses.

All right, so they just didn't want you moving. That makes sense to me. That seems like a reasonable policy. they just didn't want you moving. That makes sense to me. That, that seems like a reasonable policy. So they don't want you moving out of your district essentially. Yeah. So much. So,

uh, they have, uh, like I said, there's been absolutely no lockdowns, but here in Japan, it works a little bit differently. They suggest things and people seem to follow them.

I think it plays into the, uh, situation that you were talking about before with people not wanting to create some kind of a problem there's an actually a phrase in japanese which is uh translated as the nail that sticks out is soon pounded down right well that works in with their mask situation as well a big part of our uh country was settled by essentially wildlings if you watch game of thrones and they're not prone to submission or cooperation whether they're prone to uh dancing to their own drama as they say or i was kind of the same way i was always me too fighting upstream a little bit as well a little

bit but uh yeah no here things are really quieting down a lot more people are uh getting the vaccination we had uh we would refer to like that you called lockdowns, state of emergencies, where they were kind of suggesting that people don't do this and don't do that. And those played out well. But like I said, I can't remember exactly when this was, but like last week, Tokyo had 14 cases and all over the country. They're on like 200 cases or something like this. So the whole numbers are dropping. But how do we you know how are they testing where the numbers coming from these are you know unknown things but uh it's still not it's not like you mentioned the hysteria is not here the what the scare tactics yeah there's no i mean yeah yeah because like say

for example i'm i'm basically a non-mask person of course i wear it when the situation's there and i have to but i will go all over the place without wearing a mask and i've never once been approached by a person you know oh that's ridiculous why are you doing this and putting your mask on things like that and so i mean there is a an understanding to a degree i guess but i think like you mentioned the majority of people are just wearing it not wanting to you know to create a problem not wanting to be the nail that gets pounded down exactly yeah i'm bald so i've been pounded down quite a few times all right and uh anything else going on with you? No, that's it. I did get my two shots towards, when was it? I think in September.

And so remind us again, Randy, what are you doing? He got COVID, right? Yeah. No, no, no. I didn't. I didn't get it. I didn't get it. I had the two shots. I'm just, my situation here in Japan is that I'm a teacher of the Japanese tea ceremony. Right. That's what it was. So I'm dealing with matcha. Actually, Dr. Du mentioned a bit about green tea and that before.

A little bit of confusion between what green tea was and what matcha is. But at any rate, I think green tea might come into it. A lot of people have said also vitamin D plays into it here. Green tea actually has a more powerful association even than vitamin d so they're yeah people when it when it when they look at it it looks pretty strong i i found myself reaching for vitamin for uh green tea more than i normally do because of that data well then definitely send me your address and i'll send you some of my matcha because it's definitely gonna be a good boost done a done my friend thanks randy thank you thank you very much you bet uh all right let's uh

see if we can get one more in here guys um this is russ i think russ you up there there you are russ what's happening hey dr drew um nothing major i just wanted to quickly tell you how much i appreciate what you and susan and caleb do and y'all have taken my calls a bunch of times and i just wanted to hop on and let you know it's helped out a lot good tell a friend we love it we love building a little community here it's it's kept us sane during the uh this whole ride this whole experience being able to be purposeful and reach out and help and try to make sense for people and just have a little community where we kind of,

I don't know, maybe calm each other down even. That's sort of the connect. And I don't know if you've noticed that people are dying to get out and be around other people now. I've noticed that a lot. And it doesn't surprise me at all. And I recommend that people do it. Yeah, I have noticed that. And I and i myself am pretty solitary in general but the the first time i was able to get

out and socialize it was uh i appreciated it more than ever before even you thoroughly enjoyed it even it's even uh uh what are you what do they call it when somebody is uh my recluse a recluse when you're a recluse or what would they call it when somebody they do they call it when somebody is a recluse? When you're a recluse. What do they call it when somebody, they used to call it when somebody lives in a cave for a long period of time. A hermit. Come on, Susan, help me. Hermit! Thank you, Karen. Hermit. That's the word I was looking for.

I don't know how SANA kept me working with you every day, but. Uh-oh. Let me get the MFT back. We can have a little session here all right russ thanks buddy appreciate the kind words of course y'all have a good night i'm a lot more sane now because caleb and michelle are working harder so what uh what was the problem with me you're a workaholic yeah when we had to do like seven days a week and i was like can we just take a day off and you're like no we got to do this tomorrow and i was like oh my god we're not it's not like we're these are 12 hour uh no i

know endeavors but i i had to produce most of them so it was a lot of you know i didn't really mind lockdowns um i didn't mind them because my wife really wanted to have a baby so lockdowns were great for us that worked out and you're locked down now that the baby has come you're really locked down anyway exactly that's the way that works i i have to admit this i have to admit there was more sex definitely during the lockdown so so you don't like responsibility is that right no i do but i don't like right now i like working middle of the week and you know having a having a few days off. It's nice. And, you know, like I don't mind loading up one week doing five shows and then when you're traveling and then not having to work for a while. So you disdain me because I like work.

No, you're pushy. I'm pushy. Yeah. But I mean, it was good. It was fun. It was fun for me to learn how to use a system and how to run a system and have something to do and and and you know trick my brain into thinking i'm smart but um it was it was good for that but i don't know i think working with your husband is a lot sometimes okay i like that now you have other projects and you're doing other things because then i feel like i can have a little

more me time like i would prep the house for Thanksgiving. I put on a party, you know. Yeah. It's stuff that I used to do that I don't do as much anymore. Like right now I'm ordering falafels and hamburgers for dinner because I don't want to cook because I didn't. I had, you know, I like cooking. I like, you know, fixing up my house and stuff. So when we work as much as we did it just wasn't easy to do

everything right and um i i just never feel like i'm doing enough because it's so different than when i when i was really working a holic when i was really doing it well you're going to new york and you were like i you know i don't have that much to do so i i just booked you on a bunch of stuff so you could stay busy because i know you want to stay busy like that. Yeah, it's good. But the last time you went to New York, you were miserable because I wasn't there to entertain you. Right. I get this. I get a weird.

I think COVID has left me a little depressed maybe or something. And so I've always dealt with depressive symptoms by working hard. Well, you also get yelled at in an elevator by that guy at STK. Yeah. I'm just saying now right I'm talking about right now and and I think the fact that after dark moved down to Austin I'm not as engaged with those guys on a regular basis yeah yeah so yeah that's harder and then I have a very strange thing which I start feeling you forgot you made money over there I start feeling inadequate I

start feeling this adequacy i know shortage and it's it's a it's an old feeling i thought maybe during the pandemic you'd get used to not working as much and you'd just sort of like be happy with what we're doing i mean you've got five podcasts so it is that's why i think it's some some leftover covet thing because it doesn't make sense to me it doesn't feel right so it might be just some little biological state that i'm stuck with or something maybe i'm ready to retire before you but no and i'm really glad that now we have a system like we have a team the running the show and i don't have to produce every day we're gonna larry king this all right right don't worry i'm good i'm good i'm good but one to stop. One of the reasons I'm pushing on Susan a little bit right now is that one of the upcoming episodes of After Dark is me interviewing Susan Pinsky.

You're allowed to tell? Yeah. I think that should be coming up very soon. So I recommend you keep an eye out for that because that was – I've never – Susan, who we've already established today, frightens a crazy man with a wolf on his head and a knife in his hand. He's afraid of Susan Pinsky. Got very weirdly anxious during this interview. In a way, I'd never, Jason is scared by Susan. She got very weirdly anxious.

The boys were afraid of me, too. And I told Nadav at dinner, said you know i just really appreciate you know everything you do and you know i never really get a chance to be sentimental with you because i'm it's usually like calling because we're working or whatever and i think he he really appreciated that we took him out to dinner i think they like yeah and they also realize that i'm not as bad as they think because you know text right can be, you know. Oh, your text. My text. Yeah, I don't.

Susan's texts are curt and hard to decipher. Caleb, back me up on this. Susan just has things to do. So it's like she has other things to do and then she sends a text. I don't have typing skills. I appreciate them. But the kids and I read them out loud and just entertain ourselves with the threads. We're like. Well, but when I started working with Nadav, you know, we put together the whole thing together.

And, you know, Tom sort of handed off to Nadav. And then, you know, we had to do the music together. And then somebody took our jingle away. And we had to get a new jingle. And I always get the shit runs downhill here. You know, I get the worst job. So, you know, I'm a little, a little tart, but I'm also, you know, game on when I'm working. Like when you're doing a show, I'm really serious.

But when the show's over, I'm having a cocktail, having a great time. So you just, there's two Susans. There's the, you know, business size Susan and then the fun Susan. So that's how I feel. None't know maybe happening without susan uh no you're like a driving i think it's all fun it's yeah it's all fun susan it's all fun susan relax for you relax for me yes for me you're you're not always fun but it's but it's still i would defend you as i have highs and lows mostly fine everybody else is hysterical so look for that interview no it's it was fun meeting them and i got to meet any and i got to meet you know they they had fun

making fun of me and they were actually they weren't too hard on me, actually. It wasn't that bad. They're afraid of you. Maybe the next time. But there is going to be, the next trip out is going to be really interesting. Casey Gates, why are you sleeping? I think we're putting some people to sleep. So we're going to wrap this thing up.

Did he say he was sleeping? I don't know why he said that. Thanks, Casey. I hope his friend Jorge is is okay what happened to all the other letters uh in the greek alphabet and uh there were some reasons they seem to jump over them i'll just say uh here's rex in the room ready to go you're not gonna say it out loud well one of them was g and if we're not allowed to say the virus came from comes from china to call it the g variant seems to me is going to create some uh some raised

eyebrows i'm just saying yeah uh so all right so maybe and i suspect we will fill back in i i wonder monica reiki's been texting me and giving me kudos all right good all right thank you so much so tomorrow two o'clock pacific time with dave navarro he has a big uh uh fundraiser coming up that we go to every year. Yeah, so if you're in LA, you got to sign up, come out and see Dr. Drew. And don't forget to check out and look for me on Instagram.

I'll try to do some lives over there at Dr. Drew Pinsky, Dr. Drew Pinsky. And then don't forget Twitter at Dr. Drew and the podcast where we do me and Carolla three days a week and me by myself talking

to most of the clinicians. And Dr. Drew after dark for all your sexual endeavors. Well, I wouldn't quite call it that. But you're – Well, I'm glad we don't have to do that topic here anymore. Were we doing that? They do all the heavy lifting over there.

Right. Oh, Ori wanted to meet Vinay Prasad. I forgot to bring that up. We'll have to – Caleb, can you help out with that? Yeah, I'll set that up. By email or something, an intro email. Okay, great. All right, guys.

Thank you, Caleb. Thank you, Susan. We will see you tomorrow at two o'clock Pacific time with the great Dave Navarro. 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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