Ask Dr. Drew - Vaccine Mandates, Protests & Boosters with Dr. Arthur Caplan – Ask Dr. Drew – Episode 56

Episode Date: November 26, 2021

Dr. Arthur Caplan is a Professor of Bioethics at NYU & author of over 800 papers in peer reviewed journals. He addresses ethical questions about vaccine mandates at jobs and schools. Dr. Arthur L. Caplan is the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at New York University Langone Medical Center and the founding director of the Division of Medical Ethics. Dr. Caplan is the author or editor of thirty-five books and more than 800 papers in peer reviewed journals. His most recent books are "Vaccination Ethics and Policy" and "Getting to Good: Research Integrity in Biomedicine". Follow him at https://twitter.com/ArthurCaplan  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

BetMGM, authorized gaming partner of the NBA, has your back all season long. From tip-off to the final buzzer, you're always taken care of with the sportsbook born in Vegas. That's a feeling you can only get with BetMGM. And no matter your team, your favorite player, or your style, there's something every NBA fan will love about BetMGM. Download the app today and discover why BetMGM is your basketball home for the season. Raise your game to the next level this year with BetMGM. Download the app today and discover why BetMGM is your basketball home for the season. Raise your game to the next level this year with BetMGM. A sportsbook

worth a slam dunk. An authorized gaming partner of the NBA. BetMGM.com for terms and conditions. Must be 19 years of age or older to wager. Ontario only. Please play responsibly. If you have any questions or concerns about your gambling or someone close to you, 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. Hey, everyone. Welcome. This is the beginning of some very special guests we have for the next couple of weeks. Today, Dr. Arthur Kaplan. I put the request in, and my crack team made it happen. Dr. Kaplan is the William F. and Virginia Connolly

Mitt Professor of Bioethics at the NYU Langone Medical Center, Founding Director of the Division of Medical Ethics, author of 35 books, more than 800 papers, all peer-reviewed journals. Most recent books are Vaccination Ethics and Policy and Getting to Good Research in Integrity in Biomedicine. You can follow him on Twitter. Arthur Kaplan, A-R-T-H-U-R, Kaplan with a C, C-A-P-L-A-N. Our laws as it pertained 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. Say, 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. You have trouble, you can't stop, and you want help stopping, I can help. I got a lot to say. I got 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. I want to give a shout out to our good friends at Blue Mics. If you've heard my voice on this show any time over the past year, including right now,

you've been listening to blue microphones. And let me tell you, after more than 30 years in broadcasting, I don't think I've ever sounded better. But you don't need to be a pro or have a fancy studio to benefit from a quality mic. You may not realize it, but if you've been working from home or using Zoom to chat with friends, you probably spend a lot of time in front of a microphone. So why not sound your best? Whether you're doing video conferencing, podcasting, recording music, or hosting a talk show, Blue has you covered. From the USB series that plugs right into your computer to XLR professional mics like the mouse or the blueberry we use in the studio right now. Bottom line, there's a Blue microphone to fit your budget and need. I can't say enough about blue mics.

And once you try one, you will never go back. 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. Anyone who's watched me over the years knows that I'm obsessed with Hydrolyte. In my opinion, the best oral rehydration product on the market. I literally use it every day. My family uses it.

When I had COVID, I'm telling you, Hydrolyte contributed to my recovery, kept me hydrated. Now, with things finally reopening back around the country, the potential exposure to the common cold is always around. And like always, Hydrolyte has got your back. Hydrolyte Plus Immunity, my new favorite, starts with their fast-absorbing electrolytes and adds a host of great ingredients.

Plus each single-serving easy-pour drink mix contains 1,000 milligrams of vitamin C, 300 milligrams of elderberry extract. Hydrolyte Plus Immunity comes in convenient, easy-to-pour sticks that rapidly dissolve in water, make a great-tasting drink, has 75% less sugar than your typical sports drink, uses all-natural flavors, 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

hydrolite.com slash drdrew. Again, that is H-Y-D-R-A-L-Y-T-E dot com slash D-R-D-R-E-W. Be sure to use the code drDrew25 for a special discount. Dr. Kaplan, welcome to the program. Hey, thanks for having me, Drew. And I'm sure I'm not the only one to spell your name with a K once in a while. No, my mother used to say we're the better Kaplans, but yes. The more refined Kaplans. You and I have spoken a couple of times over the years and it's always, I don't

know if you remember, we've occasionally on radio and things like that, you recall? Absolutely. Yeah. And we've had some very, very great conversations. I've always appreciated it, but boy, never did I foresee a time like we are in presently. There was nothing to foreshadow all this when we were talking last. And I think last time we were, if I remember right, it was more about insurance companies directing medical decision-making and things like that. We were sort of getting into the weeds on that, but so much more to talk about these days. So let's get right into it. You wrote an article. Let me see if I can pull it up here. It's okay. Let me get the title right.

It's okay for doctors, I want to get the title right, to refuse to treat unvaccinated patients. And I want to dig into that a little bit because I think that's a frame for an interesting conversation. And maybe that wasn't even your words. Maybe they just stuck it up there as a headline. But the headline on this commentary I'm seeing is it's okay for docs to refuse to treat unvaccinated patients. Tell me about that position. So it's partly a little bit of a provocative headline as headline writers are wanting to do. By the way, you know this, I know this, you really don't get to pick your headline. Everybody thinks you do. You don't for reasons of space and many other odd reasons. So you kind of live with what gets out there. But anyway, what I was trying

to say was this. If you're in a hospital emergency room situation, I understand you have to treat everybody that comes in there. There may be rationing decisions that have to be made. And we can talk about that in a minute about when you're short on ventilators and things. But primary care doc, family medicine, internist, OBGYN, pediatrician, do they have to treat you if you're not vaccinated? And there I would say they don't. Why? Because we actually don't have in this country, we still don't have a right to health care. And so any doctor can decline to start a physician-patient relationship with you for any reason, including I'm too busy. I don't want to. I don't take Medicaid. I don't take Medicare. I'm cash only. You know this, Drew. There are many doctors out there, primary care, who will say, pay me $5,000. You'll get concierge care, right? I mean,

if you don't have it, you don't go. So if you're trying to say to potential patients, I don't want to deal with a safety issue. I don't want you in my office putting me or my staff in danger or people in the waiting room in danger. Plus, if you're not going to follow my office, putting me or my staff in danger, or people in the waiting room in danger. Plus, if you're not going to follow my advice, which is to, let's say, vaccinate, then I don't have to take you on as a patient. And I'll add one other thing while I'm ranting here. A lot of pediatricians were already doing this with parents who wouldn't vaccinate their kids. You know, they would say, I'm not taking you on as a patient because you're not going to vaccinate your kids. You're not following what I'm telling you you ought to do. So I'm not a good doctor for you.

So let's kind of, I want to dig into that a little bit because there is some territory for discussion and all this stuff. Even just the fact that we have concierge services, some people feel that's not ethical, correct? I mean, that can't be the matter of fact. Yeah, right. The pulling out services for the rich when a lot of people can't even get to anybody, that's a problem. Okay. And so would necessarily right to care, which you mentioned, change these capacities of individual primary care practitioners? In other words, let's say we have a right to care in this country.

I may not have the ability or the capacity or the staffing or the room. There might be a lot of other reasons I can't grant you that right to care beyond access and beyond you're not following my instructions, right? Oh, yeah. So certainly people say, you know, I'm full. I've seen all the patients I can. Somebody said to me, well, you could just see them more quickly. I don't think that's a good idea. We don't really want to, you know, it's already, what are we down to,

11 minutes a visit in a lot of places. I don't think we want to shorten that up anymore so yeah but yes I mean doctors are free to say I just can't take on another patient sometimes I say things like I'm going to retire right and as I do that I'm phasing out people uh so they have a lot of discretion that's one thing to keep in mind in the primary care setting I'm not talking about the er yeah but if you're going no i want to we'll we'll get into that we'll get into that so really we're talking about hospital settings but let's keep going with the last part of the of the primary care setting which is you don't take my advice now i don't i don't like that one uh even though i understand it i

mean i'm sympathetic to it let's put it that way. Because part of the job is to deal with that resistance. I mean, my drug addict patients always don't want to take my advice. 100% of the time, we start from some version of good luck or screw off is really what it usually is. But you could argue also that that's a specialized form of care. It's sort of breaking through those resistances that you have to have a certain skill set to be able to do that. So I understand people not doing it. In fact, as I'm talking out loud here, I would argue that if you can't tell lying and obfuscating and manipulation, if you're not aware of that, you should not be dealing with those patients. Right.

Understood. I mean, look, not to try to suck up here a little, but it's almost heroic to deal with tough patients, addiction, anorexia. You know, there are conditions that are really, really, in my experience, boy, it's hard. It's very hard in the practitioner. And some aren't up to it. And some will admit they can't do it. And then others are going to say, look, you and I, you know this language.

We have a contract. You agree to do this. You agree to do that. You break the contract. We're going to end the relationship because we can't get anywhere if you're really not going to do what I tell you for the next 18 months. So here's the deal. We'll go incrementally or, and I, and you may backslide. I get all that, but nonetheless, if you're not really going to play ball with me ever, I'm kind of turning my wheels here. Yeah. And, and though, even that though, I i i worry about that that spot with with my colleagues because

even that has to be managed artfully skillfully let's say because you have to know when you're there and really be there you have to not reject and abandon the patient you have to get them to some sort of ongoing something or at least have fulfilled that obligation. And that's not simply sending them a letter with three referrals on it, which is usually what they get. It's much like how the warm handshake helps with getting people into mutual aid societies. I think we have an obligation as practitioners to maybe it's a warm handshake on the way out as well as on the way in. So I got a question. What about the patient who's violent? Patient who's violent, you should, again, this is a really a nuanced area. If it's in a set,

I have low threshold to bringing law enforcement in. I just, I'm sorry. If somebody's in a set, I have low threshold to bringing law enforcement in. I'm sorry. If somebody's violent, somebody breaks the law, law enforcement comes. That's it, period. That's my rule. And if I have not foreseen that as a potential problem in an outpatient setting, bad on me, not bad on the patient. And by the way, I would go to bat for that patient with the judges and everybody else to say, get that guy into treatment or that calendar treatment. This never happened. This never happened to me because people that are violent in my world, I always have a team around me. And when you have a team, meaning four, eight, 10 people that manage can be easily managed without further violence,

without escalating. This is the thing I'm sort of thinking about these days when it comes to law enforcement. There are de-escalation techniques that we use in a psychiatric hospital. Sure, sure. All the time, all the time, with people that are wildly violent sometimes. And just a skilled group, a unified wall, a show of force of a unified group where no one can be manipulated,

everyone knows each other's strengths and weaknesses, and you just present the wall, calm down it's they do they they now it can be you know it can go beyond that and again you need help sometimes but uh the times when i've seen it in a hospital setting when i've seen it go past what could be managed, and it usually was because it was sort of at the door of the hospital where people couldn't quite get into the hospital. It was rue the day. It did not turn out well for anyone that the law enforcement got involved. They're not trained to deal with that. That's not what they do.

It's not what they do. I've literally seen people killed that way. Where I am, we at NYU run Bellevue. So Bellevue is a pretty jumping joint. And one of the things it does is we treat all the prisoners from Rikers, the city prison. When they come in, if they act up, if they get violent, we may say, you only get treatment here with a cop present I've seen people treated with shackles um so I'm not saying you can't do it but what I am saying is there are primary care people out there are going to say I can't manage that yeah I wish I had I wish I

get the knowledge yeah and they shouldn't yep I agree they should. I agree with that. So now, and we are now. That point, you know, there are some limits. Yeah. And to put even a further spotlight on your point, what now really we're doing is we're backing into the front door of a hospital is what we're doing. We're talking about now we can't handle things out here. It's different inside the hospital walls, which it is different, right? And the ethics that apply are different as well. All right. So you and I both agree that

in the hospital walls, the place that most people roll in, the ER, we have an obligation to treat, obligation for care, period. I've been in the ER when really serious criminals have come in there. I didn't want to treat for what they had just done. had right i did it and so that's that but now we get into the allocation of resources how does that change the diathesis or the considerations so this came up in covid in a big way because new york city last year and other places this year, Idaho, Seattle, they've really gotten crunched on beds. They don't have enough. So many people got sick in a narrow period of time that they came to the ER. We took them in, but we knew that we didn't have enough beds, ventilators, and i might add dialysis machines

because covet definitely requires often kidney support that fails too um what are we going to do so one argument was we'll just not take the people who weren't vaccinated they brought it on themselves they're responsible for their plight I heard this argued by some of my colleagues and we're not gonna accept them. My view was we can take not being vaccinated into account or even having COVID into account, but only as it predicts how well you're gonna do. So if you're really so sick with COVID, your lungs are

shot. We know you're not going to, it's extremely unlikely you're going to make it. We might say then we're going to prioritize somebody else who has better odds. Is that different from what we would do in any rationing situation, say a train wreck or a terrorist attack not really but there was a lot of anger i'll just say against people who wouldn't vaccinate and there was a temptation you had to fight it to say don't punish them you know this i'm telling the uh authority on this there are plenty of people who self-harm or people come in commit suicide. We don't say we're not going to treat you and we take them on. But sometimes COVID was relevant to predicting outcomes. That makes sense?

Kevin Kennedy 06,00 Yeah. So I want to, again, zero in on these things. Sometimes much like a lot of ICU care, you know when somebody's going to be benefited from that ICU care, let's put it that way, and when somebody isn't. When they're too far gone or going too fast, you kind of know what you're getting into. And even, you know, I used to say, I used to work in ICU for many, many years all the time, back when internists could work in an ICU before they were hospitalists. And yeah, I think that's a missing piece of internal medicine right now, but in different conversation. But there were plenty of people

that would come in and that we were responding to the family demands. And I felt like I could pull them through, but that the patient would wish that I hadn't because I knew what was coming in the next six to 12 months, optimally six to 12 months of survival in horrific circumstances. And you could argue, you could make a similar call with COVID, couldn't you? Jim Grant Yes. And in fact, we did a little test on this. I asked our ICU people, as you can imagine, they're pretty good at Bellevue. They see a lot of ER and ICU transitions. I asked them to predict to me based on, let's call them biochemical measures, ability to do oxygen intake.

I'm going to say 99.9% accurate. They knew who was coming out. They knew who wasn't going to make it. And I'm not talking six months. I'm talking within a week. So it seemed fair. In fact, yeah. In fact, one of the questions I had for all my ICU nurse and doctor colleagues was, that's what you do all day long working in an ICU. Why did COVID burn you out? And I, you know what I mean? This is nothing new in an ICU. This is just what ICU work is with people dying most of the time. And what they told me was- So I'll answer that. Yeah. What did they tell you? Go ahead. Well, they do make decisions about

starting and stopping and is this worth it? But they really were pushing numbers like they'd never seen before. And then there was anger. There was anger that these people were perceived as putting them at risk because they had infectious diseases. And you'll remember in many places they didn't have protective gear. So we had people running around trying to grab some mask from somebody or put on a garbage bag to wear, and that really angered them. So angry, which is an interesting response. i'll deal with that in a second what the other things i heard was young people that bugged them understandably and difficulty predicting these outcomes that they at least through much of the pandemic the the the the the

what's the word i want to look look for A word like vagaries or sort of the strange manifestations. The peculiarities of this pulmonary syndrome made them feel helpless, made them feel helpless, and they didn't like feeling helpless. I think there's some of that. Although, again, if you put somebody in the unit, I'll tell you where the real triage decisions came up. It wasn't in the ER. We just referred them on to the ICUs.

And as you know, we could stretch beds to cover and make it sort of an ICU. And okay, we did that. That's the ethical thing to do, stretch. But they knew after three or four days, some of these folks were not coming out and they were giving up faster to make room for more people. So the toughest decision wasn't the intake. It was saying, I'm done. Kevin Patton Davis, The giving up.

Mark Havard, This isn't going to work. And I got Art and he's going to do better in here than this guy is. Kevin Patton Davis, Let me ask a terrible question. And I don't know if you're going to be able to answer it. And I don't know if anyone can answer it because it's a terrible question, which is when I spent a lot of my time in the ICUs, there was tremendous frustration with the over-utilization of ICU services for people that had no probability of a good outcome.

If there was something pushing the hand, so to speak, to end those fruitless and frankly excessive suffering that was incurred by the patient, some doctors and nurses would like that, would prefer that something push them so they could justify ending end-of-life services that are really fruitless. Did any of them feel that way, or could they not admit that to themselves, or was that too horrible a thought? Most of the patients with bad COVID- You get what I'm asking. You get what I'm asking. You get what I'm asking, right? Yeah. I do. A lot of the patients they were dealing with COVID-wise, intubated, non-communicative, and really often

no relatives around because you couldn't let them in. The group you're talking about, the invisible hand sometimes becomes the relative who comes in and says, what are you doing to Drew? This is awful. And I think you're hurting him and harm him. We didn't have that trigger. It was all the burden of decision onto the caregiver to say, I see, I see this guy is not going to make it. Yeah. But you know, the physicians that welcome the family that says, stop this fruit fruitlessness what they normally get is when's it going to get well do more do more do more and the doctors and nurses are like no this is not this is terrible so it's an interesting again this this is this level of conversation about covid in the icu is not being had publicly i'm afraid no it's concerning. And again, they felt the burden of decision was completely on them.

Even if you don't want to continue, you can hide behind the, you know, the aggressive family's view, do everything, religious miracle, something's going to, at least it's not on you. Right. You may think it's wrong, but here it was all on them. Yes, I get it. I get it. That, that, yeah, people, which is a whole, I think this is what we talked about last time, if I remember, one of the things we talked about, which is the utilization of end of life's care that is so overdone, so, and, and nobody in medicine

thinks they're doing something worthwhile. Mm-hmm. I, I mean, again, they again they just aren't allowed to use their judgment they have to follow whatever the wishes are whatever the demand dates are and things like that and that has that has not changed has it it hasn't much a little bit toward uh shall we say a little more Frank discussion once in a while with the family. But in all honesty, even when that discussion starts to happen, it's like three hours before they're going to die anyway. So it's really nothing done early enough. I was hoping COVID would start to get people to

talk about end of life issues. I mean, for instance, I mean, I'm sure you're thinking about this. There were some studies on men admitted to nursing home and the average duration of admission after admission before death was six months. It doesn't mean that there aren't people that last for years. There are, and we could keep people alive in crazy suspended states for a long period of time. And we do it again, not necessarily because the patient wants it. The patient did not leave any directives. The family wants it. I'm super clear. If I am so far gone that I need somebody to, two people to turn me, two people to feed me, forget it. Palliative care. Thank you very much. No, no, no. And I don't get this generated. I'm going to jump in for another lesson.

We're actually exploring sort of the little bit of the underbelly of COVID care. So this drove me even more crazy. You know what we were short of? Palliative care. We weren't set up to take all these people in and then somebody says, well, we're going to discontinue them. I mean, you're not going to do great on the vent or the vent plus dialysis shift them to palliative care so we're shifting them they're not set up for infective patients i can't tell you the number of people who died alone in a room no visitors nobody coming in and i'm not saying palliative care

was jumping up and down about it but we we never planned for it. So the honest truth is one area that I did learn something was, you have to have iPads, you need telephones, you got to say to somebody drew your dad's in there, you want to put on the protective gear and take your chances. We'll let you do that if you want to be in the room, but we weren't doing it. People were like throwing a tray of food in the room and running weren't doing it people were like throwing a tray of food in the room and running away and remember too we had deaths not just doctors nurses staffers room cleaners you

know it was was dangerous in the early days to get in there they didn't know what the heck was going on so i'm a fan of palliative care you and i are both going to sign up for it if we get into dire circumstances, but we didn't have enough and we didn't know what to do with infectious disease deaths. Palliative care was built, as I think you're well aware, for cancer. That's the model. Yeah. And advanced age and, you know, multi-system, whatever. Yeah, and it's really, I was hoping that COVID would bring more conversation, for encourage people, but we publicly didn't have the conversation about the way older people were being taken down by this illness so much and what that meant and what to do with that.

It was a missed opportunity. So I'm gonna be a little personal here. I haven't been personal enough. My mom died of COVID in a nursing home last year. She was in Massachusetts. She was 94, pretty healthy. I mean, had some disabilities, but liked her reading her books and playing her card games.

And she was one of those people who said, I'm never going to a nursing home. And guess what? She adapted to it and made friends and was having a final time. The staff definitely brought COVID into the facility because the people inside didn't go anywhere. So, you know, it was the nurse's aides or people coming in who brought in the virus. I think one thing people aren't aware, if you have everybody in a double room in the middle of a plague, you're going to kill both of them. You know what I mean? There's no, you can't isolate anybody in a nursing home. They weren't built for this.

My mom was one of those people who died with nobody in the room, my sister, tapping on the window, holding up my boy, iPad, that sort of thing. We did not treat our elderly well in COVID. And we still John Greenewald, the job. It's like we haven't been honest about that. It's like we have not really because if we were to sort of focus on the population most damaged by the illness, which is what we usually do, we'd prepare for that.

It reminds me, what you're describing reminds me, you know, I used to, when I was in training, we had an infectious disease building that was an old tuberculosis and I think polio building. And so it's all designed with windows outside the room and then holding chambers and this and that and uh i remember thinking oh my god what a bygone era how terrible you know i'd be like oh how did they do now we've taken it one

step worse we put we put people into those situations but not giving them all those sorts of uh necessary elements for for sustaining humanity their humanness yeah crazy uh one other group that never got attention and then i'll get off the dark side of this people with intellectual disabilities in group homes the death rate was i don't know if you know this was nine times what the rest of the population was that's a neglected population too they you know people with adult down syndrome that's the kind of folks i'm talking about crammed into institutions understaffed uh just awful and again often overweight overweight no infection control policies a lot of secretions sometimes. They got Fodder-Willis syndrome.

They got other, I mean, it's like, some of them have genetic reasons that they're overweight. Some of them are just overweight because they got nothing else to do. I wouldn't say the world's best diet is made available. Or the meds, the meds to settle them down, make them eat more and stuff. It's all kinds of crazy stuff.

Yeah, yeah, I could see that. Those homes have always been horrific and gotten little attention yeah that's a that's a great point so okay so let's let's flip over to vaccine mandates if you don't mind i'm just wondering if anybody's still left listening to us after that series of ours my god well i i they're hanging. They're hanging on. They're hanging on. They're waiting for the good stuff. I just, no, no. I just think we have to have these conversations. No, I understand. And better with a medical ethicist than anything else, it seems to me. Especially because I, if you don't mind me pulling the curtain back, you have a wife who's very, you know,

very much engaged in hospital administration. And so you're familiar, and you've been a professor in a medical school setting. So this is all familiar territory to you. It's not as though you're just, so many people are just coming to these issues or just learning how to pronounce medication they've never heard of before that we've all been using for a hundred years.

And they magically have opinions about all this stuff. So strange. But back to vaccine mandates. So let's talk about, well, maybe we should talk about public health mandates generally and the sort of parameters or limitations of public health mandates. I don't have a good beat on that. And who should be making those mandates? And should there be a, I don't want to say a due process, but a clinical pathway to how a mandate is defended? Is anybody thinking? It seems like that was all thrown out the window this time.

Is that being discussed? Yeah, it does. Well, first, let me say, years before COVID, I pushed through a mandate in hospitals and nursing homes for flu shots. This was my idea that if you're going to work in a nursing home or hospital, every year you had to get a flu shot. And we mandated it. We started in NYU, we passed a law in New York State, and it's basically national policy in the US and Canada. When that mandate came along, I knew that there was going to be resistance. Some people don't want to get a flu shot. Some people don't like shots. They have their own views sometimes about how to avoid the flu, healthy eating, lots

of exercise, so-called immune boosters, which I don't believe in, but okay, they didn't like it. Still, it seemed to me we had to argue morally every year 50,000 or so people died from the flu in the winter months, particularly in the colder climates, and we got to protect protect them and that's your obligation. The duty of the healthcare worker is do no harm. Duty of the healthcare worker is protect the vulnerable. Duty of the healthcare worker is to make sure that patients come first, not your choice. So I'd already been thinking about the principles behind mandates for a while and that's what I thought about when we got to health care mandates for COVID. I think for health care workers and people who work in

nursing homes and around health care and EMT and ambulance, they have special duties. They really have to get vaccinated. They're dealing with very, very vulnerable, often immune, suppressed people. Different argument is what do you do if you're an employer and you want to stay in business and you want your workforce mandated so you can send out the salespeople or you can bring people into the office? That's an employer-based mandate. It's different from what I just said about the healthcare workers, but again, employers have a lot of discretion. And then we get to government mandates, either Joe Biden's mandate, we're going to do it through

OSHA, you know, as a safety requirement of any workplace, or many state governments saying we're going to mandate for whoever city workers restaurant owners whatever so to answer your question as with all things in this vaccine coveted world it's complicated because i think it's different mandates for different folks. But you've taken me over to vaccine mandate, which I'm going to keep drilling on in a second, but I first want to step back and talk about public health mandates. Okay, just masking or quarantining? Yeah, I feel like that the risk-reward analysis was not performed very often. And the mandates were coming from people that had no background in risk-reward analysis or making clinical decisions. And so I was watching this all go down and thinking there should be requirements for clinical pathways or ways of defending the decision making or something that

that it's all was very arbitrary i asked the the head of the clinical direction of public health in la county i said here's some data why are you doing i forget what i was asking her about i was asking her about uh i forget what it was but i was saying you know here's the data here's the direction we're going. Why are you making the decision you made? And she goes, I like my debt. And her response was, I like my data better. And I was like, well, that's subjectivity is now the criteria for how you make decisions.

I thought, wow, that we are really in a strange time. But is anybody thinking about this is my question. Are we looking at the public health decision making and the way the mandates were provided and the lack of risk reward again just need point no further than all the mental health consequences from everything is somebody thinking about this so pre-vaccine is where we're in and what we were going to do to either lock down or force behavior and I'm going to give you an answer that you're not going to like but my impression and I talked to a lot of political people a lot of policy people is that panic drove those decisions too many deaths no doubt no doubt in my mind no no my mind it was pan i i saw it i i saw it coming and it was panic driven by the press the fact that the new york times editorial board

had a position on what physicians that the cdc should be doing is insane and more insane than anybody listened to them well listen so here you've got uh pre-vaccine again some parts of the world are like china south korea australia absolute lockdown right they're saying the only way to do this shut everybody in and that's what we're doing so we're alert to that we're watching that as that seemed to work. And then you're asking a different question. So who's computing the mental health cost or the employment cost or the cost of the gross national product or whatever? Something.

Yeah. Some consideration of consequences. Yeah. Yeah. And no, the people who were charged with battling the pandemic were charged with reducing the death rate. End of story. Not much more discussion. I suspect your CDC official was saying to you, here's my data. I'm making up a number. 2,000 people a day are dying. I got to stop that. What happens to their mental health? What happens to the economy? What happens to daycare?

What happens to kids losing a year of school? Not my problem. I do this. So siloing drove a lot of the initial, in my view, policy decision making. And I'm not even here, I mean, I get the same idea of, you know, there's huge costs to doing what a lockdown, a full lockdown meant we haven't even told them up yet, much less, you know, understand what the risk trade off was. But the short answer to your question, by my view, you gave public health officials one job, stop the deaths from the virus. And that is what they did or tried to do, sought to do. I don't know.

That seems like a, I have the voice of my father in my head, who was a family practitioner for many years, worked in the darker days of infectious diseases and i just can imagine him going wait a minute they they they shut the world down for respiratory yeah dangerous respiratory virus dad a respiratory virus was it like yellow fever is it like polio is it like tuberculosis which we were fighting is it like smallpox no no it's a respiratory virus that most people are in trouble with what he'd he would have been just gobsmacked and so unfortunately i have that in my head you know i'll tell you

what also shaped this response a little bit people forget because our memories are short we were freaking out over ebola ebola yeah we were travel lockdowns people were doing uh bring strategies that you can't leave this zone. You know how hard it is to get Ebola. You got to pick up a body, basically. It's not airborne. But people were going nuts. And it showed that we weren't ready to manage public health threats. And yet when I look at the HIV epidemic, which, you know, a severe

epidemic, a dark pandemic with a 100% fatality, we learned how to shape behavior and change behavior and educate and bring everybody on board and create treatments and not panic. We did it. And that was where my affection for Anthony Fauci developed. He was my guiding star during all that. And I don't understand what happened this time. The panic. I saw the panic. I saw the panic coming. You're absolutely right. The panic is the deal. The panic is what drove so much. And I hope people are really looking at that and being honest about it. Go ahead. One tiny bit of happy news.

We haven't had much of that in our conversation, but here's a little happy news. Remember, the way we beat HIV was through pills, not vaccines. We still don't have a vaccine for HIV. Merck is about, I'm going to say within six months, to release antiviral pills that look pretty promising for COVID. Hopefully, they'll do what HIV medicines did, turn out to be preventative. Well, that would be a hell of a step to have available as another kind of a tool.

And we may have that before the end of next year. I'm also going to tell you, even though we're all hepped up about Moderna and Pfizer and J&J, there are 30 other vaccines, some inhalable, some on a Band-Aaid that are still in the shoot they may last longer they could be cheaper if you said to me what do you think is the biggest source of vaccine resistance don't you laugh at this i think a lot of people are afraid of needles get them to inhale it i agree with you get them to wear it on a band-aid i think you'd get over

a lot of not all of it but some serious vaccine resistance would tamp down. So I think there's good news coming. Better news. Better news. I completely agree with you. I totally agree. But the big issue with resistance and so much of the craziness going down is trust. The trust has been violated or has been sort of eroded in public health and physicians.

My profession froze in place during the panic and were afraid to say anything, I think because so many of them are employees now, which was a shocking thing. And and ceded all of their responsibility to the public health and to the decision makers, bureaucrats who are not really not designed again, not designed to make risk-reward analyses, but we froze, handed it over to them, and antics ensued. But what was I just saying? God darn it. The COVID did leave me with this problem where I lose my train of thought regularly. That is my one. So I'm going to jump in, Ben, going to take advantage of you. You know what else is parallel to this? We'll have to do another show on this sometime, but it's the opioid epidemic and pain control. So everywhere I go, we're like, I can't get pain medicine. Why don't you do some PT? And you're sort of like,

PT? The heck are you talking about? This guy can't, he's like in agony here. His back is killing him, whatever it is. And I think, again, we panicked. I mean, I get, I'm not denying that there was an opioid epidemic, but to say we're going to switch from that to we're not treating pain anymore, or I'm nervous to prescribe pain meds. So I lived through that one. And I can tell you the day, the reason we ended up with the opioid epidemic or the sort of principle dynamic was they started prosecuting physicians criminally and civilly for patient abuse for inadequate treatment of pain. It was no longer a malpractice issue. And when in North Carolina, Florida, and California, several suits went through, millions of dollars, people in prison. That was it.

Doctors, again, froze in place, sent anybody who needed pain medicine to pain management. Pain management took the position that pain is what the patient says it is, and pain control is what the patient says it is. Therefore, you don't even really need a doctor. You just go to the counter and tell you, doctor, what you need for your pain control. Cause it's what you say it is. And it was, and my patients, it was game on game on at that point. Then it was actually Jeff sessions. Cause I was, I saw sessions do this. He said, I'm going to stop this thing. And he put about a half a dozen doctors in prison, did the same thing on the other direction for overprescribing of opioids. We froze it in place again and are unwilling to prescribe opiates.

It's an insanity, an insanity. Have you seen, is that, am I getting that correct? Yes, I think you are. But again, what I'm pointing to is we don't seem to be able to come up with temperate positions. We come up with either we're shutting the world down and no one's moving anywhere and until we get these deaths under control no one's going to school don't go out and vacate don't go anywhere stay in a two by eight apartment and we'll see in a year or as you're telling the story you know you're well

sorry you got pain but there is PT I mean I'm using that as a, I don't mean to say PT. No, I get it. I hear it all the time. Plus, we have a great new treatment for chronic pain when they worry about the chronic pain patients and the overuse. Suboxone really works for chronic pain. And for some reason, there's some weird energy about not using Suboxone. It's like, I can't do it. It drives me crazy.

Anyway, so back to vaccine mandates. I said, I wanted to drill in that a little further. So let's look at the, let's just look at the case of California. You've mentioned that it's not, it's not a one size fits all. It's a little complicated. There's OSHA, there's employers, there's healthcare providers, and each of these need to be considered in their own terms. But I, but I think where a lot of the energy is around children and mandates. And so

in California, we have a mandate for under, for children now, for children. My concern about that is not so much that the mandate is a little, I mean, it's a little extreme, but my fear is that whenever you find serious reaction to vaccine therapies, meaning vaccine panics, vaccine resistances, vaccine conspiracy theories, it's when children die because of the vaccines. That's when people go off the rail. And although thus far, the myocarditis we've seen from the vaccines has been mild and reversible, when we start doing this on a large scale, you're going to see some bad outcomes. And I'm fearful about that more than anything else. Do you share that with me? Well, this is interesting. You were talking to somebody who's very pro-mandate, very pro-mandate. You heard me say I believe it for healthcare workers. I actually do believe it for employers. If they want to

say I've got to be safe here and I got to maintain my business, I get what they're doing. And as you know, we're in a nation of at-will employment, basically. So if they want to impose that, they can impose that. Those people who say the governors are going to challenge the OSHA requirements, forget it. But I don't favor mandates for kids yet. And it's because, partly of what you're talking about, Drew, the goal is to get kids vaccinated. And I'm not too worried about heart inflammation. I think it's worse to get COVID than if you get vaccinated. But okay, you got about 40% of the public that seems to say they're going to get their

kids vaccinated. There's a big segment that says they don't want to. I'm not ready to go to war yet over the kid mandate. We only have emergency use authority, right? It's not fully licensed vaccine. I wouldn't try that because you're going to get caught up in court. And I also believe here's what's going to happen with parents. They're going to find out, hey, I'd like to fly to Europe or Hawaii, and I'd like to take the kids.

Guess what? If they're not vaccinated, they're not going. You'll get peer pressure people are going to start to say is johnny coming over to play with susie is he vaccinated um you'll see that kind of forces at work and i think you'll get enough people vaccinated so that we can answer your question and say we really you know doing good here is this what's best for the kids. I believe it will turn out that way in terms of deaths and hospitalizations for kids. You know, kids are pretty sturdy, but it's still the eighth leading cause of death right now, COVID among children

in the newly sort of eligible group. But I am actually with you. I would not push the trigger yet on a kid mandate. And i'm all for adult mandates but yeah i don't think so so you're i don't want to turn into a civil war for kids well not only that i mean we meet on the on the territory of again risk reward which is you don't want to you know you're not saying you know if you're 65 saying, you know, if you're 65, mandate's fine. I think we should be getting that. I mean, why aren't you? What's going on? And then, and that's, there's a subcategory there I want to get out in a second, but at least there should be real significant energy to get everybody vaccinated. And then we have the issue of our collective responsibility to one another, reduce viral replication and as much

as we possibly can. And I believe that's a serious responsibility that people should take very, very seriously. And then there's risk. And as I said, you don't want to die on the hill of making healthy kids sick. Healthy kids that get an infectious disease and have a problem we all understand that's not good that's no bueno but when the parent advocates and gives something the doctor gives something that makes a child ill and maybe dangerously ill again we don't know that's that's going to be bad that's going to be bad for everything so that's why i'm afraid another kind of weird

yeah full licensure is a minimum before you start doing mandates. Let me say one other thing about kid mandates. Let's remember, we have a ton of kid mandates. They're in place. We have MMR. We have hepatitis. There must be 10 of these things. Some states mandate HPV. I think there are three of them. So there's a bunch of shots that are mandated. These may turn out, the COVID ones, to be safer than those. It's entirely possible. So we have a framework. We understand what it means to look for the right information. But I think given the dangers that kids face right now, they're not huge. Given the, well, let me say one other thing. Here's another stupid aspect of our policy

on COVID. Why aren't we testing every child before we send them to school? Why don't we have home testing everywhere? I mean, I don't want to get into you know masking and uh putting people into uh torture chambers of isolation and all the rest of it what kind of dopes are we not to test every day every kid before they go to school yeah yep i i'm with you and and some in straight you know some countries and some states are doing that. It's a great effect. Show me your antibodies of natural immunity. Show me your vaccine cards.

Show me your antigen test. Show me your antibodies. Whatever. Show me data, and then we'll behave accordingly. It's like, what the hell happened to us? But anyway, this is back to that public. I fear the public health officials are often, well, here in L.A. County, she's a sociologist. She's not a clinician's a sociologist.

She's not a clinician, a sociologist making these decisions. So that's gravely concerning to me. But anyway, back to the population of 65 plus and mandates, not mandates. I'm sort of, I'm a pragmatist. I just want to help people. I don't like government mandates because I don't know that's the government's responsibility, but I'm very much into getting people to do the right thing for themselves and others. What about medically unnecessary procedures? I mean, the idea of advocating a procedure that is medically unnecessary as a physician

was always, for me, one of the most egregious violations that you don't do that. And, you know, we have new data on the vaccines for people with natural immunity and it's a sort of a, it's a moving target right now, but it's certainly three or four months ago. It looked like people with natural immunity didn't need vaccines and yet they were mandated to take vaccines, to be able to go into restaurants and to do anything. What about medically unnecessary procedure? Do we just sort of

push that aside for now? Well, I think you got to pay attention. What I see on the data there is natural immunity is not as good as getting a ghost immunity because you don't know how much virus load you've been exposed to. So you may get a mild immune response from a natural infection. You could get a full bore one. Would it be cheaper to just test everybody and avoid the vaccine? No. So the cheaper strategy is to just lay the vaccines out for the, certainly the high risk groups.

Um, I'm okay with mandating vaccines still, but I agree with you, you've got to watch the data. By the way, for instance, for instance, go ahead, you keep saying I was gonna say, people sometimes say to me, look, I'm not anti vaccine, but I had the natural immunity. So let me off the hook. The other question is, can you really sort everybody out that way in a way that is reasonable if the levels of infection are high? If the levels of infection drop down, then the argument starts to swing into your camp and it's sort of like, well, what are we doing all that for? It's sort of fading out. Right. I get that point. And that's something I hadn't considered. But I personally, there are not widely commercially available B-cell antibody and neutralizing antibody screens you can get.

I've been getting them. And I can tell you, I've sustained nine months later at the highest level measurable, but I couldn't do anything without getting a vaccine. Even though it was biologically very clear, I didn't need the vaccine. I went ahead and got it. And it's probably, you know, I went from very high to very, very high on my neutralizing antibodies. Okay. I feel all right. I had a terrible reaction to the vaccine. I woke up with a raccoon's eye. People here that watch my stream know that, which is the presenting feature of the transverse sinus thrombosis from the JJ vaccine. So I was like, oh shit, here we go. But everything turned out fine. And I'm glad I got the vaccine. But again, it was clearly medically unnecessary as a physician looking at the data and saying, you know. And I just wondered where medically unnecessary procedures.

They just not entered into the conversation, it seemed to me. But I get why. You know why they really have it? It's for a funny reason. When you used to worry about it, it would be from a clinician's point of view, I don't want to expose you to any risks. And there are always some risks of a procedure. Okay. From a public policy point of view, it was always unnecessary cost. We bought all the damn vaccines. There's no cost issue. We own them. You own them. There's some shmillion

of them up in warehouses. Nobody's saving any money by not using them, right? You don't save a penny. You bought them. So that issue is off the table. There's no cost saving. Yes. Gross, but yes, I get it. Which does bring up the next topic though. So I got to take a break. we gotta just do some some ads and things like that here but but the but uh what i what i want to um or caleb can we just do that all at the end after i say goodbye to dr caplan uh no it has to be a mid-roll okay i'll be in the middle here okay um but when we get back i want to talk about um what what those vex those shmillion vaccines are doing up in their warehouses, and what is our obligation to the rest of the world, which I think is another

massive ethical problem. Okay, we'll be right back. Here with my daughter, Paulina, to share an exciting new project. Over the years, we've talked to a ton of young people about what they really want to know about relationships. It's difficult to know who you are and what you want, especially as a teenager. And not everyone has access to an expert in their house like I did. Of course, it wasn't like I was always that receptive

to that advice. Right, no kidding. But now we have written the book on consent. It is called, It Doesn't Have to be Awkward, and it explores relationships, romantic relationships, and sex. It's a great guide for teens, parents, and educators to go beyond the talk and have honest and meaningful conversations.

It Doesn't Have to be Awkward will be on sale September 21st. You can order your book anywhere books are sold, Amazon, Barnes & Noble, Target, and, of course, your independent local bookstore. Links are available on drdrew.com. So pre-ordering the book will help people, well, raise awareness, obviously, and it'll get that conversation going early so more people can notice this and spread the word of positivity about healthy relationships. So if you can, we would love your support by pre-ordering now.

Totally. And as we said before, this is a book that both teenagers and their parents should read. Read the book, have the conversation. It doesn't have to be awkward. On sale September 21st. Dr. Arthur Kaplan is our guest today. He's a medical ethicist at the Langone NYU School of Medicine. Where? I can tell you his position if I pull it up here. Give me a second. Oh, there's Dr. Kaplan. Your professorship, is it at the medical school or is it in the university generally? Medical school. So I am, for those who know NYU, there are two separate campuses and I'm up on the medical school campus and we might as well be in Bulgaria compared to the rest of the school.

Right. We don't have, I think I'm one of the few people that transits a little bit, a little bit. Yeah. That's where, that's Southern, USC, the University of Southern California was like that. The health sciences campus was in East Los Angeles and the main campus is down in Central. Exactly. And there the tween shall meet. He is the William F. and virginia connelly

professor of bioethics at nyu langone okay so let's talk about the schmillion vaccines that are sitting around in closets somewhere what it feels and it feels like another area to me where we have been woefully unethical i don't know how else to call it i mean just we just have not been thinking it through or somebody's not been thinking it through. I don't understand what's going on. All through this pandemic, I have multiple times said to myself or to people in leadership position, who made this decision? Who told you to do that? Why did you do that? I really, I've found, I talked to school board members about that. I talked to county health officials, to state health officials. Like what, where did that come from? And this is now another one. A shmillion vaccines in a closet. Why? Why are we doing that? Well, it's partly

because public health policy is really devolved to the states, and then they give it authority to the counties. And so it is the most decentralized. If you ever wanted to fight a pandemic in a bad way, you'd say, well, how about we have 2,811 decision makers with inconsistent policies? That's what we've got. The federal government controls vaccine policy if it concerns travel inside or outside the country. Basically, after that, it's pretty hard for them to sort of tell anybody to do anything. So they make suggestions, right? CDC recommendations, but they can't enforce them. Anyway, so let's go to the million vaccine question because this is interesting ethics about zero percent of Africa has any vaccination that most of the little in South

Africa and nothing else anywhere else and there are a bunch of other countries Indonesia India they need a lot more vaccine we have a lot of vaccine, by the way, so does the UK. A number of other rich countries have vaccine supply. China, too, as a matter of fact. We don't seem to care about getting it to the rest of the world. And I think that's partly because we literally don't care about what's going on in the rest of the world if we have a pandemic problem. As our problem diminishes, we start to make political space to worry about elsewhere. But it's very hard for Republicans or Democrats to go to the American people and say, you know what, you might need a booster, or maybe we're going to save some vaccine supply for your kids but i gave it to botswana because they need

it because they don't have any tough politics there just hard to do morally it makes sense to do it because we should try to save their lives too and i think many people have heard this they're incubators for new viral strains that can really cause us trouble. So you want to tamp the thing down worldwide, not just in your own country. But that's part of the answer is politics. Here's the other answer, which people who want to send vaccines overseas are not honest about. You don't just get a plane, fill it up with vaccines, and fly it to Ethiopia. You need roads. You need a refrigerator at the other end. You need sterile needles. You got to teach people how to give the vaccines. And guess what? Not every person is necessarily jumping up and down saying, yeah, I'd like a vaccine,

because they read the same social media we do. So you already have vaccine hesitancy. I'm going to ask you a trivial question, Drew. You'll like this. You know, we've been trying to eradicate polio worldwide. It's a big campaign gates foundation rotary international we're getting pretty close i think the four or five countries still have some endemic polio how long do you think it took to get there get rid of polio i'm not trying to since the i'm not trying to understand the question since the advent of the the to get rid of polio. I'm not sure I understand the question. Since the advent of the... To get rid of polio, how many years? I feel like that's been going on for a long time.

I don't know how long. 30. Yeah, yeah. So you got massive... I remember people saying it was over and then saying, oh no, over is impossible. It's never going to happen. Yeah,'s never gonna happen that's what i remember so it's pretty close but it took 30 years you had to have people go into villages you know to administer the vaccine they don't come to you you got to go to them you had to train people to do it for those who don't know polio is an oral vaccine you know

deal with needles and refrigerators and all that stuff. When somebody tells me from the WHO, well, we ought to just go vaccinate Africa, I'm thinking to myself, A, not very likely, most of those countries couldn't do it. B, which countries go first? Because guess what? You have to triage there too. You're not going to just load up airplanes and send them all over the world and administer vaccines. So before you get away with an easy out, you tell me which countries we ought to go to first. Finish Indonesia, which could take up all the shmillion vaccines we've got. Start fresh in Algeria. Where? So that's been my whining on this issue. Get real. You need an infrastructure,

roads, refrigerators, train people. I saw it with polio. I know what that takes. And you've got to start to set priorities because you're not going to do the world all at once. Sorry, I'm really ranting about this, but it irritates me that people sort of set up as well. We could vaccinate, you know, with boosters here or send them all to the rest of the world and they'd get vaccinated. You would be lucky to send them to the rest of the world, not to add in corruption, people selling stuff to third parties, shall we say. I don't know that we're going to be shocked. I don't mean to sound like the movie Casablanca, but there's some cheating going on out there. Yeah, I get it. And I had not thought about that, but that's very important. So we just sit on our chameleon vaccines? Is that

the ethical thing to do? Or do we find a way to put it out there? I would target a couple of places. Here's one idea. Do we do our allies? Might be nice. The Chinese like that strategy. They're always running around trying to vaccinate somebody where they want to get their crops or their minerals.

Vaccine politics. But we could play that game a little bit. I think our vaccines happen to be better than theirs which is another debated point but i think so or just go where you think the uh next big breakout is going to be where they do have the infrastructure and start there i think we could answer it but let's not sound like we're having a discussion in the dorm freshman year about trying to vaccinate the world. That's not realistic.

Yeah. Well, and didn't Gates got into a whole lot of trouble with the tribal leadership, them saying that he was trying to harm the citizenry or something? Remember all that story? Oh, I do. It was, he got into trouble. The polio campaign got in trouble in Afghanistan. They were accused of getting people's DNA when they were trying to confirm the death of bin Laden. And they started to shoot the vaccinators.

So, you know, let's put it, I'll be blunt. Here's countries I'm not going to start with. Ethiopia, Yemen, North Korea, Sudan. You get my point. I'm going to try a little easier, perhaps, on my road to help. I'm not saying we don't help. Let's do it. Think about this a little bit. asking the most difficult questions I can ask you because I only have this one to crack at you. So let me ask one more difficult one. Why is it different to suppress viral replication in, let's say, Ethiopia or a place we could make an effort to go or someplace we could make an Indonesia as opposed to trying to reduce replication in children and adolescents in this country? Well, one superior over the other. i think there is i think their need is bigger than our kids right now we have enough to do both by the way i don't think it's either or we could

probably get pretty far in indonesia and then they're still a big threat to us in terms of ginning up new viral strains that just undermine the whole vaccination effort. One other factor. So let's say we've had this discussion about natural immunity, but I'm going to add in a different twist. Are we giving out third shots as boosters or are these really three-shot vaccines? You know, and listeners know, HPV is a three-shot vaccine. I don't know if you remember polio is a four-shot vaccine. There are a lot of three-shot and four-shot vaccines out there. I tend to look at the Moderna and the Pfizer and think, you know what? Those aren't boosters. That's finishing the run on the vaccine. If I'm right, then you got to think about that when you go overseas,

because you don't want to be there eight months from now and said oh and by the way it's no good because now we got to give them all a third shot so that way worse yet worse worse yet we we we didn't plan for that third shot now we have to start the series over again shot one and give everybody three listen johnson and johnson is clearly johnson jnj is clearly framed like a two-shot series. Absolutely. It's pretty clear that's what that is. That's not a booster. The only reason we don't know this or haven't established this is we were in such a hurry through warp speed trying to get to vaccination.

Trump was pushing. They wanted vaccines. When we got efficacy out of two shots two weeks apart, people said, well, great, let's stop having people die. Let's not lock people up. Let's, you know, overturn all these economic disasters that we're causing. Okay. I agree with that, but we didn't really learn what's the optimal spacing. We didn't really find out what the third shot was going to do. Okay. But you got to take it into account it's very interesting well dr kaplan that was the land that was the the narrative i wanted to review with you the landscape and i think we

i think you did it justice is there anything more you'd want to say i do i saw a couple of people posting some comments and i want to answer one thing, which they won't like, but I think it's true. People do come up to me and say, you know, Art, I know you're big on mandates. I'm not anti-vaccine.. You don't have to show your opposition to government mandates by not getting vaccinated. If you're really not anti-vaccine, get vaccinated, then hit the streets and tell me why, you know, you don't like mandate X, Y, or Z. I can, you know, walk and chew gum. It's okay. I get it. I get it. So I don't buy that argument.

I hear people saying it to me a lot. Don't accept it. I like that. That sort of characterizes my position, which is, eh, I'll do it. I'm not sure this is government's job. I really have concerns about the way public health has sort of been, but okay.

And that's why I'm sort of sympathetic to people who are resistant. I think those people need a trusted source to help get them to that point where they'll take it and then go object to mandates if they wish. I'm with you on that. Was there another point? I like that one.

I think people would agree with you on that. I'm looking at the restream. You guys agree with him on that? It's a pretty interesting, I love the middle grounds. We need a lot more middle ground positioning for just about everything these days. Politically, public public health everything needs more of a of a pragmatic middle ground that's sort of my my my my i'm with you there but i don't know if we're sailing on that ocean right now it's tough out

there it's very tough everything's so politicized it's hard it's hard and even to do what we did tonight which is to say i kind of get your point. I may not be quite there, but I hear what you're saying. Could use a little of that too. I don't always agree with everybody about ethics issues. God help me. But I hear what they're saying. By the way, I was thinking about something the other day. My daughter and I put out a book, and she has a very extreme position on a lot of things. And I got to understand her position a lot better, and I found myself admiring it.

I thought, yeah, I can admire people's position even and not agree with it. You know what I mean? We can admire each other's position and think. Go ahead. I'm going to say something hyper-controversial. You'll never have me back. I'm a pro-choice person on abortion. Pro-choice. I would not make it illegal. But I fully appreciate somebody telling me they respect right to life.

They want to try and do what they can to discourage abortion. I get it. I hear it. It's not an ignoble position. I understand what they're saying. I don't have to go to war over that kind of thing. I respect people who tell me they want to protect human life. That's a pretty good moral view. I get it. It doesn't happen to be what I think the policy should be because I think that's an individual choice in a way, but that's what we're talking about. I hear people don't like midgets. I get it. Yeah, yeah. And I don't think you would find people that watch this stream or present on some of the chat rooms and stuff would would object to either of those positions like people people are hungry for truth and new ideas and and you know they they want

exactly what we've been doing here today which is just trying to expand our point of view and get to a better place for all of us people are hungry for that and um you know uh so good i don't think i don't think you saying that you have a position and you appreciate other people's position is an unpopular thing to say today. So, well, listen, thank you so much for spending time with me. It's all, I always love talking to you and I read your stuff and I think about you all the time and, and appreciate your stuff. Enjoy your trip coming up. Well-deserved. I hope you guys have a great time. By the way, I was going to say, I'm about to take a trip, Drew, mentioning to Hawaii for a long-delayed series of celebrations.

Hawaii is one of the toughest places to get in and out of. You've got to show cards. You've got to be maxed. You've got to, I don't know, give a blood test. You have to leave your firstborn. It's funny. They're very tough. Yeah. Yeah. It'll be interesting to see if you come away with a different opinion about all those mandates from that particular state. Because we have been to

other countries and I have found the ones I like the most, that they can have lots of requirements, but they give you options. Just all you got to do is give people options, and you feel much better about what you're doing. You can get the test. What airline are you flying on? United, so I hope that makes it. Oh, good. I hope so, too.

Not American. I'm watching the airline news with alarm. Thank goodness. Oh, boy. Yeah. I heard United. Actually, United's okay. United's been very, very good to us.

Yeah, yeah. Very good. I love United. All right, all right. Thanks again. It's Arthur Kaplan with a C. And I hope we talk in one day soon. Have a great vacation.

We'll say good farewell to Dr. Kaplan. Cheers, sir. To those of you on the clubhouse, this was not, I set up the clubhouse, but Caleb, do you think we should spend a couple minutes taking calls just to make everybody happy or are we out of time? Where do you sit? Sure, I'm good. I'm good.

Okay. So we'll take a few minutes, take a couple calls and see what you guys want to talk about. I know, let's see, this nurse tribe. Oh, it's Vini. Is that who I called up there just now? I don't know. I think I called Nurse Tribe up. Hey, Dr. Ju, I have absolutely no clue how I got here. You can put me down. I apologize. I don't know what happened. All right, Pam, let's back to the audience. And then let's see who's, if I can get, then it's funny, the screen names are different than the names. Let's see who this is. If you raise your hand, I end up calling you up to the platform here. So whoever that was, oh, there they are. Keith. Dr. Drew, Caleb, Susan, you all live.

Welcome back from New Orleans. Thank you, man. We had a good time. I'm glad. So I emailed you last week about this and I heard you touch on it on the Adam and Dr. Drew podcast today. Doctors are often unaware of the only treatment for early COVID-19, the monoclonal antibodies. You're just shocking to me. bodies. I'm just shocked. I'm heartbroken on how much ignorance there is about this life-saving treatment for COVID patients at high risk of a bad outcome. Forget even moderate risk right now. We're using it for more moderate cases. So it is, I'm sort of disgusted meets Verklem versus disbelief. I'm hoping to channel that to something good here. So my wife and I, we've got a good plan.

We're informed. We listen to you. We do our research. We know what we're going to do. I think maybe did we talk to a caller on Adam and Drew where a guy had to go to a hospital and go to another place and then another place in order to get it?

Or is that you? I don't know. But know that that was in there was a story like that in the in the article it's in cnn it's terrible anybody wants to look it up it's uh if you just google cnn antibodies it's the second result it's by elizabeth cohen it's a it's a long read but it's very detailed very good and there are some systems in the country they're doing well with this after not doing so well initially. So here's my question for you, Dr. Drew. What can we do to increase awareness among physicians and the public about monoclonal antibody treatment? Because it's so important to get it early. Now, I work for a large healthcare

company here in California. I can email my CEO, but what channels do you have, Dr. Drew? Well, Keith, I have stuff like this. So what I did was when I was sick and had the extremely positive response to monoclonal antibodies, I got on Instagram live and I thought I can be an example. And what struck me then that strikes me now is that should be public health policy number one, helping people stay out of the hospital. All of our sort of machinations around what we do with COVID have been to prevent the health care system from being overwhelmed. Well, guess how you do that? You keep people out of the hospital.

And guess how you prevent deaths? Keep people out of the hospital. So the fact that our public health officials aren't on campaigns all the time, and you just heard Dr. Kaplan, the reason that happens is there's no federal public health policy. It's all distributed to the states, and then the state's distributed to the county. In my county, I have a sociologist in charge who doesn't know what an antibody is. So what are you going to do? So we have to keep talking about it wherever we can mandate and demand. If you know somebody who's sick, if you get sick, tell them about it immediately. Did you get the antibodies from our, your physician, or was it through Dr. Yeo? No, no, no, no. Jeff immediately set it up. My physician set it up

immediately. He was, why? That's why you have a doctor. That's why we love him. He was all over it. He knew all about it. You didn't want to have a doctor. I made you do it. Well, that's a different issue. That's my own stupidity.

That's a different thing. Let's see, guys. Sorry, here. Let me put this on. One more. Here we go. I wish they had the names that they sort of keep on as a screen name or the same as the name for the person calling or if you had both. This would be my recommendation to Clubhouse. So when we call somebody up, we can call them by name.

All right. I'm running out of steam. We got to wrap things up. I'm just going to go ahead and say farewell to the clubhouse. We appreciate you guys coming in and listening with us. Dr. Kaplan, we appreciate you. We're going to be in here tomorrow with another physician. Is that a physician this time? Correct. Can I tell that to the clubhouse?

Yes, it is. Yes. Yeah. Dr. Peter Chin Hong, who is a, I remember what we're talking about there. This is the. I'm not on here for some reason. Oh, that's February. He was, he's got a lot of information about these kinds of topics, as I recall, which

is why I wanted to talk to him. But I'm talking to a lot of really interesting people coming up the next two weeks, really. And so. Peter Chin Hong. And why did I want to speak to him? There it is. I will tell you in a second. Dax is at 4.30 on Wednesday. Can you move your care appointment? Nope. Why not? All right. Dr. Chin Hong is a regional dean for regional campuses, medical director, specialized infectious diseases. Yeah. we're going to talk about just the immune function.

Young children are vaccinations. One of his main things, why are so many doctors unaware of monoclonal antibodies? I've got this on his fact sheet. Why are so many doctors unaware of monoclonal antibodies? We're going to get into that tomorrow. That will be, to your point, Keith, that'll be purpose number one.

Thank you all at Club clubhouse and then for the rest of us on the restream uh we always value you guys we appreciate your comments uh let's see if there's anything else here yes rational revolution tom cigar anything else you guys want to talk about here david pierre core, and Zelenko. Boy, you guys are all over the place. Yeah, we can't have them on. They get us cancelled on YouTube. Yep.

Let me just look at some of your comments, see if there's anything I missed. Florida is pushing them for sure. The monoclonal antibodies, they were trying to anyway. Does minoxidil and Rogaine work for them? Yes, it does. It can be helpful in any event. Okay, let's leave it at that. We'll see you guys tomorrow at, is it Does minoxidil and Rogaine work for women? Yes, it does. It does. It can be helpful in any event. Okay. Let's leave it at that.

And we'll see you guys tomorrow at, is it 3? Mahalo. 3, 4 o'clock. Speaking of Hawaii. 4 o'clock tomorrow Pacific time. 4 o'clock and thank you and mahalo. 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

and informational purposes only. I am a licensed physician, but I am not a replacement for your personal doctor, and I am not practicing medicine here. Always remember that our understanding of medicine and science is constantly evolving. Though my opinion is based on the information that is available to me today, some of the contents of this show could be outdated in the future. Be sure to check with trusted resources in case any of the information has been updated

since this was published. If you or someone you know is in immediate danger, don't call me, call 911. If you're feeling hopeless or suicidal, call the National Suicide Prevention Lifeline at 800-273-8255. You can find more of my recommended organizations and helpful resources at drdrew.com slash help.