Sawbones: A Marital Tour of Misguided Medicine - Hypodermic Needles

Episode Date: November 13, 2020

With news that a COVID-19 vaccine may be on the horizon and flu shot season in full swing, we take things back to basics with a history of the hypodermic needle and syringe. Also, a strangely large amount of car talk for you gear heads. Music: "Medicines" by The Taxpayers

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We saw through the broken glass and had ourselves a look around.

Some medicines, some medicines that escalate my cop for the mouth. Hello everybody and welcome to Sobhones, a marital tour of misguided medicine. I am your co-host Justin McAroy. And I'm Sydney McAroy. Well said, some exciting news on the COVID front, not the present situation, which is a dire. Yes. Yeah, I hope everybody is staying safe out there as much as you can stay home. If you can't wear your mask when you go out social distance. Also remember that depending on the state you live in your government or government may not be looking out for you. So don't necessarily take their guidelines to be the safest practices. You need to be responsible for

yourself and your family. Yeah. Staying home and staying safe. Back when all this started in March, I feel like a lot of people were being really cautious and taking it very seriously. And I understand that fatigue has set in. Hmm. But I would say that for a lot of us who are in states that weren't initially impacted strongly, we now need to take it that seriously and be just as cautious as everyone was back in March.

Yes. If not more so. But we're not doing a whole episode about that. No, ma'am. No, it just the announcement from Pfizer, which I'll talk a bit about at the end of the show about their vaccine progress, which is good. Good news overall. That's the TLDR.

There it is. Look at you. The announcement was good news. Okay. Wait, the Webby Awards are here. Best Internet acronym goes to Cindy McAroy. God, see, congratulations. But note, sorry, I'm reading here most improved, but still huge achievement. Thank you, thank you. But that's not what the whole show is about. We do want to talk about medical history.

And something Justin, you asked me about kind of tied in to vaccines and the COVID vaccine and the fact that it is flu vaccine season and everybody should be getting their flu shot. I realize that I am, I am our most prolific sobbing's episode suggests or, that's true. Mainly because I have so many gaps in my understanding of the world around me that I am free-wently plagued by like, wait, Sid, Sid, how do we know

that we could squirt medicine into people? How do we do that? How do we figure it out? Well, it's really interesting. You asked me about the history of hypodermic needles and I it was something I'd never really thought about investigating. I don't know why that I'm so curious about diseases and treatments, but like the equipment didn't Accurdemy as an area of interest, but it definitely is and there's a whole history there and a lot of people have written about it

So it's not it's not a wild question to ask. How did we come up with the idea of a needle? What brain can see into it? Because I think they're so terrifying to so many people, right? Like it's a fear. That's what prompted my thought of it as our daughter has a real, our oldest daughter, Charlie, has a real genuine phobia when it comes to needles.

And I guess in my bad parenting brain, I was thinking that if I knew the history of how bad it used to be, then maybe that would impress upon her the value of the current system. Now, saying it out loud, fellow parents, I realized this is a multi-blan. No, I think as I'm going to share this information with you,

I think if we told her how it used to be, it would just further terrify her of all of it I don't think she'd be grateful for the modern needle. She calls she calls the flu shot the Because she doesn't want to say it. Yeah. Yeah. Oh, and she is also Strightly made it known to anyone who will listen that she will not be getting the code vaccine made it known to anyone who will listen that she will not be getting the code vaccine. When it is awful, she'll tell anybody, I'm not getting that vaccine. Spoilers. We got an anti-vaxxer right now.

Spoilers, she will. She will. Nairator. And she did. She did get her flu shot. And she actually afterwards made the point of saying it really wasn't that bad. We made her film a video. I remember.

There's a little parenting tip for you. Yeah. There's a video of her saying future Charlie, the flu really wasn't that bad. We made her film a video. Remember? There's a little parenting tip for you. Yeah. There's a video of her saying future Charlie, the flu shot was not that bad. And I said a calendar reminder to myself on October 1st to remember that that video exists. So when she gets worked up about it, I'll be ready with that flu shot.

We need to set it sooner. We might need to get it out of the way. Yeah, we're gonna try to get it sooner. Actually, first anyway. Anyway, so the idea of a hollow tube to deliver things into people is not new, as you may imagine. It's an ancient idea. The word syringe, do you,

are you interested in the word syringe? Yeah, obviously. I'm here, aren't I? Syringe, I think a lot of people use the term syringe to talk about like the whole thing, right? Like the, yeah. The needle attached to the barrel with the plunger and the whole thing together as a syringe. I mean, as you know, if you've ever given a child or an animal medicine, the plastic thing

that you delivered in is the syringe and there's no needle on the end. Right. So the needle is not necessarily, but I think in our minds, we tend to tie it all together. The word syringe comes from the Greek serencs for a pan flute. Why, why is it, well, it's hollow, I guess that makes sense. This is tied to, I found this myth where all this comes from. I put a little picture in there. No, thanks, Ed. Yeah.

I see a little, I've never, you've never put a picture of pan. You've never put a picture in the notes before. This is really something, a real AV component. They're ready to enjoy. Really, a really growing. A really growing. Syrians was a nymph in Greek mythology, and the God pan tried to seduce her, so she was running away from him, and she asked some river nymphs to help her hide escape, get away from the God Pan.

And they turned her into reeds. These myths are always so. A lot. A lot. There's just a lot there. Anyway, she turned into these reeds that would make a horrible sound, I guess, was the idea, but instead Pan took the reads and cut them into the pan flute, which he is often pictured with.

You see Pan and he's holding the little flute saying, anyway, there you go. There's Syringes, there's Sarenge, there's the whole history of that in case you're interested. I am. I took a class in high school on Greek mythology. I find this stuff fascinating. You don't. Okay, moving on. Early Greek physicians were inspired. I'm allowed to not be interested in some things. That's okay. I'm a Roman myth guy myself. You want to talk about Hades? We can talk about Hades. That's true. I'm not interested in woodworking. That's true. There we go.

Daddy does woodworking, mommy loves Greek myths. Greek mythology. Among other things. Early Greek physicians were inspired by snake venom, by the idea that somehow in a snake bite, they're delivering venom. Oh, that makes sense. somehow in a snake bite, they're delivering venom. Oh, that makes sense. And so the idea of delivering, and a lot of these were like,

not, again, the syringe did not have a needle necessarily attached. It was more like the idea of delivering a precise amount of an ointment or something to a site on the body or an open wound or something as opposed to any sort of like puncturing, sharp instrument attached to the end. Do you know what I'm saying? Really think about, that's why I want to conjure up that image of the way that you draw up like a child's medicine, or I assume it's the same for

animals, but like, it's not the needle. It's just the syringe part. That's why I'm kind of driving that home. Is that that idea came before? Okay. The first attempt at actually using a needle to inject something into someone so to speak. A hollow needle. Yes.

Like the idea of the whole unit, not just like let's squirt some stuff in the right place, but the idea of an injection, so to speak. We really trace back to 1656, and I'm going to preface this story with the dog lives don't worry. I know our audience. The dog lives don't worry. The dog does not die at this time. No.

The first, that was the first person to be injected was a dog. No, honey, I want, I need you to, let's take a trip back. I'm going back to the car, I'm going to look at that sentence where we're talking. Let me know if there's any problems with it. I don't want to say thing because that's, that's, I mean, it's a dog. You can't say person. No.

Okay. Well, that one's taken. That's ours. Being living. Sure. Being creature. Mammal. Not person.

I love you. Can we say something? It's a point where since it's because the forest when you just start bully proclaiming all dogs of people. I try to be I'm a cat person, but I try to be careful and sensitive to the needs of dog people. Yeah. You know, anyway, as all good gelicles should.

Christopher Ren, a scientist and philosopher and founding member of the Royal Society of London did these explorations initially. The Royal Society, by the way, I didn't know much about it. I think probably a lot of people do, but I don't know much about the origins of the Royal Society. But basically, it was sort of like an informal group of guys, they were guys in the beginning, who got together and sort of talked about stuff, you know, just like science and stuff.

No, I don't, I mean, maybe that too, I don't know, but like understanding of the natural and biological world and all that kind of thing, and usually ended up like, probably cars. You know guys. You get a bunch of guys together. Well it's 1656. Oh yeah. That's gonna be talking about cars. Your hands. What do you guys imagine cars will be like? Let's talk about and what kind of posters of cars will have with girls in them.

And then we'll sell them at book fairs in the future. girls in them. And then we'll sell them at book fairs in the future. Anyway, they would usually end up at the pub by the close of the night. You know, my, what I'm getting at here is I wish I was there. There you would. I want to go to there and be part of this. This feels like a place that I belong. Yeah, you would actually historically hilariously You would be the one in that group that knew the most about cars Actually me you'd be Cockin' the walk I would blow their minds with my book fair poster car poster knowledge. I bring to you A vision from the future. It is a babe a babe on a smoking hot rod

And then I would enroll it, and it would accidentally be one of the cat posters from the book fair. And I go, oh, no, you guys have cats, right? And then they would all laugh and go, oh, he's hanging in there. Yeah, we love it. And Leonardo da Vinci is just like feverishly taking notes. These are the visions I have in the way things are over the place. I'm in there for the kids to say it.

OK, OK. Ta-sa. So basically, after one meeting, Ren, after they, I have the way things all over the place. I mean there's the kids to say. Okay, okay. Pazah! So basically, after one meeting, Ren, after they, I don't know, I don't know he- He's so happy he don't break out enough, they're kind of his story, but I know, we're just laughing. Sorry, I didn't realize the picture was a rowdy one.

Well, becoming episode Doctor Who. I don't know the election. Doctor Who or Bill and Ted, I don't know, one of the things. After one of the meetings, Renided to try out some of the theories that they had been discussing. So I don't know that he had been having a few at the pub or not. We're gonna say, we don't know, he may have quaffed a pint.

Okay. But he was, they were talking about putting substances directly into the blood of a person. Like could you, like an injection? Could you inject something into somebody? Is that possible? How would you do it? Whether that be for like poisoning or something,

not nefarious, like something positive. And so he decided to try it out on a dog. And- Which lives. Yes, which does live. And he described it like this. This is, these are his words. I have injected wine and ale in a living dog

into the mass of blood by a vein in good quantities till I have made him extremely drunk, but soon after he pisseth it out. And so kids, there's your wonder, and where Spud's McKinsey came from. There it is. There's the origin story right there. The story of the dog.

We've got a higher high 30s, low 40s. There it is. There's the origin story right there. The story of the dog. High 30s, low 40s. A solvents. I've been enjoying the spuds and kids. The story of the dog is that I maybe he had a hangover. I don't really know that part, but he lived. He was fine. He recovered just fine from this experiment. Grew old and fat.

And I think was stolen later, but I would say I would have stolen party dog. If I could have you kidding me, but I guess how to hold his biz. He survived his night of scientific fame and drunkenness and is and was fine. But the this early attempt was an IV injection, right? Intervenius. So they were actually trying to put it, which is not exactly what we're talking about with shots, but can you draw a distinction there? Well, when you get a, when you get your flu shot, for instance, or another vaccine, or your fish, they're not putting it in a vein, right? Right.

Think about it. I don't, I don't. They're just sticking it in the muscle. Okay. It's an I.M. Intramuscular injection. Okay. They're not putting it IV intravenous in a vein.

All right. Yeah. Got it. Yeah, because you don't you don't need to have a vaccine delivered into your bloodstream. I'll take it though. When you get, when you, uh, same thing with insulin does not, it's not an injection that you get in your bloodstream. Like when, um, a person has to give them self an insulin shot at home or someone has to give someone insulin shot at home They're not delivering that into their bloodstream. They're putting it subcutaneously Down into the subcutaneous tissue If you get a medicine while you're in the hospital through your IV That is an intravenous

So my antibiotics might be delivered that way Among many other things anyway, so these early attempts were mainly IV injections, intravenous, and they were basically you would get a quill, because they're hollow, and some sort of animal bladder attached to the quill to hold whatever substance, I guess in this case, wine and ale.

And I believe Ren later repeated this with basically opium. It was like poppy juice, but it was opium. And you actually at this point would have to make an incision, because you think about a quill, that's a lot to puncture. I mean, the quills aren't that sharp. I guess you could maybe file them. I don't really know. But you would make, you would actually cut open to get to the vein and then use the quill to puncture the vein and Then deliver it from the animal bladder and usually they were the early experiments were done with pain medications That's where a lot of a lot of these things were tried was there was no idea like what else would you want to put in somebody?

We didn't have a lot of medicines We didn't really know what we were doing So the only things you would try these with were like, I don't know, maybe here's some alcohol numbs, the pain, here's some alcohol, or this, we're figuring out that this opium stuff is pretty cool. So like, maybe we give that to people. Exactly. We didn't really know what to do with it. And so it really didn't take into the mainstream for like 200 more years, especially because if you imagine these early experiments, all of a sudden we know how to deliver something like opium directly into the bloodstream, but we have

no idea what the effects will be, how much, or the other effects of it. Some of these early experiments were quite catastrophic and kind of pushed physicians away from this and said, let's not do this. So it wasn't until June of 1844, an Irish physician named Francis Rind injected morphine into like the face, the side of the face around the cheek area of a patient who was in a great deal of pain. And for some reason, like he did it in June of 1844,

but then it was not published, like an account of it wasn't published until March of 1845, when there was an article in the newspaper, like nine months later about it, where he detailed how he did it and how he used a hollow metal tube and introduced the medication with a syringe. So it's like the first account of somebody applying it

in a way that actually helped and wasn't just to figure stuff out. And all of that kind of culminated in two doctors sort of simultaneously. You know, that happens. We've talked about that on the show before. We're like an ex, like a discovery will be made by two different parties almost at the exact same time. It makes it hard to know who, who really made it first. But two different doctors kind of discovered what we think of as the hypodermic needle as we know it today. There was a French doctor named Charles Provas who gave a sheep that was bleeding some sort of substance to make it stop a coagulant.

And around that same time there was a Scottish doctor named Alexander Wood, who gave a human some morphine. And both of them used what we would kind of think of as the hypodermic needle, as we know it today. Wood generally gets the credit for it, although he didn't call it hypodermic, he called it a subcutaneous needle. The word hypodermic comes from a British physician. This is all over the place. This is like a really we're all coming together. Global effort to come up with this

thing. Charles Hunter, who he actually argued with wood, he was a contemporary and he said, you know, I like this thing you got going on. I'm going to call it a hypodermic needle. I'm not going to call it subcutaneous. I'm going to call it something else. And my name's going to stick by the way. I've looked into the future. And that's the one we not going to call it subcutaneous. I'm going to call it something else. And my name's going to stick by the way. I've looked into the future and that's the one that we're going to use. But also way to you find out about cars. He argued that would said you could only put the pain medication where you wanted it to work.

So like you had to deliver medications locally to the site of injury or whatever. Whereas Hunter said, you know, I think you could just inject morphine into somebody anywhere and it would probably... It seems like you could assess to that really easily, right? Well, I mean, I think that they did and Hunter was right and that was born out eventually, but would get the credit for the needle one way or the other. He refined the device so that the needle was smaller, the original barrel of these needles, the original of the syringe, you know, you think about the big hollow part where the medicine goes. It was hard rubber and the plunger, the part that you, you know, used to squirt, was made of leather.

Mmm, wow. Yeah, and they would have like, oiled leather at the top to try to create a seal. Because right, you got to have a seal. Because right, you gotta have a seal. If you think about it, if you think about a syringe, there's the barrel and there's the plunger part that you scored it with. But there's gotta be like, what we think of now is like a little rubber seal part at the top of the plunger

or else the medicine would just fall out, right? It's gotta be, it's gotta be sealed. So they would use like an oiled leather. So the medicine wouldn't leak out, but all of this you can imagine was kind of cumbersome because leather can warp and change, is it dries, is it stored, temperature and all that, you lose suction. So eventually they replaced the whole thing with metal, which was good in that it was a lot more stable, but bad in that you can't see through metal.

I mean, you can't. No, I can't. And even Superman has trouble with lead. So you couldn't really see how much medicine you were giving people. Yeah. So they made marks on the plunger so you could kind of tell how much, but like none of this is like, right, this is not ideal. So there's bubbles in there. It wouldn't be able to. Sure. You want to see what you're doing. So eventually glass became the default. You can see through it. It doesn't warp easily. you can see where that would be the easiest way to do it. And in World War II, specifically, there was a version called a serret that was popular, and this was like this little

pre-loaded syringe. Exactly. And you could just... Well, there you go. You could give somebody a serret, and you knew exactly how much you were giving them for pain relief in the field, and you would just have those kind of stocked So you would have to take the time to like get out the syringe draw up the more if all that kind of stuff And this was followed with the introduction of glass syringes with detachable needles so that the whole thing wasn't one unit You could take off the needle you know, though easier to store and you know, you could use multiple different Parts on different you know, what I mean? They, you know, you could use multiple different parts on different, you know what I mean, they're all interchangeable. The first mass production of them for delivery

was for the polio vaccine. That was the first time that we made a ton of these all at once in 1954 after Salt Created, the polio vaccine. That's when you first see these things like made in mass quantities. And only a couple of years after that, there was a New Zealand pharmacist, inventor Colin Albert Murdock, who made the first plastic syringe, which was refined into what we think of today as a hypodermic needle, a plastic disposable syringe, a separate needle, all single use yada yada. They should have started with the plastic syringe. That's obviously the best one. Well, we'd have it.

Sorry, sorry. So much luck. We didn't have plastic. It asked the J-Mans. For cars. For book fairs. Maybe I don't know. We may have cars. I don't really. You've had book fairs. But of course there were some problems. It was a book. It was so hard to create that it was literally a book fair. Everybody would come for the one book that they had. Hooray for the book! It's done. Don't drop it, I'll be sure if we're ever to eliminate. There are issues that arise with this, but before we talk about that, let's go to the billing department. Let's go. The medicines, the medicines that ask you let my God for the mouth.

This is the part that Charlie would like where you admit that there's a bunch of problems with syringes. No, I just mean it's interesting to me because like the history of the development of the syringe is a lot like I would imagine the history of the development of the syringe is a lot like, I would imagine the history of the development of any technology. Cars. Where you, for example, I'm not going to use the example of cars, because I don't know enough. I mean, I know about cars, like I know what you know what I mean.

I'm not like a car person. Anyway, the idea of like, we think we could put something directly into a human, but we don't know exactly how to do it. And so we come up with one thing and it sort of works and then you gradually refine it. And then as materials become available, I mean, that's like everything, right? Like as we knew better how to shape things out of metal

and out of glass, and then eventually with the invention of plastic, like none of this is much different than a lot of technologies that have been refined, right? What was interesting to me is that there were a couple problems that are medical and relevant historically that would arise with the invention of the hypodermic needle as we know it today, especially once they got to something that could be mass produced and easily interchangeable parts and all that kind of stuff that has great like social relevance, medical relevance as we move forward.

Beyond just like, good job, you made the best version of the thing. First, doctors didn't immediately understand infection. Ah. And if you didn't really understand germs or infection, why would you think you needed a different needle for different people? Yeah, that seems bad. Yeah, so this was one issue is when you first had a hypodermic needle, it was like this great new tool for physicians to use,

and they were very excited and wanted to use it on a lot of people and use it on a lot of people. So this was one problem that quickly arose. Now of course, it didn't take us, it wasn't long after the invention of an easily available, I mean, because just because these ideas were existed in the 1600s, didn't mean anybody had access to them.

By the time we had these easily available mass produced vaccines, I mean, hypodermic needles, we did understand germ theory and that kind of thing. So that problem was not long, but this didn't need to be understood. Secondly, the quick relief of pain that you get when you give someone an injection of like morphine was the big standard in the beginning. Is so, I mean, it's such a great thing for a physician to be able to do. Think about how little we could do before that. That could provide a patient with immediate relief or a cure or any, I mean, like we were so lost in the woods with so many things to have, you can come into my office in pain, I can pick up this syringe of medicine

and give you an injection and immediately solve your problem. Became a little too tempting to use it all the time. Which is exactly what we see is that there was this sort of overuse of morphine by injection as a default because there're just weren't. And we talk about this on the show a lot. Like we move through this period of history

where everybody got a lot of opium all the time and all their medicines, whether they be from doctors or from the patent medicine salesman who came to your town. Because it did something. You know, and a lot of medicines didn't. So there was a lot of overuse in this lead to the third issue,

which is addiction really starts to become a problem as hypodermic needles, at first, as morphine is introduced to the public and more people experience opioids. But then secondly, as syringes become easier to make and more widely available. You've got people who are getting a taste for it and then they can buy the syringes. Yeah, exactly. Because before that, if it was just something that maybe your doctor had one of, it would be really hard to give yourself an injection, but once that they were something that you could buy. So with that, we have more patient suffering from substance use disorder and as

they became addicted morphine, they had the tool. So all these problems sort of arise with the hypodermic needle. I think that's a really interesting social history because at the same time as we have this amazing medical advancement that makes it possible to treat people in a whole new way. And like really the end of the hypodermic needle story, well, not the end, but the, for me, the culmination is the vaccine. It makes a vaccine easily deliverable, you know? I mean, if you think about the process of like, very elation where we have to, in order to, like, inoculate you against a disease, we have to cut you.

Yeah, and then, like, rub substances into you and, like, the way that we used to do it before we could just give you a shot. Yeah. So, it's this huge advancement, but then, obviously, that there are these unintended side effects. Sure.

Always are. So, now we have these plastic interchangeable pieces. We have stainless steel needles. You will see glass syringes still occasionally for certain medicines. They're just certain substances that do better in glass. So you will find those and you'll see medicines that do come. I see them mainly in like these little preloaded syringes. Those do exist. They're not morphine. I mean, they could be, but the ones that I am most familiar with are certain vaccines. You'll see these little pre-loaded vaccines that come.

Do they save the syringes? Is it just that needles that get swapped out? Everything gets everything seems bad for the planet. Everything Everything single use. That's a problem number four. I mean, I just came up with. You could, now I say that you could auto-clave things for sure. Yeah, but that was the thing I was thinking about was auto-clave. Yeah. But a lot of, a lot of... But that's so...

There's a lot of stuff that single use. Yeah. Yeah, no, then that, I mean... I don't claim that. And then, but the advantage of like the preloaded stuff, though, is that the alternative is you have the little glass vials. And those work, like you can have a substance in a glass vial, you draw some out of it, inject into the person, and you can use that glass vial on more than one person. Yeah. As long as you're cleaning it and everything.

So, but those are the two ways you could do it. Needles, in case you're interested, we talk a lot about in the medical world, the size of needles. The gauge. The gauge of needles. Why are it the same way that's the only reason I know? Well, then you can describe what is gauge. Gage is the diameter of the instrument that you're using, be a wire or syringe.

So how thick it is? Exactly. And a syringe, we're talking about sort of the opening. And in wiring, the lower the gauge, the bigger the thing. Same thing. Same thing. So that's part of it. And then the length is the other part of it. And that matters because as I talked about, some things we inject in the muscle, which would need to be a little longer. I am. Exactly. Some things are subcutaneous.

SC. There you go, which just go into the subcutaneous tissue. There's intradermal. I'd. Sure, I'd. Like if you've ever had to have a tuberculosis test, a TB test, and it goes right there under the skin, you make a little bubble. And then there's also, of course, intravenous IV things, which are going to the vein.

And we even need needles that can, sorry. And we even need needles that can go all the way into the bone marrow, I.O. interosseous. And we have all those different links and different gauges. The different gauges, by the way, are in part because different substances have different viscosity. And so you need the gauge to be larger, which would mean the number is smaller, in order for a thicker, more viscous substance to be pulled through the needle. Otherwise, it just won't so they're requiring if you have thick juicy electricity, you can use a little gauge. Example of a sub-q injection, like I said, would be like insulin, and you would use a 30-gauge needle, like a really tiny gauge. And if you've ever seen like an insulin needle, insulin serenge,

it's a tiny little deal where like your flu shot that you got or should get, if you haven't gotten yet, you could use like a 22 gauge because it goes in the muscle there. In case you're curious, I have found that this isn't always widely known, maybe you already know it, but just in case, when you have an intravenous line placed and IV line placed, they use a needle to puncture your vein, right? They use, they don't leave the needle there. Yeah, when you told me that, it really kind of shook my world.

This is part of why I wanted to say this. The needle gets removed and what's left in place is like a little flexible catheter thing inside your vein. Not the needle. The needle is just to introduce it. It's crazy. Yes. So I, well, I feel like that that's worth knowing because for me when I learned that a long time ago It took away a little bit of the fear of an IV

Yeah, I always used to think once you have an IV in place You have to hold really still or else you accidentally poke yourself with it or something And then when I learned that I was like, oh, okay, well, I mean you still shouldn't like I Don't know why you've got the IV but don't like go wild with that arm, don't like wave it all over the place or anything. But I don't know, that brought me some comfort. And on another side note, I think I was thinking for our episode next week, because there's a whole other history of the needle that we haven't gotten into, and that's the history of needle exchange programs, which I think pairs well with everything we've been talking about. Yeah, so I think we need to talk

about why they are evidence-based and effective public health tools. But the reason we talked about needles, the reason we wanted to get into this is because there was this big announcement we wanted to get into this is because there was this big announcement just this past week about progress made on a COVID vaccine from Pfizer and by, by on tech, bio in tech. Do you think that's how they, they have that capital in there. So by, by on tech, by on tech, sure. Let's go that. Uh, so the results that they have announced are preliminary results, but they're very positive results from their phase three vaccine trials. And all this is actually, I think, from what I've read is even kind of a surprise to them, because the way that they were doing this, they were applying initially for these special, like, they were going to release data to independent, like reviewers reviewers as the process went a lot earlier

than normal to try to accelerate things. And they actually have backed off from that, not for any reason other than just like we're not going to do that. We're just going to kind of go by the books. And they have gotten the preliminary results are way more positive than I think even they expected. They are seeing that patients who get two doses, three weeks apart, have 90% fewer COVID cases

than patients who receive the placebo, which is huge. We thought maybe 60 to 70%. So, and of course, this is not the final result that might change somewhat, but this is really positive early stuff. They're still in phase three. They are not going to apply for emergency use authorization. That's what we're waiting for.

And you'll see that if you see like people within the medical world talking about it, they'll call it their EUA emergency use authorization. That is the moment where like make your dinner reservation. It's good to go get your football. Not when they apply for it but when they get that. No, when they get that. That is the big like that's the that's the big hurt. Now there's a ton of other hurdles past that but like that's what we're waiting for is the that when one of these vaccines gets emergency use authorization to go for it. And they're not going to apply for that. They haven't yet. And they're not going to until half

of their participants have been observed for side effects for two months after their second dose. So after they receive both doses, we wait two months. And when half of their participants have been observed for that period of time and have not, have done well, have not had problems, then they will apply for the emergency use authorization. They, that should happen around the third week of November. Okay. So very soon.

Very soon. Very soon. But this is all. And that should be it for COVID. This is good news. This is good news. Now we still need more time to see how effective the vaccine is in preventing severe cases, preventing deaths, all that stuff that you can't bear that out and just, you know, these early months of data and stuff. There are side effects, but nothing too serious to suggest that the risks outweigh the benefits so far they're talking about things things like fever, chills, body aches, sort of what we expect. And if the vaccine is approved soon,

they're still the distribution hurdle. So again, this is the other piece of it that has to happen is once yes, you can give this to people, they have to make it, and then find a way to give it. Like, how do we get it? What channels do we use for distribution? Who gets it first?

How do we stratify that? All that. Now, what has been happening the last few months, hopefully, is that all those plans have been put in place. Hopefully. That is... Yeah, we hope, right? That is what has supposedly been happening

at various levels of government. I mean, I know I will personally say that through my own employer, I've received not like a plan, like a concrete plan, but like the beginnings of it from... I know that we're talking about it. And I know I'm not the only one across the country who is getting this sort of like, get ready, this is coming, we're going to notify you as soon as it's available, blah, blah, blah.

Like, so obviously people are thinking ahead and planning and preparing. So I'm hopeful, but the nitty gritty is that to give this vaccine to all the people who need it is gonna take some time. Yeah. And a lot of effort. They project that they could have 50 million doses available by the end of the year, and then 1.3 billion next year. I've heard a lot of talk about protecting our podcasters

being sort of a top priority. So I assume that's you, me, and then we'll kind of figure out the other 49 million, 9999, 998 after that. You think so? You think that's, you think that'll be the, there's a lot of, you can read out there. There's a lot of literature suggesting how we risk stratify this, how we, who gets it, because it has to be an equitable distribution. It can't, it's tough, because while some of the vaccines

were made using a lot of government funding, which you would think would ensure that it's not just like, because it's not all for profit funding, then maybe you could have some influence over how it's distributed. The Pfizer vaccine actually did not, it was not part of operation warp speed and did not receive funding on the front end. Now, they have agreed, like the plan was that they were going to receive government funding in the distribution phase.

Yeah. So that moving forward, they would receive government funding. My understanding is that they haven't as of yet. So, but I mean, there is no suggestion at this point that it's going to be something that like, if you're rich enough, you could buy. Let's hope we keep it that right. Well, that's what that's then it shouldn't be. That's the right idea is that it should be something where we stratify. This is going to sound really selfish. Health care workers say it. Dr. McArroy. Yes. I know.

I know. I know. Up-or-crest friends. No, I know that sounds really, but like I, I work in a hospital. I'm looking forward to never leaving the house once you're vaccinated. And I'm not, I will not be going anywhere. I don't go anywhere right now, but I will not go anywhere. I hope you're looking forward to going to the hardware store to pick up lumber. That is, that is where we'll find ourselves,

the immune doctor, McAroy. I, my understanding is that top, the top tier are gonna be frontline healthcare workers. And at risk, high risk populations are way up there too. So that would be people over a certain age limit. I don't know what the cut off is gonna be and people with certain chronic diseases. Is there a possibility of,

I probably talked about this, but is there a possibility of there being another vaccine to support these numbers like different distribution channels and different manufacturing pipelines and stuff like that? My, and this is just me based on everything I've read about it. So this is my personal opinion. Not only do I think there's a possibility, I think absolutely there will be multiple vaccines

available and being distributed. So that these numbers that I just gave you for this vaccine will not be all the COVID of the year, but I think definitely moving into early next year, who will start distributing their vaccines to. So this will, my guess is maybe this is the one, some of us who are frontline healthcare workers get, but there will be other vaccines that you might get. I'm sorry, Justin, you're lower risk. I have to imagine you would be lower down. I'm not because I'm incredibly physically fit.

But there are plans in place to make sure that we can get it out there equitably to the people who need it most to the highest risk populations and health care workers and so on. Hopefully that is the plan. Thank you so much for listening to our podcast. We hope you've enjoyed yourself. Hope you're looking forward to that COVID vaccine. But also again, right now you're staying safe, staying home, looking out for people

reminding your family members, especially those vulnerable populations to please try to be as safe as possible. Yeah, I know it's tough because we're going into the holiday season and a lot of people want to gather. I understand that impulse. But I've seen a lot of people say if you choose not to gather with your family members next year, it might be a way of guaranteeing that we can all be here. This year, we can all be here next year to gather with your family members.

So not guaranteeing. I mean, P&L has dropped on people all the time. Well, you know what I'm saying? I know it's hard. I know it's hard, but I would really advise like like this is the time to be as cautious as you've ever been during this pandemic. And if you have never been cautious during this pandemic, I can't believe you listen to our show. Welcome to your first episode of Salmas. But do it now. Now is the time. And in does inside.

Thanks to the taxpayers for the use of their themes, some medicines is the intro and outro of our program. Thanks to Max from the network for having us on and thanks to you for listening. I really appreciate you very much. That is going to do it for us, but be sure to join us again next week for a saw button. So tell them and then just don't.

And get your flu shot. You didn't say that. Get your flu shot. Get your flu shot. Get your flu shot. My name is just Michael. I'm Cindy McRome. And as always, don't draw a hole in your head. Music Maximumfun.org Alright! Maximumfun.org

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