The Chris Cuomo Project - What We Got Wrong (And Right): Ex-White House COVID Coordinator Speaks

Episode Date: July 9, 2024

Dr. Ashish Jha (Dean, Brown University School of Public Health, and former White House COVID-19 Response Coordinator) joins Chris Cuomo for an in-depth discussion of the origins, implications, and governmental responses to the COVID-19 pandemic. In this wide-ranging conversation, Chris and Dr. Jha tackle topics such as vaccine efficacy, public health communication, treatment misconceptions, long COVID, and the critical need for trust and preparedness for future pandemics. Dr. Jha emphasizes the importance of open dialogue and honest communication, reflecting on the pandemic’s chaotic early days, the impact of misinformation, and the lessons learned to better address future public health crises. Follow and subscribe to The Chris Cuomo Project on Apple Podcasts, Spotify, and YouTube for new episodes every Tuesday and Thursday: https://linktr.ee/cuomoproject Join Chris Ad-Free On Substack: http://thechriscuomoproject.substack.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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Benefits vary by card, other conditions apply. Do you wanna have a real conversation about COVID? Do you wanna have a real conversation about how it started and what it was like in this country? And what was the real basis for a lot of the decisions and determinations that were made by the Trump administration and then by the Biden administration.

If you wanna have a real conversation, you gotta talk to somebody who lived it in a position of decision-making at that time, who has a clinical understanding and a pedigree to put those situations in the context. You gotta check all those boxes. I have that person for you. Dr. Ashish Jha was a White House COVID coordinator

during the Biden administration. But I was talking to him way before that. Look, I think a reason he got that position, he was at Brown University, he's a very esteemed professional obviously, but we had him on TV all the time and others did too. But we were early because he was reasonable and open to the unknown. Now that has become a precious commodity when you talk about COVID.

People are absolutists. As Dr. Jai is going to argue to you when you listen to this interview, you can't make vaccines, COVID protocols partisan. One, both parties were responsible, but also once you do that, you go down a scary road. The reality that without question, look, you can believe what you want,

but the data is not going to back you up. People who are not vaccinated died more from COVID than people who were vaccinated. I know morbidity is tricky. I know died from is different than died with, I know. Then look at hospitalizations. Hospitalizations after the COVID vaccine was introduced

and had some penetration into societies, the hospitals, the numbers were all lopsided with unvaccinated people having more serious illness. It's not right that there's such a thing as red COVID that Republicans paid a price for being skeptical in part, then cynical in part, because of bad messaging or a lack of messaging and people on their right fringe pushing their obscenes. And Dr. Ashish Jha lived it, studied it, put out policies for it, and now is open to discussing it. So you wanna talk about masks, testing,

the fear that drove lockdowns, mandates, what we know about the vaccine, what we know about long COVID and what we don't know and what's coming next, this is the guy. So here's the Chris Cuomo project. Thank you for subscribing and following and being a part of this. If you want it ad free, go over to Substack,

five bucks a month, you can't beat it, great deal. And you'll get my personal COVID journey with my doctor, who's at the tip of the spear of dealing with long COVID. Dr. Ashish Jha helped Brown University, helped the Biden administration, helped us deal with the pandemic. And here he is to discuss the full complement of issues that are bouncing around on the internet. Support for the Chris Cuomo Project comes in part from AG1. Alright, look, we all know that I try to take care of my health.

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And here's how we know. They do the research, the entire formula. Everything's put together through science. The right ratios and in a way that they know it will get maximal absorption. So I don't have to have a lot of bottles and when do I take each of these things and what do I take with what? AG1 does the thinking for you. Try right now and AG1 is going to give you a free one-year supply of vitamin D3K2

and five free AG1 travel packs with your first purchase. Drink ag1.com slash CCP for the Chris Cuomo project. Drink ag1.com slash CCP. Tell them we sent you. Doc, when you think about the pandemic, what do you think the biggest impact on you and how you approach what you do is from your experience

during the pandemic? Wow, Chris, that's a great question and thanks for having me here to talk about this. And obviously the pandemic was so disruptive for so many people's lives, including mine. But when I think about things I learned, the biggest lessons, the biggest impact, I mean, first of all, the biggest impact, I mean, first

of all, I lived through the pandemic as everybody else did. So I had all the same fears, fears from my parents. Thankfully, no one I know close to me got particularly sick or died. But I learned a lot about public health, Chris. And one of the things I learned was that we have got to do much better at reaching people. We've got to do much more, much better at listening to people. That there's too much in public health of talking at folks

and saying, let me tell you the right answer. And not enough asking what's on your mind and how do I help you navigate this crazy time. I think that is something that will stay with me and hopefully shake how I do things better in the future. When you look at what you watched happen around you, help people understand how chaotic, how much unknown, how much first instance confusion and change as a result

was part of the mix. much first instance confusion and change as a result was part of the mix. Because I do think one of the unfair hindsight things is that feeds the idea that things were intentionally done in certain ways. So you understand what was it really like for those making the decisions early on? what was it really like for those making the decisions early on? Yeah, look, I think back to February, March of 2020, we knew so little about this virus.

And what we were seeing was just horrible deaths, but then shutdowns of China, of what was happening in Italy. It was a very scary time, and part of the scariness was the unknown. We just, we did not know. And there is no question in my mind that a lot of that, that bred a lot of confusion. I often think about though, what could we have done better at that time?

Like we couldn't have known more than we did. And that was just the reality. We didn't know much. We could have done a better job of communicating uncertainty, helping people understand that we don't know all of this. And I think one of the mistakes I saw a lot of public health people make was speak with a level of certainty they didn't have. And that meant that three months later,

when it turned out they were wrong on things, which we were all wrong on because we didn't know much, you went from like, wait, you were so confident three months ago, what happened? And, and I think that it was driven by a desire to calm people down. I think that was a mistake. People are not calmed by certainty. People are calmed by competence and openness and honesty. And, um, and I saw a lot of my public health friends

make that mistake. I tried not to, I'm sure I made that same mistake at times, but it was a chaotic moment. Remind people about the shock factor, shock value of how much death and how much extreme illness of how much death and how much extreme illness came in like a huge wave in this country after thinking and as we saw said by then President Trump,

it's not gonna be that bad. We're gonna have a few dozen cases, this is gonna be okay, which I don't believe even for Trump, he meant a hundred percent. I don't think he was trying to really pull off that level of lie. But remind people just what we saw in America. Yeah. Look, again, I never ascribe bad intentions to people. My sense is maybe Donald Trump did that because he wanted to assure people.

But the reality on the ground was, I mean, I was talking to my friends who were working in emergency rooms in New York City. I was talking to colleagues who were in Italy. And what they were describing, like in Italy, they were describing, okay, we now have a protocol of who are we just going to let die and not even bother trying to save and who are we going to try to save and how do you make that decision? I mean, decisions that me as a doctor, I have never had to make.

And they were making that decision day in, day out, because that's how overwhelmed they were. And then in New York city, it was wave after wave, day after day. It was relentless. We all know about the refrigerated trucks parked outside of Elmhurst Hospital in Queens, because the morgue was full.

And no sense that this was going to slow down any time soon. And so, and then we were, and I was sort of doing more of the data stuff. I was modeling, like, where was this going? And every model, every assumption I made was just gave me a, like, oh, horrifying, like, we're going to have this many deaths, we're going to have this many deaths.

So it was a very scary time. And if you were talking to people on the front lines, it was bad, it was bad. It was bad. And that's what led to the kind of extreme kind of shutdowns that we saw because we didn't have very many other alternatives. Panic. It is fundamental to people who are pushing anti-vaxxer, deep state, totalitarian, they did this on purpose to help big pharma or just to control us, removing the element of panic is fundamental for their arguments.

We had to tune in every day so that our governor or whoever would tell us where we could go and the crowd goes crazy. Yeah, what the fuck? What they have to forget is, yeah, because they were in a panic. Nobody was happy to do lockdowns. I remember very clearly that lockdowns were not an idea. They were the result of not having any other idea, but worried to the point of panic. Fair? Yeah, and I would put it this way, Chris. I mean, first of all, for people who are like,

this was done by the Democrats or Tony Fauci or whatever crazy story, I remind people this was a global pandemic. India, with its 1.4 billion people, locked down. I mean, you know, India was not doing this to help Donald or help or hurt Joe Biden. I mean, I think this is just, you have to have a certain level of kind of craziness. I think the whole world went along with some hoax. That's not what happened. I do want to talk a little bit about the lockdown thing. It was very interesting.

I was on a National Public Radio show recently where they played a clip of me talking about lockdowns from March 7th, 2020. And what I said then, which I still believe now, is I said we need a two week lockdown while we get testing stood up. Here's the point, Chris. If you have really good surveillance and testing, you don't ever have to do lockdown. Never have to do lockdown. Because we could have tested, we could have known things were bad in New York, we would have known that there's not much virus in Mississippi or Montana. And then what

you do is you put in a lot of aggressive policies in New York, but you leave Mississippi and Montana alone. We didn't have any testing. And so people are like, well, why'd you say two weeks? Because I was talking to my friends at the White House and they were hearing from Vice President Pence and President Trump, we're going to have testing in two weeks. I was like, great, we're going to have testing in two weeks. Let's do this for two weeks. We'll have testing. We'll be good to go. They were never going to have testing in two weeks. They hadn't actually didn't have a plan. So this was a response to a failure that all of us thought was gonna get corrected very quickly.

It didn't. And the whole world had this kind of issue. But the last point on this, South Korea stood up testing immediately. They didn't end up going into lockdowns. They didn't have to. You can get away with never having to do lockdowns if you have plenty of testing.

I remember you, that's your introduction to me and my world was testing. I mean, you know, you know so many different things, but you're always coming in. And it was always a function of what we didn't have. Remind people again, because that was a fundamental piece. Now we take testing. I remember not only living through this part with you, but the idea that I wouldn't think it was reasonable to test.

We had so little testing that could be relied on that it was like, yeah, well, you're not going to be able to test. Now people are so comfortable with the ease of tests. You got your Binax, you got your rapid tests, you got them all over the place. People don't take them anymore, but they're around. Why wasn't there testing and what did that mean at the time in terms of informing how government and then private sector responded?

Yeah, all right, so why was there not testing? It's a really good question. I think there were two or three major problems. One is our CDC screwed up testing. They were supposed to develop the test. They have plenty of capability. For five weeks, they couldn't figure out how to do this. WHO made a test early in January.

And the CDC said, nah, we don't need your test, we'll build our own. That's fine, CDC knows how to do this generally. But then they completely screwed up for six weeks and could not get a test right. Even when they did, we just, there was like no effort to scale it up and make it widely available.

And again, here's the reason why that's so important for us. From early January when this virus first arrived in our country, till early March when it was causing so many deaths in New York, the virus spread. And we did not know where it was spreading. We didn't know how much it was spreading. You can't know these things unless you're doing testing. And so we had two months of being a flying blindly. And when you're flying blindly for two

months in a pandemic, that's a long time to be flying. And so we found ourselves in mid-March going, oh my God, we have no tests and the virus feels like it's everywhere. And that's what led to some very draconian policies that I think if we're smart, we never have to do again. If we're smart, meaning that you know how to fix what went wrong the first time, we haven't done a review of what happened the first time because I believe, and feel free to disagree.

There are three primary reasons. One is people wanna move on. Two is this is the worst reason. There is no advantage of one party over the other when it comes to the pandemic. It is such a weird dynamic. You're not exposed to it the way I am, especially now. Anti-vaxxers are almost exclusively,

they used to be lefties, far lefties, and moms. Now they're almost exclusively, we have men and women, but they're almost exclusively Trumpers. And yet Trump, it's the only animus Trump doesn't share with his base. You do not hear Trump bashing a vaccine because he was Operation Warp Speed.

Even though they forgive Trump because they say the deep state lied to him about the vaccine and Big Pharma lied to him. So he gets a pass. So all of these anti-vaxxers are on the right. They believe all of you lie, you, me too, lied to them on purpose, kept them from remedies that would have made COVID not a big deal

and no need for the vaccine. And the right doesn't wanna deal with them. They never speak to those people or about those people, even the COVID committee, the subcommittee we see now, they are not engaging in what those people want them to. So one, everybody wants to move on. Two, there is no ability to do this for the Democrats and Republicans because they both have plenty of stink on them. And the third one is we don't know how to do the review. The only model we have was the 9-11 Commission and it's not as easy to line up experts on this as it is on that that will satisfy everybody.

How important is it though to look back and make judgments and preparations for the bird flu or whatever comes next? Yeah, I think it's extraordinarily important. Look, I don't understand, obviously no one ever calls me for political advice. I don't know what the political advantage or disadvantage is to one party or another. What I know is it's very, very important.

When I was at the White House before I left, one of the things I thought was very important was to at least try my best to understand what went wrong and do what I could to start putting into place policies that are going to make things better. Great. I tried to do that. We can talk about some of the things I did.

But that's not a substitute for a review. A review should be open. It should be transparent. People across the political spectrum should get a chance to weigh in. I worry we'll never do that. And there will be important lessons that will be lost to history because we didn't do that.

And it means we're not gonna be as well prepared next time. Do we have enough PPE right now for another pandemic? Right now we do. So we have PPE. Testing is not fair to say do we have testing because you don't know what you have to test for yet. But our testing infrastructure has gotten a lot better. It's gotten a lot better.

There was a whole set of things we didn't have in 2020. The biggest thing we have now that we didn't have, and then I'll tell you where the risk here is, is we have wastewater surveillance. I have to tell you, Chris, most people don't understand this thing. They're not talked about. It's kind of gross.

It's like sampling municipal wastewater. It's awesome because you can go into community after community, pull out wastewater samples, and look at how much virus there is. And that gives you a sense of how much infection there is in the community. Only anonymized, you're not telling like, you know, Mr. Jones has it or doesn't. That's not what you get. You get a community level infection data, but it allows you to track where it's spreading. We have this in majority of communities across America. We didn't have it. If we had it in 2020, we would have seen the virus spreading. It would have been amazing. We didn't.

Here's the problem. So we have enough PPE. Yes, we have a whole bunch of COVID tests in our stockpile. We've done a lot of progress in making testing better. We've made a lot of progress in surveillance wastewater. The problem is these things are not a one-time investment. You got to sustain it. PPE doesn't stay in the sock pile forever. You gotta refresh it. These masks are good for a couple of years, and then you gotta buy more. You need money to do that.

And there is just not a lot of political interest in Congress to continue to fund preparation. And I've talked to members of Congress, they get it, but a lot of them are like, well, maybe it'll be another 100 years before we have the next backup. I doubt it. I think it's gonna be much sooner. But the preparation stuff, we got to keep going on this. And there's just not a lot of interest in Congress to keep it going. How do you think, and it's interesting, because you know, in your world of understanding the DC dynamic, understanding the academic communities, you're not in the fringe.

You don't get a lot of fringe exposure. But what is your take on the level of acceptance by the American people of anything government would tell them is necessary next time. Yeah, you know, Chris, I will tell you that I have a view on this that may or may not be right. But there is a lot of loud, fringe voices from the left and the right. The left that's convinced that the pandemic is just as bad as ever and we all should still be masking indoors. And then the right with all of it's kind of a lot of, you know, conspiracy theories as well.

But when I look at the broad middle, I see a lot of people who think that was terrible. We didn't get everything right. Maybe there's some issues with our government and how it functioned. We're in a better place. Thank God. And are still open to listening to reasonable voices. And I think that broad middle is in Democrats, is among Republicans. That has been my experience. You know, I will tell you when I was when I was at the White House, I'm not just a Biden official. I'd go up to the Hill and talk to Republican senators and behind closed doors, they were like totally

reasonable and thoughtful. But their problem is they have a political base that's a little crazy. By the way, a lot of Democrats have a political base that's also a little crazy. So that's the problem on the Republican side. And so these guys would say, I mean, I had a senator who I was trying to convince to support a specific initiative. And he said to me at the end, he said, you've convinced me this is really important. I wish I could vote for it. I want to vote, but I can't vote for it. But I'll tell you what

I'll do. I won't actively campaign against it. I was like, all right, that's good enough. I'd love your vote instead. It's very hard and the politics has gotten really messy here. Welcome to the game. Some examples that people cling on to because I'm not worried about the far left when it comes to this, the idea of the pandemic is as bad as ever. You want to wear a mask, wear a mask. Wear a mask. But there is a magnification effect to social media that you have to account for. Magnified minorities. And here's why they matter.

The broad middle is not loud and proud on social media. No. Middle is not a strong word. The media covers what happens on social media like Vox Populi. So you have an over-sampled minority that the media relies on. The lament for me in this is long COVID.

Long COVID is only really invested in by these fringe anti-vaxxer, you know, some of them don't believe in long COVID, they think it's just long vax, they're just wrong, but whatever. And you don't get a lot of buy-in on the left and in the center to long COVID because they're not familiar with it enough.

And by the time they are, we're gonna have a real problem. So that's how I was exposed to it. But when you go through things, people like you aren't given enough opportunity to discuss them and explain them in a way that competes with what these people are being told. For example, I have a few of them. Masks. Tony Fauci said, masks don't work. You don't want to use a mask, you'll spread more infection, then all of a sudden we need masks. Now, this is a layup for anybody who's open to what the facts were.

Why did it go in the analysis from no mask to mask? Yeah, look, again, the way I talked about it in early in the pandemic was, I don't know if masks are gonna work or not, because I didn't know. Because I didn't know how this virus was being spread. This is in March and April of 2020. So I would not have said no masks.

I would have said, I don't know if it's gonna be useful. To be honest, I don't know. And I would say by June, July, it was starting to become clear this was an airborne disease. It was spread through aerosols, and a high quality mask absolutely makes a difference. And so a lot of this is like, don't be over certain when you don't know. Say I don't know, it may not work. We're going to find out.

And then once you find out, then you can tell people, okay, we've done the studies, we've looked at this thing. Now we're more confident that it is going to work. It literally does. But that, I think if you walk people through this and acknowledge your uncertainty, it's a lot more powerful. You have no money in this. It was not your doing. And intellectually, you have no reason to carry water on this proposition. But here's the proposition. proposition, but here's the proposition. You guys knew, the cognoscenti knew that one-off treatments,

whether it was remdesivir, which they were definitely using in hospitals, hydroxychloroquine is one big one, ivermectin. Ivermectin is the most clinically researched substance COVID related and not for good reason. is the most clinically researched substance, COVID related and not for good reason. It was mostly became this kind of Trojan horse for people. Do you remember anyone reaching out to you for advice or once you got in, it was a little too late into the administration,

but where there was an active effort to say, no, don't let them take that stuff, it works too well. Let's push them all towards the vaccine. So let's think of it this way. Let's talk about hydroxychloroquine and ivergurte. In March and April, when we had frozen, or, you know, refrigerated trucks and people to take away dead bodies, we had no vaccine.

It would have been awesome if hydroxychloroquine and ivermectin were. In fact, I had friends who were working in the hospital in April of 2020 who were using hydroxychloroquine, not because we had any evidence that it was working, but these people were dying and were just like, let's just try anything. So absolutely, I think there was

a lot of effort to try to use it to study it and then the data just started coming in saying it's not making any difference. If you go again you can think about whatever conspiracy theories about America go to go to the UK go to Germany go to France go to all of these countries Sweden people love talking about Sweden were they using hydroxychloroquine and ivermectin? No. And then people are like, it's Big Pharma. Who makes these drugs? Who makes hydrox- Who makes ivermectin? Merck. Like, Merck is Big Pharma. Like, if they had a drug that worked, and I was- I and everybody else was in it for Big Pharma, why wouldn't we be pushing that stuff?

It's sort of crazy. You know, there's a lot of like conspiracy things that like sound good until you think about it. Then the moment you think about it, you realize, oh yeah, that makes zero sense. Like these drugs were not made by some nonprofit charity. These are drugs made by pharmaceutical companies. If they worked, I would have pushed them in all day because they would have saved lives.

They just didn't. They still don't. The vaccine. Now I think it's fair to say at this point, and I've talked to all the relevant players that I can about this, we had a messaging problem on the vaccine. Now I say we, because the media took on a very unconventional and probably ill-advised role of echoing government messaging, which was you need to take the vaccine.

The vaccine is gonna make it less likely, well, early on it was, take the vaccine, you won't get sick. Take the vaccine, you won't get sick. Take the vaccine, you won't get sick and you won't get anybody else sick. In hindsight, was that an exit? Well, we know it was an exaggeration of what this thing did, but why do you believe that was the messaging early on?

Was it an act of deception? So that messaging began in in late November, early December of 2020, as the vaccines were coming outboard. So that was the messaging out of the Trump administration and then the Biden administration. There was a genuine belief at that time that once we got people vaccinated, the pandemic would come to an end.

And the reason was we had had one version of the virus, the original Wuhan strain. There had been no variants. And because there were no variants at that time, people were largely not worried. That's why the president, President Biden, went out and basically was like, let's get 70% of Americans vaccinated

and the pandemic will essentially be over. Turned out the virus had other ideas. So in retrospect, and I got asked a lot at that time, like, do vaccines reduce transmission? Will they stop? Will they end the pandemic? And I said, look, as long as a virus doesn't change in a meaningful way, these vaccines should really bring the pandemic to an end.

I did say that. Turned out the virus changed. Now we started getting new variants and all of a sudden the vaccines efficacy certainly against infection dropped dramatically. And I think we should have had more humility upfront to be more clear that the virus may very well change. And if it does, our vaccines are going to be less effective over time. That's essentially what happened. And I think we weren't very clear with people about it. If it does, our vaccines are going to be less effective over time. That's essentially what happened. And I think we weren't very clear with people about it.

If we went through something like it again, do you believe that who would be mandated to get the vaccine would be much more narrow? Yes, I do. I do. I look, I say this to my public health friends and I remind them that the history of mandates in public health is not a glorious history. In general, you don't want to use mandates unless you absolutely have to. I say that as somebody who supported vaccine mandates early on, but I'm also someone who ended all the vaccine mandates

when I was at the white house. Um, because I felt like the era of mandates was, was well past its prime. Um, what I will say on this is you should use mandates rarely. You should use it very narrowly. Um, and I get why people did it. I was I get why I was supportive of it. Initially, it seemed to work, it certainly saved a lot of lives. But in the long run, it also

bred a lot of distrust. And I think was harmful as well. So in a hindsight on this is 2020. But to your question in the future, I think to the extent that there are mandates, they're going to be very, very narrow. But you don't believe that the mandates were an act of bad faith or the require an apology? No. I mean, look, it was very clear in the spring and summer of 2021, the people who are dying were people who were not vaccinated.

Like that data is just overwhelmingly clear. And there was a mental model that if we got, you know, people vaccinated, people would stop dying, the pandemic would end. Well, it certainly is true people would have gotten to stop dying, the pandemic wasn't gonna end because the virus was mutating. Right.

It was not an act of bad faith. It was an attempt to like bring this thing to a close and save lives. The idea that it's not a vaccine, the definition of a vaccine was changed to call this a vaccine. What is the truth? So what is a vaccine? By the way, the term vaccine is a term for about 150 years ago. And all it means is something that trains your immune system.

Right? That's what vaccines do. People are like, I'm going to trust my immune system. Yeah. And vaccines are like training videos for your immune system. What vaccines do is they introduce something that looks like the virus and gets your immune system all trained up so when it actually sees the virus, it's much more effective. That's what the Johnson & Johnson vaccine is, that's what the Moderna and Pfizer vaccines

are, that's what the vaccines are that were used in other countries, not here. These are vaccines. They train the immune system. People say all sorts of crazy things. All of us in medicine, public health, see this as just another version of the types of vaccines we've been using forever. The material difference would be that a vaccine traditionally

makes you immune, meaning you don't get it. I don't get polio, I don't get measles, I don't get mumps or rubella, I did get COVID. Ah, so two things. First of all, some vaccines, yes, not some vaccines, no. Flu vaccine, you get the flu vaccine, you can still get the flu. Is it still a vaccine? Yeah betcha. What it does is it improves your immune system. So when you see the virus, even if you get infected, it's much, much milder. That's what a flu vaccine does. That's what a COVID vaccine does. Um, there are other vaccines, you know, even the polio vaccine, the latest

versions of the polio vaccine don't create what's called sterilizing immunity. Meaning people can still get infected. They just have very mild GI symptoms and they don't get sick and they don't get, they don't get paralyzed. Um, but these vaccines, there are some vaccines that are sterilizing, meaning you don't get, they don't get paralyzed. But these vaccines, there are some vaccines that are sterilizing, meaning you don't get the infection. There are other vaccines that really reduce serious illness. COVID vaccines, our hope was it would be in the former group.

It has turned out to be like a lot of other vaccines where they just reduce your seriousness of illness. So I'm knee deep in this long COVID stuff now because I'm trying to get rid of this histamine response that I have that I have that's been elevated since I got my first bad case of COVID or whatever. My first moderate case of COVID wasn't that bad, I wasn't hospitalized.

And one of the things I now know that I think is a really potent messaging point that is largely ignored. Like I was getting attacked recently for poor Joe Rogan. He told everybody the secret of ivermectin and everybody shit on him and shut him down. And so many people would have been less sick if they'd just taken ivermectin.

Now I reject that, but there's a missing piece. Look, nobody should have been demonized when people didn't have good answers. He was offering something, ivermectin in all likelihood won't hurt you, maybe some GI symptoms in the rare cases. But here's what was left out that needs to be reminded. Overwhelmingly, okay, and now I now know this

from these people who are just crunching data, trying to find ways to understand what long COVID is and what to do with it. Overwhelmingly, people who got COVID got better with one essential ingredient, time. And it is so predominant as the factor that made the difference that nothing comes close to second other than water.

So with time, a healthy Joe Rogan, a healthy Dr. Jha, a healthy most people, were gonna get better no matter what they did. So you don't know that it was the Tylenol or the Doxy or the Amoxicillin or the Ivermectin or whatever it was. It was the time. That's why you were only sick three, four days.

Most people overwhelmingly who got it were only sick a few days and it went away. We have forgotten that and we don't message that point. Do you accept that point and what does that mean to you? So absolutely and what I remind people is it used to be 50 years ago, 100 years ago, if you went to a doctor with any condition If you went to a doctor with any condition, they would give you some set of potions and elixirs and you'd go home and three days later you'd feel a lot better. And it'd be like, I love that guy. I was sick as a dog when I went in three days of his fancy elixir and I feel great. Love that guy. Chances are that elixir did nothing. Think sure of time. There's an old saying, it's almost like a Renate, I think like Descartes or somebody who said, the art of medicine is amusing the patient while nature heals the disease, right? But that changed 50 years ago. 50 years ago, we started doing scientific studies. We said, you can't just give somebody elixir and say, are you better?

You got to give half the people the elixir, the other half people nothing. And then check in on them five days later and see did one group get better than the other. Randomized trials, that's where that came from. And all of a sudden we started learning like some things work, some things don't work. They're no better than placebo. And so when people were talking about using hydroxychloroquine

and ivermectin, I was like, okay, we don't have any data. That's fine. They're probably safe. It's okay. But we got to get the data. We got to do the randomized trials. We did the randomized trials and they showed no effect. So I now feel very confident that like neither of these two drugs work. I wish they did. That'd be awesome. Again, it's not, oh, you're in it for big pharma. Merck is big pharma. Ivermectin is made by Merck.

You think I like one big pharma over another? I don't have any stocks in any of these things. I had to disclose all of this stuff when I went into government. I've never taken money from Pfizer or Merck. So the point is that there's a little bit of like logic that this is something we have learned in medicine. You can't say I took Ivermectin and I got better. You can also say I drank six glasses of water and I got better. Great. But that's not what caused it. Right. And that's your point. And that's very, very important. And that's by the way,

one last point I remind people, that's how we do cancer studies. That's how we do heart disease studies. We have built entire modern medicine on these kinds of studies, and we should not abandon them for COVID. We should use the same strategies that we do for cancer and heart disease therapies for COVID therapies. What is the current understanding of what the vaccine is doing to people in the negative space?

That's a good question. Look, I was on a show recently, I think on News Nation, where I talked a little bit about this. I think this is unfortunate, Chris, and let me say what I mean. First of all, 90% of adults have gotten at least one shot, right? So that's about 250 million people, maybe. And when you have something that 250 million people have gotten, even if you have a very rare side effect, let's say something in one in 10,000, well, you're still going to end up with thousands of people with side effects and issues. And where I think things have gone wrong is in some communities, it's become taboo to even talk about vaccine side effects, because now you're an anti-vaxxer. Like, no, I'm a very pro-vaxxer. I think vaccines are awesome. Do I think there are some proportion

of people who end up getting hurt by vaccines? Almost surely, yes. Nothing in the world is completely 100% safe. Nothing. I give my patients who are having heart attacks, aspirin. Aspirin causes GI bleeds. Aspirin causes all sorts of other problems. There are side effects. But I look and I say the benefits outweigh the risks, and that's why I give that treatment.

Same thing with vaccines. But I think we have to acknowledge the fact that there are people who were injured by the vaccine. We have to treat them. We have to treat them with respect. And it doesn't make you an anti-vaxxer to say that. Why isn't the government jumping on long COVID and vaccine side effects more? Now people beat me over the head with the recover initiative and there's been a billion

dollars, but there's almost no therapeutics that have been, there's not even a protocol that the government puts out of what to do if you have this kind of symptom base with long COVID. Why? Why so little attention for something that dominated attention? It's a very good question. Look, first of all, let me take a minute to talk about how I think so long COVID, because there are people who minimize long COVID, long COVID is real. You know it's real. I know it's real. Long COVID can be debilitating. And we don't fully understand its mechanisms.

And this will get to your therapeutic question in a second. In my view, there are probably three or four different conditions that we're lumping into long COVID. One is you had a pretty bad case, you had tissue damage, let's say in your lungs and in other parts, and you're suffering the symptoms of that damage. There's a second where people probably have what I talk about as persistent virus,

maybe persistent amounts of spike protein, persistent amounts of virus in your body that just hasn't been cleared. And then there's a set of people who have what we call immune dysfunction. Their immune system just got revved up and has never fully kind of gotten back to normal. If you think of those three things, they need very different treatment strategies. Same thing is not going to work for every one of those things.

And so absolutely true. I wish recover had done more on treatments. I think Congress should fund the next round of research on this. I wanna see more companies getting into this space. A lot of companies wanna study and long COVID therapeutics, but they're like, where's the market gonna be? Is anybody gonna actually help us get this funded?

There's a lot we could be doing in this space and I wish we were doing. We're opening ourselves up to snake oil because you have a lot of people who now, the messaging has a secondary or the lack of messaging has a secondary effect, which is you have a lot of people, autoimmune, you know, obviously, just for you guys who are thinking

this is the first time I've really talked to Ashish Jha, I've talked to him more times than I can remember in part because of my long COVID, in part because I don't wanna remember. But I've known and benefited from his intelligence for a long time, which is why I'm bringing him to you guys. And there are other people who I don't because I just, I trust him on a different level.

So one of the secondary effects of the lack of messaging, so one is the snake oil effect. There's nothing out there, so then everything is kind of on equal footing, right So one is the snake oil effect. There's nothing out there. So then everything is kind of on equal footing, right? And is always going on. The secondary effect of it is autoimmune disease and illness is huge. And we don't talk about it that often.

It's like the new version for some people of idiopathic. Idiopathic is of course to us lay people the fancy word for when they don't know why you're sick. So autoimmune is the new thing that is kind of a catch-all and it's getting conflated with long COVID because a lot of long COVID presents like an autoimmune disorder. So the numbers are expanding exponentially because there are a lot of sick people who are chronically ill who never really knew what it was and are now saying it's long COVID. And they may be right, they may not be, but that's from the absence of messaging. And I feel like we're setting ourselves up for a lot of people getting taken advantage of.

Yeah. So two things on this, Chris. First of all, I agree with you. There is, look, there is clearly for some proportion of people with, who have long COVID, what I think of is immune dysfunction, not even autoimmune disease where autoimmune is like when your immune system essentially attacks your body. Right. Immune, I'm using immune dysfunction in a slightly different way, which is your immunologic response to almost everything becomes dysfunctional. It overdoes things.

It underdoes things. It does the wrong thing. Um, we do see that with a proportion of people with long COVID. And that's a group where we've got to figure out what I think of as immunomodulators, drugs that are gonna help you modulate your immune system. We should be testing a lot of that stuff. That's important.

You're absolutely right. There's a different group of people who have had autoimmune diseases have been around. Lupus, rheumatoid arthritis, Sjogrens, there's a whole bunch of them. And as people develop them, because we've always had people people develop them, because we've always had people who developed them, if they got COVID in the last couple of years, and a lot of

people got COVID in the last couple of years, they tie them together. Say, maybe my autoimmune disease is from my COVID, this is really long COVID. Getting people to understand which ones are really related to COVID and which ones are not is going to be very, very important. And then you actually raise a much bigger point, which I agree with wholly, is if we don't do a better job in the scientific community, both acknowledging what people are going through and giving them options, they become sitting ducks for people who are happy to exploit those folks who are suffering with all sorts of crazy treatments, most of which will do no good and some of them will actually do more harm than good. Do you believe that there is anything to support the notion at this point

that these vaccines are more destructive than traditional vaccines or previous ones, that there's something about the mRNA that is worse than anything else? Nope, I've looked at the data carefully on this. And look, I'm the first one I told you. There have been people who've had side effects. But the data on this, to me, is clean and clear.

Are there people with side effects with mRNA vaccines? Sure. By the way, some people got Novavax, which is a protein-based. A lot of people got Johnson & Johnson, which was a vector-based. But I of people got Johnson & Johnson, which was a vector-based. But I look at vaccine side effects here versus Europe, where they use a lot of other vaccines. It's almost identical. I have no evidence whatsoever that the mRNA vaccines are any worse. I just don't think they are. What do you make of the bird flu?

Now, I think it's an interesting test case. You know why? Nobody wants to hear shit about the bird flu. I remember when it was like H1N1 or whatever it was, like 20 years ago, I forget when it was. There was more interest in what is this, what isn't it? How does it transfer from one thing to another? How worried do I have to be?

Then there is today, because people are like, nah, nah, you're not doing this to me again. Yeah. Yeah. So let me take a minute to talk about bird flu. So bird flu has been around forever. And in the last 10 years, especially the last five years, we've seen it become way more widespread. The reason it's bad and scary is in humans that have been known to be affected, the death rate is close to 50%.

Katie's fatality rate of 50%, one out of two people who caught bird flu in the past died. Young, old, kids, elderly, awful. Now, two points. It's probably almost surely an overest because that's just who they tested and then probably other people who've gotten bird flu and did fine and no one tested them. So that's one. Probably not as deadly as that. Probably still quite deadly though. The issue is it's largely in birds. It doesn't spread among people. So like, okay, don't handle dead birds. You'll be fine. In the last four months, we started seeing it spread among cows. I don't like that. Cows are mammals. Like we're mammals.

And humans interact with cows. These are dairy cows. So then you have workers. So the way I look at this is right now, if you're an average American, should you be worried about bird flu? No. Like, go live your life. But those of us in public health and those of us who think about these issues,

we got to start preparing and planning for, if that thing jumps and becomes something that spreads from person to person, we want to be ready. Testing, surveillance, vaccines, treatments. We want to make sure we have all that ready to go in case it does. I am relatively hopeful that it won't, but relatively hopeful. I didn't give you an assurance it will not.

Didn't tell you it will. I don't know. But my best guess is, my best estimate is it's probably not going to happen. I think we'll be okay, at least for a while. I tell my family and friends, because people call me and say, well, am I worried about the bird flu? I'm like, are you handling dead birds? Are you handling dairy cow?

If you're not, don't worry about it. But I gotta worry about it a lot. And I gotta make sure that we as a country are ready. When you look at the pandemic as a whole and as an experience, what do you think the best assessment is of why America did worse than a lot of other big countries when we had pretty much every advantage except a nation of sheep. Yeah, you know, it's interesting.

I'll actually broaden that a little bit and then I will come speaking about America. There's some pretty good data looking at dozens and dozens of countries asking why did some countries do better than others? And the number one predictor of how well a country did is not how wealthy you are. It's not how quickly you got the vaccines. It's how much trust you had in your government, how much trust you had in other people in your community. Trust drove all of this. So I look at a country like Japan or South Korea, people are like, well, culturally they're different. I don't know. Okay. I look at places like Germany.

I mean, Germans are not that different. They're not sheep. And they just had more trust in their government. There were still anti-vaxxers in Germany, but they were much smaller numbers. And I really think that it is important. We have a long history in our country of not trusting our government. I get that. That's part of the American culture, right? Individualism, not gonna trust our government.

But we also have to build more trust in our communities. Okay, so you don't have to listen to, you don't like Donald Trump, don't listen to Donald Trump. You don't like Joe Biden, don't listen to Joe Biden. But you care about your community, you care about your neighborhood, you care about your family and friends. And we've got to do a better job of building trust at that local level. We

just didn't do that very much. And I think that's what hurt us. How about being fat? Was being so fat important? Clearly obesity was a marker and a risk factor for death. No question about it. And so people are like, well, isn't that what caused more deaths here? Yes, but I'll give you a counter example. What's the number one predictor of who died and who lived? Age. The elderly died at astronomically higher numbers. Which country is older, Japan or America? Which country is older? France or America? France is much older than America. They had much lower death rates. So yes, obesity is important. Nothing is as important as age.

We could have done better if we had done some of these other things better. Do you believe that there's such a thing as red COVID and that reluctance to take the vaccine in these counties? I mean, I could send you the data. It's all over the place, but that reluctance to take it had a result in extreme hospitalization or cases of hospitalization and death. You know, I'll tell you, Chris, I've seen all that data.

And when I was at the White House, we would look at data broken down in a hundred different ways. I will say the following. I don't think it serves any of us well. I'm just telling you my personal view, not criticizing anybody who does it differently, to talk about this as a Republican or a Democrat issue. And I remind people that in 2019, if you said to me, 2019, which state has the highest vaccination rate among kids in America? Which state has the highest vaccination rate among kids in America? Mississippi.

And which state has one of the lowest? California. Vaccines have not been partisan. And you started us off by reminding us that to the extent that we're anti-vaxxers, a lot of them were kind of liberal, you know, I want to live naturally and kind of stuff. So I want to get us back to a point where vaccines are once again nonpartisan, like make vaccines nonpartisan again. Vaccines work for Democrats and Republicans.

I think it's really important that we delink political identity with vaccines. It has never been linked in the past. I agree. I do not like where we're heading. I agree. I am linked in the past. I agree. I do not like where we're heading. I agree. I am pushing back on it. I agree. I will say anyway.

Here's why I push back. Because you can't have it both ways, not you, they. You can't say, God, I'm glad I didn't take that vaccine. I'm glad I didn't listen. I can't believe how you people shamed me and compelled me to take it and we didn't and have it where people who made choices like you got sick more and died more.

You can't have both. And without that fact, if you ignore that people who aren't, I mean, look, I mean, you know, either of us could Google it right now from the government to the extent that anybody wants to believe their data and look at who died more, vaccinated people or unvaccinated people.

Well, so here's what I will say to you, absolutely. Who got hospitalized more, vaccinated or unvaccinated. It was like 90 out of 100 after the vaccine got some penetration into country in the hospitals. Exactly, so there are two points that I will make. Point number one is I don't trust the data from the government. By the way, the federal government doesn't collect any of these data. All the data comes from states and counties. And so I remind people, okay, you're in Florida.

You don't, you don't trust Governor DeSantis' department of health and their data. Take it up with your governor. You don't trust, you know, governor in Mississippi's data. take it up with your governor. You don't trust, you know, governor in Mississippi's data, take it up with your governor. The truth is health departments are collecting the data reasonably, thoughtfully, and accurately. Yeah, nothing's perfect, but these guys have all been doing a good job in red states, purple states, and blue states. All the CDC does is rolls it all up and shows it to you. CDC does not out there collecting any of this. Point number one.

Point number two is it is uncontrovertibly true that people who did not get vaccinated died at much, much higher numbers. You and I are on the same page on that. I mean, that's just what the data shows, it's pretty clear. My point is I get the temptation, I don't wanna turn that into a Republican versus Democratic. I don't want to turn them into Republican versus Democratic. I don't because I'm not asking Republicans to be Democrats or Democrats to be Republicans.

I'm saying just freaking get the vaccine. And I remind people, you know, I used to do a lot of Newsmax and Fox News before I went to the White House. Then they cut me off. They're like, you can't talk to Newsmax and Fox News when you're at the White House. But I was on Newsmax all the time. And I would say, Rob Finnerty, bless his heart, would have me on in the mornings, like three times a week,

and I would remind people, these are great vaccines. They were developed under President Trump's leadership. I call them Trump vaccines. And by the way, a majority of Trump voters took the vaccine. And we have got to delink, do you like Donald Trump or Joe Biden with are you gonna get vaccinated? That is a terrible linkage.

We gotta just get rid of that. You know who, if you wanna please the right audience, remind who started us down the political road with the vaccine. Sure, Trump was celebrating it, but all politicians celebrate getting something done. It was Kamala Harris, who was the first politician to say that I recognized,

I'm not taking that Trump vaccine, I'm not taking any vaccine that he was a part of. That was the first person I heard. So if you're on the right and you need to have some comfort that you're not to blame for all of this, it started with a lefty. Dr. Jha, I really appreciate you having this conversation because for my audience,

which is largely what I refer to as free agents, the largest, the plurality of this country, as you referred to them, the reasonable middle. I don't like the word middle because middle sounds weak. Nobody wants to be in the middle of anything. That's how you get punched by both sides. But critical thinkers, independent, not tied to parties. And you are rare air in terms of pedigree,

experience on the ground with what we're talking about and being open to conversation and counterpoints. So thank you, I appreciate you. It's always a pleasure, Chris. Thanks for having me back. He lived it. He served during it. He understands it and he's open. That last part was what we were probably missing early on.

I get it. I get it. There was no time for uncertainty when people were not gonna listen to you. I don't know that that makes it the right choice, but I get why the choice was made. Thank you very much for having the conversation with me here on the Chris Cuomo Project. I hope you heard your questions being answered.

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