The Comedy Cellar: Live from the Table - The Virologist

Episode Date: March 29, 2020

Dr. Satish Pillai

You're listening to The Comedy Cellar, live from the table, on the podcast of New York's famous comedy cellar in Greenwich Village, New York. We are coming to you via Zoom and via Sirius XM 99 Raw Dog. Here tonight, Noam is here, even though I'm giving the introduction, but Noam didn't want to do it for some reason. Periel is here, and we have Satish... What's your last name? Now you know why I didn't want to do it.

All right. Satish Pillai. Satish Pillai. He is a specialist in... He's a physician. No, I'm not a physician. No, I'm a scientist. I'm's a physician. No, I'm not a physician. No, I'm a scientist. I'm not a physician.

I'm a scientist and a specialist in HIV, I believe. That's right. But obviously can probably help shed a little bit of light on Corona because he's in the virus space, if you will. He's a virologist. I am a virologist. Yeah. And just to be clear, I am, you know, my historical expertise is not in coronavirus. I've been mainly focused on HIV and retroviruses in general. But virologist I know, we've all kind of decided

to temporarily put down what we're doing to really nucleate around the challenge of the day. And so I've been doing a lot of homework in the last couple of weeks to learn everything I can about the biology of this virus and what we can do about it. Just a quick question about HIV before we jump into the news of the world. Is the HIV virus of 2020 the same HIV virus that was wreaking utter havoc in the early 1980s, or is it a mutated, less lethal form? Awesome question. That is a really, really awesome question, which is actually a controversial question. I would say that there's no conclusive evidence that it is either more or less virulent than it was. So there have been many people that I've known over the years that have tried to do these massive meta-analyses of data sets to look at how quickly people lose their

T-cells in the modern era versus in the old era, or look at how high patient viral loads are in the modern era versus 20 years ago. And here's the big caveat. You have to look specifically at people that are not on small molecule drugs, right? Because that's changed the whole ballgame. But if you look at untreated HIV disease, I would say that there are little hints here and there, but there's no real conclusive evidence that the virulence or the transmissibility of the virus has changed appreciably. There's anecdotal evidence from regional epidemics, but overall, I would say it's very similar. Okay, interesting. advent of highly active antiretroviral therapy in the late 90s, you know, which really changed it from a death sentence to something that's theoretically a chronic condition that you

could manage with daily drug therapy if, and this is the big if, if you're lucky enough to live somewhere and have the resources to obtain the small molecule drugs for the rest of your life. Okay, well, go ahead, Dan. Go ahead. Oh, do you have any question about that topic? Well, it's sort of, I mean, it's kind of related, like, so we have HIV, which is this really, was really, really deadly virus, but it was hard to get. And then you have this coronavirus, which is far less deadly, but is very easy to get. What happens when those two things happen at the same time? Is that something that could happen? Ooh, that's a good question. It's an excellent question. And I would say this virus is already in territory that's kind of an interesting ratio of those two things. So usually there's a trade

off between lethality and then transmissibility, right? Why? Is there a reason for that? Or is that just luck? I'll tell you what the reason is. So, I mean, the truth is the last thing a virus wants to do is kill its host, right? Because it wants to, number one, continue to make a living. And number two, it wants the opportunity to jump from one host to the next host. So really what a virus wants to do is just maximize its opportunity to jump from one person to the next person to the next person to the next person. And so what happens is if a virus is too lethal and so it you know brings about the demise of its host too quickly, it'll lose out on a lot a lot of opportunities for transmission because you know that that host is only around for a little bit

there's not much of a chance for that host to disseminate the virus. But here's the converse of that. If a virus is really not virulent at all, and you know, it infects an individual, but then it's just kind of replicating at a background level, it's just sort of hanging out at a low level, then the likelihood of it being successfully transmitted to another individual is low also. So viruses are constantly walking this balance point between being virulent enough to produce enough virus to have the opportunity to jump to another host, but not producing so much virus that you kill the host very quickly and you lose those opportunities. Sorry, would it be possible to have a virus that had the lethality of AIDS, but it took time

so that it had the opportunity to jump to other people, but was easily transmissible? I think the opportunity does exist. And here's what I think, and this is kind of one of the lessons that we're learning from this virus, is a lot of the combinations that we've seen of transmissibility, virulence, pathogenicity, these things, we haven't seen everything, right? I mean, I think that we will continue to see pathogens that occupy a balance point between these features like viral load in the host, lethality and transmissibility that we have not seen. And there are no firm rules, really. There are no firm rules. You say that in the thousands of years of human civilization, so far, nothing has come along to

wipe us out. Oh, I mean, well, when you say wipe us out, something that's taken all of us out entirely? No, because we're still here. But I think that there's probably, it's very hard to prove, but I think there's decent circumstantial evidence that, you know, throughout like the evolution of hominids, that we've been attacked with what you could consider to be sort of ancestors of HIV, like essentially other retroviruses that have caused massive epidemics in early humans, which has probably resulted in several different evolutionary bottlenecks. So there probably have been viruses historically, like prehistorically, that have decimated hominids along the way where, you know,

maybe a small number of individuals could get through the hatch. And, you know, this is a theory that's been bounced around. And I want to make it very clear that this is a theory. You know, I don't think there's any hardcore evidence of this, but I'm sure you're very familiar with the story of like the smallpox laden blankets, right? You know, so there's kind of a version of that I've heard, you know, with, with Neanderthals, for instance, there's some possibility heard, you know, with Neanderthals, for instance. There's some possibility that, you know, if Neanderthals and Homo sapiens really did coexist for a period of time,

and if their populations overlapped in both time and space, you know, I've heard some theories, not very well-founded theories, but one possibility is that their demise was actually brought about, you know, through the transmission of a pathogen that, you know, maybe pushed them over the edge. And the other thing I'd like to bring up that I think is a really important piece of circumstantial evidence. So if you look at the human genome, right, somewhere between 8 to 12% of the human genome is actually just fossilized retroviruses. Okay. So literally more than one 10th of our, our genome are just fossilized, archived remnants of retroviruses. So essentially viruses that are architecturally similar to HIV that infected us thousands to millions of years ago. is the virus went through a process called endogenization, where it just got usurped into the human genome and became part of our germline. And essentially, the virus stopped being an invading pathogen

and really just became part of who we are genetically. That's science fiction. It's freaking like science fiction. It really is like science fiction. It really is. By the way, I hear the term, what does retrovirus mean, as opposed to what's it going to do with from the 70s? Actually, there's some cool, cool i mean really nerdy memes but i've seen a couple of like nerdy memes memes about retroviruses where there's like a virus dressed in disco gear with like a big like

um it's really awesome but so the the definition of a retrovirus is that the um the genome is uh composed ribonucleic is ribonucleic acid that's exactly right so the genome is composed of ribonucleic acid. That's exactly right. So the genome is composed of ribonucleic acid, but there are lots of viruses, for instance, like coronavirus, whose genomes are composed of ribonucleic acid, which is RNA. But the canonical defining feature of a retrovirus is that the RNA genome is, quote, retro-transcribed back into DNA. So part of its life cycle is, even though its core genetic material is encoded in RNA, all of these viruses encode a protein or an enzyme that copies, Xerox copies their RNA back into DNA, and then that DNA is then stitched into the genome of its host, which is really a trip, right? So that's why they're called retroviruses,

because they retro-transcribe the RNA into DNA. I was about to say, you sound like you know what you're talking about. Everything you've just said could be completely made up. I just sound really convinced. I don't know anything. You sound legitimate. Because I always, you know, Periel said, oh, I know this guy. And, you know, Periel knows you. I always just assume, you know, the worst.

But I'm kidding, of course. So, okay. So somebody literally just texted me a column, a scathing column by Ann Coulter. Oh, God. Okay. Well, and here I am. So she, I mean, you can look it up,

but essentially she says that, first of all, she goes a little dig at Dr. Fauci. In 1987, he warned that French kissing might transmit the AIDS virus. Health officials, quote, health officials have to presume that it is possible to transmit. Well, that's presumption to be made extra safe. You can't really fault him for that. Then by 1992, after a decade long epidemic with more than a million infections the cdc could find only 2300 cases of white heterosexual transmission of aids and then she goes on to make the point and then she talks about how the average age of death in italy is 79.5 years old okay drawing a parallel which is you know which is a is a fair is a fair thing to consider that uh like i lived through that there was a time when aids came when we all thought we

have to stop having sex we're all gonna we're all gonna die and then apparently when the dust settled we realized no heterosexuals really didn't have to go through all that and she's kind of making the point that she thinks that, she thinks that this is a, almost no, I think she said zero people under 30 have died or something in Italy. And she's, you get the point.

She's making the point that we're overreacting to it and that we should just be addressing this as a very old person's problem. What do you say? So, first of all, there are components of that that border on truth, and a lot of it that's not. So basically what we know, you know, all of these things are probabilities. And there's no doubt, if you look at all of the epidemiologic data that have been collected in China, South Korea, Italy, anywhere this virus has been, there is a heavy bias in the data. So the older you are, the greater the probability that the infection will lead to either severe disease or death. There's no doubt. So if you look at like the data from China, you know, if you're above, I forgot what the cutoff is, but if

you're above 80 years old, it's like 15% mortality, whereas it's a small fraction of that if you're 40 years old. So it's inarguable that if you're elderly, the likelihood that you'll encounter your demise if you encounter the virus is higher. However, I guarantee you that there are tons of people all around the world right now that are either intubated or are dying that look like all of us right here that are in our age groups. There's certainly statistical differences in the proportions of people in different age groups. There's certainly statistical differences in the proportions of people in different age groups, but there are lots of people around the world right now

that are severely ill or dying that are much younger and that are younger than us. So let me add into the, I don't know if you can see that. I can share the screen, but I'll just add it to it because I also got, I got this from not an Ann Coulter fan. This is from a mainstream uh, a mainstream, uh, statistical guy.

This is New York city COVID-19 death. I was going to add this into this mix. Um, over 75, 103, that's 52%. 65 to 74 is 46 under 64 or is 40 is 23%. Um, But this is underlying illnesses. 166 out of all these deaths, 95% had underlying illnesses. No underlying illnesses, 5%.

If you have other comorbidities, cardiovascular disease, diabetes, you are at a very significantly elevated risk of dying as a result of coronavirus infection. That's all true. So I guess my question, and I guess maybe this would be to Ann Coulter, but my question is, let's say all this information is true. How does this affect the choices that we make as a society? That's exactly my question to you. So, you know, and actually I've had this conversation with people that are dear friends, to be honest, because I've actually talked to some people that, you know, are very close to me and stuff who've just been like, you know, well, you know, every once in a while you got to thin the herd, bro. And I don't know, it's like, I frankly can't even think that way. So I,

although I'm not a physician, since I'm a biomedical scientist, I'm married to a physician, and I work very closely with clinicians, I think really from a medical perspective, and to me, our society's number one goal should be to minimize the number one goal that we want to ascribe to, that we want to minimize the number of people that die right now, we have no choice but to just take this social distancing business just as seriously as possible. I mean, obviously, if we really wanted to minimize the number of people, the number of deaths, whether from this or anything else, we just all stay home and no, we wouldn't drive a car and we wouldn't do anything. So obviously, there has to be some risk that is taken. There has to be some risk that is taken. There has to be some risk. But, you know, I've heard from some people, it's like, well, you know, since the risk is so skewed towards the elderly,

why don't we just kind of keep trucking? And maybe the other thing we could do is, you know, try to do our best to selectively quarantine the people who are at greatest risk for the disease. And I just don't believe that that would work. And I just think that there's some major ethical, ethical problems with that. And here's the other thing is that, you know, and I know that Dr. Fauci has said this many times, and you know, other talking heads, but, you know, let's even say

that people who are, you know, 25 years old, you know, they're unlikely to die when they when they contract this infection. So go to the beach, whatever. Okay. So what they're doing, even if they're not going to succumb to the virus themselves, they are amazing vectors for the disease. So they're spreading it everywhere. And then what's going to happen is you have every single hospital bed, every single ICU bed, every single emergency room just filled with the gills and you have people spilling out onto the streets. So when these people end up breaking bones or bleeding for some other thing like a car accident or a drug overdose or anything else, they're screwed, right? They don't, there are no more critical care

facilities to give anybody else. And so it does directly affect the people that may not be directly killed by the virus. And I would say dramatically if we didn't do the social distancing thing. I was reading, you know, I was, I'm reasonably confident that I wouldn't die from this thing. I think you would. I was in that thought for a while. And then I started reading of people that didn't die, but went through horrific experiences

and had to, to say the least, a very bad week after contracting this virus. And what's insidious about it from what I've read is unlike a flu a flu at least has a decency to be straight up with you and as you and it says here's what i got and it hits you all at once this virus when i read it starts off like ali he's yes he's dancing i like that a little fever it gives you a little bit of a cough. Not so bad.

But you have no idea. And then for a couple days, you're just, you got a cough, you got a fever, but it's okay. And then one day you wake up and you can't breathe. Or maybe you don't wake up and you can't. You don't know. You don't know where it's going. So I wake up tomorrow, I've got a fever, and I don't feel that bad, but I'm petrified because I think in three days I could wind up in the ICU. Yeah, I think it's so insidious.

Like the pathology and the disease. Here's what I got. And you were like, okay. I totally hear you. And I love your Ali analogy. But yeah, it is just much more insidious and cryptic disease progression than seasonal influenza. That scares the crap out of me.

So I totally agree with you. You know, even if I didn't feel like there was a great chance that I would die if I contracted this thing, it scares the daylight out of me, the idea of getting infected by it. And the thing that I really hate about this virus, the whole idea that, I mean, there's very compelling evidence that people who are completely asymptomatic, you know, are transmitting this virus like gangbusters. And that really sucks. I mean, that is a major public health challenge when you can't use something like a, you know, stick a thermometer to somebody's forehead and determine whether they're at risk to society. You know, if there are no obvious symptoms, that is a really, really monstrous challenge to deal with in the public

health space. I got a couple questions. First of all, also, do we know, just as an aside, people don't die, but I've read something that said there might be permanent lung damage from this thing. I've heard anecdotal reports. I haven't seen myself, I haven't seen any peer reviewed publications yet that have described that, but I've definitely heard things anecdotally that there might be a permanent damage. And so I can tell you a little about this, not based on my own experience, but I'm actually working more and more closely with, with pulmonologists and people who are doing like pulmonary, like airway epithelial research, because I think, you know, for me as a basic virologist to make any sort of dent in this COVID disease business, I need to pair with people who understand how lungs work. And so I've been

doing more and more of that. And really, I think what might be one of those things is that during this lung injury process that this viral infection can induce in the setting of severe disease, you actually get the development of fibrosis in the lung, right? Which is what? Fibrosis, I'd say, is kind of a fancy word for scarring. And so when you get scarring in the lung, you're irreversibly depriving certain regions of your lung of functional capacity. And so the way I like to think about it, you know what alveoli are? Yeah.

Those are those little air sacs all over your lung. Like grapes. I saw the movie Fantastic Voyages. Like grapes all over your lung. I saw the movie Fantastic Voyages. Grapes all over your lung. And essentially what happens is you get scarring, you know, on the surfaces of a lot of those grapes. And so you no longer get efficient exchange of oxygen across those alveoli. And it irreversibly deprives the capacity of those alveoli to function as they should because you get permanent scarring there.

All right. So let's go back to the difficult philosophical. So like 40,000 people die of auto accidents every year, right? Yeah. And we could save a tremendous amount of lives by lowering the speed in the highways to 20 miles an hour. And obviously, we don't do that. So as much as we don't want to talk that way,

if we don't have to talk about it, we do know that underneath it all, we are trading lives for economy all the time. So let's talk about this. Much of, I think much of what you want to see happen here has to include your estimation of how quickly we're going to have a solution. Because if you could tell me, listen, it's going to be this way for 18 months. We're not going to develop any therapies and we're not going to develop a vaccine for 18 months. Yep.

I think we'd have to let it out, right? We'd have to say, oh shit, I guess we're just going to have to find some way best we can to protect the old people and people with pre-existing conditions but we're not going to live this way for 18 months yeah so i'm with you i'm sorry to keep talking about give just one second i'm with you that i err on the side of life i find it impossible to think the way that that we're describing but just because we don't think that way doesn't mean reality isn't that way. Sure. What do you see? How are you trading this all up? Like, how long do you let it go on? At what point would you say, are you extremely optimistic about a therapy? Like, there's gotta be some reason that you have a lockdown indefinitely. You must have some end game. So there's a few things. So let's, let's take the worst case

scenario, right? Worst case scenario is, you know, therapeutics vaccines take a long time. There is another mechanism that comes into play here, which is just the idea of natural human immunity and herd immunity that's independent of any human interventions, right? And so what I mean by that is like, I mean, let me ask you this, like, if influenza comes along every year, you know, everybody should be vaccinated for influenza. And frankly, that's still the smartest thing you can do right now in the setting of this, just to make that clear. But even if, you know, people aren't vaccinated for influenza, you know, you won't have like some of the modeling estimates you've seen, you won't have millions of people in America die in any given

year from influenza. And the reason is that most of the time we've seen versions of the virus that are similar to what's circulating. So we have some degree of immunity towards the virus that minimizes the damage it can do to us, right? And some of the exceptions, obviously the 1918 Spanish influenza, you know, that was like, you know, putting everybody in a toaster. And then the other thing was even, you remember the swine flu came along and it was the same kind of deal, you know, where we didn't have any immunity to it. But really, once this thing is transmitted through large swaths of humanity, I do think that there will be hopefully protective immunity in a large fraction of the individuals so that that right there will cut down on the overall transmissibility of the virus because the ratio of susceptible hosts to protected hosts will be low enough that you won't just have it spreading

like wildfire through the community. How long? Well, so on. So there's one assumption there too. The assumption there is that people who get infected with this virus cannot get reinfected by it. And that's a critical thing. And I think that remains to be fully demonstrated. There's data from like monkey models and stuff where they've infected animals with versions of this virus, re-challenged those animals afterwards and they were protected from it.

So I just really, really hope that that holds true in the human population. That would be sort of unprecedented. That would be unprecedented, wouldn't it? Because for a virus to be able to reinfect, the same virus to reinfect a person, isn't that sort of how viruses never work? Viruses usually confer immunity, do they not? Well, there's two things. One way that viruses can slip around that is if a virus has a really high evolutionary rate, the immune responses that

you mount against it could be useless the next time you see the strain because it's just moved away from its genetics just enough that there's not cross-reactivity. And frankly, that's kind of what happens with influenza to some small degree, right? Like the reason why we have to get vaccinated for influenza every year is that influenza continually mutates.

And so- As you said, we're still partially immune. Wait, wait, wait, Dan, but let's- Partial immune. But to answer that question, it is not unprecedented. So there are viruses. So if you look at viruses like, you know, there's some examples with like chikungunya virus or dengue virus.

Sometimes the immune responses that you mount against those viruses, like the antibodies, for instance, that you mount against those viruses, they may not help you when you see another strain of that same virus later on. And sometimes weird things happen where it can even make the infection worse. So I wouldn't say it's unprecedented. I'd say it's hopefully unlikely, and I'm optimistic that that won't be the case, but it is not impossible. It is not impossible. Right. So how long, we're trying to think about a timeframe here. So how long for how long we're getting, we're trying to think about a timeframe here. So how long before herd immunity is sufficiently built up that you'd be ready to end the economic lockdown? The short answer to that one is I don't know, because there are a lot of assumptions that

would go into how we'd predict that, that we don't know. And so the things that we need to know there is what essentially what the immunity looks like after people have been infected. And that's what my lab and lots of other labs are working on right now, where we're collecting tons and tons of samples from people that are getting infected so that we can characterize what level of immunity they have against the pathogen, which will give us the numbers we need exactly to predict that. Okay, but anyways, that was the worst case scenario. So in terms of therapeutics and vaccines, like Dr. Fauci keeps saying, and I 100% think he's right on this,

vaccines will take a while because you need to go through very rigorous testing and you're manipulating the immune system, you know, in ways that can have unpredictable consequences. And so you really need to go through a long and arduous trial process to make sure that you're not going to accidentally kill a bunch of people drugs are drugs that are already on the shelf that were generated for other diseases. So they've already been through like phase one and phase two clinical trials. And so we already have data on like safety and tolerability of those drugs. And right now they're being rigorously tested to see if they're able to save the lives of people with COVID-19 disease. Those ones, so there's so many different clinical trials. I don't even know the number at this point. There's so many clinical trials of small molecule drugs and biologics right now.

So if any of those really show promise in these clinical trials in just like the next couple of months, I think there's a possibility that those ones could just get ramped up and they could get slammed into the human population quicker than a vaccine can. So let me see if I correctly understand what you're saying. There's a very good chance in your mind that over the next two to three months, some therapies will be developed, which will flatten the mortality rate by half, let's say, such that when we let people out, we'll be letting them out into a danger, which is closer to what we're used to with the flu, even it'll maybe still more than the flu, but, but a lot closer to the flu than it is now. I think that is possible. I think there's

no guarantees, but I think, but that's what we're hoping for. We have good reason for hope. We have good reason for hope. If we knew the answer to that was no, then we might just have to let this out, right? We can't stay home for a year. We can't. It does seem pretty impossible to sustain human society if nobody's going out of their house for a year. But I don't feel like I'm equipped to make that kind of a policy call. And again, once again, coming from the biomedical perspective, my number one thing is saving lives. But of course,

even from a modeling perspective, at some point, people starving to death could start exceeding the rate of people getting killed by the infection. I don't think we're at a stage where we need to entertain that number right now based on all the things that are happening. We have a deep, philosophical, empathetic mind like Donald Trump to make this decision for us. God help us. I mean, it's really the perfect storm that this virus showed up on our shores during this administration. I'm confident. He may not be as heartless as we think he is.

I'm confident that Trump, if he's told by Fauci in no uncertain terms that this is insanity, won't do it. And even if he does, who's leaving their house? I'm not. That's exactly right. And, you know, people have made that point that, you know, how did this country get shut down? Frankly, it didn't really get shut down by Trump. It got shut down by city, county and state level officials who really decided to take the reins. Can I add to that? And, you know, I feel bad knocking the president. I was trying to make a joke, but I actually,

I'm not one who thinks that he's a monster. I think he's struggling with it. But now I lost my train of thought. What did you just say? We're saying that. So even if Trump says, okay, it's Easter time and Easter is a beautiful day, you know, and he decides to open the floodgates. I think that a lot of state and county. Oh, I remember. Yeah. Will say no, you know, we don't care.

So President, I mean, Governor Cuomo, who, you know, they're talking about drafting him to be the next Democratic nominee because his his manner and his demeanor is so impressive. Yet, yet every order that he's given has been about two weeks too late. He was advocating groups of 500. He limited groups of 500 or more when the CDC, when the federal government was already recommending 50 or more. And really, the CDC was too late. It should have been 10 or more. I can't for the life of me understand how New York wasn't just completely locked down weeks before when it was. I think that they, that was a real missed opportunity. And very tragically, they're paying the price for that right now. I think that was a real error

in judgment. No, actually, I was just talking to my friend from college who, you know, we were talking about Trump's reaction to this and I was giving Trump the benefit of the doubt and saying that, uh, you know, he, he liked most of us,

like the governor, like a lot of people underestimated this. And my friend is, is more convinced that Trump is just an evil man that his election prospects more important than the lives of Americans. That makes no sense. Even if you view him as a venal guy, he has his businesses to it. I mean, why would he want the...

Yeah, I frankly don't think he's evil either. And I think evil, you know, that's just like an oversimplification. Well, not evil at least. But I do think that he's... I just don't have really any faith in his judgment. And I really don't think that the interest of the common American citizen is really his number one priority. But one thing I will say, regardless of whether he's evil or whatever, one thing that I think has been completely inexcusable in the way that this epidemic has been managed,

and I can't, as a scientist, I just, there is no obvious reason why this had to be the case. It is bogus that we are this insanely wealthy country with some of the most brilliant minds on the planet. And we essentially were caught with our pants down with absolutely no testing capacities here when this virus arrived. That makes no sense. We knew this virus was coming here.

What was that? That wasn't Trump's fault. Well, I don't know whose fault it is. I mean, I think it's multiple people's faults, but I think that he's got to be at least partially to blame for that. I mean, it is not, developing these tests is frankly not rocket science.

It's really an infrastructure motivation kind of problem. And, you know, you could, you look at the difference with South Korea, right? Like they had, you know, millions of tests poised and ready to go when the epidemic was- We had a defective test. How could the president possibly have the expertise to be responsible for that? No, the president's responsibility is clearly not at that micro scale level where he should be like benchmarking and validating tests. It's literally making sure

the resources are going where they need to, to just start generating a crapload of tests and then doing aggressive benchmarking before the virus could have blossomed. So that's my question. How are we suddenly a third world country? Because I talk to doctors all day long who are in the New York City hospitals who are screaming for masks.

And where are the tests? How long does it take to make a fucking test? I totally agree with you. And it doesn't. I mean, these things, it's a simple process. This nucleic acid detection thing is a simple process called real-time PCR

or quantitative PCR. It requires a little bit of tweaking, but it is not rocket science. And there is absolutely no reason why we shouldn't have had millions of tests in place early in the game. And the personal protective equipment thing for doctors is just batshit crazy. My wife's a physician.

She's going to work every day. She has essentially no access to PPE. She's not an ER or an ICU doctor, so I guess she's considered kind of a second-level priority to get. But still, she's going to a hospital every day, and she doesn't have access to PPE unless if we scrounge it up from a hardware store that has an extra mask or something.'s bogus it's totally bogus that that's happening here. How is that continuing to happen though how is that possible? I think you know there's been a

constant discussion about this whole defense production you know act thing where the federal government has to come in and just say General Motors this factory that factory you know your job is just to crank out masks and respirators all day, have a good day. And like, you know, he keeps saying this thing that, oh, it's like, you know, I don't need to do that, because they're voluntarily coming to the table. But clearly, something's not happening here. Because I can tell you, not only is my wife a doctor, but my wife is close friends with physicians all over the country. And actually, Perry, you would love this. Have you heard of the Physicians Mothers Group? No. You should totally look up the Physicians Mothers Group. It is, I think,

one of the most powerful lobbies and just a bunch of brilliant badasses in the country. But they, you know, she's part of this network across the whole country. And just everybody's saying the same thing. Nobody has access to personal protection. Let me push back on that. I would be sold on that except for one inconvenient fact, a couple of inconvenient facts, but one particularly that I was looking at the curves of Europe, of Germany, Spain, I think France and Italy. And in terms of the curves of how many days before the number of cases double in those countries. Yep. And they're smacked right up next to ours. Two days.

I think, I think Germany is a few hours longer than us, meaning that these European countries with non-Trump leaders with industry, Germany is a pretty able manufacturing company, a manufacturing country of its own. That is a good counterfactual, and they are not doing any better than we are. So it's hard for me to understand why we would be so much better than Germany, even if we were doing things right. So maybe we've been doing somewhat better. And I do think that Trump probably didn't take this as seriously as he should have. I think that probably that any president might've done that. At any given time, there are

a thousand different one in a thousand type tragic events that could happen. And they're on there, you need to do this. The same thing with 9-11, you know? And then when one of them happens, it's very easy to work backwards. Say, you see, he didn't take care of this. It's like the last chapter in a mystery novel. Once you know who did it, you look backwards and it all seems so obvious. But out of all these urgent things going on in the world that he was supposed to know right now

that he should be worrying about testing for the Wuhan virus, when many credible left-wing places were discounting it, and CNN was talking about how this is not going to be so serious, and NPR had an article about how this is not going to be so serious. And NPR had an article about how this isn't so serious. And, and all of a sudden when it does, when the, when our number did come up is low, this high, you know, highly improbable thing did happen. It's very easy to say he should have known. But as I say, if the other countries were doing better, now it's true, the Asian countries are doing better, but they've been through this before. So as soon as it began to bubble up, they're like, shut everything down,

shut everything down, get the testing because they learned from their mistakes. We've never been through this. Believe me, next year, if this happens again, we're not going to, we won't be in the same situation again. But how come, I mean, fair enough, but how come even now we're not, now that we know what we need, how long does it take to make these tests? How long does it take to get masks? They're ramping it up very quickly now. I've been saying that for days and I just don't see. It sounds like from the front lines, it doesn't sound like they're ramping anything up quickly. Well, that's why, why do you think there's so many more cases in new york because why don't the doctors still have masks that i don't know about mass i think i think they i think that there is some sort of um

first of all there's two things i hear about i don't know what's true what's not the supply chain for all these things is no longer wholly within the united states. To make a mask, you have to get things from other countries now. And so we're at the mercy of the world demand on these supply chains. And then the other thing is that it does take a while to get, I mean, to get things going in a couple of weeks is hard. And then there are surpluses that the federal government has, and they probably don't want to give them out until they know exactly where they're needed.

Because, like, if I had 10 masks, I would be, if I gave them out easily, I just know that they'd be given out easily, and all of a sudden they'd be gone. If you give 100 masks to a hospital now, everybody, let's be honest, they're going to grab them, take them to their families, give them to their sister-in-law, whatever it is. These masks have to be treated very, very carefully now.

So the government, I think, if they have a short number, this hospital needs them now. Get them there. I don't know. I would actually fight you on that last point. I think that if they wound up, if hospitals were getting the masks they need, I don't think that any of these physicians would be bringing them home to kids or family. The physicians, but these things disappear. That's just human nature. I'm not saying doctors are bad people. They're better than most. I'm just saying that if the government

has a limited surplus, they can't just distribute them. They have to distribute them like last minute to know exactly where they're needed and distribute them until they have, until they're ahead of the game so but they're private citizens including a friend of mine who's a pretty famous handbag designer who has all of these contacts in china because of her company um who is in the middle of a $250,000 GoFundMe that is working with hospitals all across the United States to get them personal protective gear. Right. What?

No, I mean, the orders are in. They're happening. Her name's Geller M. Mizrahi, by the way, and everybody should go check it out. I ordered something six weeks ago. It was supposed to come the next week. I mean,. Mizrahi, by the way, and everybody should go check it out. I ordered something six weeks ago that was supposed to come the next week.

I mean, their orders are in, but let's, again, Germany doesn't have them, or maybe Germany does have masks. I actually don't know that.

I don't know that doctors in other countries are lacking gear. I don't think they are like we are, frankly. Probably right. Not to the levels

that we are. No, I think. Trump. Yeah. I did read. I was reluctant to say this but I did read in a credible place that these masks were depleted and nobody and the Obama administration also left them on

didn't refill the numbers I mean I don't want to go easy on people making bad mistakes I just know that these bad mistakes are always made early on. World War II bad mistakes were made early on, and the Civil War bad mistakes were made early on, and we have to be realistic to expect nothing to have gone wrong

and everybody to have been way out in front of it. It would be great if it happened that way, but it just usually doesn't. It just usually doesn't. That's all. Satip, can I get back to something about herd immunity? Yeah, sure. You said that after enough people are infected, that we'd be somewhat shielded from the continued propagation of this.

But in order for that to happen, we've got to let people out of their houses because they won't get infected otherwise. Right. I think that people will, so that's an interesting concept too. So the exact thing that's going to minimize the number of casualties right now and keep hospital beds from overflowing is also going to decelerate the pace that we develop herd immunity. That's your thinking there? I think that there's something to be said for that. If herd immunity is going to wind up saving us, how do we get there?

Yeah, I think the ratio of those two things is something that's interesting to consider. But you're right. So if you keep people away from each other, the rate at which that you develop natural immunity against the virus will also be slowed down. But I once again still think that the near term possibility of just having, you know, hundreds to thousands of people essentially dying out in the streets because there's no respirators available for them is a worse fate. So, well, that's what I've been reading. Like I've been reading that we're all going to get it. It's just we got to figure out, we don't want to all get it at once. That's it. I think we're all going to, pretty much everybody who can get it will get it. I think so. It's just we want to slow it down so we don't just have any,

so we have no longer any hospitals to work with anymore. But, of course, as a human being, if we're going to get it anyway, I just as soon get it right now. I mean, I know that that might not be good. You wouldn't because you're going to have no place to go because the hospital beds. If I get it right now, I might have a place to go. I got to act fast. Hey, right now versus two weeks from now. I don't know. Maybe that's there's some way to think that way. Well, this ought to be interesting now that men and women are locked up indefinitely in quarantine. Guys, do you remember the days when you were always ready to go?

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Yeah. The national shortage of N95 respirator masks can be traced back to 2009 after H1N1 swine flu pandemic when the Obama administration was advised to replenish the national stockpile, but did not, according to reports from Bloomberg News and Los Angeles Times. So, you know, I'm not blaming Obama. I'm just saying, yeah, and if in 2010 this had hit, we'd be saying, how come Obama didn't replenish the masks? You know, shit happens. It sounds very flippant, but I think... Well, the difference there is that apparently Trump was warned in no uncertain terms by people that there was a catastrophe in the offing.

You think he knew? Did they warn him and say, and maybe they did, President Trump, there's a catastrophe in the offing. You think he knew? Did they warn him and say, and maybe they did, President Trump, there's a catastrophe in the offing and we don't have masks. I have to believe he didn't know we didn't have masks. Maybe he should have known. Maybe Joe Biden would have known. I don't know.

Maybe. Yeah, I can't speak to that directly. But I mean, I'm told that he didn't order masks after he knew that something was on its way or maybe maybe he did he should he should really be uh um raked over the coals for that well he was still saying things like he was using words like democratic hoax and i mean that was that was not that long ago right he didn't say the virus was a hoax he said the the the the accusation that he was fucking it up was the hoax. But yeah, he downplayed the virus wrongly.

I'm sure he did. Consequences, again, if that was very consequential, then we'd expect to see much worse here than Germany and France, and we're not. Well, not yet. We're not going to see people come to New York for two weeks. Per capita, we're better off than those countries, but we're doubling at the same rate that they are, is my point.

So here's two things I'd say to that. One is Perry's point. We have no idea where we're going. The other point is that our testing has been so insanely shallow in this country. We have no idea what the denominator is. I don't even think we can really compare ourselves side by side. Perry, was that her name? But wait, can I say...

Nobody calls me Perry anymore. Perry L, sorry. That would mean we're better off, right? All my old friends call me Perry. It was Perry to me, but okay, Perry L, sorry. What other nicknames did she have? Hold on, hold on, hold on. If the denominator is actually bigger,

if the denominator... We know how many people are showing up at the hospitals needing respirators. And we know how many people are showing up at the hospitals needing respirators, and we know how many people are dying. If the denominator is five times as big as we think it is, then we really are overreacting, no? That's true. So then, well, in terms of overreacting, at the end of the day, it's the number of people that are dying as a result of this infection. That's the number that we need to really react to. But what you're, you have a good point there, is that let's say 10 times as many people are infected out there as we think, then the lethality associated with this virus is

significantly, like the per case lethality is significantly lower than we think it is. And we just don't know. We really just, we have no idea how many people out there are infected at this point because our testing has been so woefully inadequate. And yeah, I agree. I agree with you that actually, if we found out that 10 times as many people were infected and we had this number of deaths, then that would suggest that the lethality of the virus was lower than we thought, but we just don't know. We just don't know.

Now let's talk about Perry Ellen College. Pardon? Yeah, Perry Ellen College. Her nickname was Perry. Her other nicknames, who knows? No other nicknames, just Perrie, that was it. Me. Well, I think Noam wants to talk briefly about Perrie Allen College.

Yeah, I was wondering, in college, if you were to date Perrie L, if a virologist was going to date Perrie L, how many days before he might be nervous? She was way out of my league, man. I was just happy to get a coffee every once in a while. Shut up. Out of your league? Really? Why? Satish and I

were very good friends in college and we used to... Satish is also a very accomplished musician and so is Noam, by the way. What is something for us? I can tell. Your room, man. Is that an oud behind you? That's an oud. Yeah, yeah.

Nice. Nice. Sweet. Play something on the piano. Come on. Turn around and play something. Play Farrelly's. All right, here.

See, I don't play that. Oops. What happened there? I don't play Costco kind of stuff. I just play sort of goofy kind of stuff. Just like. I just play it sort of goofy kind of stuff, just like... -♪ -♪ -♪ Hey!

-♪ I play, like, just sort of improvisational crap. Very good. It's hard to believe, Satish, that you could not have had Perrielle. And maybe you did, by the way. I did not. I will say that right here. I did not. First of all, he... I know you're married now, And maybe you did, by the way. I did not. I will say that right here. I did not.

First of all, he, I know you're married now, but I mean, he really was quite the ladies' man in college. That is a fact. Time has been rough, man. Time has been rough. He is not a reasonably attractive man, but more than that, he's intelligent and he plays piano. And that seems to be a fairly

impressive combination. And you add that to Perry L's sex positive attitude and you get a, you get an almost inevitable situation. I love it. I love it. All right. I think we settled coronavirus. Satish, anything else you want to tell us what's what's your you've been doing are you in lockdown are you an essential worker you get great question so I am technically in lockdown and so the way that so my lab is associated with the University of California and then also another blood banking company called by

talent and so the policy that we have is only workers that absolutely have to go in to keep like the train on the rails can go in. And then the other exemption is COVID research. And so what I'm really doing right now, we're not doing any HIV work in the lab at this point because it's considered non-essential, but we're really ramping up on doing COVID research in the lab but I don't go out on the bench and you know move pipettes around so I haven't I don't actually go in but there are people in my lab that are going in now to what's the as far as HIV is concerned you know I think there's a lot of sense that we've kind of we've kind of cured it I mean if not entirely at least

you can live with it is it what's left to be done on the HIV front? Yeah, I get this question all the time. And so, you know, basically, once again, if you are a lucky enough to live in the developed world and have access to the latest drugs, you can, you know, live a relatively normal lifespan, right? If you just take these drugs every day. So that's, let's consider for the fact that this epidemic is mainly in heavily resource-limited settings where they cannot afford to take like $20,000 or $30,000 a year drug cocktails for the rest of their life. And so those people desperately need some sort of solution, really a cure or a prophylactic vaccine where they can get one or

two shots of something and it's a done deal and you can forget about it. So a lot of it just has to do with the economics and feasibility of infection there. That being said, even for people who do have access to these drugs, this is an imperfect solution. And really, if you go down the street and talk to anybody who's living with HIV, who's on these drugs, they really want to be cured of the disease because for number one, the drugs never fully restore health. You know, you can live a relatively normal lifespan in terms of years, but individuals with HIV infection still have all sorts of inflammation-associated disorders, and they tend to show signs of more rapid aging, et cetera, et cetera. And then the other thing for people living with HIV is just the stigma of being infected,

and that's a huge, huge, huge thing for people living with HIV infection. So because of all of those reasons, and that's kind of a partial list, there's still a massive interest in figuring out how we could completely eradicate the virus or design a vaccine to just stop it before it infects people. Now, what about HIV positive people in the age of corona? As a pre-existing condition where does that where does that leave us there's so many people working on that exact thing right now so there are people who are doing including at my university here they're doing all of these

reviews of cases now where people are co-infected with hiv and covid to see see you. Ha! Yeah, the video was put up of Satish at the piano. You know, one of the great... Like a Hasidic Jew at Musaf service. Could you hear it when I played

the audio? I didn't hear the audio. I just saw the thing. So, you know, that video, one of the

greatest days of my whole life. I'm a huge Deadhead, like a huge Grateful Dead fan.

And that was for this competition that the Grateful Dead had for like the best cover song of the country or fan. And that was for this competition that the Grateful Dead had for like the best cover song of the country or whatever. And for a while, I was number one in the country. And so on the Grateful Dead website. Wow.

That video and my picture was, that was on dead.net for like a few days. Like that was the homepage. And that was like, you know, I took all these screenshots, like sent it to everybody. It was like one of my favorite days um was um really how we that was like our group of friends in college because we were all pretty big deadheads yeah there was um a good cover of ripple oh yeah that was what's it called with where they they clips of people

all over the world oh yeah yeah i don't know what it's called. Sort of like a... A song for peace or something. But a whole series of covers. And Ripple was... Ripple, which is a Grateful Dead song for our listeners who may not be familiar with that. But you were talking about HIV, unless you want to talk more about the dead.

No, no, no. Sorry, you just asked me a specific question. I lost my... HIV as a... You know, I feel like a doctor. We're all doctors now. Now I remember. like a doctor. So people are very, very interested in that. And so people at our university and several other sites are already looking to see if there are differences in outcomes in people, you know, who have HIV infection, who get infected

with COVID. And everything that I've seen so far is not alarming, actually. I think most of the patients that they've considered are well suppressed, so they're on antiretroviral drugs, so their HIV disease is managed. But at least in the setting of adequately managed HIV infection, so far the data I've seen doesn't seem to suggest that they're at any greater risk of severe disease when they get infected. That's based on the data I've seen so far. Is there anything to this? And, you know, I spent most of my days reading about COVID. I kind of find it fascinating. And I do derive some, I don't want to say pleasure, but I get, but it is pleasure, learning, you know. Is there anything to this? It could be a crackpot

theory, because there's more than a few out there, about countries with a high level of malaria having a lower susceptibility to COVID because the anti-malarial drugs also function as anti-COVID drugs. Yeah, I mean, this is the whole thing. And this is where, you know, again, words are really important,

and, you know, the things that come out of Trump's mouth, again, have, you know, massive consequences, but you know, he's definitely made some of Trump's mouth, again, have, you know, massive, massive consequences. But, you know, he's definitely made some kind of flippant remarks about the efficacy of chloric and treatment for this disease. And I'd say, you know, there's enough out there that makes you raise your eyebrows a little bit. I certainly haven't seen anything that makes it seem like it's going to be a silver bullet.

But it, like everything else out there right now, should be pursued in, you know, informal clinical studies where you can really see if it's doing anything. But as of right now, I can't say that it's really blown my mind, like the data that I've seen. Everyone, every single person in the French trial recovered. No? The specific French trial that you're talking about, I don't know. But the data that I've seen out there so far do not look that compelling. Probably worth pursuing on a larger scale, but nothing where I feel like that's going to be like our...

So this is interesting because, you know, this Trump thing again, because I heard what he said. He said, listen, I think it may work out. It may not have a good feeling about it. And everybody went nuts, except that today I read that Governor Cuomo is going to start using this in the New York hospitals. And he's an angel. He's just wonderful, right?

So he's actually using it and he's an angel. And Trump says, now, I mean, now Governor Cuomo didn't say he has a good feeling about it, but I don't think you're giving it out in the New York hospitals if you don't have a pretty positive feeling about it. So what's the difference? I don't see any daylight between Trump's words and Cuomo's actions. But Cuomo's an angel and Trump's a monster.

And that doesn't make me a Trump supporter. I just don't get it. What were you going to say? Say what? I've been saying Satish. Satish. Satish, Satish, yeah, but whatever. People call me much worse.

First of all, I have not heard Cuomo say that himself, so I don't know that directly. And maybe he's seen some new data that have come down the pike that are a lot more compelling. Just from what I've seen so far, I haven't seen anything that makes it seem that. Okay, new experimental treatments for COVID-19. Okay. Combination drug therapy, plasma serum will be tested on

but see look at look at this so this is this is this is a key semantic point here so a combination drug therapy and plasma serum will be tested on the state's sickest patients I'm sure it's entirely worthwhile to to take the provocative sort of preliminary data that are out there on chloroquine to test them formally. And that's what is being done in a setting like this. So the emergency rooms right now are giving us an opportunity to test candidate drugs that are promising. But what you can't do is say that they're effective until you've actually formally tested them. And that's what's happening there, right? I mean, they're using, I mean, basically what's happening, and this is not for chloroquine,

but it's for a whole bunch of small molecule drugs and even, you know, biologics, a whole bunch of different drugs out there. They're using people showing up at the emergency room right now, you know, under these compassionate use scenarios to collect robust clinical data on how all these things can actually save lives. Okay, but I'm just saying, they're not testing, you know, four-leaf clovers. No, sure. And then here's the New York Times that Claude Klimba showed encouraging signs

in small early testing of coronavirus. You know, I don't see anything dramatically different in the language that I'm reading in the Times, USA Today, and Trump saying, and maybe it will, maybe it won't, but I have a good feeling about it. And they act as if what he said was just monstrous.

And it's just, you know, I mean, I wish you wouldn't have said it. I think what's monstrous is that he's saying that the churches are going to be full for fucking Easter. That's monstrous. Yeah, that might be. I agree with that. That is monstrous. I mean, that's like absolutely sociopathic.

I think he said he hopes for that outcome. I mean, hopes. Well, that's a little different, Perrielle, saying you hope for it. We all hope for it, don't we? Yeah, but it's different if I hope for it than if the president of the fucking United States goes in front of the entire country

and starts giving these like delusional speeches. I mean, it's insane. Agreed. Thank you. Actually, it's insane. Agreed. Actually, here's a Forbes headline just came out. One of the trials showed no benefit in first, but small limited control trial. So that's maybe the truth is somewhere in between, you know, and the other thing too, is like, you know, with all of these clinical trials, right, there's multiple dimensions going on here, right? You have different populations. There are different socioeconomic factors that go in there, different underlying genetics.

And maybe something that works in one population is not going to work in another population, which doesn't mean that the other results were not valid, right? I mean, there's a lot of things to consider there. A lot of things to consider. What's that? What kind of a doctor is your wife? Actually, directly relevant to this chloroquine thing, my wife is a rheumatologist.

I think you're asking Jewish or Indian. Actually, well, I married a Jindian. I married a Jindian. I like to joke because my wife, it's so weird. I met her in San Francisco, but my wife grew up in Boston, like 20 minutes away from me. I'd never met her back there. But she's like me where she's born and brought up in Boston, but she's Indian, right?

But then she's basically a Jewish girl because she went to Brandeis. So she's sort of like an Indian Jewish girl, which is kind of, I'm basically like an Indian Jewish dude. It's really weird how this all happens. Well, I performed at an event for M. Night Shyamalan. No way, did you? You know, the Indian director,

because it was his father's 85th birthday, or 80th birthday, one of the two. And he had me, he hired me. I don't know why he didn't hire Aziz or an Indian guy. He certainly could afford anybody he wanted. He hired me to perform for his father. I felt quite at home amongst the Indians there. And there were more than a few lovely young Indian ladies that probably wouldn't have anything to do with it. Not so shabby, huh? Not so shabby. Indian women can be quite spectacular, I will say that. Yeah, I can't argue with you, Terry. I can't argue with you. I guess that's why I married one. Yeah, so she's a rheumatologist, so she mainly treats patients with rheumatoid arthritis, lupus,

just a broad range of autoimmune diseases. But, you know, a lot of her lupus patients are on hydroxychloroquine. And actually, there's been a shortage of chloroquine because people are buying up all of the chloroquine. So she's had all these patients that are frantically reaching out to her being like, I can't get my medication. And so all of a sudden, you have this drug. And I'm completely in support of it being studied in clinical trials. If it's promising, it should be studied formally. But what we don't want to do is premature studied in clinical trials. If it's promising, it should be studied formally. But what we don't want to do is prematurely get out this message that,

you know, it's going to be the silver bullet. So people start hoarding it like freaking toilet paper. And the people who need it to stay alive at this point, independent of coronavirus, their lives are at risk. That's dangerous, right? Where are you? I posed a question on Facebook last night. Not a question, but an idea.

I thought it was an interesting one. Maybe it wasn't. Okay. I basically the point that no matter how much you might dislike Trump, I think anybody would agree that if the choice was between a cure for this tomorrow and getting rid of Trump, which would you choose? If you had to make that choice? Are you serious? A cure for this thing tomorrow?

All right. So that's the point that I kind of made. I said on Facebook, I said, you know, if chloroquine works or whatever it's called, that would probably help Trump, you know, because he. I don't give a crap. If I could get something right now that would cure everybody tomorrow, I don't care.

I would definitely take it, even if he stuck around. That's the point I made. And then lots of people... I was chastised by a mutual friend that I won't mention his name on Twitter for what he considered to be an ignorant comment. But I disagree with him,

and I'm sure we're still friends. But anyway. I'm on your side with that one, think pardon i think i'm on your side with that one but uh in any case um noam do you have any noam you haven't been talking for the past few minutes so i think that i i was assuming you're researching something but maybe you just tuned out i i got nothing to say i i i shot you to say. I said what I wanted to say. I'm listening to you guys. I would like for guidelines for not leaving the house. Because my understanding, and, Noam,

I believe this is what you're doing as well, is not leaving the house is not leaving the fucking house. It's not going to the supermarket and going for walks in the park and taking your kids out on a scooter. I mean, it seems insane. Hmm. I don't leave the house. I know.

But what about a walk? I mean, you know, first of all, exercise is important for the immune system. Let's face it. And vitamin D is too, actually. Getting some sunlight. And I read masturbation. And that was a topic

on a recent episode of This Week at the Comedy Cellar. One of the topics was that masturbation boosts the immune system. So that's why I know that. I also know it because it makes sense.

Because you never get sick. I do get sick. But imagine how sick I'd be if I also know it because it makes sense. Because you never get sick. I do get sick. But imagine how sick I'd be if I didn't masturbate. Have you seen the Pornhub usage statistics and how they're just going through the roof during this whole thing? What's that? Have you seen the Pornhub usage statistics?

Oh, no, I haven't seen. But that makes, certainly makes sense. You've got an exponential year in this period because everybody's just cooped up at home and nothing to do. Well, I'm glad that the economy is not, somebody's benefiting. Somebody's making money, yeah. I'm glad that the economy is not... Somebody's benefiting. Somebody's making money, yeah.

I'm sure there's people making money. You know, I mean, yeah, there's people that are making money from this. Most of us are losing it, but a few people are benefiting. I guess companies that make respirators are obviously doing well. Would you buy a respirator if you could buy one, Dan?

Do I need my own at home? Yeah, would you? I think I might. But is it something you can use by yourself or would you bring it with me to the emergency room when I go? That's not a bad idea, I guess.

I was looking them up. They're very complicated pieces. The machinery, I can see why it's hard. Like, how is General Motors going to start churning out respirators? The respirator itself can kill you.

If it's not made correctly. Yeah, it has a very sensitive software and feedback equipment. And, you know, who knows what goes into a respirator. I'm hopeful that a lot of people before they got them right. But it is. You know, I, you know, you, you, you, there was a, I think somebody that was 18 years old that just died.

And I, they didn't mention her name because she's, she was under 18. She's a minor. I don't know any details whether she had preexisting conditions, but you hear these stories about young people that if, even if they don't die, they're, they, they're in dire straits in the ICU. And, and of course we're all dying to know if they have, uh, underlying conditions so we can make ourselves feel better. What we don't know is, I mean, what, 30,000 people died of the flu. Like every single one of these stories is now in the papers and we have no way

of gauging whether this is actually noteworthy or you could, you could find a story like this a couple of times a week in good times, you know, who knows, who knows? knows i i seem to think this is more serious i mean i'm i'm sold that it's serious but but obviously a newspaper article about a young person who finds herself uh close to death is just anecdotal it doesn't prove anything well i don't know if it proves anything, but it keeps me from getting back to sleep because I usually read these stories in the middle of the night. And I wake up and I want to read something. And then I have to find another story to calm me down.

I'm convinced that if I get it, I'm going to die. I'm convinced I'm going to die if I get it. I had a call for two weeks. Why is that, out of curiosity? Why do you think so? You may not come across on camera, but I'm just not the most robust, burly person you've ever met in your life. And I just think I'm no match for this virus.

And I feel like when I get coughs, they linger. I don't know if that's related or not. My wife gets pneumonia, bronchitis, so she seems more vulnerable even than I am. But I don't have any underlying conditions. I don't have a high blood pressure. I mean, on paper, I would not. I'm premium elite for my life insurance policy, you know,

which means that they don't think I'm going to die. I would suggest that that would probably mean you'd make it through. Though, as I said, you might not have the best week of your life and you won't be playing music that week. Also, I'm so fucking scared of getting a tube down my... Oh, yeah. Do they push you to sleep for that? Dude, I don't know, but it sounds nightmarish.

It sounds really horrible. Yes, it does. I was reading about people on ventilators, and they can't talk, and they feel helpless. Who would want to go through this? Even if you live, it's hard. It sounds miserable. It sounds really, really miserable. All right.

Well, that was good. On that note. Wait. Thank you, Satish. Thank you, guys. Satish, you are by far the the smartest friend periel has ever produced all my friends are smart you guys don't not like satish not like satish no no no my wife is indian too by the way my wife is indian oh awesome really she's indian puerto rican

dude that sounds awesome yeah that's even better than Indian Jewish. You know, I'm wicked smart because I went to the University of Arizona, which is like basically the Harvard of the Southwest, right? Cariel went to the University of Arizona? Yeah. I didn't know that. They see me like twice a week and spend hours of time, and they just know nothing about me.

It never ceases to amaze me. We didn't know that they called you Perry back in your flapper years. Barack Obama used to call him Barry. You're like Perry. Barry-o. Let's just conclude by reminding our listeners that they can give us

feedback, questions, and comments on ComedyCellar at podcast.com. And if you go to my Instagram, they can find it. Podcast.com, right? Yeah. And then if they go to me,

Periel Ashenbrand, they can find this information about Geller and Mizrahi, who is, I think surpassed the $30,000 mark and is disseminating personal protective gear to all hospitals across the United States, which is really incredible. Amazing. And also my screen is totally fucked up

and I have no idea how to fix it. So Noam, any other thoughts or we conclude on that? I just want to say it's been a super pleasure meeting all of you and talking to you. And, Periel, it's always a blast

interacting with you on any level. And I hope I can tell you all again. And when all of this clears up, hopefully, sooner than later, you have to come visit us

in New York and come by the cellar and play with Noam's band. You guys could get together. That'd be awesome. Perrielle, I have a question. That photograph behind you, is that like a kind of pretentious, artsy-fartsy picture of your son that you had done? That photograph of my son was taken by the photographer, the very controversial photographer, Terry Richardson, who is one of my dear friend's husbands. Controversial why? Well, I'll send you. You don't know the whole.

I mean mean Terry Richardson he was like the first kind of famous guy to deal with the Me Too movement oh yeah you told me that story yeah brilliant photographer be well everybody don't eat

all your quarantine food I don't want everybody to be fat when I see you again can I make a suggestion to Dan and Perrielle? Actually, Perrielle's better. Go on amazon.com and get yourselves a better webcam if we're going to be doing this for the next three months. You see how my picture is very clear? At least use a computer. Yeah, that's not good. Get yourself a decent webcam. Do it right. Do we have to do this on the show or can we do this later? I think it's entertaining, but okay, we don we have to do this on the show or can we do this later I think it's entertaining but okay

we don't have to I don't mind discussing show business not show business but show business on the show I've done it before and been chastised

but alright be well everybody and wait but I actually need you guys to help me Satish

you don't have to sit through this oh where can they find you, Satish? Where can our listeners, if they want to learn more about your work? Yeah, so there's two things. So one is my lab website is just pillilab.ucsf.edu. P-I-L-L-A-I-L-A-B. Yep, pillilab.ucsf.edu,

which just kind of gives a broad overview of the type of stuff that we do in my lab. And then I also have like a personal website that I admittedly have not updated in like 10 years, which is supersatish.com, which is where I have all my music stuff and other crap I'm into, you know, vintage cars and all this other jazz.

It's like my nonsense website. Oh yeah, that's my YouTube channel where I have a whole bunch of... But a lot of people are going to be listening to this audio only, right on Sirius. I think we're obviously just doing the audio. But in any case, is that all? So be well everyone.

Stay safe as they say. Thank you. Yeah, be well all of you guys. See you guys say. Thank you. Yeah, be well, all of you guys. See you guys soon. Take care. Bye. Bye. Bye. Bye-bye.