The Dispatch Podcast - Virus Inside the Wire

Starting point is 00:00:00 Welcome to our special Friday episode of The Dispatch podcast. I'm your host, Sarah Isger, joined by Steve Hayes. This podcast is brought to you by The Dispatch. Visit The Dispatch.com to see our full slate of newsletters and podcasts and join us after each of the debates this month for our dispatch live, especially for members. Still a few days left in our free trial. It's thedispatch.com slash 30 days free, and we hope you'll try us out. We'll hear a little later from our sponsor today, ExpressVPN. But today, we're joined by Dr. Jonathan Reiner. He is a professor of medical surgery at George Washington University,

Starting point is 00:00:39 where he has been on the faculty since he finished training in 1994. He spends most of his time fixing hearts. He is the cardiologist for Vice President Dick Cheney and was a consultant to the White House Medical Unit while he was vice president. He is the author of the book Heart, an American Medical Odyssey. He joins us to talk about the latest, news, the president and first lady have tested positive for COVID-19.

Starting point is 00:01:18 And let's dive right in with Dr. Reiner. Doctor, I want to get to how you became a medical consultant to the White House in your time with Vice President Cheney. But first, let's start with, what is. happening at the White House right now in terms of medical protocols? I'm sure there's a lot of scrambling, maybe even a lot of chaos at the White House right now. So, you know, to say this simply, there's virus inside the wire, to borrow a military term. The White House has tried to protect the president by testing everybody in sight, by basically enveloping him in this cocoon of rapid tests, which are by their very nature imperfect,

Starting point is 00:02:08 and someone close to the president has tested positive, and that person has traveled with the president, that person has met with people throughout the executive branch, and now apparently legislator branch, and maybe even judicial branch. So what the White House is scrambling to do is to do contact tracing. So what we're seeing really is a microcosm of the pandemic as a whole. We're seeing an infection spread, and we're seeing health officials trying to track down everyone who might have been exposed to the virus. What they should be doing is getting everyone who has potentially been exposed to anyone now known to be positive to quarantine, and then eventually they'll start testing people probably at multiple time points. But if you think about

Starting point is 00:03:02 the universe of people that encounter the president or encounter the people that the president encounters, it's vast. And this is sort of the nightmare scenario, which is largely avoidable. Which is sadly largely avoidable, yeah. Was this a failure of testing? No, it's a failure of common sense, right? It's a failure of masking. So I spend most of my time working in a hospital, working in a hospital in downtown D.C., six blocks from the White House. And when I go to work, I park in a lot across the street. As soon as I open the door to my car, I put a mask on. And I walk into the hospital. You can't walk into my hospital without a lot. a mask on. Actually, these days, you can't work in the hospital unless you also have eye protection on. So every employee, every staff member, every physician, every nurse is wearing a mask and eye protection all day long. It doesn't matter if I'm in the presence of a patient or not. If I'm in the presence of anyone, I'm wearing a mask. And we do this for two reasons. We do this to certainly to

Starting point is 00:04:19 protect ourselves. But we also do it to protect each other because we've known really since the beginning of this pandemic that there was a substantial amount of asymptomatic carriers of this virus. The White House learned this probably at the end of January, that there was asymptomatic community spread of this virus. So because you can't rely on somebody. basically being sick, being febrile, having a fever, or sneezing, or coughing, or having any of the classic symptoms that some patients have, you have to use what we learned in the early days of AIDS-H-I-V, which was universal precautions. So in the hospital, we adopted universal precautions. Everyone wears a mask all the time. And if you look at multiple studies of

Starting point is 00:05:19 hospitals, you find something very interesting. You find that the incidence of COVID-19 is lower in the hospital than it is in the community as a whole. You think that's sort of counterintuitive. How can it be lower in a place where you're caring for patients with the disease, but it has to do with universal mask precautions? So what the White House needed to be doing from the beginning was, first of all, limiting the universe of people that interact with the principles, as opposed to what we saw at the beginning, which were these task force meetings where the president would line up behind him, you know, all these titans of industry, introduce everybody, everyone would come to the same podium and grab the same mic and adjust the same mic.

Starting point is 00:06:11 I mean, it was horrifying. You know, for those of us who know how viruses are spread, and it's not that complicated, it was horrifying to see all these people in close proximity to the president. I thought it was really malpractice for the White House to allow so many people so close to the president. But it suited their narrative, which was, there's nothing to see, move along. and, you know, this is all going to go away. So they had all these people come by the White House. What they should have been doing is limiting access to the president.

Starting point is 00:06:52 They should have been doing a lot of their meetings through secure video link, which they have prodigious capacity. And everyone who worked in the White House, every single person who worked in the White House should have been wearing a mask at all times. And if you've ever visited the West Wing or the Eisenhower old executive office building next door, you know, the hallways are teeming with people. So everyone in that environment should have been wearing a mask. And what we heard this week is that that was the instinct of the NSC to get everyone masked up.

Starting point is 00:07:31 But it was discouraged by the president's team because they didn't like the look. Steve? I want to just read to you a brief section of an article in the Washington Post this morning. We've talked about how things that the White House might have done to better protect the president. I'm interested in looking at something that the president might have done to better protect others. The passage reads, After White House officials learned of Hope Hicks symptoms, Trump and his entourage flew Thursday to New Jersey,

Starting point is 00:08:06 where he attended a fundraiser at his golf club in Bedminster, and delivered a speech. Trump was in close contact with dozens of other people, including campaign supporters, at a roundtable event. The president did not wear a mask Thursday, including at events at his golf course and on the plane, officials said. So this is after he knows he's been directly exposed. And potentially, we don't know exactly when the initial positive tests came in.

Starting point is 00:08:32 One assumes that the president was probably tested pretty soon after Hope Hicks was was determined to be a positive. What's your reaction to that passage? Well, it's totally on brand. Look, what we've seen throughout the pandemic and certainly over the last several months is a willingness of the president and his team to expose his supporters to peril.

Starting point is 00:09:01 We saw this in Tulsa where he did an indoor event that's the event that was attended by by Mr. Kane. He's done, you know, multiple indoor events, a lot of outdoor events. And Mr. Kane, you're referring to Herman Kane, who then passed away from coronavirus. Now, you know, we'll never know whether he contracted the virus at that event or not, but the timing works. You know, he got sick about a week to 10 days later. and it's, you know, the chronology is certainly feasible, maybe even probable that he acquired the virus there. It was a super spreader event. Tulsa at the time had a very high community positivity

Starting point is 00:09:47 rate for the virus, but yet the president held an event there. The president was disappointed in the turnout, but there was still thousands of people in that arena. You can't bring thousands of people unmasked shoulder to shoulder together without transmitting the virus. But we've seen this over and over again, this really blatant disregard for the public. But if I was a supporter of the president, and he was holding an event, and the president has been playing down the risks anyway, the president hasn't been wearing a mask, and the president continuously tells me that this is about to go away, and he was holding an event, I might say he wouldn't hold an event if it wasn't safe, right?

Starting point is 00:10:31 That's the, that's sort of the benevolent kind of explanation. Why would he hold an event if it wasn't safe? But he was holding events that weren't safe. They weren't safe for the attendees. Now, the White House tried to protect him as best they could, you know, with a double layer of barriers so that he was never, you know, more than, you know, really many feet away from the attendees, even though on television it looks like the supporters are able to basically scratch his back,

Starting point is 00:11:01 they're really quite a distance away from him. And, you know, the president has not been on a rope line since, you know, since the beginning of the pandemic. He doesn't approach any of the supporters. So he's relatively safe or had been relatively safe. But there wasn't really much attention or concern apparently about all the people that would come. So you mentioned contact tracing and what's being done now just to contain what's going on. Assuming that that is completed, what would you suggest that they do now moving forward to protect

Starting point is 00:11:40 everyone who works at the White House to continue to have a functioning government? So everybody that's been in contact with the president or Hope Hicks, or now apparently also Ms. McDaniel, the R&C chairwoman has now tested positive. See, we don't know who the index patient is here, right? So yesterday, initially we thought, well, perhaps, you know, Hope Hicks is the index patient, but apparently not. Apparently, Ronan McDaniel and Hope Hicks worked together, I think, on maybe Friday of last week. But we don't know who the index patient is.

Starting point is 00:12:25 And we don't know who all, we don't know, again, the entire extent of infection now. But everybody who has at least been, has spent any time in close contact with any of those three people in the last really 10 days to two weeks needs to quarantine. quarantine first. Testing is not a replacement for quarantining. At some point, the people who have been exposed will be tested, but what they need to do now for public health and also to protect the continuity of this government is they need not to come to work. They need to be home quarantining and then probably sometime next week get a test to see where they are. But what about the idea of herd immunity. Right. It's, you know, this is, this is, this is an irony slapping us all in the face. So, hurt immunity really is an elusive goal of, that we wouldn't really come close to until

Starting point is 00:13:37 most people think 60 to 70 percent of the population has been infected with the virus. A herd immunity with with the coronavirus would come with probably one to two million Americans dead. If you do the math, if 60 to 70 percent of Americans contract the virus, that's at least 200 million people getting the virus. And if you use the most optimistic case fatality rates. And of course, we don't know what the true case fatality rates are because we don't know the denominator, right? We only know the numerator. We don't, we don't, we haven't tested nearly a large enough proportion in this country to know what the true incidence of the virus is. But even using the most optimistic scenarios, if the mortality rate, the case fatality rate was only 0.5

Starting point is 00:14:35 percent, and I say only in quotation marks, because that would be about five times the mortality risk for the annual flu, which kills a lot of people in this country, and you infected 200 million people, that's a million deaths, right? And I think the mortality rate might be a bit higher than that. So it's, and no one knows if the immunity that you acquire after being infected is durable. We don't know how long that lasts. It certainly lasts for a period of time, but, you know, And this is not necessarily and probably not likely a lifelong immunity. So it's nonsense. It's been debunked by everybody except the principal advisor to the president now, Scott Atlas.

Starting point is 00:15:30 Can I give you a statement from the president's doctor? As you and I were corresponding into the wee hours of the morning, we first had a tweet from the president acknowledging, that he had tested positive along with a first lady. And then we got a statement from the president's doctor, and it was a short statement, but the line that sort of left off the page to me was the following. I expect the president to continue carrying out his duties without disruptions while recovering. Do you expect that?

Starting point is 00:16:01 Well, I hope that. I really do hope that. But it's unpredictable. So some people have, some people, as we said, are asymptomatic. Like some people have sort of mild or moderate and tolerable symptoms. And some people get really sick. And the time course is typically, after someone tests positive, it takes about a week for someone to get sick enough that they need to be hospitalized,

Starting point is 00:16:28 about a week out. And then for hospitalized patients, it takes about another week for the wheels really to come off. so I you know right now the president may feel well enough to work and that's great and that I hope that continues and and maybe it probably will but look at the experience of the British prime minister Boris Johnson who had the virus several months ago he's almost 20 years younger than the president and he's also a man of of of higher body weight, but almost 20 years younger, and they almost needed to intubate him.

Starting point is 00:17:13 He was in the ICU not doing the duties of state. He had, I think, relinquished temporarily the day-to-day management of the government to his deputy because he was in no capacity. Think of it this way. The patients who get into trouble, many of them get into trouble, or maybe even most of them get into trouble as a consequence of respiratory compromise, and they need increasing amounts of oxygen. Well, you know, if you've

Starting point is 00:17:46 ever seen somebody in respiratory distress or on high flow oxygen, that's not somebody who's, you know, reviewing briefing reports or meeting with CIA briefers, right? Those people struggle. So, you know, I expect that the president probably will recover. recover because most patients do, even people in his age group and even people with his comorbidities, but he does not have an insignificant risk of something bad happening. You know, a 74-year-old man, morbidly obese, probably has a 10% risk of dying from this. So I think you speak for all of us when you say that you hope he recovers and recovers quickly and does not have tremendous symptoms. The reality is there's a lot of government planning that goes

Starting point is 00:18:33 into a situation just like this. And, you know, I know from writing a biography of Dick Cheney and you know from working alongside him for so many years that this was something of an obsession of Dick Cheney's, was this continuity of government participated in these exercises Cheney did going back to the four years. If you are in the White House working on the medical team, at what point do you, I mean, I mean, what's your advice? I mean, if the president does have these, it is in respiratory distress, just as you describe, at what point do you feel like you have to make a determination about

Starting point is 00:19:15 whether he's able to carry out his responsibilities as president? And how does that work? I mean, just in, you know, in lay language, what, how does that work? I mean, do you, with, with the medical professionals, make a recommendation to vice president, would they make a recommendation The president, can you walk us through how that might unfold? Yeah, so the 25th Amendment, most people think the 25th Amendment came about after Kennedy's assassination, but it did in terms of timing. It really came out as a consequence of Eisenhower's near fatal heart attack in the 1950s, where he was out of Washington and out of commission for months.

Starting point is 00:19:59 And it provides this pathway for a majority. of the essentially cabinet secretaries to determine if the president is no longer fit for office or for the president to voluntarily, temporarily, or permanently relinquished duties of office. But as you correctly state, it requires someone to make the determination that the president is not medically fit for duty. So who would that be? Well, you know, in the case of George W. Bush when he had colonoscopy, he just basically signed the paper and said, I'm going to get some propofal for the next half hour. So temporarily ceding control of the government to the vice president. But what happens if the president doesn't do that voluntarily? Who is

Starting point is 00:20:47 responsible for doing that? So the cabinet doesn't have the medical capacity by themselves to make these determinations. So they would defer to the White House medical unit. Now, the White House medical unit is staffed by career army officers. I've worked with these people throughout the years. They're the best of the best. They're fabulous people. They're patriots. They do a very hard job. They travel millions of miles a year away from their family. But they are subordinate officers to the president. So it would take a very mature, confident officer. to say to the president of the United States, sir, I don't think you're fit for duty right now.

Starting point is 00:21:35 I think you should consider the 25th Amendment. Now, imagine that conversation with this particular patient. Back in 2001, I sat in the then-vice president's hospital room, and I said to him that, and I didn't work for him. I was a civilian, right? I was his physician. but I wasn't an officer whose career could be derailed or I could be immediately removed. I said to him that if I ever thought he was not fit for duty, he wouldn't have to ask me.

Starting point is 00:22:11 I would tell him. And I hope there's somebody in the White House Medical Unit who feels the same way. The willingness to speak that kind of truth to power requires a lot. of confidence, and I hope that someone there has that. Now, I'll tell you, I have some concerns about the White House physicians because they spent a lot of time with the president. So I don't know if the president's physician, Sean Conley, has been exposed to the virus. Because if he's been exposed to the president in the last several days, then he needs to quarantine. I have a real just nuts and bolts question on that, by the way.

Starting point is 00:23:00 You know, for instance, if Steve, our head of dispatch state, gets sick, his doctor can't then come tell me, Sarah, you know, Steve is too sick. It's time for you to take the helm of the dispatch podcast because there's all sorts of rules about the, you know, violation of PIPAA and everything else. That would be sort of an Al Haig moment. Let's be honest. sorry. Don't worry, everyone. I'm in charge. It's what I would put in the Slack channel. Steve, you know I would. Can the president's doctor, if he cannot say that to the president, say that to Mike Pence. The 25th Amendment, of course, talks about a majority of the principal officers of the executive departments, but even a majority of them cannot act without the

Starting point is 00:23:46 vice president as well. It is always the vice president plus. And so can that doctor go to the vice president and say, you know, the president isn't receptive to this information, but I need to tell you, Mr. Vice President, that in my medical opinion, the president is not fit for duty. And I would hope he or she would do that. And they're allowed to do that. It's an interesting point in terms of HIPAA. It's a fascinating question.

Starting point is 00:24:12 I would hope that they would do that because the stakes are greater than one person. right. HIPAA is designed to protect the privacy of a single person, but in this case, we're trying to protect the welfare of an entire nation or maybe even the planet. So, you know, the Constitution has another provision, which no one speaks about, but the sentence that follows the one that you basically paraphrased also says, or some other body that the Congress may provide. So the Constitution actually envisioned a circumstance where Congress would decide whether the president had a fitness for office. I'm now, I'm not sure how that would. This is where we get into fun legal things because it says another body as Congress may by law provide, which means

Starting point is 00:25:05 they would have needed to pass a law over the president's, presuming then the president is not able to sign that law. They would need to pass it over his pocket veto at that point, pretty difficult. And interesting. Especially with this Congress, right? Right. Congress as currently constituted 30 days. This Congress getting a majority on anything, let alone a super majority. Yeah, yeah. Can I ask one more medical question than I think Sarah and I are both very interested in talking to you about the implications of the virus on the hard? The reports out this morning we're recording this Friday mid-morning. The reports out this morning that the president is experiencing mild symptoms. Is that something that should be encouraging to us that he's only experiencing

Starting point is 00:25:50 mild symptoms? Or is it the case that mild symptoms would be sort of the logical precursor to more severe symptoms? It's hard to know. Okay. It's really hard to know whether, first of all, I have to say, it's hard to know what the truth is. It's really hard. It's really hard to know whether the president really only has mild symptoms. I think the only thing that we can say is that if it's been reported that he has mild symptoms, we know he's symptomatic. Right. So we know that he's not asymptomatic.

Starting point is 00:26:25 So we can cross that off. So now that we know he's symptomatic, but I don't think we really understand how symptomatic he is. You know, I thought last night, as all of this was breaking, that it would be incredibly important for the president to, address the nation, you know, from the residents, and basically say, look, I'm okay. You know, I feel achy and have a little bit of a scratchy throat. I'm going to hunker down. I'm sure I'll be okay. I'll be in touch with you throughout the week and, you know, next couple of weeks, but we'll get through this and with your prayers, et cetera. And...

Starting point is 00:27:07 But Dr. Reiner, he called into Hannity last night. Isn't that the same thing? Yeah, almost. That's almost, particularly the prayer portion. But to reassure the public that he's okay, and maybe even to do something bigger than himself and say, you know, I haven't been forceful enough with you about masks. And if there's anything we can learn as a country now, is you got to mask up. because that would be this enormous, positive outcome of this really horrible moment where the president and first lady gets sick. Now the president comes out and encourages the entire country to wear a mask. That would have this spectacular benefit in terms of public health.

Starting point is 00:27:59 And so, you know, turn what looks like fiasco. into into something positive. And if I were his people, that's what I would be advocating. I mean, it's the obvious thing to do. But in order to do that, you have to be willing to say, you know, I wasn't right about this. I mean, that's a human attribute to be able to admit that you've been wrong about something,

Starting point is 00:28:31 a very personal attribute. We've never seen that from this man. and and you know far be it i mean i'm a doctor so no one really cares what i think about politics but if i were a political advisor what a boost he would get from that showing a little bit of humanity showing a little bit of of humbleness about about not being right about everything well it could make him a more i mean certainly i think from a political perspective it could make him a more sympathetic figure in this in this moment What does it mean for the rest of us?

Starting point is 00:29:07 I've taken three COVID tests so far since the virus outbreak. By the way, all of them pretty unpleasant. Then you had the right test. If they were unpleasant, you had a good test. Yeah, I mean, the one I gave birth this summer to my first child, and the one that they did before that to enter a hospital was, I think they, you know, to quote that, the quote that Reagan used,

Starting point is 00:29:31 slipped the bonds of earth to touch my brain. Right. It's all like a brain biopsy. That's the way it should deal. Oh, God, it was awful. But the fact that this is such a lagging indicator, and yet businesses are using these tests to determine whether people can come back to work and work together. Should that not be the case? Should we not be sending people back to work and saying, yeah, but we're testing everyone before they come in? Or that plus masks, you think, in your medical opinion, is an acceptable way? to start reopening the economy? What would you do now that, you know, the people who are testing the most in the entire world, probably, the White House bubble, as you said, the virus got inside the wire, even with all that testing, mind you, without masks? Oh, we need a massive increase in testing. And we need to use these rapid antigen tests, some of these paper tests, they're called lateral assay tests, which can be done at home for a buck,

Starting point is 00:30:32 maybe. And, you know, these tests haven't yet come to the market. We're seeing the first one, the new Abbott test, which the government bought the entire allotment of 150 million tests. But that's the trick to opening the economy. That's the trick to getting kids back to school. If every household had a supply of these tests. And many of these are now configured with an app that lets you sort of scan the result and you get like a green or a red QR code on your phone. And that's how you walk into your office building in the morning. That's how you walk into the school in the morning. We have tens or hundreds of millions of tests a day. We start testing like crazy. That's how you open the economy. These tests have not yet hit the market

Starting point is 00:31:22 because the FDA has been concerned about their sensitivity, whether they're sensitive enough. But the way to think about these tests, these slightly less sensitive but much more readily available tests, is that it would be the equivalent of casting a gigantic fish net, which has greater spaces between the fibers of the net so that relatively more fish get through the net, but since the net is so gigantic, you catch many, many more fish. so you don't worry about the occasional fish getting through the net because you're catching so many more fish and that's what these antigen tests will do we need to start doing that and yeah and we need to be a mask culture until we have a herd immunity from a vaccine and I feel

Starting point is 00:32:13 good about a vaccine going forward yeah for the next couple of years you're going to be wearing a mask in public you know we just have to get used to that the if you've ever traveled through Asia, it's been part of that culture for a long time. People walk around in the streets all the time with masks. The only people not wearing masks in the street are Westerners. So it's no big deal. Put a mask on. That's your ticket to getting back into a movie theater or getting back into school or getting or getting, you know, kids back into sports. It's not a big deal. But we politicized it. But that's the path forward. So, you know, perhaps there's an opportunity in this crisis to take that and to get more of the country to wear masks, right,

Starting point is 00:33:01 to stop this red-blue split when it comes to wearing masks. It's nonsense. We need to move beyond that. We're smarter than that. We had Nobel Prize winning economist Paul Romer on months and months and months ago laying out his plan for mass testing. And he made substantially the same case that you're making. And I've thought about that interview quite a bit since then because you think if we had done that then, where would we be now? And I think the question answers itself. Before we let you go, I'm eager to understand better what you've learned as a cardiologist about how the virus affects the heart. And among the more fascinating things I've read about the virus itself and kind of the mysteries that it's given us relates to blood clotting

Starting point is 00:33:56 and circulation. And it's particularly of interest to me because I have a blood clotting disorder. But you've read stories about, you know, doctors operating on an aneurysm on a blood clot in the brain and literally in real time watching as another aneurism happens, which is, you know, not certainly common and you see you you read about thousands of of clots in the lungs yeah what what what what have we learned about this since we first uh encountered the virus you know now 10 months ago so first of all you know the public is getting to see um medicine and science learn about a disease in real time this has never happened before you know the let well the last time this has

Starting point is 00:34:45 happened was with HIV-AIDS in the early 1980s, basically before I started medical school. But that was before the Internet era allowed the public to basically get this data in real time. So what we know is that this is a respiratory pathogen. It infects the lungs. But it also affects the blood vessels. And it affects the blood vessels in a way that does promote clotting. And there is some data that suggests that patients who are sick with COVID do better if they're anticoagulated, right? If their blood is thin.

Starting point is 00:35:24 We know the virus can affect the heart either directly or as a consequence of a over-robust immune response. We know that to treat that over sort of exuberant immune response steroids seem to be beneficial. That's one of the therapeutics that does appear to make a difference in patients, if given early enough, high doses of steroids. If you do cardiac magnetic resonance tests, cardiac MR tests on people, you see a lot of these little scars on the heart. So people, you know, there's concern been raised about whether, you know, the virus has been damaging hearts. I think some of that is overplayed. And actually, if you scan people who have been hospitalized with influenza, you can find the same kind of small scars on the heart. So I'm not sure how clinically meaningful it's going to be in most people. This is one of the reasons why some of the college

Starting point is 00:36:27 football conferences closed down for fear that these elite athletes would take a hit to their heart and no longer be elite athletes. I think that concern is probably overplayed. But we're learning. We're learning about it, and it's a humbling disease, and we'll continue to know more. I think that as we go forward, we're very likely to have multiple vaccines that work. And then we're going to have, that's going to be an incredible logistic challenge to get vaccines out to the public, particularly the RNA vaccines, which require ultra-cold, transport, and storage. And then, you know, all kinds of interesting philosophical and ethical issues related to who gets vaccinated first and how we do it, but we'll do it.

Starting point is 00:37:22 But there are a lot of challenges. We've never vaccinated more than 60% in a given year. We've never vaccinated more than about 60% of the public for influenza. And we want to vaccinate basically everybody for this. We certainly want to vaccinate 70 to 80% of the public for COVID-19. So we're not turning the corner. The way I like to describe this is this isn't the beginning of the end, but it probably is the end of the beginning now.

Starting point is 00:37:53 What are you telling a patient like Vice President Cheney, someone with, obviously, heart condition, older American, are you telling him that as long as he's wearing a mask, he's okay to go out most places? Are you saying as long as he's outdoors, it's okay? Are you telling him, you should really be staying at home and not seeing people? Yeah, I've been telling, well, I'll tell you what I tell most people his. Patients like him.

Starting point is 00:38:20 I'll tell you, right, most people his age. Yes. I tell them that they need to, they need to minimize their viral footprint. Right. I don't tell people they need to be a hermit necessarily, but I tell them that, you know, if they don't get their groceries with via some app, and they go to a grocery store, go to the grocery store once a week.

Starting point is 00:38:46 Don't go every day, you know, just sort of to buy, you know, to pass the time. Don't go in, you know, every day for one and two items. Go once a week. Go early in the morning when the store is empty. Make sure you have a mask on. Make sure you have gel with you to sanitize your hands after you touch the card or even wear gloves and distance from people, you really want to

Starting point is 00:39:12 decrease your footprint. Don't go into a crowded place. Don't be near people who aren't wearing masks. If you wear a mask and you socially distance, you will not get this virus. This is a primarily respiratory transmitted virus. If you wear a mask, and you keep your distance, you'll be fine. That's what I tell people. I want them to go out and get exercise. Go for a walk, go for a jog, if you can do that. Wear a mask, and you'll be fine.

Starting point is 00:39:49 One of the biggest mistakes made, besides, you know, everything, one of the biggest mistakes made was telling the public that masks were really only to protect, you know, your neighbors. that this was an altruistic thing we were going to do. I mean, I'm sad to say that in America, that that didn't resonate, right? What we needed to say, because it was true, was that the mask will keep you from getting the virus. Then I think the uptake would have been more robust. It didn't work so well when we simply said, you're trying to protect the old guy next door from dying from this.

Starting point is 00:40:29 we needed to tell the public that wearing a mask will prevent you from dying of this virus. Let's take a quick break to hear from our sponsor today, ExpressVPN. When you use the bathroom, you always close the door behind you, right? You don't want random passers by looking in on you. So why would you let people look in on you when you go online? Using the internet without ExpressVPN is like going to the bathroom and not closing the door. Do you know that your internet service provider like Comcast or Verizon knows every single

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Starting point is 00:42:04 Okay, last question we try to ask something fun but I want it to be on brand and I'm going to ask it to Steve as well. Obviously you want to emphasize masks and masks are becoming quite the item to pick up You can get any number of masks online and every store you walk into. Do you, Dr. Reiner, have a fashion mask, you know, a non-medical-looking or black mask? I don't.

Starting point is 00:42:36 I don't have a fashion mask. I have because of, I have a mask that was given to me by a plumber who I take care of. So when I wear it, I'm, you know, I wear his brand on my face. So I'm wearing his, his plumbing. Oh, that's kind of, that's a fashion mask of sorts. But I don't have like an RBG mask or a Fauci mask. I thought about that. But no, no, I don't, I, and I'll tell you why.

Starting point is 00:43:06 The best, the best masks to wear, frankly, are, are the, you know, more formal surgical masks. the, you know, the bandana, you know, there's actually a gradient of efficacy. So while I'd like to wear like an American flag bandana around, you know, or skull and crossbones and look like a true bandit. Those are two very different fashion masks you're describing. I know, I know, I know. But I, you know, I'm a doc, so I try and wear something that's going to protect me and protect other people.

Starting point is 00:43:45 these should be readily, they should be basically free. There should be kiosks on the street where you can just pull a mask and put one on. Maybe we should start doing that in big cities. You go into the metro or you go into the New York City subway, you just take a mask out of the kiosk. Well, at one point, the postal service was going to deliver masks for free to households across the country. And that plan was scuttled, I believe, back in. That was a gigantic failure. Yeah.

Starting point is 00:44:12 They were going to send five masks to every household. April. Yeah. And the White House didn't like the look of doing that. That probably cost 100,000 lives, that decision. Wow. So my, uh, my suggestion to you, if I can make one, would be you, you could do sort of a meta mask and you could have a mask with a picture that Liz Cheney tweeted out with the vice president wearing a mask saying real men wear masks on your mask and it would be sort of meta, I have a Green Bay Packers mask that my sister sent me from Wisconsin. So that's going to be, I just got it in the last couple of days. So that will be my go-to mask, certainly as long as the Packers are continuing to win.

Starting point is 00:45:03 I like that. I should get a Yankees mask. I would wear a Yankees mask. There you go. That would make you pretty unpopular. If you hear that in New York, send me a Yankees mask. I my aunt sent me for these like very beautiful like silk you know silk on the outside like cotton in the inside like flowerish colorful masks and I have not bought any masks so I've just been

Starting point is 00:45:26 using her for and so my husband does our once a week once every 10 day once a week grocery shopping and so I send him with one of these but I've told him that they're Jimmy Buffett masks instead of a female mask which they obviously are that's awesome smart Thank you so much for joining us, Dr. Reiner. And again, the book, Amazing Heart, an American Medical Odyssey, and we'll see you out there. Thank you for all your good advice. My pleasure. Thank you. I'm going to be able to be.

The Dispatch Podcast - Virus Inside the Wire

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