The Munk Debates Podcast - Be It Resolved: The Scientific Community Has Overreacted To The Threat Of COVID-19 And The Data Prove It

Episode Date: September 9, 2020

Six months into the pandemic researchers continue to be perplexed by COVID-19. There are many unknowns with the virus, and one of the most controversial is its deadliness. Leading health institutions have warned that COVID-19 is much more dangerous than the seasonal flu and that without expansive public health measures millions of people could die from the virus. But there are some in the scientific community who disagree.  Antibody testing of large population groups indicates that we could be underestimating the number of people who have been infected – which means we are overestimating the death rate. Given these findings they question whether lockdowns are the way to approach a possible second wave of COVID-19 this autumn. In this episode of the Munk Debates Podcast medical experts Jay Bhattacharya and Sten Vermund debate the essence of these two competing arguments. Sources: Associated Press, TIME, BBC, TRT World, Bloomberg, CNBC, Unherd.com, Yahoo Finance, AZ Family, MSNBC, The Sun, RTE NewsBecome a Munk Donor ($50 annually) to get 72-hour advanced access to the full length editions of Friday Focus and Munk Dialogues. Go to www.munkdebates.com to sign up. Hosted on Acast. See acast.com/privacy for more information.

I think it's time for this toxic binary zero-sum madness to stop. We're not an imperial power. We're a revolutionary power. We are no longer in a world where you can plot out moves statesmen to statesmen like a chessboard. You don't know anything about my background to where I came from. It doesn't matter to you because fundamentally I'm a mean white man. We can't do this to the next generation because America will cease to exist. Welcome to the Monk Debates podcast. Every episode, we provide you with a civil and substantive debate on the big issues of the day. Free of spin, focused on the facts, and animated by smart conversation.

To arm you, the listener, with enough information to make up your own mind. Today's debate, be it resolved, the scientific community has overreacted to the threat of COVID-19, and the data proven. Obviously, this is an evolving situation, you know, right now the State Department is now as a level four for Wuhan, essentially no travel. This new virus may be more infectious in SARS. Super spreading events are must be occurring, otherwise the number would not jump so high. There's plenty of things we do know, but it seems that the list of things we don't know is even larger. The next few weeks could be difficult, as several scientists are worried that relaxing rules,

on the virus too soon could lead to an increase in infections. Hello, I'm your moderator, Rudyard Griffith. While six months into a global pandemic and 63,000 scientific papers later, scientists and medical researchers continue to be perplexed by COVID-19. There are many unknowns with the virus, and the question of just how deadly it really is is one of the most controversial. Since the beginning of the pandemic, leading health institutions such as the World Health Organization and the National Institute of Allergy and Infectious Diseases

have warned that COVID-19 is much more dangerous than the seasonal flu and that without expensive public health measures, millions of people around the world could die of the virus. This is a really serious problem that we have to take seriously. The flu has a mortality of 0.1%. This has a mortality of 10 times that. And that's the reason why I want to emphasize we have to stay ahead of the game in preventing this.

But there are some in the scientific community who disagree, and they say that they have the data to prove it. Antibody testing of large population groups seems to indicate that we could be grossly underestimating the number of people who've been infected by the virus, which means we are dramatically overestimating the death rate. Now, a new study out of Germany using antibody testing shows that the coronavirus may not be as fatal as once previously thought.

The study focused on one of the hardest hit regions in Germany. It found that 15% of the population had antibodies for the virus with a mortality rate of 0.37%. That's less than one-fifth of the mortality rate considered in Germany as a whole. Given these kinds of findings, some scientists are questioning whether sweeping public health controls

are the way to approach a possible second-recent. wave of COVID-19 this autumn. You know, I think that everybody panicked. They were fed incorrect numbers by epidemiologists. There's no doubt in my mind that when we come to look back on this, the damage done by lockdown will exceed any saving of lives by a huge factor. One very easy way to see. On this installment of the Monk Debates podcast, we challenge the essence of these arguments

by debating the motion, be it resolved, the scientific community. has overreacted to the threat of COVID-19, and the data prove it. Arguing for the motion is Jay Batacharya, professor of medicine at Stanford University. He's also the director of the Center on Demography and the Economics of Health and Aging at Stanford. Arguing against the motion is Sten Vermind, Dean of the Yale School of Public Health. Stan, Jay, welcome to the Monk Debates podcast. It's a real pleasure to be here. Thank you.

Happy to be here. Thanks. Well, I'm really looking forward to today's conversation, the opportunity to have two people of your breadth, knowledge, and experience on to talk about a vital issue, the scientific community and its assessment of the threat of COVID-19 now that we're months into this pandemic, and many of us kind of wondering about what the autumn and winter will bring.

Should we anticipate a second wave? What is the real risk and threat of that second wave? And how should we respond to it? And again, it's a real treat. have your two big brains on for us to dissect these issues through a debate. So our resolution today that we've all agreed on is be it resolved, the scientific community has overreacted to the threat of COVID-19 and the data prove it. Jay, you're arguing in favor of our motion. So I'm going to put two minutes on the clock and pass the proverbial podium

over to you. Thank you. So I'm going to make two points in favor of this motion, that scientific communities overreacted to the threat of COVID-19. The first has to do with the infection fatality rate of COVID, of SARS-CoV-2 virus. And I wanted to just bring back the debate to 2009 in the H1N1 epidemic. In that epidemic, people estimated a haste fatality rate that was very, very high, and people panicked over it. Later, as people did studies of how widespread the disease actually had been in the population, those fatality rate numbers came very sharply downward.

Well, we've seen the same thing happened in the case of SARS-CoV-2. The initial estimates, which were these case fatality rate estimates by the World Health Organization and even published in JAMA from the Chinese experience, said that the estimated rate of fatality were on the order 3 to 4 percent, 3 and 100 to 4 percent. The problem is that these case fatality rate numbers are misleading. There are many more infections, as it turns out, that are not recorded because the people just were never tested or showed up because they had very few symptoms. In studies that have been done since then, now 50-some studies from around the world,

they found that the disease is much more common than people thought, and the fatality rate is actually more on the order of somewhere between 2 and 3 and 1,000 overall, and much less, more on the order of 5 in 10,000 for people that are less than 70. I also want to bring up a second way in which the scientific community is overreacted, and that has to do with scientific censorship. In particular, we've seen during the epidemic a very long, number of very prominent scientists, some less prominent, whose views don't match the orthodoxy, be censored.

John E. Niedes, for instance, has had his YouTube video censored. There's the Bakersfield doctors, Gabriela Gomez, who's written an article on potential herd immunity thresholds, Harvey Rish, with his work on safety. So I think this is another area where it's very important to understand how the scientific communities reacted in ways that are not consistent with good science. Jay, thank you for that concise and focused opening statement. Sten, you're going to be arguing against our motion, be it resolved. The scientific community has overreacted to the threat of COVID-19 and the data prove it. Two minutes on the clock. Let's hear your argument. The global community did not have very robust immunity to the novel coronavirus, and infectiousness

has been substantial. In many venues of intense transmission, we've seen community rates of 20, even 30 percent of persons in the community infected, 10 percent of health workers in some communities where there's been more of a lockdown. Those rates are lower and where health workers were prompt and effective in use of personal protective equipment, their rates have been held lower. Nonetheless, we will in the near future have 200,000 deaths from coronavirus, and that's a minimum estimate since a number of cases are not reported. There was a 19% excess death rate from the 1st of March to the 30th of May, and excess rates are probably about 28% higher than the official tally of COVID. So this is in excess of the past four years of flu deaths. At Yale New Haven

Hospital, we had 450 persons in the hospital on any given day in April. We had to open up two new ICU floors. We had over 100 persons on ventilators, which was a historic high by a factor of four. We were really quite overwhelmed. And our circumstances were no. nowhere near as bad as hospitals in the Bronx or Queens. So I think that one can objectively say we've had a massive burden of disease from coronavirus, which has overwhelmed health systems at their peak. Terrible stories coming out of Louisiana where persons were sent home from the auctioner hospital essentially to die without any protection for their loved ones who

then often got coronavirus. those people sent home to die were invariably African-Americans. So we've seen terrible social injustice in the context of this circumstance. I actually agree with Jay that the infection fatality rate has been overestimated. I was shocked when I saw the WHO saying 3%. I thought it was going to be half of 1% and it may be less than that. and I also have been right in the middle of this censorship issue. One of the persons mentioned, Harvey Reish, is a member of my faculty here at the Yale School of Public Health.

And he's had an unpopular view of hydroxychloroquine, and I've spent the better part of three months defending his right to have an unpopular view. So there again, we actually agree. Let's push this debate a little bit further and come back to you now, Jay, and put another couple minutes on the clock, and have you react to Sten's opening statement and specifically what you might disagree with in it. It is a deadly disease, and we have seen many, many deaths. The excess burden, especially in the early months, March through May, as Stan mentioned,

was really high of excess deaths, not just in the United States, but around the world. Actually, since then, they've come down, though. If you look at the CDC's excess death numbers, they no longer are above the seasonal norms, I mean, I think the initial projections of the course of the epidemic turned out to be overly pessimistic, So, for instance, the Imperial College model that in the early days of March suggested there would be over two million deaths in the United States. And it doesn't seem like we're anywhere near on track for that. Let me, they also say that the overwhelmed hospital systems, there were some examples of that,

as Stan said, but around the country, for the most part, it was an opposite problem. The hospitals were empty, and there were big stimulus package aimed at keeping hospitals out of bankruptcy because they're empty. Now, this has had health consequences that are really important to understand. In the United States and around the world, a lot of other health care needs have not been addressed because of the lockdowns due to COVID-19. A growing number of British Columbians are dying from the opioid crisis, many of them in their own homes. Penny Daphlos now on the grim new record and how COVID-19 is making the overdose epidemic even deadlier. The World Food Program USA estimates that 300,000 people a day worldwide could die from starry.

over the next three months because of what COVID-19 is doing to the global food supply. Fewer children are getting important vaccines amid the pandemic. That's according to new data from the Centers for Disease Control and Prevention. Today, Max Gordon spoke to Arizona. I predict a resurgence of measles and polio cases around the world. Missed health services, including cancer treatment and cancer prevention, stories of people staying home with heart attacks because they were too afraid to go to the hospital because of COVID. The CDC reported that 25% of 18 to 24-year-olds in the United States in June seriously considered suicide.

The lockdowns, as a result of the scientific overreaction to COVID, had an enormous deleterious health effect. And if you're thinking about whether the scientific community has overreacted, well, just think about the underreaction to the statistics I've been talking about. And we really underplayed those or not thought too little about the cost of the lockdowns on those things. Thanks, Jay. I like where you're taking this conversation. I think it's interesting to drill down into this question of, has the scientific community overreacted to COVID to the detriment of underreacting to all the ancillary knock-on effects? The circumstances in my state of Connecticut were not favorable in April, as I alluded to earlier, in terms of the number of cases per 100,000 persons. because we were the third worst in the country after New York and New Jersey. Connecticut, the state's death toll now stands at 2089, and more than 26,000 people have the virus. We're expecting an update on those numbers later today.

The seven governors from Delaware up I-95 corridor and Amtrak corridor up to Massachusetts have coordinated their state reopening. And we've done remarkably well. And now Connecticut is one of the three or four best states, lowest rates in the country. So there's no question that one can go from best to worst or worse to best, depending upon how successful one is in controlling viral spread. And I would agree with Jay that if we use instruments that are just too blunt and we treat rural Wyoming exactly the same way we treat New York City in the month of April, then we are

overreacting in Wyoming and we're probably underreacting in New York City. To say one size fits all, I think would be a mistake. But if you look at states like Georgia and Louisiana and Texas and Arizona, which had done a reasonable job with controlling viral spread, they then chose to reopen their states precipitously and against federal guidelines. And they experienced second waves, which filled up their hospitals again and resulted in the need to close businesses again. So I feel like the best way to mitigate the secondary damage from the response to COVID is to suppress COVID as quickly and efficiently as possible and then re-opening. And then re-opening, in a thoughtful, measured way.

And I think the states that have done that have been more successful at reopening than the states that have not. So, okay, now we get to get into the details of this debate, this conversation through a kind of three-way exchange. And Jay, let me start with you. And I'd like to get your thoughts of where you think the scientific and public health community is overreacting today. I think we can all agree that based on declining numbers of case fatalities, you know,

per whatever population sample you want to select, that the lethality of the virus is certainly less now or perception of it, maybe the reality of it, than it was a number of months ago. But where today do you think the overreaction is going on? If you think about what's happening today, I think the scientific community is still overreacting on the efficacy of lockdowns. This is one point of disagreement is about what actually has been successful and what has not been successful. By any measure, I don't think it is right to say that Connecticut, New York, and New Jersey are successful states in controlling the epidemic. We know that there's age-based

difference in mortality, and Stan alluded to it, but it's an enormous difference where, you know, on the order of two to three or four percent mortality for people over 70 versus, you know, five and 10,000 people under 70, that's such an enormous difference. The policy has to take that into account. So for instance, I think in New York and New Jersey and some other states, there was not enough done to protect nursing home residents. And we saw massive deaths in those locations where people were most vulnerable. At the same time, the lockdown locked away people who were relatively not at risk. On the other hand, in places like New Zealand, Australia, Peru, where there have been massive lockdowns, the virus has come back, despite the lockdowns. It seems like these lockdowns are a two

blunt to actually suppress the virus for a long period of time, and then be too costly on populations who don't face a huge risk than virus. Focused lockdowns that take into account that enormous death rate difference seem like a much better policy to me. Thanks, Jay. So have we misperceived or miscalibrated on the actual threat in terms of the falling levels of estimations of the lethality of the disease, especially for people under the age of 60, where, again, please correct me if I'm wrong, because it's important to get our facts right, but the danger of dying of COVID under the 60 years of age is approximately the same as dying of seasonal influenza on a apples-to-apples comparison. Is there a risk that we end up in a situation where we're back

into lockdowns that may be anything but calibrated? Obviously, it depends on a lot of things. that we don't fully know yet, right? So for instance, will there be a vaccine early enough to deal with it? What is the herd immunity threshold? Some folks like Gabriel Gomez argue that it's much lower than the initial numbers that said like it was 60, 70, 80 percent of the population. Gabriel Gomez argues it's on the order of 10 to 20 percent. We find that between 10 and 20 percent, depending on the country, depending on even regions, in a country would be sufficient to have a population with herd immunity.

And in fact, we say that based on mathematical models. So I think it's very difficult to say and forecast. What we can say is that areas that have experienced a large case outbreak have not experienced a resurgence in the month since. Areas that have stayed locked down and suppressed the virus have. I think Sweden is a really important example here because they famously have a policy that didn't lock down and they have very few cases and very few deaths. Will that hold in the fall? I mean, that is an uncertainty that I think is difficult to forecast largely because we don't, you know, we have less than a year of experience of the virus. Everything here is a balancing

of risks, and we should think about it that way. And one of the, I do agree with you about the, risk for people under 60 generally is, I think it's probably, is probably the same order as the flu. there's a caveat for kids, though. I think for people under 20, the flu is more dangerous. So, for instance, there's a, I think some of the order of 150 kids under 18 have died of the flu. The flu season this year. And I think fewer than 50 kids, something on that order anyways, have died from COVID-19.

Thanks, Jay. So, Stan, come back on some of those points and maybe focus a little bit just again on the numbers Jay is talking about here, people under the age of 60 children. I mean, to the layperson such as myself. these seem like a pretty low-risk situation generally for people to go about leading their lives in a normal way. I guess it depends upon how you value the health of the elderly. Swedish death rates were four times higher than neighboring Norway and Denmark. So it wouldn't be fair to say that the Swedes got away with a more open and relaxed response to COVID. They paid a terrible price.

and I'm not sure I understand the concept of a focused lockdown. I've heard David Katz and others argue that we should lock away our elderly and let the rest of society go about its business. But here in New Haven, which is not a prosperous town, we have many multi-generational households. We have grandparents, even great-grandparents living in the same households as children. And I think for persons of lower income, that's not uncommon. And given the social determinants of disease and disability from COVID, it's a little cavalier to say, well, let's let transmission run rampant in our school and try to lock away our elderly because I don't know any model where that's been successful. And I think the burden of proof would be on the debater who advocates for such a risky profile. Go back to March and April when we were filling our hospital.

at least here in Connecticut, we were, people were dying every single day at high rates. Our nursing homes were being devastated. There wasn't any brilliant way of saying, well, we're going to segregate our elderly. I think this concept that we can somehow segregate the elderly and protect them, and the rest of society goes about its business is a fanciful one, and I don't know of any circumstance in which that's been successfully achieved. I do think, it's possible to lock down for a limited period of time and then to thoughtfully in a measured way reopen to minimize risk to us all. Keep in mind, too, that if we simply open up the schools willy-nilly without physical distancing, masking, without reasonable precautions, we can expect school

absenteeism to be pretty substantial and for our death rates to start rising, not in that young age group, but among their grandparents. There's a couple of things, Stan, where I agree and then others where I think I'm going to take some exception. So first, let's talk about the possibility-focused lockdown. In Florida, which famously has a pretty substantially large elderly population, they've actually done a pretty good job of protecting the elderly. So the elderly are underrepresented relative to the infections in the rest of the country.

It's possible to protect the most vulnerable elderly if you simply do. just make sure that nursing homes are isolated. So staff who work in multiple nursing homes, they get tested repeatedly before they're allowed in, limitations on visitors. So those kinds of restrictions, I think, are completely reasonable given we know about the high risk they face. For elderly people in the population, I think people take precautions, even in the absence of a lockdown. So my in-laws have not left their house out of fear of COVID. They won't leave it, even if the lockdown is lifted until there's a vaccine. Now, there's lots of people who like that.

And there are other people, older people who I've met, who are willing to take that risk. I'm uncomfortable telling people that say, okay, I want to hug my grandson. No, you can't do it. I mean, people take risks in their lives all the time. I think we should be honest with people about what those risks actually are, not scare them unnecessarily, but tell them honestly what it is and let them decide. focused lockdowns are certainly possible. Two other really interesting points I wanted to address.

The second one has to do with the lifting of lockdowns. What we found is that once lockdowns are in place, it's very, very difficult to get the political will to lift them. In California, there was just a plan put out by Governor Newsom, even though the death rates in California are on their way down. It may be months before the lockdown is lifted, if at all. I believe New York is still under some extensive lockdown. So the political will to lift the lockdown once implemented empirically just doesn't seem to be there.

The last point I wanted to address has to do with schools. I don't think there's anyone that's arguing for opening schools willy-nilly. I think the few places where school reopening has not, the people have not taken precautions, have not gone so well. But the vast majority of the world, certainly all through Europe, have opened their schools safely. Denmark reopened its schools while case numbers are going up. The UK has a massive report just put out,

just a few days ago where they examined how well school opening has done. According to Public Health, England, there were 198 confirmed cases where more than a million pupils returned to primary schools in June. The health body stresses this number is low, and that most of those outbreaks involved staff members infecting each other. They've done it very, very well. The schools have reopened to in-person schooling with very little effect. Let me just end with this, just talking briefly about the cost of closed schooling.

So we've worked for generation to try to close the gap between rich and poor minority and non-minority in schools. In this short time, we're going to reopen that gap. We've already reopened that gap. We're essentially robbing a generation of kids of an education. When the data suggests that it is safer for them to get COVID than for them to get the flu. I think it's an enormous mistake that will have consequences through their entire lives. So I feel that Florida did learn from some of the mistakes made in the Northeast and elsewhere. They only are about 17th ranked in terms of death rates from COVID, even though they're second ranked in the case rates.

So they haven't done a particularly good job reducing COVID transmission, but they have had more segregation and success with the elderly. have to remember, there are so many communities of elderly in Florida, and these are not necessarily nursing homes. They're often communities of middle class or upper middle class. I think Florida is a bit of a unique circumstance. Similarly, if we use Denmark as an example, Denmark had a very rigorous shutdown, far more rigorous than Sweden. So while they had rising case rates, it was rising from an extremely low number to a still extremely low number. So just the fact they were rising, I don't think is interesting. If you want to use Denmark as an example of a successful lockdown, you and I would agree completely because they were extremely rigorous, masks, stay at home,

physical distancing, all the hand hygiene. When they were confident that they had the epidemic under control, they then opened up in a highly successful way. What are you seeing internationally that leads you to believe that we're witnessing an overreaction here domestically in North America? I think most famously is the case of Sweden. I mean, now it looks like the epidemic is well under control in Sweden right now. On the flip side, you have countries like New Zealand and Australia that thought that they had defeated the disease, essentially by locking down, and the disease come back.

I think the international evidence suggests that these kinds of long-term lockdowns that I've seen advocated in the United States and elsewhere cannot last and will not be effective in controlling either the spread of the disease or the death toll from the disease. The only thing that will work is recognizing which populations really are at risk and focusing our interventions on those populations. I still don't see why Sweden is such an optimized model with four times the death rate of its neighboring countries. I think Sweden has been a failed model. If they had had a more thoughtful short-term lockdown, they could have dropped their transmission rates much more precipitously and opened up much more safely. So I just would reject that out of hand. And I certainly don't see New Zealand as an example, a negative model, where the lockdown was very successful. They were able to reopen. Today, I am announcing that Cabinet agrees to open up the economy, but to do it as safely as possible.

On Thursday this week, retail, malls, cafes, restaurants, cinemas, and other public spaces, including playgrounds and gyms, can reopen. They had a small surge, about five cases a day, and they locked down again to some extent. But they intend to reopen as soon as they feel they've got a handle on transmission. So I would see Sweden as a failed model, and New Zealand is a successful model when I'm afraid Jay sees it the other way around.

I think the U.S. example, which really was way too relaxed, and I think that if we'd had a more aggressive and successful early response and a more consistent response across the country, we might have been able to lock down for a briefer time and reopened more assertively. But when the governor of the state of Connecticut has to put 31 states on a quarantine list, that their rates are so unacceptably high that if somebody comes from those states into Connecticut, they have to quarantine for 14 days. That is not a coherent national response. Our goal should be pandemic control so we can return to normal. I don't think letting the transmission run amok is going to get us anywhere. Jay, is there anything particularly you want to rebut from what you just heard? Sand talks about New Zealand as having successfully control the virus, and opened up again and did with business as usual. It's not business as usual. If you look,

there's no travel in and out of New Zealand. The island essentially is an island, isolated. And if the idea is to permanently isolate itself from the virus, it will never be connected to the rest of the world. And so I don't think it's possible for any place to cut itself off from the rest of the world and say, look, we can be safe from the virus. As far as a coherent national strategy, I did a study on the prevalence of the virus in mid-April using data from the Major League Baseball teams around the country. It was very low prevalence in most of the country. Most of the country, that lockdown in those early days did nothing other than cause costs. The problem is that we suppressed the virus in places it wasn't growing.

The cost I mentioned earlier in my opening talk, I think the lockdowns themselves are not a tool either to suppress or eradicate the virus. We have to think carefully about this tool. it sounds good, but it hasn't worked out as well as I think people hoped. Thanks, Jay. Before we go to closing statements, just for the benefit of the listening audience, let's have a couple recommendations from you guys in terms of what you think the United States, countries like Canada and Europe should do in the fall if we're confronted with a second wave.

Stan, let me start with you. What would be your big three policy prescriptions if we hit a significant second wave this autumn? I believe that a respiratory pandemic can build from what we've learned from influenza, tuberculosis, respiratory syncytivirus, SARS, the SARS-coronavirus. And I believe that mask use, face coverings, the physical distancing, and the six feet two meters is not arbitrary. It comes from airplane and train and bus and restaurant outbreak studies. I believe the hand hygiene makes sense. We've known that for many hundred years. And the pivoting to outdoor activity and keeping groups small.

This is a small price to pay, I think, to limit spread of a highly contagious respiratory agent to which very few of us are immune. I think that lockdowns are something we did when we had a massive surge of cases in the greater New York area. We also did lockdowns in places that had little to no circulating virus. So I think it's a tool, by no means the only tool. And I frankly think that we can go about our business if we reduce risk. Thanks, Stan. So, Jay, what are your big three prescriptions for the autumn if we are confronted with a substantial second wave of this virus?

Well, so let me first start with the point of agreement with Stan. I think some of the mitigation kind of ideas, you know, you don't even need to require them. People will adopt them if there is a increased risk on their own. Mask, you know, like physical distancing, hand hygiene, all those things will, I think make sense if there is a wide community spread. On the other hand, I don't agree with Stan about the lockdowns. I think the lockdowns are too costly, too blunt, and do not serve the purpose that they're supposed to serve.

I do not think we should adopt them basically almost ever again, absent extraordinary evidence, which we didn't have when we adopted in the first place. You're listening to the Monk Debates podcast. If you like this podcast, check out our other episodes, including debates on everything from the U.S. election

to the impact of COVID-19 on cities, to whether fears of deaths and deficits are overblown. All free to download or stream on our website, munkdebates.com. Let's go to closing statements. This is an opportunity for both of you to kind of sum up this debate, leave our audience with the key points that you want them to reflect on when it comes to trying to understand whether or not the world's scientific communities have overreact,

reacted to this virus and whether there's data out there that proves it. Stan, let's go for your closing statement first. First of all, I'd like to remind the audience that 2020, 2021 is likely to be a unique year. I'm hopeful, and many of us are, that the intensity of clinical trial activity and product development activity will yield superior antiviral drugs, monoclonal antibodies, and steroid-like immune-modulating approaches so that we can more effectively treat COVID-19 disease. Also, the vaccines are looking very promising. This looks a lot closer to some of the vaccines that have already been developed, as opposed to

vaccines that we've struggled to develop. So it's plausible not only that we'll have one type of vaccine, but we may have several. So I'm hoping that a year from now will be in a very different position. So what do we do in this unique year where our tools are unavailable for vaccination and inadequate for treatment? Classic public health measures that have been developed over hundreds of years still hold their appeal. So perhaps at the end of the debate, Jay and I can agree that promulgating these preventive measures is advisable. I guess where we still disagree is the role of a broader lockdown. I frankly lived through this horror story of Yale New Haven Hospital and our sister hospitals in the state of Connecticut. And I can't imagine how we could have coped

with the magnitude of our disease burden in our healthcare system, if we had not shut down the state in the months of March and April, I don't know how we would have coped because we had such massive death and inpatient services demand and respiratory and ICU demand, historic demand, multiple fold over anything else we've ever experienced. So to have a lockdown in the magnitude of epidemic that we experienced in New York, New Jersey, and Connecticut, I think was a prudent thing to do, and I'll defend it. And perhaps we should have done it two weeks earlier. Whether that's the approach that we need in Wyoming or New Mexico or the rest where rates are indolent,

I think Jay may and I may have more agreement than he realizes. Thanks, Stan. Okay, Jay, we're going to give you the last. word in this debate. A couple of minutes on the clock. Let's hear your key arguments. What do you want to sum up here to leave listeners with when they're trying to understand the threat of this virus? So first, Stan started with the very hopeful facts that the clinical community, that the scientific community is working on therapeutics, vaccines, and so on, that potentially could be quite useful and actually already have proved useful in improving how we care for people with COVID. We know much better than we did in the early days of the epidemic, how to manage patient work. And I agree with

Stan, the vaccine trials look very promising, much more so than I ever would have anticipated six months ago. I will say, I think if the scientific community doesn't work to keep discussion open or on these, I'm afraid that those kinds of advances can't happen. The evidence of people censoring, see, you're very prominent people being censored when they have their views out in public scientists censoring each other threatens those kinds of advances. When we think about what the after effect of COVID, what we could do better, we should work to make sure that science remains open. I agree also with Stan about the role of some of the classic public health measures,

you know, hand hygiene, I said already, you know, physical disorders. Those kinds of measures can be useful and people will adopt them, even if you don't enforce them, as long as you communicate fully about the necessity of them and people, trust the scientific community as not just telling them to do things whether there's been censorship and no evidence. On lockdowns, I think we're going to continue to disagree. I think the places like New York, New Jersey that had massive lockdowns did worse, much worse than Sweden, for instance, that didn't have these lockdowns. I think it's going to be interesting to calculate what the cost and benefits are exposed of all these lockdowns. And I think we don't have to wait for the long,

I sort of started to see the evidence that the lockdowns themselves cause more damage than anyone sort of may have hoped in the early days, maybe even more damage than COVID itself. Thanks a lot. Jay, thank you for that closing statement. And thank you both for coming on the program today. This has been a civil, substantive debate of a complex and challenging issue. And I want to just thank you on behalf of the listening audience for lending us your expertise, your knowledge, your insights, and most importantly, your civility. Jay, Stan, on behalf

the Monk Debates community, really appreciated our conversation today. Well, that wraps up today's debate. The Monk Debates podcast is that special place for civil and substantive discussion of the big issues of the day. To listen to more debates on everything from climate change, to religion, to geopolitics, to the future of human progress, visit our website. www.w monk debates.com. You can also find detailed show notes on today's debate. Thank you for helping us bring back the art of public debate one conversation at a time. I'm your moderator, Rudyard Griffiths. The Monk Debates are produced by Antica Productions and supported by the Monk Foundation. Redyard Griffiths, Marilyn Missouri, and Christina Campbell are the producers.

Abbey Rahesia is the associate producer. The Monk Debates podcast is mixed by Kieran Lynch. The president of Antica Productions is Stuart Cox. Be sure to download and subscribe wherever you get your podcasts. And if you like us, feel free to give us a five-star rating. Thanks again for listening.