This Podcast Will Kill You - Special Episode: Dr. Paul Offit & Tell Me When It’s Over

Episode Date: June 4, 2024

The COVID-19 pandemic started with a bang - lockdowns, grocery store shelves cleared of their goods, toilet paper shortages, and a pervasive sense of panic. But more recently, it has slowly faded into the background for many of us. The WHO says that while we’re no longer in crisis mode, we are still in a pandemic. What does that mean for us in our daily lives? In this TPWKY book club episode, we’re joined by Dr. Paul Offit to discuss his recent book Tell Me When It’s Over: An Insider’s Guide to Deciphering COVID Myths and Navigating our Post-Pandemic World [Interview recorded February 21, 2024]. Dr. Offit, who is a pediatrician, vaccine expert, vaccine co-inventor (rotavirus), member of vaccines advisory committees, and long-time vaccine advocate, explains some of the COVID disinformation that continues to circulate about the virus, discusses where government institutions went wrong during the early months of the pandemic, and what we can expect now that the pandemic is no longer the public health emergency it once was. Tune in for a fascinating reflection on where we are in the pandemic today and how we can all fight against the rise in anti-science that threatens the future of public health. See omnystudio.com/listener for privacy information.

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I'm Clayton Eckerd in 2022. I was the lead of ABC's The Bachelor. But here's the thing. Bachelor fans hated him. If I could press a button and rewind it all I would. That's when his life took a disturbing turn. A one-night stand would end in a courtroom. The media is here. This case has. gone viral. The dating contract. Agree to date me, but I'm also suing you. This is unlike anything I've ever seen before. I'm Stephanie Young. Listen to Love Trapped on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts. Hi, I'm Aaron Welsh, and this is, this podcast will kill you. You're

listening to the latest episode in our TPWKY Book Club series, where we chat with authors about their popular books in science and medicine. gotten to have some fantastic conversation so far, and there are so many more to come. If you'd like to see the full list of books we've already covered and those that we'll be covering later this season as a part of this series, check out our website. This podcast will kill you.com, where you can find a link to our bookshop.org affiliate account under the extras tab. On our bookshop page, there are a bunch of TPWKY lists featuring books.

we've read for our regular episodes, memoirs about health and disease, a list of fiction books about disease. Should we do a book club on disease-themed novels? Is anyone out there a member of a book club on disease-themed novels? Because that sounds like so much fun. And also on our bookshop is, of course, a book club list where you can find all of the books we're featuring in this and last season's TPWKY Book Club series. As always, we'd love to hear from you. you about how you're enjoying these episodes, whether you have any book suggestions for future episodes, favorite episodes so far, whatever your thoughts are, send them to us via the contact us form on our website. All right, let's get into the book of the week. Dr. Paul

Offutt joins us to discuss his recent book, Tell Me When It's Over, and Insider's Guide to deciphering COVID myths and navigating our post-pandemic world. Frequent listeners of the podcast, are no doubt familiar with Dr. Offutt's name. We've mentioned a few of his previous books in some of our episodes, such as his book Vaccinated, One Man's Quest to Defeat the World's Deadliest Diseases, which tells the story of Maurice Hilliman, who developed many of the most common vaccines in use today. Or maybe you've heard us mention deadly choices,

how the anti-vaccine movement threatens us all, which takes readers through the history and rise of anti-vaccine. sentiment. And Dr. Offutt is somewhat of a public health celebrity, appearing on popular news programs championing the life-saving power of vaccines. Offit's titles and credentials are almost too long to list. The Maurice Hilliman Professor of Vaccinology, Professor of Pediatrics at the Parallin School of Medicine at the University of Pennsylvania, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, member of the FDA vaccines and related biological products advisory committee, and so many others. But perhaps one of his biggest accomplishments is as co-inventor of a

rhodovirus vaccine, which has prevented hundreds of thousands of deaths around the world. Off its passion for communicating about the power and safety of vaccines, as well as combating the mis and disinformation undermining public health efforts, takes shape in his newest book, about the COVID pandemic. In the aptly named, Tell Me When It's Over, Offit takes readers through what we have learned about the COVID pandemic and SARS-CoV-2,

the virus at the center of it all. He breaks down where this virus originated, dismantles the lab leak conspiracy theory, discusses some of the ways that the public lost confidence in U.S. government institutions during the pandemic, explores this new flavor of anti-expresses, anti-vaccine sentiment that took hold during COVID, and which has really only grown since,

and presents ways that we can fight against the rise in anti-science and regain public trust. The COVID pandemic revealed how we can accomplish incredible feats by investing time and resources into public health, giving us a safe and effective vaccine in record speed. But it also showed the gaps in our system. how myths and disinformation can quickly fill a knowledge void, and how crucial it is to learn how to communicate our science to the public, including when science doesn't know it all or gets it wrong. COVID is here to stay, and unless we do something about it,

so is this rise in anti-science and anti-vaccine sentiment. Let's get into this interview right after this break. Dr. Offutt, I really, I really can't express how excited I am to be chatting with you today. You are a huge public health hero of mine. And the incredible and impactful science communication work that you do, especially when it comes to vaccines, and not to mention your work on developing, said life-saving vaccines.

It is simply amazing. So thank you so much for being here. Well, thanks for asking me. It's my pleasure. Your latest book, Tell Me When It's Over, covers the COVID pandemic, getting to the root of some COVID myths, explaining the vaccine, and it essentially acts as a guide for how we're supposed to get used to this post-pandemic world. How did you decide that you wanted to write this book? Well, it was cathartic.

I mean, you know, the virus came into the U.S. early 2020. In April, Francis Collins, who was then head of the NIH, asked me to be part of this public, private partnership called Active A-C-T-I-V, which stood for accelerators. COVID technological innovations and vaccines. And so, you know, we were essentially advising pharmaceutical companies on how best to test vaccines and potential antivirals. And I'm on the FDA's Vaccine Advisory Committee. So I really got to watch this up close. And in many ways, the book was cathartic. I don't know if you remember the way it played out in 2020, aside from having nothing, right? We didn't have antivirals to October. We didn't have monoclonal still November. We didn't have vaccines until December.

So we had nothing other than avoiding human-to-human contact. And then in April, the Trump administration was convinced that hydroxychloroquine was our ticket out, right? This was going to be the magic medicine that was going to make it all go away. And so the government bought almost 30 million doses of hydroxychloroquine and successfully twisted the arm of the FDA to authorize it without any evidence that it worked, without any evidence that it worked to either treat or prevent the disease. You certainly already knew about the safety issues, which were potential heart arrhythmia.

And so they approved it. And that scared people. It scared me. I wrote an op-ed for the New York Times saying, fearing an October surprise. Here, the Trump administration successfully twisted the arm of the FDA to approve a drug that didn't necessarily work to treat it prevent disease. That's their job. I mean, the job of the FDA is to stand between pharmaceutical companies and the public and protect the public. So now, you know, you're scared about how the vaccine's going to play out, right?

I mean, the Trump pulled Stephen Hahn into his office and in an invective, latent tirade, said, I want this vaccine out before the election, which was the beginning of November. And were that to be true, then you wouldn't have that two-month safety follow-up that you have for pretty much every vaccine, after the last dose, which wouldn't be until December. So Hans took it to his credit, stood up to him, put it on their website. This is what we're going to do. But people still didn't. Now you really had a critical loss of trust in the FDA.

Country after country, state after state stood up and said, we're going to have our own vaccine advisory committees. They didn't trust us. They didn't trust the FDA vaccine advisory committee. And so it was a really turbulent time. And between that and a number of what I think were communications errors, including not trivial ones that occurred after that. I just, this was a catharsis. I just had to get this book out. I feel much better now. Thank you for letting me write it.

And as you began putting this book together and deciding what you wanted to include, how was your approach guided by your intended audience? And was that audience, is your audience for this book different than for past books that you've written? No, I think it's the same. I think it's the same from my book. I guess the audience will decide that, but it's for a general audience. It's kind of a what happened. Because I think in many ways, the book is a story of two remarkable contrasting things. One is that we isolate a virus in January of 2020.

We sequence it. So now you can potentially make a vaccine. It's an unusual virus. It had an interesting sort of biological and clinical characteristics. And then 11 months later, using a technology, messenger RNA, that we never used before. We had no experience with that technology or with the vector virus approach by Johnson and Johnson. You had two large clinical trials, and then in February of 2021, you had a large J&J, Johnson and Johnson trial that showed that the vaccines were effective, remarkably effective. And then over a period of six or seven months, we immunized 70 percent of the U.S. population, a million people a day, two million people a day, three million people a day.

And then, and I think that, I think that was the most significant scientific and medical accomplishment in my lifetime. And I'm old. So my lifetime includes the development of the polio vaccine. I think it was amazing, actually. Then we hit a wall. And by mid-2020, 30% of this country did not want to get vaccinated. Ultimately, 300,000 people lost their lives because they didn't trust us. They didn't trust the FDA.

They didn't trust the CDC. They didn't trust other public health agencies. Why? What happened? How did we lose that trust? And I think that's why I wrote the book. What happened? How did we lose it? And how can we get it back? Let's take a quick break here. We'll be back before you know it. Dinner shows up every night, whether you're prepared for it or not. And with Blue Apron, you won't need to panic order takeout again.

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Improve your sleep tonight. shop caroloha bamboo sheets now at caroloha.com. That's C-A-R-I-L-O-H-A dot com. Cooler sleep starts with Caraloha. Welcome back, everyone. I'm here chatting with Dr. Paul Offutt about his book, Tell Me When It's Over. Let's jump back into some questions.

Like you said, you've been in the vaccine game for quite some time, and you've witnessed firsthand and have written and spoken a lot about this rise in anti-vaccine sentiment over the past few decades. But now, post-COVID and during COVID, we're seeing a drop in vaccine compliance rates, unlike anything previously witnessed. What do you think is unique about this decline? And why was COVID this perfect storm to grow anti-vaccine and anti-science sentiment? Well, I would have imagined the opposite was true. I mean, typically what anti-vaccine activists will say is, give me a pandemic. Then I, then I, then I, I get the idea of being vaccinated or even mandating vaccines.

Show me a pandemic. Well, this was a pandemic. We had more than 1.1 million people die in this country. People were dying right in front of us. I think all of us at least know someone who was at least seriously ill and died. I mean, my aunt died of this virus. And so you didn't have to convince people, I would think, that it was real. And the vaccine clearly worked.

And it was safe. It wasn't absolutely safe. But it was pretty darn safe, the MRNA vaccines. It was myocarditis within four days of dose two, which was generally self-resolving and short-lived. But in the scheme of things, considering it was a novel technology for a novel virus, I never really saw the other shoe drop. So you had your ticket out of this pandemic, and nonetheless, people reject it. And I think the reason was, because you're right, I think the anti-vaccian movement is stronger. They're better funded and they're stronger.

And I think it all has to do with this, which is politics. I think there, although there's always a political implication for vaccines because they require support, you know, that they, you're going, anything, I think, that requires funding, public funding is going to be political, but it doesn't have to be partisan. But this was partisan. You know, on the left, anti-vaccine activity was always, you know, just don't inject me with anything with a chemical name, you know, so, which is pretty much water, of course, has a chemical name. And on the right, it was this libertarian, I don't want the government to tell me what to do. That is the current politics, which is federal government off my back. And so that's where all the money came from. Eric Trump, Donald Trump's son, stood up at one of the rallies and said,

if you don't want to get a vaccine, know that the Republican Party has your back, which is amazing because it was the Trump administration that created this vaccine with Operation Warp Speed. And yet, if anything, Donald Trump distanced himself from arguably his greatest accomplishment. So they're very well-funded. they're more active than ever. And I think that at the heart of it is mandates. I think when we mandated that vaccine and people lost their jobs and people couldn't go to the bar, they wanted to go to the restaurant, they wanted to go to the sporting events closed down. You know, schools closed.

Travel was restricted. People felt they, you know, they were mandated to wear masks, mandated to get a vaccine. And that leaned into this libertarian left hook. And this is what you have. A well-funded sort of libertarian anti-vaccine campaign that has. has now been embraced by the right. And I kind of wanted to get into this a little bit more when it comes to like how this miss and disinformation spread and the role of social media. What do you think social media is doing to kind of facilitate the spread of this bad scientific information?

Right. You can very easily find awful information about vaccines that will fit any conspiracy theory. If you're hesitant about getting a vaccine, and it's understandable that you would be hesitant. I mean, you're asking people who are otherwise healthy to inject themselves with a biological. In this case, the biological is something with which we had no experience. And it's a genetic vaccine. And the minute you say that word, genetic, people are thinking, it's going to alter my genes. And that's part of the argument that people have made, right? There's DNA fragments in this vaccine that will alter your genome and that the MRNA can, you know, can enter your

nucleus and get reverse transcribed and then enter your DNA. and that would be the best news for gene therapy ever if that actually was possible with this MNA vaccines. But, you know, so it's very easy to get that notion out there that this vaccine can do harm. The CDC director in 2009 was a man named Richard Besser. And that's when we had this swine flu pandemic. And he was great. He was out there every other day, every third day in front of the media, answering their

questions. This is what the vaccine is. This is how we're going to distribute it. This is how it's made. This is what the virus is doing. This is where the virus is now. This is where we expect the virus is going to be. He was the model of how you communicate what we were doing and why we were doing it.

So I saw him at a national foundation of infectious disease meeting a couple months ago. And I said that to him. I said, you were great. You were a model. He said, thank you. I could never do it today. Two reasons. Politics and social media.

You know, I want to go back to something that you mentioned, which is about how this anti-vaccine movement is so much better funded these days. And, you know, when it comes to other subjects that are popular with the anti-science crowd, so things like human-induced climate change or historically cigarettes and lung cancer, feel like it's easier to make those connections, to see the motivations of the people or the groups that are spreading disinformation. With climate change, of course, the fossil fuel industry doesn't want to lose profits as a result of changing policies.

And that's more or less the same thing with big tobacco. As soon as that link about lung cancer and cigarettes came out, it was like, let's quash this, you know, pretty clear motivation there. But I feel like identifying the drivers of the anti-vaccine disinformation campaigns, it's not as straightforward. So how can we categorize some of those drivers? No, that's a really good point. I hadn't thought of it that way. But you're right.

I mean, what exactly is the financial motivation here, assuming there's always a financial motivation. And I think it's just an expression of, um, this notion of autonomy, sort of personal freedoms, and Uber alas, I think that's just sort of become the mantra of the Republican right. And I think that's why, or especially the, although, well, the right, I'll just say. And so that's their current mantra. I think it just fits into their zeitgeist. I'm not sure that there is any financial motivation, but there's certainly a lot of money to support it. I mean, more so than ever, there is, you know, there was an article remodograph by a group called the Center for Countering Digital Hate. And they had what they

called the disinformation dozen. And so it was 12 people or groups that accounted for about 70% of the misinformation that was out there. Their funding was often the same. They all got pretty much funding from the same source, which was the dietary supplement industry, which in many ways is the same thing, because there are two as a matter of medical freedoms. We don't want the FDA telling us what we can or can say because when we say things like, you know, this will make your prostate smaller or this will make your immune system better, we want to be able to say that even though we have no evidence that's true. And so the FDA sort of pushes back and doesn't really let you say that. You have to be vague or right. It supports prostate health, immune health, you know, heart health, whatever.

And so they really are in many ways aligned with this group, which also likes to make claims that are unsupported. And I feel like so much of this has to do, too, with how uncertainty is communicated in popular media, where scientists and, you know, people trained as scientists or as medical practitioners are sort of, it's ingrained in us to be more conservative in saying this causes this, or this is the evidence for this, or there's a strong relationship. And I kind of wanted, this is like a very roundabout way of getting to my question, which is sort of about the way you think that scientists are trained in how to communicate with the public or the popular media and how we can do better with that.

I think our training as scientists is the opposite of the training that we need to educate the public and the media about scientific issues. Because when you write a scientific paper, or publish a scientific paper, the biggest sin you can commit is to ever go, beyond the data in front of you. So you're a good scientific paper is one that in theory draws a conclusion. And then the discussion section is full of caveats, right? I really can't say this or this or this because my data limit me in terms of what I can say about that. And so we're always very careful. That's number one. That doesn't come off well, at least in a popular press or in the media, because it sounds like you're wishy-washy. Sounds like you're not sure of what you're saying.

The other thing is just the nature of the scientific method, which is that you formulate hypothesis, and then you can do two things with that hypothesis. You can reject it or not reject it, but you can never accept it, which is to say you can never prove never, because the null hypothesis is paramount, and you can't ever accept the null hypothesis. So, I mean, so as an example, as a little boy, I watched the TV show Superman, which was black and white and Christopher Reeves, it was before Chris Reeves, George Reeves. And, you know, he flew. And when you're five years old and you're watching TV, TV does not lie. And so, you know, he tied.

He had his cape and his hair would fly and he would look at the city below and he would fly. So what I did was I went in the backyard and on a small chair, I stood up and I put a towel around me and put my hands in front of me using the interlocking thumb grip, which I thought was critical to the whole experience, because that's what he did. And I just, um, I just, you know, I just, you know, jumped a few times and didn't fly. You know, spoiler alert, I didn't fly. Now, I could have done it a million times. That wouldn't have proven that I couldn't fly.

It would only have made it all the more statistically unlikely. I could have done it a billion times, 10 billion times, because the scientific method does not allow me to say, I can't fly, at least not without a plane, but I can't fly. And so I can say that. And I think you have to get used to that. So, for example, you can't say the MMR vaccine doesn't cause autism. All you can say is that there are 18 studies that have been done on seven countries, on three continents,

involving hundreds of thousands of people that show that you're no more likely to develop autism if you've gotten the vaccine or if you haven't. That's what you can say. And so I had to testify once in front of Dan Burton's committee, Office of Government Reform, about that issue. Andrew Wakefield had just published his paper. He was on the other side. I was on the side of good, trying to explain what we,

knew about MMR vaccine or what we knew about autism and Colleen Boyle, who was great from the CDC, you know, she got up and she explained what the early data showed in terms of there was no association, no statistical association with those two things. But Dan Burton heard weakness in that. And he said, so you can't tell me. You can't tell me it doesn't cause it, do you? Because you have, and I quote, an out in the back of this thing. And so that, you know, it's hard that you have to get use of that at some level, at some level, scientifically you can't say. And, and you know, it's hard. And for scientists, that's hard. Let's take a quick break.

And when we get back, there's still so much to discuss. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture.

It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly or work in harsh conditions because it actually works. O'Keefs is my hand cream of choice in these dry color.

winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keef's. Just visit o'keefs company.com slash this podcast and code this podcast at checkout. Sleeping hot? Waking up sweaty at 2 a.m. It's not you. It's your sheets.

And Keraloha is your answer. They're the original for bamboo sheets that are naturally. breathable, moisture wicking, and luxuriously soft, designed to keep hot sleepers cool and comfortable all night long. You can feel the difference in how much cooler you sleep. Keraloha's innovative bamboo fabric pulls heat away from your body, so you fall asleep faster and stay asleep longer without cranking the AC. Improve your sleep tonight. Shop Keraloha bamboo sheets now at keraloha.com. That's C. A-R-I-L-O-H-A-com. Cooler Sleep starts with Keraloha.

In 2023, a story gripped the UK, evoking horror and disbelief. The nurse who should have been in charge of caring for tiny babies is now the most prolific child killer in modern British history. Everyone thought they knew how it ended. A verdict, a villain, a nurse named Lucy Leppie. Lucy Letby has been found guilty. But what if we didn't get the whole story? The moment you look at the whole picture, the case collapses. I'm Amanda Knox, and in the new podcast, Doubt the case of Lucy Lettby, we follow the evidence and hear from the people that lived it,

to ask what really happened when the world decided who Lucy Lettby was. No voicing of any skepticism or doubt. It'll cause so much harm at every single level of the British establishment of this is wrong. Listen to Doubt, the case of Lucy Lett be. Letby on the IHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Welcome back, everyone. I've been chatting with Dr. Paul Offutt about his book, Tell Me When It's Over, an insider's guide to deciphering COVID myths and navigating our post-pandemic world. Let's get back into things. What do you think is the appeal of conspiracy

theories like the microchip in a COVID vaccine? Well, conspiracy theories are easy to understand. understand. They explain something clearly. They give you a handle on it, even if it's not true. I mean, I think the best example at the beginning of this pandemic was the notion that it was a lab leak. This wasn't a lab leak. I mean, I was actually just on Morning Joe this morning at like a quarter of 10. And that was his question. He said to me, I used a thoughtful, smart man. He said, you know, I've had people say to me, people in the medical field or the scientific field, say to me sort of on the as if this is our secret, you know, that we're trying to hide this, that, you know, this, what this may well have leaked from a lab. And, you know, it's, it's, first of what's never

happened. Never has a pandemic virus ever been created in a laboratory. Two is all the evidence is on the other side, right? I mean, here you have the western section of the who not seafood market where there were dozens of animals that were sold illegally and very close unsanitary conditions. And the kinds of animals, you know, red foxes, raccoon dogs that kids, they and catch and transmit a virus like SARS-CoV-2. I mean, SARS-1 was an animal-to-human spillover event in 2002. MERS was an animal-to-human spillover event in 2012. I mean, you know, it's not like the black plague was, you know,

created in a medieval biocontainment lab. You know, it says these things are invariably animal to human spillover events. And you have, you know, there's sort of pictures that were taken of that Western checks in the market that were sent to people in the United States, media people in the United States. So you see how unsanitary conditions.

those conditions were. And the Chinese really did look at for genetic evidence of this virus, SARS-CoV-2 virus, in things like the machines that kill the animals, the, you know, the brushes that brush the animals or the tables in which the animals were sacrificed or, you know, the other, the cages themselves and found the evidence of SARS-CoV-2 virus there. So it's creating the lab. Then what the laboratory person had to do was then travel nine miles to where this Wuhan seafood market was, cross the Yangtze River, and then deposited in a place exactly where you would expect an animal to human spillover event to occur. So this is not a scientific kind of reason. I mean, you don't have, you know, the clear smoking gun. I mean, you don't have like a raccoon dog standing up like at the

end of crime and punishment and saying it was me that killed a seafood vendor, right? So you don't have that. But you have a confluence of evidence that tells you it's all on one side. And actually, the best comment I've heard is that this is a promiscuous virus. I mean, it's not if you were trying to target it to humans, it's targeted to at least three dozen other animal species. And so the line was, if this was created in the lab, it was created by an underperforming graduate student. I like that. Yeah, I mean, we have so, like you said, we have so many roadmaps for how this happened. And we, people have been predicting something like this for decades. But, you know, I think that going back to sort of this cognitive dissonance between

people were hoping and hoping for a vaccine. And when it finally came out, when it was finally available, there would be someone who, as their relative is dying in a hospital, this person would be simultaneously tweeting about microchips or tweeting about fatal side effects from the vaccine. Like, where does that cognitive dissonance come from? Maybe that's just like a philosophical question that we can't answer, but it's just something that I find really hard to kind of like grapple with.

I think part of it is we definitely lost trust. And I think that there's a few reasons for that. One is that there's just a general anti-institutional bias. So it's not just the FDA and CDC that's lost trust, the Department of Justice, FBI, etc. Two is there is this flood of disinformation at a level I think we've never seen before. It's never been better funded before. But the third is that I think we did make communications mistakes. And that's one reason why you lost trust. And therefore, those conspiracy theories become more. were attractive. So for example, to me, the biggest one occurred in July of 2021 when thousands of men go to Providence, down Massachusetts to celebrate the July 4th holiday. And 79% were already vaccinated. Nonetheless, there's a COVID outbreak. So 346 men who were in attendance got COVID, all of whom had been vaccinated, four were hospitalized. So that's a hospitalization rate of 1.2%. That's

a vaccine working very, very well. Right? I mean, the vaccine's doing what you wanted to do, keeping you out of the hospital. The other 342 had mild or asymptomatic infection. When the CDC reported this, the headline in M.M.M. Morbidi and mortality weekly report was breakthrough infections.

They called these asymptomatic and mildly symptomatic infections, breakthrough infections, as if this vaccine had failed. I mean, breakthrough was a very negative word. Whereas the goal of this vaccine was to keep you out of the hospital. The goal of this vaccine was to prevent serious infections, and the vaccine was doing exactly that. I mean, if you watch Brett Kavanaugh, for example, Supreme Court Justice, you know, he's entering the Supreme Court chamber.

He's routinely screened and found to be positive. It was around the same time. And they called that a breakthrough infection. If you watch the way that CNN carried that story, you would have thought the man was fighting for his life. I mean, Lindsay Graham actually had, again, because this is mid-2020, it's two-dose vaccine time. He'd gotten two doses of vaccine. He had a three- or four-day illness that was characterized by sinusitis. And he said, and I quote, this would have been much worse if I hadn't been vaccinated.

Right. Lindsay Graham got it exactly right. And how often do you get to say that? Even a broken clock is right twice a day, I guess. Yeah, I think that that sort of messaging has still. had lingering effects. You know, I remember seeing a news report maybe a couple weeks back about the latest booster and how it prevented symptoms and X number of people who received it. And it's it's still perpetuating this notion that vaccines are there to entirely prevent any sort of

symptomatic disease. And that's not the case. This upsets me more than anything else. I mean, it's a short incubation period of mucosal infection. My mild infection is present. prevented by high levels of virus-specific circulating, neutralizing antibodies at the time of exposure, and antibodies don't last that long. They will fade over four to six months. I think we were fooled in a sentence in December of 2020 when those two large clinical trials were presented with Pfizer-Moderna, you know, Pfizer, 40,000 person, modernity 30,000, you know, placebo-prospect of placebo-controlled trials. The efficacy was 95% against severe disease. It was also 95% against mild disease. And the reason is, is, those.

Those were three-month studies. Those participants had just gotten their second dose. That's why it was so good. So six months later, five studies showed that protection against severe disease was holding up well in the 90% range. But protection against mild disease had faded to 50%. That had to happen. And see, that in combination with mandating vaccines, you have to get this vaccine or else you don't get to go to work. And then people would did it.

They got the vaccine. Then they had a mild illness and said, say, the CDC told me that this vaccine was going to me, and now it didn't. I'm having this breakthrough illness. I mean, it really angered people. Actually, if you'll watch away, for example, Ronda Santis, doing his stump speeches would often say, you all know the CDC told us this vaccine was going to work, and it didn't. Well, it did. It worked to prevent severe disease. Actually, if you look at the way that they're currently messaging the flu vaccine, the CDC, it's exactly right. Their slogan is, wild to mild. I wanted to ask you about something you discussed in your book, which is this difference between a deficit of knowledge,

and a deficit of trust when it comes to the COVID vaccine. And I was wondering whether you could explain a bit more about what you mean by that and also how unequal access to health care plays into this. Right. I think probably the most telling studies were that those who chose not to get a vaccine often had little contact with the health care system, which I think is underlining kind of the sorry state of health care

in this country. I mean, we don't have a national health care system. So not everybody easily gets health care. And so, therefore, there's that deficit of knowledge because you aren't able to ask your doctor, you know, should I get this vaccine? There was a story I telling this about a nurse name or an intensivist named Brittany Kobe in Alabama, who, you know, who would often see people come into the hospital, had unvaccinated, you know, suffering and dying. And she said the question that I always asked was, did you talk to somebody about this, somebody in the health care profession, and the answer was invariably no. And so I think, you know, if you look at, for example, people over 65, they're certainly more likely to, the older you are, the more likely

you are to be a Republican. Two, the older you are, the more like over 65, you're more likely to watch Fox News. But misinformation isn't destiny. I mean, they're also very likely to be vaccinated. Because 95% of people over 65 are vaccinated because they have, because we have Medicare in the United States. And so they often can get health care. And I think that's, that's key. But I think, I think it is fixable. And the story I tell is one of Aela Stanford, who's an African-American surgeon in Temple, the Temple University. And she, with her own money, formed something called the Black Doctors COVID Consortium. So with, you know, many of her colleagues, she went into North Philadelphia, a predominantly black and brown community with little contact with the health

care system other than an emergency basis. And she just sat in people's living rooms and tried to convince them of why they should get the vaccine. So they're seeing someone who looks like her, who they therefore trust. And eventually, you know, if they said, no, she'd come back again or she'd come back again. And she ultimately vaccinated 50,000 people in North Philadelphia. She's a hero. She is an American hero. I just wish that there were a thousand, Aela Stanford's, who could get out there and do what she did, because I think that's the solution. I mean, yes, the CDC and the FDA should explain in detail what they're doing and why they're doing it. And yes, I think local and state government should do that.

But I think that Ala Stanford represents a solution to this problem, which is we have to find who those people are in those communities that are trustworthy and then get them the resources they need to get into those communities and tell people why vaccination is important. Absolutely. I could not agree more. And I think that part of the challenge with that is kind of something we've already touched on, which is the lack of training for research.

researchers or medical professionals in how to communicate information to the public, where, you know, we learn about how vaccines work. We learn about how epidemiological studies work, how clinical trials are carried out, but we don't necessarily learn how to explain that to someone who, you know, isn't sitting next to us in the same classroom or even explaining it to them. And so how do you think these sort of opportunities can be improved upon at every level from like training to development of these programs to execution? Right. Well, I think, as always, it probably starts at the beginning.

I mean, my father since past, but he's, he's thought in the World War, too, but he explained to me that as a elementary school and high school student, he was actually taught critical thinking, taught the scientific method. We often don't do that anymore. I think that would help. So, so, and I think, I do think that, so, for example, if you see the CDC recently changed their guidelines in terms of how long one should quarantine associated with being infected. And they said something that made a ton of sense, which is

one a February all day. See, why that makes sense to me is that the virus occurs in two stages. This is true for all viruses. So the first stage is the virus replication stage, right? Reproduce itself over and over again. Then what happens is the immune response stage. which is when you get symptoms. It's when you make antibodies against this virus, or you have cytotoxic T cells that kill virus-infect cells. That's when you have symptoms. So now, as the symptoms increase, because the symptoms are based on your immune response trying to eliminate the virus, virus replication decreases. So their argument is, and it's a reasonable one, if you have one a febrile day, if you've been febrile, and you've had fever, wouldn't make sense that the immune system

is abating. And if the immune system is abating, doesn't that tell you that virus, replication is really not a critical part of the disease process anymore. So you're much less likely to be shedding virus. That makes sense rather than saying, you know, quarantined for seven days, 10 days, 14 days, because first of all, viruses don't replicate on the basis of the metric system or the lunar month. So wouldn't it make sense to just peg it to the person rather than to this arbitrary number? So I like that. But explain it. You know, you know, I mean, get out there and explain it because or else what you have, you have then other people trying to explain it for you

that may not understand it as well. I want to kind of circle back to this issue of politics and public health. And politics has been involved in public health in the U.S. for hundreds of years, even before the U.S. was the U.S., just look back to smallpox inoculations during the American Revolutionary War. And I think that for a lot of us, the political discourse, during the COVID pandemic, revealed just how much public health policies are influenced by the politics of the day. As we head into this election year, what public health discussions

do you think that we'll hear more about or will be central to campaign issues? You're absolutely right. I think politics has always been part of public health because public health requires resources and therefore there will always be a political component, but there doesn't have to be a partisan component, which is what I think is happening. here. I don't know what's going to happen. I fear that what's happening is that science is losing its place as a source of truth. I mean, Kelly Ann Conway said it best. Well, we have our alternative facts. The birth of the term alternative facts, which somehow is acceptable. And I think with that erosion and trust, what science is becoming now just sort of another voice in the

room, anything is possible. And I think we just saw that. We just saw, people denying the impact of this virus when 1.1 million people died, when 300,000 people lost their lives because they chose not to get vaccinated because they chose to lose their lives. I mean, that's a frightening time. Worse, I think, you know, have hundreds and hundreds of pieces of legislation that have pushed back on vaccine mandates, masking mandates, isolation or quarantine procedures, and vaccines. I mean, these are the important weapons in public health that are being stripped away at some level. We want freedom, but we don't want protection. And I fear that's kind of where we're heading. So what changes all this? I think, again, I'm an optimist. I mean, I'm a Philadelphia

Eagle season ticket holder. So by definition, I'm an optimist. But I do think these things have to occur very early on where we educate people about science and educate people about, you know, how to think critically. And I think some of that is gone. I don't, I maybe, See, I think I became a better critical thinker as a scientist than when I was an MD. When I was just doing clinical work, I think I was more of an anecdotal thinker, more of a pattern recognized. I think once I moved into a basic scientist working on rotoviruses, I think I became much better at sort of hierarchically establishing burdens of proof, well, you know, formulated hypothesis,

subjecting those proofs to analysis. I became a clearer thinker somewhere in there. But I'm not sure I learned that in medical school. I really loved what you just said about how science being just another voice in the room, and I feel like this is a future that we have created for the past several decades, where in general there's been sort of this demand for and acceptance of debate, where we need an equal sides debate, where on one side is the scientific evidence and the other side is whatever agenda, you know, somebody is pushing,

whether that's, you know, big tobacco, whether that's people who don't believe in evolution. There's this, like, kind of false, equal footing debate that doesn't really exist because the science has already been debated over decades of peer review, over decades of conferences and basically what science actually does. And I think that we have now gotten to the point where it's not even just a two-sides debate, but it's science versus a thousand different agendas. And I agree that I really worry about what that's going to look like in the future. And I feel like if we say that training students and creating these critical thinking courses in younger students, I mean, how many generations then will it take for this to make an impact in policy? That's, I think, one of my big worries about this.

You know, it is sort of a corollary to your worry. I think science, when I would do scientific studies and then go to, you know, double-stranded RNA meetings, you know, to resent the science of working on rotavirus. And so you would draw a conclusion. And then you would present your data and people would challenge your data. So it's not really debating science, maybe in the way you mean it, I think. But, you know, they would challenge the criteria on which you based your conclusion. Did you do that? Was it internally consistent?

Was it robust? did you do the right controls, et cetera. And that's what you, you wanted that. You wanted to hear that because that's how your scientific studies got better. That does not work well in a public health arena. It doesn't. And I think the best example of that for me, two recent examples, but one is the bivalent vaccine. I mean, the bavent vaccine was the thinking was reasonable, right? Omicron, B-A-1, the original omicron came into the country in December 2021. It was an immunovasive strain, even if you'd been naturally infected or vaccinated with alpha or delta, you weren't particularly protected against mild disease from Omicron.

So shouldn't we include Omicron in the vaccine? Perfectly reasonable. So the thinking was, all right, let's do a half a dose of the ancestral strain, half a dose of one of the Omicron variants, which became BA4, BA5. Not a bad idea. Didn't work out. I mean, if you looked at the data that were presented to our committee in June of 2022, it didn't look like immunologically you were more likely to develop an immune response.

a neutralizing antibody response to this omicron variant if you got the monovalin vaccine, if you got the bivalent vaccine because of imprinting. That's what happened. So I was a no vote. I voted no for that. Now the next day, the government bought 105 million doses of fives vaccine. You know, but remember, I'm in an advisory committee. So we just give advice.

So, you know, anybody who's in medicine knows people don't have to follow your advice. And then the clinical studies were done. There was one in the U.S., one in the U.K., one in the U.K., one, in France showing that you were no better off getting the bivial vaccine or monovalial vaccine. So I said that. I mean, I said that nationally. I wrote a prospective piece for the New England Journal of Medicine that said that. And it was published at the same time that David Ho in Columbia or Dan Brook in Harvard published

their paper showing there was no difference immunologically in those two vaccines in inducing an immune response, likely neutralizing or protective immune response against the omicron variant. Okay. That's okay. not to get it right the first time. You learn as you go. There's always a learning curve. It's invariably steep with this kind of, it's a novel virus. It's a novel vaccine strategy. It's a novel disease. We're trying to learn as we go. And so explain that. We didn't get this exactly right, but we've learned, and so you don't see bi-valent vaccines anymore. But that's not what we did. What we did was we kept saying it was better because we wanted it to be better.

And when I was saying, you know, publicly that it's not better, it's not worse, boosters boost, it's a value for people who are in high-risk groups. You know, I was hammered by the public health officials who were really angry at me because what had I done? I'd gotten off the bus. It's a divisive time. You're on the bus or you're off the bus. And they felt, I mean, because we wanted people to be vaccinated.

And I get that. But don't misrepresent the data because you're only going to lose trust not only the public, but of scientists who see what the data are. So just be honest and know that you're not going to get it right. But see, the fluidity of that, the fluidity of scientific discovery, of learning as you go, is disconcerting to the public. I mean, I think if you ask people, do you think we're going to know more about science or medicine 50 or 100 years from now than we know now? I think everybody would say yes. But when it comes to your disease or our pandemic, they want to believe you know everything you need to know right now. And if you don't, then you got it wrong that I don't

believe you anymore. I was wondering, do you have, like, any tips of, you're such a great science communicator? Do you have any tips for science communication that you, that you have found over the years, like, work really well, or even just, like, general advice? Well, I think, don't be afraid to explain the science. I mean, when this whole thing, there's a surgeon general in Florida, this Florida actually is one of the, I think only four states actually has a surgeon general, whose name is Dr. Joseph Lado. So he's become famous for his notion that he put out there and sent something to all

these sort of health care people in Florida, that the MRNA vaccines are contaminated with DNA fragments, which, first of all, it's a manufacturing residual, it's not at all surprising, anything that's made from cells and certainly the plasmid DNA that is the beginning of the process of mRNA vaccines. That doesn't just completely disappear as you go through the manufacturing process. nanogram levels of fragmented DNA, as it's true of in any vaccine that is made from cells. Measles, Moms, Rebella, Barracella, Roto Virus, all those have small fragments of DNA. And in fact, we eat foreign DNA all the time, assuming you eat anything made from plants or animals on this planet, which is pretty much everybody, which ends up in your circulation,

by the way, and fragments much larger and in quantities much larger than you're ever getting in a vaccine. But anyways, he put it out there, right? DNA fragments can essentially insert themselves into your DNA and cause cancer. So explain that. Now, you can explain that. You can explain how, you know, the cytoplasm doesn't like foreign DNA. It's hard to get across the nuclear membrane of a non-dividing cell.

Then you have to insert yourself into DNA, which, you know, requires some sort of enzyme like an integrates. But so you can, so I was on CNN, right, with Brianna-Killer. And you don't have much time. You've got about four minutes to explain why Joseph Lado is wrong. But don't be afraid to do that. Try and explain the science simply. Don't just say, so the FDA when they dealt with this is fine. I mean, they said, you know, vaccines are carefully tested for safety.

We know, you know, we know that this exists. But so when they do that, when they don't express the science, explain the science, they're basically saying, trust me. And people don't trust you. So when you give them something to hang on to, even if they don't necessarily understand all those words, they like, in it. You know, an enzyme like an integrase, but it is an English sort of sounding thing, right, integrate into something. So just, I'd say, don't be afraid of that.

Don't be afraid to say people appreciate that. I think they appreciate not being talked down to by making it too simple. In your book, you discussed many different important lessons that we learned from the COVID pandemic. And this is a two-parter. So the first is what do you think is the most important lesson that we actually did learn? And what do you think was the biggest missed opportunity or the thing that we, the lesson that we didn't learn or unlearned? Well, I think we learn we can make a vaccine quickly and well and that we can distribute it quickly and well. That was good.

I think that the thing that hopefully we've learned is that we need an international surveillance system. You can't depend on a whistleblower in China to tell you that there's a virus that's circulating that's killing people. And China was xenophobic. They didn't let other scientists come in. That gave rise to conspiracy theories. I mean, that kind of inability to let foreign or other researchers come in. I think it's in us. I do think, as I sort of talk about at the end of the book, I mean, when 9-11 happened, we all held each other and hugged and cried.

We were all in this together. I think that was also true when Pearl Harbor happened. I think we do at some level see ourselves as part of a larger group, and we have to. If we're going to move forward, we have to see ourselves as part of a larger group. There's 9 million people in this country who can't be vaccinated, for example, because they're immune compromise. They depend on those around them to protect them. Do we have any responsibility to them?

Of course we do. And I think we have to just kind of do our best to sort of emphasize that we are part of a whole, we benefit from being part of a whole and just make it clear that that's true. So, I don't know. I mean, I think we'll see how the next, the story of the next pandemic is told about, but there will be a next pandemic. We've had three pandemic viruses in the last 20 years. We're not that far from the next one. Dr. Offutt, thank you so much for taking the time to chat with me today. I really enjoyed our conversation about this rise in anti-science sentiment and what we can do about it. It's definitely

something that is always on my mind. And for those of you who want to know when it's over and how to navigate this post-pandemic world, check out our website, this podcast will kill you.com, where I'll post a link to where you can find, Tell Me When It's Over, as well as a link to Dr. Offutt's website. And don't forget, you can check out our website for all sorts of other cool things, including but not limited to transcripts, quarantini and placebo-rita recipes, show notes and references for all of our episodes, links to merch, our bookshop.org, affiliate account, our Goodreads list, a first-hand account form, and music by Bloodmobile.

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