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1:17:00 mins

The Problem Podcast

A Nuanced Conversation About COVID Vaccines (Yes, Really!)

We’re joined by Dr. Gregory A. Poland (director of Mayo Clinic’s Vaccine Research Group), Dr. Saad Omer (director of the Yale Institute for Global Health), and Zeynep Tufekci (professor at Columbia University), who bring something that’s often lacking from these conversations: nuance. We talk through why many non-crazy people are hesitant to get vaccinated, how our public health institutions have failed to communicate effectively with the masses, and why it should be perfectly okay to ask questions about the risks and benefits of any vaccine.

A Nuanced Conversation About COVID Vaccines (Yes, Really!)
Ep. 221 Final Transcript

Jon: I need to see Twitter Files 8 of Harry and Meghan.
Tocarra: I mean, there are real big consequences for this type of misinformation.
Jon: Oh huge consequences. You know what? “From now on, his cream can no longer be clotted. [KASAUN LAUGHS] He must drink regular cream. Regular!”
Tocarra: Wow. He didn’t mean that. He didn’t mean that.
Jon: “You sir. Will drink the Finest of Cream with no clots.”
[INTRO MUSIC]
Jon: Welcome back to the podcast, The Problem with me, Jon Stewart. The show’s on Apple TV+ season 2 is out now. It’s our first podcast of the new year. We took 10 days to gather our thoughts, uh, this show is gonna be a banger. We’re gonna be talking about that, that third rail thing. That thing that can surely get me canceled no matter what I say. Vaccine safety, vaccine hesitancy, vaccine misinformation. There are smart doctors and professors, they’re gonna be talking about that, but speaking of smart professors. Tocarra Mallard and Kasaun Wilson are here. The resident doctor and professor at The Problem.
Tocarra: You may call me Professor.
Jon: Professor Mallard, uh, and Dr. Wilson. May I —
Tocarra: Oh, I like that.
Jon: – refer to you as Dr. Wilson? First of all, welcome back. Happy New Year to both of you. Tocarra, I’m sure the kiddies, uh, had a lovely New Year’s. Do you—can you stay up till midnight with the kiddies anymore or are you just exhausted?
Tocarra: Oh, absolutely not. [KASAUN LAUGHS] Uh, 8 PM everyone was in bed.
Jon: Nice.
Tocarra: I said, “See you next year.” And I woke up —
Jon: Yeah.
Tocarra: — at 7 AM on the dot next day [INAUDIBLE]
Jon: Suck on that Seacrest! [TOCARRA AND KASAUN LAUGH] Son of a b****.
Kasaun: Oh wow.
Jon: Oh, I’m sorry. That was really way more angry [KASAUN LAUGHS] [INAUDIBLE].
Tocarra: Now we have to address that.
Jon: I want no beef with anybody. This is my beef free year. This is, I am going to be the anti Kanye.
Kasaun: Wow.
Jon: Oh, no. Now I’ve just created beef.
Kasaun: Wow.
Jon: By suggesting. Oh, for God’s sakes. You guys got anything before we get going?
Tocarra: I’m having a great week.
Jon: What?
Tocarra: You wanna know why?
Jon: Yes!
Tocarra: Because I love mess.
Jon: You love mess? [KASAUN LAUGHS]
Tocarra: And you know who’s messy right now? Prince Harry.
Jon: Oh, Harry. Harold.
Tocarra: He is in his f*** around and find out era. And I am living.
Kasaun: [LAUGHS] H!
Jon: Really?
Tocarra: I am living. So his book comes out this week. Spare.
Jon: Yeah.
Tocarra: And in it he is dropping all sorts of juicy tidbits.
Kasaun: Spare? Why is it — why is it called Spare?
Tocarra: Well, because he’s the, the second child, and so there’s Prince William, he’s the heir. And then there’s Prince Harry. He’s the spare.
Jon: Ooh brilliant.
Tocarra: And that is actually what Charles said after he was born. He said, “Thanks, Diana. Now I have an heir and now I have a spare.”
Kasaun: Oh no.
Jon: Wow, that’s f***ing brutal.
Kasaun: Did you guys watch the Netflix documentary
Jon: Uh, I didn’t watch the documentary and I didn’t read the book, and I can honestly tell both of you, I don’t give a f*** [KASAUN AND TOCCARA LAUGH] about any of it. It seems like, look, I went to school in Colonial Williamsburg, which is basically a historic reenactment of a certain time, and that’s how I view the royal family. They seem to be actors in a costume drama that is playing out. It looks like one of those, Tony and Tina wedding kind of participation plays with the public. I don’t understand. It’s a vestigial tale of a colonial pass that makes no sense to me. And whatever individual hurt they have in their own f***ing inbred family matters not —
Kasaun: Oh my God.
Jon: — to me or to —
Kasaun: Oh my God.
Jon: What? Oh wait. I just said there was no beef in this. Okay. I made it —
Kasaun: It’s over.
Jon: I’ve made a huge error in judgment. [EVERYONE LAUGHS]
Kasaun: It is –
Tocarra: Put this over the ether beat.
Jon: Honestly, when you see them out in public, do they not look like actors in a period piece and someone’s about to yell, cut.
Kasaun: It is like, it is like watching a Civil War reenactment in 4K.
Jon: Right? Yeah. It makes no sense. And they wear the, oh, find me the hat that makes me look the worst. I want that one.
Tocarra: Okay. That was a dig.
Jon: Give me the one with the full f***ing chicken on it.
Kasaun: Yo.
Jon: I want the full f***ing chicken.
Kasaun: Yo. Drop some bombs for Jon’s beef with Harry and Meghan.
Jon: Tired of it. Tired of it.
Kasaun: My favorite clocks, my favorite Harry and Meghan article. The headline was, the New Princess is Straight Outta Compton. I was like, yes! This is the kind of foolishness I live for. Yes.
Jon: Oh my god.
Tocarra: Listen, listen, listen. I don’t have the book, but I’m gonna order it. I’m gonna order it from Meghan because I support black-owned businesses, and I, and I want her to be happy. I really do.
Tocarra: At this point, you know, they need the money for their security that the institution cut ’em off. And also they’re trying to combat all the misinformation about them as a couple. Meghan, as an individual, I was reading something, uh, that said I. , um, it was fewer than 90 accounts were responsible for over 120,000 tweets.
Jon: Mm-hmm.
Tocarra: That were negative about them and Meghan Markle, which is, which is insane because their reaches was over 17 million users.
Jon: I need to see Twitter files. Harry and Meghan, I need to know how Twitter colluded with the Murdochs to create trouble for Harold and Meghan.
Kasaun: But, uh, but I, I also think it’s like, it is a great example of how much misinformation you can find online, how much they’ve had to unveil things about their life. Not just to like share and be vulnerable, but to combat all the misinformation that you find online. And, you know, just kind of like every episode at this point, it’s just like, what is—
Jon: Amen?
Kasaun: This is like exactly what happens this week. So obviously we’re all like watching football one day and then, and then
Jon: Damar, Damar Hamlin.
Kasaun: Damar Hamlin happens and –
Jon: Terrible
Kasaun: And then, A lot of the conversation on Twitter ends up being like, see, that’s what happens when you take a vaccine.
Tocarra: Right. Misinformation.
Jon: Kay. The Damar Hamlin case is why I wanted to do the podcast today with the doctors and the professor because, I don’t know if you guys were watching the game.
Kasaun: Mm-hmm.
Jon: But like –
Tocarra: Yes.
Jon: As soon as that happened,you were like, that’s gonna be devastating. Whatever that was is go, he went down in a way that people don’t go down from injury. That’s gonna be devastating. And I spent the rest of the time trying to tune out the announcers, talking about how difficult it is for them to talk in this moment. But second of all, trying to find news of his condition.
Tocarra: Right?
Jon: And I can’t tell you how much I saw of terrible how many athletes are just collapsing and dying? Terrible. That you know, they’re all dying, this is what happens with the vaccine. And I was like, holy s***.
Kasaun: Uhm, when it first happened, it was, it was horrific. And I think the part that stood out to me is that people acted like it was something that had never happened before. I think that’s the part that freaked me out. Like, I don’t do, people just forget that Corey Stringer died.
Jon: Right.
Kasaun: Of a heat stroke during training camp. Like we watched —
Jon: Yeah, yeah, every year during training camp high school kids die.
Tocarra: Yeah.
Jon: Of heat stroke.
Kasaun: We watched Tua Tagovailoa twice have a concussion and, and just get thrown back out there. Um, so the idea that this got weaponized in a way that’s like no one ever gets hurt in football, it must be the vaccine. It’s just like very strange to me.
Tocarra: It’s the quick part that was so scary. I was watching the game and when it happened, I’m like, they’re not giving me enough. I’m gonna go to Twitter. Someone must be like there in the stands. I need to know what’s going on. CPR, ambulance, he’s not giving the crowd the thumbs up, like what is happening? And immediately, I’m saying like three minutes after this happened. Uh, it was died suddenly. Vaccine deaths, uh, vaccine conspiracy, all trending. And I’m like, did something else happen I wasn’t aware of? And I’m like, oh no, it’s still just about this game. And it’s about. Damar but I think this was, I think, different just because of the misinformation that happened right away and how quickly people latched on something that truthfully did happen. And then attached all this other media to it.
Jon: The interpretation I’m gonna tell you something not surprised in any way, shape or form.
Tocarra: Really?
Kasaun: Really?
Jon: At the speed of it, at the depth of it. And here’s how I know. Be honest with yourself and be honest with me. When you hear of a terrible event, shooting mass, shooting, something along those lines, how long before your thoughts traveled to White guy, black guy, Muslim, Jewish.
Tocarra: Okay.
Jon: White supremacist, right? How long? 30 seconds. How long before we look?
Tocarra: Okay.
Jon: To the cultural fault lines that exist in our country to categorize almost any event that has import. I find myself doing it all the time. It’s terrible, but I do it.
Kasaun: Okay. Point taken. I think, but here —
Tocarra: The doctor. The doctor is speaking .
Kasaun: It took me seven years to get a bachelor’s degree in acting. Don’t, don’t, don’t do that. [JON LAUGHS] I, I don’t know. I, yes, I a hundred percent agree. I just, I guess I thought this kid is 24 years old. He was born after Titanic. I guess. The part that I think stood out to me the most is his family hopping on Twitter to be like, please, please Stop sharing that video. Please.
Jon: But there is no truce in the culture war. That’s what we have to understand. There is no armistice, there is no ceasefire, no matter what happens, no matter how terrible, no matter who pays the price, that is, uh, there is no ceasefire. And it happens with everything and it’s exhausting and toxic and debilitating and corrosive and it’s really hard to contain.
Kasaun: And it didn’t help that the NFL was like —
Jon: Get back on the field!
Kasaun: We’re so sorry for your loss. Second down, [EVERYONE LAUGHS]
Tocarra: We’re sorry for your loss.
Kasaun: So
Jon: Do you remember my, the, the craziest thing was the announcers are like, well, I’ve been heard that, uh, the players have been given 10 minutes to warm up. And meanwhile the camera was in the hallway where the two coaches were like, if these motherf***ers make us go back out there, right. Are you, you’re with me, right? They’re, my guys are crying. I don’t know if you saw that, but my guys are crying and we don’t know what happened. It couldn’t have been more the, the divergence between what we were seeing.
Tocarra: Right.
Jon: And what they were saying.
Kasaun: I mean, that’s, uh, I kind of expect that from the NFL honestly, though.
Jon: Yeah.
Kasaun: They’re like, we couldn’t tell He was crying. He was wearing a visor,
Tocarra: He was so emotional about the game.
Kasaun: Yeah.
Jon: By the way, is, has there been any moment more sort of br– like I’m a Buffalo Bills fan now. How crazy is, I mean, I’m a Giants fan, but I’m rooting for those kids.
Kasaun: It’s, is the same thing happened after Hurricane Katrina where the Saints return? I think anytime something bad happens, the NFL’s like, we, we need to kick off. [EVERYONE LAUGHS]
Jon: Hey, listen, it doesn’t, after 9/11, Mike Piazza’s home run, you know, the first game back after 9/11. Like those moments happen in sports and you know what they are, they’re exclamation points on storylines and I guess we view everything as narratives anymore. Um, but I have to say it was, it was something to watch, that’s for sure. But getting back to the pandemic, I, I’m gonna grab these doctors and we’re gonna talk, and then I’ll come back and you guys tell me everything that we missed.
Tocarra: You got it.
Kasaun: You got it.
Jon: Alright, bye guys. So we’re gonna bring on Dr. Gregory Poland, Dr. Saad Omer, and Professor Zeynep Tufekci. Bring ’em on.
[TRANSITION MUSIC]

Interview with Dr. Gregory Poland, Dr. Saad Omer, and Professor Zeynep Tufekci Begins

Jon: So we’re stepping on the third rail today. We are talking about the most controversial, Medicine, known to man: Vaccines! We’re very excited, uh, to have joining us Dr. Gregory Poland. He’s the director of the Mayo Clinic’s Vaccine Research Group. Dr. Saad Omer, Director of the Yale Institute for Global Health. And Zeynep Tufekci, Professor at Columbia University, Calmness, the New York Times and Pulitzer finalists for bringing clarity to the shifting official guidelines about the pandemic. Thank you all so much for joining us. I wanna start out with a disclaimer. I am a science fearing man [LAUGHTER]. I believe vaccines may be along with antibiotics, the most miraculous invention for public health in the 20th Century. But I too have questions, and I am confused. And full disclosure, I have been vaccinated. I think it’s gotta be four times. I get a flu vaccine every year. So I am a believer, but I am also — I get fearful when I hear certain things about myocarditis.or when the sands shift beneath us between “the vaccine will eradicate this disease” and, “well, it will lessen your symptoms.” So I want to give you guys an opportunity first to just make a statement about the vaccine, this conversation and all that. And we’ll start with Dr. Poland.
Dr. Poland: Well, Jon, what I heard you say, I would call discerning wisdom.
Jon: Yes, that’s right.
Dr. Poland: — I think everything you said was absolutely correct and it was very well said. I’ve been a vaccinologist for 40 years. I would echo exactly what you said. Obviously, I’m a fervent supporter of vaccines. The data supports that it has been one of three things that has most prolonged the human lifespan and reduced suffering and disease and death. But we are right to have questions. We are right to be discerning. We are right to be skeptical and communication style should reflect where we know and where we don’t know information. And I imagine that’s what we’ll really get into and talk about today.
Jon: That’s exactly right. Dr. Omer.
Dr. Omer: Yeah. So vaccines have been some of the most effective public health interventions. That’s what I do. I work on vaccines, various aspects of vaccines. But those of us who actually work closely with vaccines are, you know, somewhat paradoxically, more respectful of people asking questions. There’s nothing wrong with asking questions where you go with those questions. What you do with these questions is another story. And you know, in the public discourse we have somehow evolved into having this dichotomy of pro- versus anti-vaccine.
Jon: Correct.
Dr. Omer: Whereas you have a whole range of perspectives on vaccines. And in fact, we know from data for several years, at least a couple of decades that a small, small fraction of people, two to three percent usually in a given year. That is gungho anti-vaccine. There’s a bigger chunk of people who are the so-called fence sitters who have questions. Some of them are answered satisfactory satisfactorily or others are not, and all of that stuff. And then there’s a huge chunk of people who don’t wake up every morning and think about vaccines.
Jon: Oh. I don’t know that that’s true.
[LAUGHTER]
Dr. Poland: Who is that?
Jon: Every morning I wake up and I think about vaccines. Professor Tufekci.
Zeynep: So I think it’s almost like it’s a victim of its success, right? Vaccines have completely transformed what childhood is like. If you walk by any cemetery, read any history books, just look at anything in the pre-vaccine era, you find that so many children died. I have a friend who got polio because, very unluckily, his family was away the week the vaccine was given when he was a kid, and he is one of the last polio victims in Turkey because of that. So like I, we’ve lost the connection to what it was like before. But with many things that succeed, you forget that there’s a lot of effort that goes into making it work. And once it succeeds, of course we want it to be even safer and even better. It’s kind of like you want to — so our standards are higher. So when vaccines first came around, people took it. They lined up their kids and cried with joy. Even though the safety standards were lower, to be honest, like at first.
Jon: But certainly trust in institutions was higher back in those days.
Dr. Poland: Yes.
Zeynep: Well, but also we didn’t know as much because at the time they were preventing something so horrible that people kind of were like, it was very obvious to people that whatever risk there was, it was less than the illness. But as time passed, as we made the vaccine safer and safer and safer —
Jon: Mm-hmm.
Zeynep: — and the illness got less and less and less because of the vaccines becoming so widespread. People have kind of lost the sort of balance between “Yes, you have to study the trade offs, you have to study the risks, you have to make sure it’s as safe as possible.”
Jon: Mm-hmm.
Zeynep: But what people have lost sight of, I think, is the other side of the equation, which is these horrific diseases that luckily people are not tested with —
Jon: Mm-hmm.
Zeynep: — because so many kids and people are vaccinated. So this is what I worry about. I think there is a solution, unfortunate solution, a tragic solution if the anti-vaxxers succeed is that we will see horrible, horrific outbreaks.
Jon: Mm-hmm.
Zeynep: That kills so many kids in such a horrible way that it’s gonna be a wake up call and we’re not gonna have to argue back and forth like this because it’s gonna be right in front of everybody’s eyes at tragic cost. And the whole reason I think we have to have these conversations and answer the questions and explain the safety and talk about the trade offs is to make sure that the lesson doesn’t happen that way.
Zeynep: That we prevent the sort of learning by human tragedy.
Jon: Well, let me, let me go to something Dr. Omer said, because I think this speaks to what he’s talking about. You said there’s probably about two to three percent of people that are just hardcore no vaccines for a variety of reasons. I mean, this has been for years now a growing movement on the far right and the far left that is very vaccine skeptical, very much about natural immunity. You know, a lot of different issues and we’re probably not gonna get into a whole lot today, but I do want to get into kind of a post-mortem as post as you can get for a pandemic that’s still going. Because for that two to three percent of hardcore folks who are very active on social media – can be, let’s face facts, brutal on social media and threats and all kinds of the things that, that come their way – but the response from the powers that be, the people that have the information really was certainty. And when you, when you start out with certainty, and I’ll liken it to something — and this may be the worst analogy that any of you have ever heard — the two calamities of my adult life have been 9/11 and the pandemic both I feel like had their mission accomplished moment where they stood behind a banner and it’s over. And slowly facts on the ground began to shift and sort of laid waste to that certainty and that sort of moment on a boat. But rather than deal with it in an upfront manner, it was dealt with either with condescension or with shaming, or with anybody who questioned it there was no discerning between the two to three who would never take a vaccine and the quite large number of people who thought, “This is brilliant, but wait, I have to get another one? Wait, but it doesn’t handle that very well. Oh wait, but I was told this cures the — so it doesn’t cure it. You can still pass it?” And so all these things start to come up and it becomes a victim of the very certainty of the powers that be. And these suspicions are not crazy. These are not crazy things to be nervous about. So how do we in a post-mortem have a more adult conversation with people and not just shut them down? .
Dr. Omer: So, that’s a really good question. Just to clarify, the two to three percent is the usual, uh, vaccine refusal.
Jon: I see.
Dr. Omer: In COVID, what was alarming was it was a bit higher, but it was around seven to nine percent. Even that wasn’t like 30%, 40%. There were a lot of others who had questions, but were persuadable. The first thing was that pandemic has been a communications amateur hour, public health communications amateur hour.
Jon: Mm-hmm.
Dr. Omer: My research group was concerned because this wasn’t our first rodeo in terms of even a pandemic, let alone an outbreak. We were, we had done a lot of work during the H1N1 pandemic that we had concerns enough to ask the question, “What will be the vaccine acceptance?” So early May 2020. We did a national survey to gauge vaccine acceptance of the forthcoming vaccine, and we found was that only 67% of the people would accept the vaccine right away. There was a small fracture.
Jon: This is in the early stages of the pandemic. When it was really raging.
Dr. Omer: It was raging, and we projected it to a few months. Nobody had the exact date available because as you remember, everyone was projecting a little bit later. So we presented these scenarios. There are systematic ways of gauging people’s attitudes. And we found that not only that, uh, it was 67% but also, there were three factor — three, four factors. We created a so-called statistically predictive model of the vaccine acceptance. One was region, the other one was education, age, and then race. And all of these things turned out to be prescient. That’s the magic of measuring things in advance. And a lot of us were jumping up and down saying that, look, we are coming up with this technology, which is wonderful. So I do vaccine trials as well. I do the other side of vaccines as well, and I was really excited about it. But we need to absolutely pay attention to these human factors. And I said that on, I don’t know, I think Dr. Poland was on these calls with the operation warp speed. A lot of us spoke up on these calls.
Jon: Right but wasn’t that the first mistake? Would — why would you name something that is, you know, that people are hesitant about – “Warp Speed?” Doesn’t that… why don’t you just name it, “Going as fast as we can and not paying attention to what might happen?”
Dr. Poland: It was an unfortunate name, I think. And gave the illusion that corners were being cut and things like that.
Jon: Mm-hmm.
Dr. Poland: But to your point, Jon, I really do think that these are discussions that should be approached with, if you will, scientific and intellectual humility. We don’t know —
Jon: Boy, humility. What a perfect word to describe what didn’t happen.
Dr. Poland: In fact I will tell you, in my four decade long career as a vaccinologist, I described this as a matrix. There are so many factors changing so quickly over time that we need to admit in many ways we’re, we’re building the airplane while we’re flying it. People are doing the best they can, but the distortion of the pandemic by human behavior has made this much more difficult. But that implies a burden on us as public health officials, as physicians, scientists to give some voice to those uncertainties, to the humility that we should have in describing this to a public that is rightly skeptical.
Zeynep: So let me jump in as the social scientist here. I always joke that, you know, I’m a doctor too technically, but I always joke, like in an emergency I can do an emergency review. If they ever call for a doctor, I can like review literature really fast. But in this particular case, it actually turned out to be very important. From the beginning sort of social scientific understanding of how people behave, why they behave, how authorities behave was put to the side. And this is a major problem, I have to say, with public health and with all the respect to the two actual useful doctors on the panel with us. It is a problem with the field of medicine as well. There is a lot of not trusting the public. Not leveling with the public. Not talking about the uncertainty and just trust us attitude that is very common among public health practitioners in places of power that is very common among medical doctors as well. I’m not saying all of them. I have great, like some of my best friends are medical doctors —
Jon: Certainly not Dr. Omer, Dr. Poland. They’re, they’re beyond reproach. Why would we even be thinking of that?
Zeynep: So this is the thing, is that — so it is of course very understandable to say, “what the heck is going on?” In fact I ended up writing a piece for the New York Times on the unvaccinated because I was so upset that they were being portrayed solely as the crazies.
Jon: Mm-hmm.
Zeynep: That you could easily find on Twitter spouting nonsense. And I was like, where is the research? Who are these people? What’s going on? And when I dug in as a social scientist and looked at what research was available, what I found was a small number of people who were genuinely irrational and just had decided this was their culture war. But for most people they were confused. In this country, we don’t have great health insurance, and a lot of people do not have a regular doctor. They do not have regular access.
Jon: That’s right.
Zeynep: And uninsured were most likely to be unvaccinated. They didn’t have somebody to ask. I found a lot of people who were confused. They were afraid of COVID, they were afraid of the vaccine. They didn’t know who to ask. They saw the shifting guidance that wasn’t properly explained, and we saw this again and again.
Jon: Mm-hmm.
Zeynep: On things like masks, on things like infection based immunity. On things like myocarditis risk. We did not get, “Look, here’s the best of our knowledge. Here’s what we changed, here’s what we got.” We got this sort of very certain speak that then shifted and then shifted again
Jon: And then pretended it didn’t shift.
Zeynep: I have a son, I looked it up. I had to make the decision, you know, Moderna versus Pfizer, all those things. There’s a lot of nuance that hasn’t been communicated. That’s not that complicated
Dr. Poland: Here’s an example. So the highest risk for myocarditis, and if it’s you’re pointing out is, is men in the 16 to 17 year old age. If we give a million doses,
Jon: That’s my son, my son.
Dr. Poland: Now we give a million doses of an mRNA vaccine. We prevent 57,000 cases of Covid 19. 500 COVID related hospitalizations and 170 COVID related intensive care unit admissions. The price we pay is 73 cases of vaccine associated myocarditis. Now, most of those are benign. In fact, if we hospitalize them, we hospitalize them more often than to, to assuage our, our own fear. There’s a rare one that can be more, uh, more significant, but it is that, it is that teeter-totter I was talking about. And you know what it ends up being is your own psychological predisposition. Is it the sin of omission or the sin of commission? I have literally walked out of the consulting room with one mother saying “if something happened to little Johnny, because I gave him this vaccine, I could never forgive myself.” I go into the next room.
Jon: Sure.
Dr. Poland: And the next mom says, “how could I not give little Ashley this vaccine if she got covid and something happened, I could never forgive myself.” And there’s the nuance that we’ve been talking about. We have not equipped the public, even the public health authorities who are discussing this with that kind or that level of communication.
Jon: And, and detail. But the real lesson there is apparently parents cannot forgive themselves no matter what they do.
Zeynep: In other countries, they also talk about how to lower their risk. So we have great research from Canada and a couple other countries. That if you space it to at least two months. Yes. Spacing terms out first vaccine. Yeah. To like two to three months. And also use, Pfizer, which is lower dose than Moderna. So in a lot of other countries they said there’s this tiny little risk, but to avoid it, you should space the vaccine and men in their forties should get, Pfizer rather than Moderna. That is straightforward scientific, that is what other sane countries did. And that’s like, as a mother of a son, I did the same research. Like why aren’t they telling us.
Jon: None of that has been communicated.
Zeynep: I hate saying this because I want the CDC to succeed. I want them to be much better. But I’ll give you a non-vaccine, uh, example is that for the longest time, the US wouldn’t approve rapid tests. For non-clinical, like home purposes because the FDA argued people would do wrong things with it. Like what? Like test themselves.
Jon: Swab the ear. You’d be like they’d do the ear.
Zeynep: They would be like, they can’t interpret it unless a doctor is involved. I was like, are you kidding me? And then, because like of course people can ma – you explain to them, here’s the false positive, here’s what it means. Here’s what you do. And let people make their empower people. And finally when we approved them, it became gungho. And we’re gonna give everybody lots of rapid tests and great. And then when Omicron hit, when there was a shortage, CDC started saying, “We’re not really sure we can trust rapid tests for like ending isolation.” I’m like, how convenient.
Jon: Right.
Zeynep: Just when we have a shortage, you change your mind again, like as a person who loves these institutions
Jon: And wants them to be better.
Zeynep: This was the most painful thing to watch. Over and over and And again.Very, very much respect to the clinicians that are at the front lines, the two medical doctors here. The whole — the, I mean, the tragedy of the long COVID patients who are still left behind and denied very often by their own doctors. There’s a lot of these things where patients are not treated. as partners. And then it fuels the worst people who use these weaknesses not to try to make this all better the way I want to. They use it to fuel their grift, their ideology, their nonsense. Which is gonna get people killed—
Jon: Dr. Poland has been waiting patiently.
Dr. Poland: Zeynep. I would endorse what you’re saying and it extends beyond that. My daughter is a mental health and trauma specialist. She and I have written a few papers on this last summer in the Yale Journal of Biology and Medicine, and we talked about the distortion of pandemics by human behavior, whether we’re talking about institutional behavior, public health officials, medical authorities, whoever it may be. Ironically, right before the pandemic started — and I have sat and been a participant in many tabletop exercises — we did an international tabletop exercise in Washington, DC. The one area that we can’t get focus on is on the whole anthropology, sociology, and psychology around pandemics.
Jon: Mm-hmm.
Jon: Well, about healthcare in general.
Dr. Poland: And that is what distorted this. Yes.
Jon: Dr. Omer!
Dr. Omer: Yeah. So if I may build on Professor Tufekci’s point, it’s absolutely correct that the face of the medical establishment and the face of public health establishment was not communicating the folks that were presenting the face of these entities were not communicating effectively. But I would add a little bit of nuance. Look these are individual people and what happened during the pandemic, was a lot of people within these organizations and outside these organizations without actual experience on communicating on you know — without the background and training that was relevant to a public health response, were not the face of the pandemic. I’ll give you an example. I would not have imagined that Anne Schuchat, for example, Deputy Director for the CDC, one of the most experienced folks during the pandemic that was available to the CDC. Uh Nancy Meesneir, the person who sounded the alarm earlier on. These people have been involved with Anthrax response, with Ebola response, with H1N1 response. None of them were utilized. to their full extent by the establishment. So they weren’t the face of the pandemic response. So that’s what I talk about, like very sincere, um, inclusion of expertise that was, a lot of it wasn’t relevant.
Dr. Omer: And not taking advantage of the agreed experience we had within the government.
Jon: Agreed. Let me proffer two things because I think that’s, you know, and again, we may be over intellectualizing something where there are certain obvious things that kind of stare us in the face. One is the face of the pandemic and many of the people that came out. And this is something that we see in every industry and perhaps the medical community needs to rethink that sort of revolving door it may seem like, “Well, that’s just how business is done, and wouldn’t they want the expertise on their boards and those boards pay those things?” But that kind of conflict of interest fuels mistrust. It does in every industry. I find the same problem on Wall Street when you have an SEC revolving door. Moderna, Pfizer, J&J, these are enormous companies making enormous profits. Now, I’m not suggesting that they exploited a crisis or created a crisis, but These are reasonable concerns for people that there are conflicts of interest between profit and public health.
Zeynep: I was just like tweeting about that today with Scott Gottlieb, I think that’s a good example because he’s the ex-head of FDA. He’s ex-head of Trump’s FDA and he’s on the Pfizer board. So when the whole thing started and when I started seeing him, I couldn’t have been more wary of the guy, like he was, he’s on the, uh, I think an AEI fellow, like as ideologically out there from me as possible. On the other hand, while I completely acknowledge that this is a major conflict for him to be speaking up, I listened to him throughout like almost three years now.
Jon: Mm-hmm,
Zeynep: And he went on business press, he went on conservative media and he actually ended up making a lot of sensible points. that I thought were informative and balanced. He was very wary of vaccine mandates. He was one of the first people to point out that natural immunity was a thing and it worked, but vaccination was safer. So I found his message correct and actually useful because he could reach people I probably could not. On the other hand, I kept thinking. Why is it him? Why isn’t there anybody else on that side of the –
Jon: Couldn’t there be somebody who isn’t on the board of the company that made the vaccine?
Zeynep: Correct and I completely — and here’s the problem, here’s the problem.There wasn’t. That side of the political spectrum did not produce people who weren’t on the board of Pfizer.
Jon: But it’s not just that side of the political spectrum. I mean the left side of the political spectrum. Is also involved pictures with those things.
Zeynep: That’s a different picture. So what I’m saying is I think he’s, he stepped up at a great risk to himself, so created the problem you talk about but on the other hand points to the fact that where are the people who don’t have these conflicts
Jon: That’s right.
Zeynep: – who could step up and not have us be discussing something like this.
Dr. Omer: So I’ll give, that’s a really good point and actually sort of, I think the response might be illustrative. Two things, but I’ll go back to your bigger point, Jon.
Jon: Mm-hmm,
Dr. Omer: Which is, you know, is this a rational thing to talk about? It is. Absolutely. And the answer to that is, look, they, we do derive some value as a society for some people to be engaged with vaccine companies so that our science remains credible, it has quality and sort of all sorts of robustness. Having said that, as a society, as a community of scientists, there should be a significant fraction of us who don’t have that perceived or real conflict of interest? I have chosen to be that person. I don’t take any money from, uh, vaccine companies. I don’t have, not even grants to my institution, et cetera. I do my own work. You know I pay for my own meals in scientific meetings.
Jon: Dr. Omer, how dare they. You pay for your — you know what if when I see you, you and me are getting a little grilled cheese something. I’m gonna, I’m gonna get you a little something, a little nosh.
Dr. Omer: But the thing is, even the small stuff, and it’s not that I see that there’s an inherent ethical flaw with people interacting with vaccine companies. I do believe, on the other hand, there’s, as part of the overall ecosystem, you should have a significant proportion of people who, if, Scott Gottlieb, who’s, you know, serving on the board of Pfizer is saying the same thing which is, which passes that sort of scientific litmus test that those of us who are not engaged with Pfizer or any other company are saying the same thing. So that the overall credibility is somewhat maintained. What we need to do is to better explicate, better communicate what is the conflict of interest and the fact that there are a lot of us who don’t do that. Coming back to the other point, so what were these people doing? Well, these people were actually working, doing the trials. So if you have the bandwidth, there’s a very small overlap in the Venn diagram where you — So I was on several, the World Health Organization committees that required that because of their meetings were globally timed. I was waking up on a given morning for the first six, seven months at 5:30 AM prepping for the stuff. These were vaccine Safety Data Evaluation Committee, so we were getting the data almost live.
Jon: Mm-hmm,
Dr. Omer: This was Vaccine Recommendation Committee. I was doing my own research, vaccine effectiveness research, vaccine acceptance research, you know, so all of that is out there in published literature. So there is that nuance. So, uh, because of that vacuum, that, you know, if I had to prioritize between tweeting out my own paper and doing the next paper, I know I made that choice.
Jon: Let me, let me jump on the word nuance and I’ll, I’ll address this to Dr. Poland cuz I think, boy, nuance is a word that, uh, uh, within any conversation in the 21st century is something that’s generally missing and maybe science in particular, uh, suffers from that, uh, that feeling of certainty. And I think what science likes to project is certainty, and I think it’s important to draw a distinction between mathematics and science. One plus one is two, but science is really about probabilities. It’s really about this vaccine will give you a higher probability of survival than, let’s say, just allowing COVID to take its course. This drug will give you higher — but nothing is certain, and I think the, maybe the myopia that, uh, afflicts that industry is the projection of certainty and the really the dismissing of nuance.
Dr. Poland: Hmm.
Jon: So in, in some ways, aren’t we talking about a problem within the industry as, as a whole, in not talking about things as probabilities?
Dr. Poland: Yeah —
Zeynep: But, you’re like looking at the wrong — I ‘m sorry. Let Dr. Poland, go —
Jon: Yeah, Dr. Poland, and, and then you can correct me professor.
Jon: I will get a B+ on this. Trust me.
Dr. Poland: Well, we’re not —
Jon: I am teachable.
Dr. Poland: We’re not certain there’s a probability, but, part of the problem, uh, is as you point out, communication and cognitive styles. So physicians and scientists are professionalized in one style, what cognitively would be called an analytic style. Okay? What the population is, if you will, professionalized is with heuristics – rules of thumb for how they make decisions. Daniel Kahneman won the Nobel Prize for kind of teasing apart how people think and the cognitive biases that they bring to this. When you think about it, people get vaccines for one of only a few reasons because they’re forced to. Because they’re bribed to do it. [JON LAUGHS] Bandwagoning, that is peer pressure. And fear. Those are the only four known reasons for why people get vaccines. What we tend not to do in the medical and scientific profession, and this is where I would argue, we need cultural anthropologists, we need sociologists, we need, um, uh, psychologists, linguists at the table, and they’re not, they are not. We need them at the table to bring that nuance because we don’t even recognize the cognitive bias that we’re using to communicate with. You’re right.
Jon: Mm-hmm.
Dr. Poland: I mean, if I tried to summarize it very simply, I would say, um, vaccines save lives. They prevent disease, they prevent disability. Do they have side effects? Yes, but wisdom resides in the balance of those risks and benefits. And in this case, it’s decidedly tipped toward vaccines. However, because there are probabilities of side effects and this is where the art of medicine —
Jon: You suffered one doctor, didn’t you?
Dr. Poland: I did. Right. I absolutely did. I developed tinnitus, a ringing in my ear, after my second dose worsened after, uh, my booster, um, and we’re, we’re still trying to work with CDC and others to focus on is this a significant side effect from it. But you know the point being that you make a decision based on those nuances. And so when you present nuance as certainty. Well, common experience is gonna mitigate against that. And what you’ve now done is bred mistrust and skepticism.
Jon: That’s right. And, and that breeding mistrust leads to that moment now where, uh, a young man is struck down on a football field and as I’m trying to search Twitter for results on his condition, all I’m getting is, “died suddenly young men all collapsing uh, all throughout the world. Tens of thousands of people.” Yeah. I mean, and I, I don’t know what to make of any of it.
Dr. Poland: This came up when Grant Wahl died.
Jon: Um, same, same thing,
Dr. Poland: You know, and, and yet, uh, with, uh, empathy to his, his spouse, uh, who, who is one of us, uh, an infectious disease doctor.
Jon: Mm-hmm.
Dr. Poland: You know, she insisted on an autopsy and, uh, recently that autopsy showed he died of a ruptured aortic aneurysm.
Jon: But she made a great point, which is that these discussions must take place.
Dr. Poland: Yes.
Jon: With empathy and, and and with data.
Dr. Poland: Absolutely.
Jon: And and with facts, because I’ve gotta tell you again, a science fearing man who’s had the vaccines, I’m in that demographic where they told us, you know, you’re the people we should keep in the basement and don’t do anything for two years. But when I see these stories, even for me, there is a part of myself that has a moment of doubt. And professor, you know, these are the kinds of things, you know, we keep talking about how people actually behave and how people actually think. you know, look, there are people that lost their jobs because they wouldn’t get the vaccine and we don’t, you know, some of them might have been trolls and crazies and things, but some of them might have been reasonably mistrustful of something in their family backgrounds or, or their lives that caused them to make that decision, and they paid a pretty stiff penalty for it.
Dr. Poland: Well, and this is really important in our society. I mean, it, What, what epistemological lens are you gonna look through in order to make decisions? Once we reject the scientific method, we’re in a world of hurt, but that scientific method needs to be transparent. It needs to be radically honest. It needs to be communicated with all the humility and nuance. Um, and we need to hear people’s stories and their journey and respond to that, not in some sort of reflexive, you know, uh, scientific way as much as we do in an empathetic way.
Jon: Right. Professor?
Zeynep: So I’m gonna put on my sociologist hat because I’m one—
Jon: Boom.
Zeynep: Uh, again. I’m going to slightly disagree. I don’t think anybody’s making that kind of individual decisions really —
Jon: Cut her mic. Cut her mic.
Zeynep: I know.
Jon: She’s disagreeing. Cut her mic. [DR. POLAND LAUGHS]
Zeynep: This is the thing. This is what people don’t understand about scientists. There’s no people that love arguing more. Like if you don’t like arguing in doubt, it’s the wrong profession. [DR. POLAND LAUGHS] So that’s what like this is what we do. We argue most with the people we love.
Dr. Poland: Peer review.
Zeynep: That said —
Jon: Yep.
Zeynep: Uh, that’s said when you get up, go to the airport and. Line up to get in in an aluminum tin [DR. POLAND LAUGHS] whatever can.
Jon: Yes.
Zeynep: That’s gonna hurl you in the sky.
Jon: That’s right.
Zeynep: At like that kind of speed.
Jon: Mm-hmm.
Zeynep: At , feet. You are not doing your own research, you are not considering this and that you’re not using the scientific method. You are trusting the institutions. and because institutions have delivered, it’s not like airplane flying was always safe. They’re like planes. But after there’s an accident, there is transparency, there is accountability, there’s research, there’s experience. You keep getting on the plane and it keeps ending up — I mean, it’s otherwise an insane thing to do. Like we just sit there and like get. You put up, I don’t know, a hundred chimps there, and there’d be no limbs left by the end of that thing. We’re a very sort of passive social —
Jon: By the way, a hundred chimps is actually Southwest’s new motto. [LAUGHTER]
Zeynep: The thing is, Jon, when you go to the air, uh, to the supermarket and you buy salad or chicken or something.
Jon: That’s right.
Zeynep: And when you don’t, you don’t go to your own basement and try to understand, does this have e coli? You don’t have an expertise in bacteriology. You are not really using the scientific method because you cannot, even though I’m a great fan of vaccines, when somebody injects me with that vaccine, I haven’t tested what’s in it. I haven’t checked if they screwed up the dose. I haven’t checked if it’s the right dial.
Jon: That’s right.
Zeynep: I am putting my trust in institutions —
Jon: Mm-hmm.
Zeynep: — that I’m expecting to function in a particular way. I’m expecting them to work on my, um, behalf. I’m expecting them to be transparent. I’m not expecting them to be perfect, but I want ’em to be trying. This is why the conflicts of interests are important. This is why the revolving doors are important.
Jon: Mm-hmm.
Zeynep: This is why, you know, right now the FDA, FAA and the SEC, all of our institutions have been captured, defanged —
Jon: Mm-hmm.
Zeynep: — corrupted the EPA, including, like,there’s a lot of good people there. There’s an enormous number of people who are trying to do their best, but they keep getting out, lobbied, uh, industry revolving doors. Um, you see this in the tech industry. Half of the Obama White House went to the tech industry.
Jon: Mm-hmm.
Zeynep: And like what they, they go back and forth. This is how do you get good tech regulation in that kind of environment. So there’s a way in which our institutions are failing us. I don’t think it is fair to expect any single person to quote unquote, do their own research and read, you know, all these scientific papers and try to, because you will be confused. There’s a reason why Dr. Omer and Dr. Poland are reading and writing those papers because it took years and years of training.
Jon: Mm-hmm,
Zeynep: It took a lot of understanding. It takes, I see this all the time on Twitter. Somebody will have a screenshot from a paper, and we’ll say, look, they found this, and that sentence does say that, but there’s like 30 paragraphs before it putting it in context.
Dr. Poland: Yeah. No context.
Jon: No context. That’s right. I understand.
Zeynep: But the thing is, what we need, and this is what I think, um, so important to this, is I think there’s like the sort of, what’s the right word? Mirage.
Jon: Mm-hmm.
Zeynep: That we can empower individuals to navigate this. And I’m convinced. that you cannot empower individuals one by one. What you need is functioning institutions that, yes, communicate properly —
Jon: But individuals can be though —
Zeynep: — empower people.
Jon: Individuals can be though. A powerful check on institutions.
Dr. Poland: Yeah.
Zeynep: Correct and they are partners in this.
Jon: And I think you need that as part of the ecosystem that helps cleanse it. And I’m talking about being able to discern between those who are bad faith actors. And believe me, in the vaccine debate, there are a lot of bad faith actors, but there are also people who are uh, genuinely concerned. And unfortunately, when these institutions struggle, the real victims, not just the public, but the rank and file in those industries. The nurses and the doctors who are on the front lines and who are dealing with in clinical settings that mistrust or that hostility or that anger while putting themselves at great personal risk on the front lines of a pandemic, that we still don’t quite understand and, and now that we’ve gone into sort of quadratic equation variants, you know, as it, as it moves along, I still don’t know. You know, when we talk about polio and we talk about smallpox, there was an eradication to it, and that became our expectation. And this follows much more of maybe a flu model than it does with, with an eradication. But that certainly was not the expectation in the beginning of this. And, and it’s been difficult for them to communicate, the ephemeral nature of these different variants and the different things that went, and I agree with you guys. I think there needs to be almost a peer review about that linkage, between the institutions of science and the public that they serve.
Dr. Poland: Well, you know, you’re, you’re really arguing for this idea of, of trust in institutions and —
Jon: And how do you build it?
Dr. Poland: And, let me just give you one example.
Jon: Sure.
Dr. Poland: The vaccination rate for COVID in Denmark is among the highest in the world.
Jon: Oh, they love their vaccinations that and herring.
Dr. Poland: And there’s a reason for that. They trust their government. They trust their public health officials and they’ll tell you that.
Jon: Trust has to be earned, though.
Dr. Poland: It has to be —
Jon: It has to be earned.
Dr. Poland: It has to be earned, absolutely no question about it.
Zeynep: And Denmark was one of the first countries to be able to drop a lot of mitigation measures,
Jon: Right?
Zeynep: they were the first to be able to get over the worst part of the pandemic,
Jon: Right?
Zeynep: Because all the things other people complain about, the lockdowns, the master, this and that. Denmark showed how you can get out of it as quickly as possible when you have functioning institutions.
Dr. Poland: What they did is they said, okay, we think it’s safe to take masks off now. And then when it surges, they said, okay, put your mask back on. And the population trusted them and did it, and they navigated the pandemic really very well.
Jon: Dr. Omer.
Dr. Omer: Coming back to trust. , so a lot of my research groups is now focusing on how do you develop the science around trust and it’s a work in progress. Stay tuned. But what we know so far, in terms of public health institutions specifically, there are three dimensions of trust.
Jon: Mm-hmm.
Dr. Omer: One is perceived empathy. So the entity has my interest at heart.
Jon: Mm-hmm.
Dr. Omer: The other part is perceived lack of conflict of interest.
Jon: Mm-hmm.
Dr. Omer: Uh, so these are overlapping but slightly different things, but, but we already discussed that. The third thing is perceived competenceAnd as much as I love my colleague at the CDC, uh, we had a falling down of actual competence not in the area of vaccine safety. I’ve been paying attention. This is what I do for a living.
Jon: Mm-hmm.
Dr. Omer: The vaccine safety was delayed. So, so the, the problem there was the systems were so sclerotic and the fact that they have, uh, this kind of, what they call scientific review, internal review
Jon: Mm-hmm.
Dr. Omer: Which, I think Dr. Poland has also suffered through that. When if you have even one CDC author, it goes through this, this, uh, black hole of review, which doesn’t add to the science.
Jon: Mm-hmm.
Dr. Omer: Because of that, there was a delay in the safety science coming out, but there were a lot, a lot of other scientific shortcomings, like not paying attention to genomic surveillance. Like what — Professor Tufekci alluded to the fact about ending isolation after five days without testing, uh, or, or sort of broader isolation guidance or not relying on rapid tests.
Jon: Let’s stand six feet away from each other, but only for minutes. and only if you’re in a laboratory. [DR. POLAND LAUGHS] But if you walk outside, then you gotta put a hood over your head, but then you gotta wait.
Jon: It really got crazy.
Dr. Poland: This goes back even further than that, I mean, uh, very early on in the pandemic, I published an editorial. My colleagues panned it. It got published and it was, I called it the tortoise and the hare. And I predicted at that point, this S only approach to vaccines was doomed to fail. And that’s exactly what’s happened. And what it uncovered was the relative lack of. Understanding. I’ve studied RNA respiratory viruses for 40 years.
Jon: Right?
Dr. Poland: And it made you realize that there was not a deep understanding of the hyper mutability of this virus. And this virus was going to change very rapidly. So unilateral one-sided, we’re gonna deal with this variant was doomed to fail. The result of this absence, you know, some really important advances in vaccinology, absent those, your great, great, great grandchildren are gonna be getting vaccines against coronavirus. That’s the ultimate implication of all this.
Dr. Omer: So, so yeah. So to build on that. One of the things that we have fallen short is that we, it was supposed to be a relay and we, after one or two legs, we gave up on the development program in, in all its force.
Dr. Poland: There was no more funding.
Dr. Omer: There was no more funding and no more sort of serious effort to develop the next generation of vaccines. For example, the Pan Coronavirus vaccine. So these are, the government is still investing there —
Jon: To be fair, you’re also, again, none of this is occurring in a vacuum, so you’re also up against a society that is suffering in isolation. And that is ultimately that mission accomplished problem.
Dr. Poland: Hmm.
Jon: You’ve got school kids that are home, you’ve got people that can’t go out, and so everybody’s rushing to have that moment on a battleship with a big sign, rather than explaining that for all our human progress, this microscopic being this virus can still have its way with a population and, and still, uh, you know, cause us great pain. And it seems like, and we can talk about the state of play right now, which is rather than losing a million people a year, we’ve sort of settled into this acceptance of a thousand deaths a week, and that’s where we’re at.
Zeynep: Let’s be fair though. This is, okay, here’s the thing. I, I take what you’re saying.
Jon: Mm-hmm.
Zeynep: And Coronaviruses like the other four human coronaviruses, also reinfect, you know, uh, quite often.
Jon: Mm-hmm.
Zeynep: We had a pandemic.
Jon: Mm-hmm.
Zeynep: And within nine months of its sort of official start, we had vaccines that were, and still are, incredible at severity, death, hospitalization across the board.
Jon: Mm-hmm.
Zeynep: And if you look at the current things, if you get the updated, uh, vaccine recently, the rates even of death and hospitalization, even among the most frail and elderly right, are very, very low. Most of our deaths is because we have not, taken up the booster. If you look at countries like Singapore, other countries that track this really well —
Jon: Mm-hmm.
Zeynep: They also have the Omicron, they also have the mutated one, but their death rates, their hospitalization rates are very, very low. So it’s not that the vaccine is — it could be better. I would love a pan coronavirus vaccine, but the one we have if we used it, would’ve gotten us so much better out of this and on top of this, there’s the question of long COVID, which for a minority of people —
Jon: Mm-hmm.
Zeynep: — is very debilitating and those people —
Jon: Oh, it’s terrible!
Zeynep: And this is what I wanna say. You need to get there. Like the firefighters, after 9/11, the long COVID patients really are the firefighters of this pandemic, they’re being left behind.
Jon: Really?
Zeynep: Everybody wants to — Yes.
Jon: Le — left behind in, in the sense that that medical science —
Zeynep: Everybody wants —
Jon: — Is not looking into it or —
Zeynep: Not looking into it anywhere near enough. There’s not enough —there’s not new funding in the new bill.
Jon: Mm-hmm,
Zeynep: These people are very sick.
Jon: How, how prevalent is this —
Dr. Poland: Somewhere around to 10% to 205 of people who develop COVID.
Jon: What?
Dr. Poland: Have a complication or a long COVID. It’s a significant number.
Dr. Omer: But the severe one is lower than that.
Zeynep: Yes. The severe one that we’re talking about is much lower.
Jon: Okay.
Zeynep: Because if it was 10% to 20%, you’d see it. If you look at the United Kingdom, which uh, calculates this really well because we don’t have good epidemiology in the US, they find about half percent of the population is severely affected. Couple of million people.
Jon: Mm-hmm.
Zeynep: Perhaps like half a percent.
Dr. Poland: Wow.
Zeynep: And these people have been sick for more than a year, most of them. Most of it is pro-vaccine. You have the occasional post vaccine, but that’s rarer.
Jon: Mm-hmm.
Zeynep: And even though Congress allocated a billion to it, like two years ago, the very first trial from it, from that billion in is starting now.
Jon: Right?
Zeynep: There’s no new money for it and these people are so sick, so severely sick, they can’t even protest.
Jon: Do you think this is because we’re still kind of fighting on, you know, that we haven’t opened up that second front.
Zeynep: We wanna move on. Look, after 1918 we got the Roaring Twenties. And there’s a small but substantial number of people who are very sick, who are the true casualties of this pandemic after the people who died —
Zeynep: And that we wanna move away from.
Dr. Poland: Well, the issue, I, I don’t think it’s quite as simple as, as, as what you’re saying. The issue tends to be one more systemic in medicine. Uh, look, there, there were post-infection syndromes after influenza, after Lyme disease, after a variety of infections. What tends to happen in medicine is that entities we don’t understand tend to get ignored. So what we need to address this issue, and it will have implications beneficial across medicine is –
Jon: Mm-hmm
Dr. Poland: The right funding for things like this, it really is difficult to begin to categorize, to develop biomarkers, to understand syndromes. We talk about long COVID as if it’s one thing it’s not. That’s a waste basket diagnosis.
Jon: Mm-hmm.
Dr. Poland: It’s multiple things, different, what we would call clinical phenotypes. Some people have neurologic predominant, uh, long COVID, other people, cardiac, other people, psychological and psychiatric, uh, diabetes, uh, difficulty with, uh, thinking and brain fog. So there are different kinds of quote, long COVID probably related to severity of disease and to genetic predisposition and, and other issues, even what variant they might have gotten infected with. So you need to, you need for, for academic investigators to get interested in this. They need funding to carry out these studies.
Zeynep: 100 % agree with this by the way. I’m not disagreeing at all. I totally agree with what you said.
Jon: Lemme make a suggestion to that, because you know, in a lot of ways, and, and listen, there’s not a lot of transparency in this at all, but there’s a lot of mistrust over kind of virus research, right? And DARPA and the various things that are going along. Perhaps if we were to look at long COVID as a national security effect and get some of that sweet, sweet billion of funding that goes to the defense department, which goes towards weaponizing all sorts of varieties of things. We could make some real headway on this, and maybe that’s the shift that has to take place. Is that it’s not just altruistic doctors in their spare time at 5:30 in the morning faxing things. It’s the United States government recognizing long COVID and, and these, uh, issues as a national security problem.
Dr. Poland: And Jon, I would agree it is a national security issue in this regard. It is an economic issue, of course, and it’s of course an economic issue among our most, if you will, productive segment age-wise of the population. So this is a real issue.
Zeynep: But you don’t have to be an altruist. So there’s a paper out the earlier in 2022 that multiple sclerosis, which, um, is wasn’t really understood for a long time. In fact, is, uh, follows from an Epstein Barr virus infection decades earlier.
Jon: Wow. It’s a post-infection.
Dr. Poland: Probably, probably —
Zeynep: Probably
Dr. Poland: That Science isn’t firm
Jon: Always probably
Zeynep: Always, always, always. But it’s a great study and it’s a very strong study, and as Dr. Poland was saying, uh, we had post-viral infectious diseases following the 1918 pandemic.
Dr. Poland: Yeah.
Jon: Right.
Zeynep: We’ve had, uh, something we EM/CFS, which is 75% of the victims. To a viral infection, and then they, it’s a, it’s a baffling disease. There’s a bunch of things in, uh, after, for example, there’s a randomized trial that shows that, uh, if you get the influenza vaccine versus not on people who had already heart disease, uh, the influenza vaccine cut all cause mortality and cardiovascular mortality by like an astonishing two thirds
Jon: But even that, you know. That’s a really smart way to put it, because one of the problems that we have is some of the side effects of the vaccine mirror the effects of COVID, So now you’ve got this all in the mix. And those who wish to create havoc. We’ll look at those and say, oh, that, that wasn’t COVID, that was the vaccine.
Zeynep: So, but I’m pitching you, Jon. We need to post-viral research money.
Jon: No, I hear you. Yes!
Zeynep: because there’s all these all
Jon: You don’t need to pitch me. I’m with you.
Zeynep: No, but you need to be out there because the thing is, uh —
Jon: Oh yeah.
Dr. Poland: She’s giving you an assignment.
Jon: Oh, I didn’t realize, I didn’t realize that was an assignment.
Zeynep: Yeah. So the thing is, like there are others, uh, like neurological complications. There’s a huge rise in say Alzheimer’s diagnosis after both in influenza and covid infections, although the postviral is potentially the next frontier and we have in long covid a large number of people left behind like a firefighters were left behind.
Jon: Yeah. And so we have to, we have to view this as an opportunity to make some progress.
Zeynep: We need funding but apparently Congress doesn’t allocate funding unless a very talented, super handsome, charming, wonderful
Jon: Gimme the name of this fella because I’ll go, I’ll go find him and I’ll go make him do it.
Zeynep: He yells at them at the galley.
Jon: Yeah, they hate that.
Zeynep: Brings some of his friends along. Do you have the number for Julia Roberts, by the way?
Jon: No, I don’t. She’s not actually Erin Brockovich. She’s just —
Zeynep: The policy people can’t always tell the difference, and so this is, we bring some friends along too.
Jon: Understood. Uh, guys, I want to thank you all so much. I know you’re, you’re, you’re awfully busy. Uh, this is a conversation that I feel like, uh, needs to be had more frequently and more publicly, and I truly do appreciate it, and I know, uh, the pressure that all of you are under, uh, to get things right. And also from a public that is mistrustful and all those different things. Uh, so truly appreciate you, uh, putting your necks out there and doing the great work that you’re doing. Uh, Dr. Gregory Poland, Dr. Saad Omer and Professor Zeynap Tufekci, uh, thank you guys so much —
Dr. Poland: Pleasure.
Jon: — for being a part of this, and I hope we get to continue the conversation, uh, further down the road.
Dr. Omer: Wonderful.
Dr. Poland: That would be great. Thank you.
Zeynep: Thank you.

Interview with Dr. Gregory Poland, Dr. Saad Omer, and Professor Zeynep Tufekci Ends

[TRANSITION MUSIC]
Jon: All right. Woo. S***. Got heated. Boom. No, I actually thought it was really interesting. I don’t know how you guys felt, but to hear the people that are really involved in the day to day talk about how they felt everything was mismanaged and what a detriment that was to all the good things that happened.
Tocarra: I thought I was crazy this whole time. I thought it was just me being like, “Mask? No mask? What’s the difference between this vaccine, that vaccine?”
Jon: Mm-hmm.
Tocarra: “Should I do it now? Can my kids really get it? What’s going on?” And it was like, “no, just take it. Just take it.” And I thought that I was, you know, I wasn’t “patriotic enough. I didn’t trust the science enough.”
Jon: Right.
Tocarra: Because I was simply hesitant. And now I can hear from three professionals that like, no, no, no. There was some, you know, some messiness going on.
Jon: Yeah.
Kasaun: I think it was just so interesting for the first time hearing, like whenever there’s something going on that you don’t know, it’s okay to ask questions.
Tocarra: Yes.
Jon: But it was not made to seem like it was okay to ask questions. And the only grace that I’ll offer, I thought the key word of the whole thing was humility.
Tocarra: Right.
Kasaun: Mm-hmm.
Jon: And I think that’s the thing that wasn’t afforded. And you can give grace to decisions made in the heat of catastrophe, but I think the hard part is getting people to separate malevolence from incompetence, from situational difficulties. And that’s the thing that I think we weren’t able to do.
Kasaun: Do y’all think that we’ve gotten past the point of trying to build trust with the American public? I thought that the comparison between Denmark and America and the vaccine numbers.
Jon: Mm-hmm.
Kasaun: When it comes to building trust, I feel like trust has become a partisan decision. Like you choose a side and then that’s —
Tocarra: Right.
Kasaun: — when they’re empowered, that’s what you trust. Like,
Jon: Oh, that’s interesting.
Kasaun: Like I guess Tocarra was saying, like talking about the com, like building trust and —
Tocarra: Right.
Kasaun:— how that’s different in America. Like I, it is just interesting to me.
Tocarra: But you have to think that again, Denmark is a homogeneous country. Yes, I know there are migrants coming in, but it’s pretty homogeneous.
Jon: Mm-hmm.
Tocarra: And here in the United States of America, we have so many different groups of people who have very distinct and specific relationships with the United States and with institutions within the United States and with the medical system care, with healthcare.
Jon: Yeah no question.
Tocarra: Um, and, uh, you know, that really affects a lot of decisions. You know, I was watching, um, Imani Barbarin, uh, I don’t know if you remember her, Jon, she’s the one who has that great quote about like, you know, “if they call you a hero, that means they’re willing to die.” But she was talking about vaccines and vaccination hesitancy, and she was saying, you know, it’s, it’s really a shame, uh, that people can’t ask questions anymore. One.
Jon: Mm-hmm.
Tocarra: But it’s also really scary that, because people aren’t allowed to ask questions. They tend to turn to a pipeline that is very alt-right. And we’re seeing that with a lot of older black people going incredibly conservative, incredibly QAnon on simply because they’re not able to ask these questions. And so it’s either, are you gonna take it or are you not gonna take it? And it’s, well, I’m not gonna take it. And this is exactly what happened at Tuskegee. This is exactly what happened with gynecology.
Jon: Mm-hmm.
Tocarra: And it becomes part of that well, true, storytelling and then also part of a little bit of mythology that’s being created on the alt-right.
Jon: You know Peaky Blinders once said something that I think is apropos here and that’s politics isn’t a line it’s a circle and that the far left and far right ultimately often end up meeting at the same place. And that place is generally the mistrust of institutions and discomfort in outcomes and I think you’re finding that far left, far right are sometimes meeting in that place. I always think, you know, it’s not that we can’t ask questions, it’s that we’re not very effective at answering them and people accepting those answers. You know, it’s a lot of those conspiracies are always, I’m just asking questions, you know, like, you’re not just asking questions, you are sowing doubt.
Tocarra: Right.
Jon: Because when people answer those questions, you’re not accepting those answers.
Tocarra: Mm-hmm.
Kasaun: Yeah.
Jon: But Dr. Poland did something that I thought fascinating in that interview. He actually read the statistics on myocarditis and vaccines.
Tocarra: Yeah.
Jon: And when I heard that, I was like, why have I never f***ing heard that before?
Tocarra: Such clarity.
Jon: With such cl—, why is it so hard? And I think as much as we mistrust institutions, institutions mistrust us. And that’s part of the issue, is that they believe as someone once said, “we can’t handle the truth.”
Tocarra: Who said it? I’m not familiar.
Jon: Might have been a gentleman by the name of The Joker.
Kasaun: I was gonna say Johnnie Cochran.
Jon: “You can’t handle the truth.” [KASAUN AND TOCARRA LAUGH] I should have said it in that way so that it was a lot clearer.
Jon: But that’s the part and in a divided country where there’s mistrust in institutions, I would actually say our response to the pandemic has been remarkably successful.
Kasaun: Mm-hmm.
Tocarra: Right, all things considered.
Jon: With all the, in-fighting and all the other things. The fact that we’ve got to 60% of f***ing anything in this country is kind of shocking.
Kasaun: When it comes to misinformation, I just hope that people realize that everything, every single thing you’re reading about Damar Hamlin and his heart condition related to the vaccine, none of that is based on the doctors who treated him.
Jon: Right.
Tocarra: 100 %.
Kasaun: None of the doctors said a word.
Jon: They’re in bed with the pharmaceutical companies. [KASAUN LAUGHS] They get a cut for God’s sake. Don’t you know anything? Doctor Wilson at long last sir.
Kasaun: Thank you, man. There’s a lot of professors. I’ll prove wrong if I got that doctor before my name.
Jon: Uh, these are the, I’m telling you, man, this is why I, I have truly enjoyed doing this podcast because you’re allowed to kind of grab some people that are pertinent to conversations that you feel like are intractable and to step, to deconstruct them and step through it.
Tocarra: Right.
Jon: I just, it’s invigorating.
Tocarra: I can’t recall which of the doctor said it, but I think there was like, “oh, you know, there’s a mother in one room who’s like, you know, if I don’t get my kid the vaccine and they get sick, I —
Kasaun: Yeah.
Tocarra:— feel horrible” and another mother saying, “if my kid gets the vaccine and they get sick, I’m gonna feel horrible.” And that’s such a representation of what people are feeling, whether it’s like making their older parents go get vaccinated, their children go get vaccinated themselves. Like, “oh, I’m the only caregiver. What if something happens to me? What if I, what if it makes me sick anyway and I still miss work and I just started this job?” Like I can’t, I think there’s so much nuance to this hesitancy and it doesn’t always mean that someone is like related to some political sphere or conspiracy theory.
Tocarra: There’s so much nuance to the hesitancy and I’m gonna share here that, I had a baby in 2021 —
Jon: Mm-hmm.
Tocarra:— and when it was time for her to go get vaccinated, I was like, I am going to need some time.
Jon: Hell yeah.
Tocarra: Because, she literally sneezed when she saw the sun for the first time. [JON LAUGHS] So who knows? [JON AND KASAUN LAUGH] Who knows what this vaccine is going to do to her? You know, that’s a real phenomena, right? With newborns, they leave the hospital the sunlight hits them and they’re like, and they’re like, what is that? [KASAUN LAUGHS]
Jon: I still do that. [KASAUN LAUGHS] if I look at the—
Tocarra: Don’t do this.
Jon: I swear to you, if I look at the sun right, I can sneeze. [KASAUN LAUGHS] I swear to you, if I feel the tickle and I catch the sun right? I can sneeze.
Kasaun: If that’s not on your acting resume, you’re doing it wrong. [JON AND TOCARRA LAUGH]
Jon: Can sneeze when it’s not raining.
Tocarra: Special talent. [KASAUN LAUGHS]
Jon: Tocarra, I think that’s dead on. Good s*** guys, as always an absolute pleasure. And, yeah, we’ll talk again when Harry has the sequel book where he reveals, I don’t know what he’s gonna talk about.
Tocarra: “A $40 million book deal there better be a sequel. I gotta get the money’s worth. Let’s go.” [JON LAUGHS]
Kasaun: I’ll tell you everything you want to know.
Tocarra: I’m very good at bullet points. Don’t you worry, I will keep you up to date.
Jon: Yeah, just send me a little something cause I really can’t watch anything. [KASAUN AND TOCARRA LAUGH] I find the whole thing. Crazy. Uh, that is all for us. Uh, please send your comments about our podcast and the vaccines to someone other than me, [KASAUN LAUGHS] Thanks to Dr. Poland, Dr. Omer, uh, Professor Tufekci for joining us. Tocarra and Kay, as always, check out The Problem airing now on Apple TV Plus. And uh, we will see you next time.
Kasaun: Yeah!
Jon: Bye-bye.
[OUTRO MUSIC]
Jon: “The Problem with Jon Stewart Podcast” is an Apple TV+ podcast and a joint Busboy Production.

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