83: The Best One Is the One You Can Get

00:00SPEAKER- Hey, Brad, you got a cold open this week?

00:01SPEAKER- I was kind of hoping you maybe showed up with something.

00:05SPEAKER- It's almost like cold opens are a non-renewable resource

00:08SPEAKERand by using an entire cube of them,

00:12SPEAKERyou both have no longer have any left.

00:14SPEAKER- The well has run dry.

00:16SPEAKER- Look, I gotta go out, I gotta replant some cold opens

00:19SPEAKERso we have some fresh batch for next week, a crop,

00:21SPEAKERa crop of cold opens maybe.

00:23SPEAKER- Off to the podcast mines again,

00:25SPEAKERwe're gonna have to dig deeper this time.

00:27SPEAKER- This does give me a business idea

00:29SPEAKERof putting open source cold opens

00:31SPEAKERlike that are CCBYA on YouTube that anyone can use.

00:37SPEAKER- We will license you some interesting intros

00:39SPEAKERfor your podcast.

00:40SPEAKER- Look, if you do a podcast, you have run into this problem.

00:46SPEAKEROne day the cold open well will run dry.

00:48SPEAKERYou won't have anything new on Netflix to talk about.

00:51SPEAKER- Should we just make the audio network of podcasts?

00:53SPEAKERJust do a ton, like thousands and thousands

00:55SPEAKERof royalty free podcast clips that people can assemble

00:58SPEAKERinto their own podcasts.

00:59SPEAKER- Wait, a podcast network?

01:01SPEAKERWhat a novel concept.

01:03SPEAKER(upbeat music)

01:28SPEAKER(upbeat music)

01:32SPEAKER- Welcome to Brad and Will Made a Tech Pod, I'm Will.

01:35SPEAKER- I'm Brad.

01:36SPEAKER- And today we're joined by a third chair, Kishore Hari,

01:40SPEAKERwho you may know from "This is Only a Test"

01:42SPEAKERand also science communication around the world

01:44SPEAKERand movies and all sorts of other things.

01:47SPEAKERHey Kish, how you doing?

01:48SPEAKER- Excuse me, and from Brad and Will Made a Tech Pod?

01:51SPEAKER- Oh yes, and our COVID, our unpaid COVID representative

01:56SPEAKERhere at Brad and Will Made a Tech correspondent, sorry.

01:59SPEAKER- You may know me from such episodes as "The Days Are Awesome"

02:03SPEAKERand "Scaring the Crap Out of Brad Shoemaker."

02:08SPEAKER- Oh gosh, it's been a long year.

02:11SPEAKER- But you know what I am famous for now?

02:14SPEAKERI am now Stachem blessed because the Stachem account

02:19SPEAKERand I had a positive interaction and now it has deemed me

02:23SPEAKERas science communication worthy.

02:25SPEAKERAnd that's the pinnacle of my scientific career.

02:27SPEAKERBrad is giving a look like he doesn't know

02:30SPEAKERabout the Stachem account.

02:31SPEAKER- Wait, do you not know about Stachem's?

02:32SPEAKER- I mean, I know of Stachem's.

02:34SPEAKERI didn't know about Kishore's.

02:35SPEAKERAre you a steak fluencer now?

02:37SPEAKER- Yes, and yes, I'm going to use that in a tweet momentarily.

02:41SPEAKER- Official Stachem brand ambassador.

02:44SPEAKER- Like the Stachem Twitter account at some point,

02:47SPEAKERlike what, two years ago now maybe,

02:49SPEAKERStachem was just like, "You know what's bad?

02:51SPEAKER"Fascism."

02:52SPEAKERAnd I was like, "Oh, a frozen meat product agrees with me

02:56SPEAKER"on my political views about fascism."

02:58SPEAKEROh, weird.

02:58SPEAKER- I forgot that Stachem's were innovators in the like,

03:01SPEAKER"Hey, this brand is actually human

03:02SPEAKER"and real kind of category."

03:05SPEAKERI forgot about that.

03:06SPEAKER- Woke brand influencer.

03:08SPEAKER- The personality is real.

03:10SPEAKERThe meat, I don't know.

03:12SPEAKER- I think the meat's real, just chopped.

03:14SPEAKERAnyway, hey, you're welcome Stachem.

03:17SPEAKERHow are you doing Kishore?

03:18SPEAKERLike last time we had you on,

03:19SPEAKERthis was kind of a bummer episode.

03:20SPEAKERAnd this time I feel like things are going

03:22SPEAKERa little bit better.

03:23SPEAKER- I would say it was an appropriately bummer episode

03:26SPEAKERgiven where we were,

03:27SPEAKERbecause I think I was on just about a year ago,

03:31SPEAKERjust a little bit more than a year ago.

03:32SPEAKERSo it was about the end of March last year.

03:35SPEAKERAnd I don't think I was bummer enough

03:37SPEAKERfor what was ahead of us here in the US.

03:40SPEAKERI'm feeling almost 180 degrees different now

03:46SPEAKERfrom where we were.

03:47SPEAKERThere's a lot of optimism

03:50SPEAKERand a lot of sense that

03:53SPEAKERnot only can we beat this back in Western nations,

03:57SPEAKERbut there's a pathway for beating back the virus

04:00SPEAKERacross the world,

04:01SPEAKERwhich honestly never felt possible

04:05SPEAKERup until the last couple of months.

04:08SPEAKER- So to give some context,

04:10SPEAKERlast year when we talked about this,

04:11SPEAKERwe were a few weeks into quarantine

04:13SPEAKERand we were kind of like,

04:14SPEAKERis this gonna be over at the end of March

04:17SPEAKERor is this gonna be like June?

04:19SPEAKER- This is such a weird trip down memory lane

04:22SPEAKERbecause I'm sure you guys feel the same way.

04:23SPEAKERThe time has completely lost any meaning.

04:25SPEAKERLike, I can't remember what I was thinking when

04:27SPEAKERor even really what year it is at the moment.

04:29SPEAKERBut like, yeah, at that time,

04:30SPEAKERlike I remember when we shipped out of the office

04:32SPEAKERin mid-March last year,

04:34SPEAKERI was like leaving stuff on my desk

04:35SPEAKER'cause I was like, oh, we'll be back in a month,

04:37SPEAKERmaybe six weeks.

04:38SPEAKERLike, I don't need that right now.

04:39SPEAKERAnd then it was like this donut,

04:40SPEAKERit'll still be good.

04:41SPEAKEREight months later,

04:42SPEAKERthey're not letting us into the building,

04:44SPEAKERand it was just like, oh boy,

04:45SPEAKERthis we've really, really underestimated.

04:47SPEAKERBecause sure it did not, like you were on top of things.

04:50SPEAKER- You know, I went back the other night

04:52SPEAKERand listened to the episode in preparation for this.

04:55SPEAKERAnd of course, I'm only gonna reference

04:57SPEAKERthe things I got right.

04:58SPEAKERBut even I was wildly underestimating

05:04SPEAKERthe nature of the pandemic.

05:05SPEAKERLike Will and I exchanged an email after the episode

05:09SPEAKERwhere I threw out like, this is actually what I'm scared of.

05:12SPEAKERAnd it's ending up being like five times less

05:16SPEAKERthe magnitude of deaths that we've actually seen

05:18SPEAKERin the US alone.

05:20SPEAKERSo I didn't, going back a year,

05:23SPEAKERI don't think I had a good handle.

05:25SPEAKERI knew we were in trouble

05:27SPEAKERbecause there was just lots of things

05:29SPEAKERthat you look for in a public health response

05:31SPEAKERthat just weren't happening in a timely manner.

05:34SPEAKERBut a lot of people were feeling that

05:35SPEAKERin the public health community.

05:37SPEAKERBut it was intensely hard to turn that

05:40SPEAKERinto a projection of what we saw.

05:43SPEAKERAnd there were so many things that happened

05:45SPEAKERin the last year that evade what you would sort of

05:51SPEAKERcommonly understand to happen.

05:53SPEAKERAnd one of those is actually the rapid development

05:56SPEAKERof the vaccines.

05:58SPEAKEREven though we had laid the groundwork for that

06:00SPEAKERwith some of the work in Ebola,

06:03SPEAKERsome of the previous work on SARS and MERS,

06:08SPEAKERit's nearly impossible to predict

06:10SPEAKERwhen basic science work like that

06:12SPEAKERcan be translated into clinical reality.

06:16SPEAKERAnd to have the vaccines that have come out

06:18SPEAKERbe so damn effective at preventing hospitalization and death

06:24SPEAKERit exceeded my wildest expectations.

06:27SPEAKERAnd I think it's important to remember that.

06:29SPEAKERLike the threshold here in the US

06:32SPEAKERfor vaccine efficacy was 50%.

06:35SPEAKERLike that's what the FDA said was gonna be

06:38SPEAKERour threshold for potentially approving a vaccine.

06:41SPEAKERA lot of experts were like, oh, if I get a 60, 70%,

06:44SPEAKERthat's gonna be such a win

06:45SPEAKERbecause it'll be like a version one of the vaccine.

06:48SPEAKERAnd we're talking about efficacy rates like in 90%.

06:52SPEAKERNow that we have real world effectiveness,

06:55SPEAKERwe're seeing those numbers maintain that high level.

06:59SPEAKERSo it's astounding.

07:03SPEAKERI haven't gotten my vaccine yet,

07:05SPEAKERbut I was talking to colleagues and friends

07:09SPEAKERthat have worked in the industry

07:10SPEAKERand they just talk about getting it and just in crying,

07:13SPEAKERjust like openly weeping

07:15SPEAKERbecause of the monumental nature of what has happened.

07:20SPEAKER- That's like, I went on Sunday.

07:22SPEAKERSo Brad and I have both gotten vaccinated now,

07:24SPEAKERbut there are at least first doses.

07:26SPEAKERAnd I went on Sunday to one of the mass back sites,

07:29SPEAKERthe one at City College,

07:30SPEAKERwhich I think is probably run by the state,

07:31SPEAKERbut I'm not sure.

07:34SPEAKERAnd when we checked in, I was like,

07:36SPEAKERhey, how many people do you do here a day?

07:37SPEAKERAnd she's like, well, we did 5,000 yesterday.

07:39SPEAKERAnd I was like, oh my God.

07:41SPEAKERAnd it's small.

07:41SPEAKERLike it's in the parking lot of a high school, right?

07:44SPEAKERIt's not a huge thing.

07:45SPEAKERThere were like 20 lanes.

07:47SPEAKERWe got our shots.

07:48SPEAKERIt took 34 minutes from the time we pulled in

07:51SPEAKERuntil the time we left.

07:54SPEAKERThat includes the 15 minute waiting to make sure

07:57SPEAKERthat you don't have any of the

07:58SPEAKERrelatively uncommon side effects.

08:02SPEAKERWe were sitting there.

08:02SPEAKERI pulled into the parking space and I started crying.

08:04SPEAKERI was like, I can't believe that this is,

08:07SPEAKERI didn't expect for this to happen for another six months

08:09SPEAKERor a year at the absolute earliest.

08:12SPEAKERAnd it's incredible.

08:14SPEAKERThere was an article in the New York Times

08:16SPEAKERthat like described the process

08:18SPEAKERfor writing these mRNA vaccines.

08:20SPEAKERAnd they literally write them like code,

08:23SPEAKERwhich we have, like we'll talk about later, I guess.

08:27SPEAKERBut the fact that they spun these up so quickly

08:29SPEAKERwhen every other similar disease has taken years

08:34SPEAKERand years and years of work to get to is amazing.

08:36SPEAKERAnd that they work is, I guess that's good too.

08:40SPEAKERSo how, so you think we're doing,

08:43SPEAKERlike in the US at least we're doing pretty well,

08:45SPEAKERit seems like.

08:46SPEAKER- Yeah, I think in the UK, the US, Israel,

08:51SPEAKERthe Seychelles is really kicking ass

08:53SPEAKERif you really want to pick a country that's doing it.

08:56SPEAKER- How many people live in the Seychelles, for sure?

08:58SPEAKER- I don't know, but I saw a number that said

09:00SPEAKERthat they have nearly 100% coverage.

09:03SPEAKERSo in the UK, I think over 50% now

09:10SPEAKERof the eligible population has received a first dose.

09:16SPEAKERWe're rapidly approaching that in the US.

09:18SPEAKERWe're a little bit down from there in the US

09:20SPEAKERbecause we've gone on a let's just do

09:23SPEAKERthe complete dosage first.

09:27SPEAKERThe pace of vaccinations is here in the US

09:29SPEAKERis about three plus million a day.

09:32SPEAKERIf they're able to keep that rate,

09:34SPEAKERwe would fully vaccinate all of the eligible adults

09:38SPEAKERwithin like four months.

09:41SPEAKERBut we're really trying to get to a point

09:43SPEAKERwhere maybe like 75, 80% of the eligible adults

09:46SPEAKERare vaccinated and that would take three months

09:50SPEAKERat the current rate.

09:51SPEAKERBut we're about to hit an inflection point,

09:56SPEAKERI think based on the data,

09:57SPEAKERthat the supply is gonna outstrip demand.

10:00SPEAKERWe're already seeing this in a number of states in the south.

10:05SPEAKERBloomberg has probably the most easily navigated

10:09SPEAKERvaccine tracker for the US.

10:11SPEAKERIt actually has global numbers too that are pretty good.

10:14SPEAKERAnd you can see state by state,

10:18SPEAKERhow many doses have been delivered to those states

10:21SPEAKERand how many of those doses have been administered.

10:24SPEAKERWhat you're really looking for,

10:25SPEAKERa state that's really doing this efficiently

10:27SPEAKERwhere there's good uptake is gonna have a number

10:30SPEAKERabove like 85%.

10:32SPEAKERStates that are crushing it are in the 90%.

10:36SPEAKERYou're never gonna get to 100% for so many reasons.

10:38SPEAKERBut if you're in a state that's like above 85%,

10:42SPEAKERyou're in a crushing it state.

10:43SPEAKERIf you're in a state that's about 80% or above,

10:46SPEAKERyou're like, it's going.

10:48SPEAKERSo California where we all live

10:50SPEAKERis hovering right about that 80% mark.

10:54SPEAKERIn Louisiana, Mississippi, Alabama, Georgia,

10:58SPEAKERit's in the high 60s.

10:59SPEAKERAnd that's because we're seeing a number of people

11:02SPEAKEReither decline or they're really struggling

11:04SPEAKERgetting doses out to where people live.

11:08SPEAKERJust because of rural population.

11:10SPEAKER- Something I wanted to mention,

11:11SPEAKERlike the kind of the dark side

11:12SPEAKERof the supply outstripping demand

11:14SPEAKERis the demand is suppressed in some situations

11:16SPEAKERwhere misinformation or conspiracy theory are rampant.

11:19SPEAKERAnd I was wondering if you have any thoughts on like,

11:23SPEAKERA, maybe what outreach could look like

11:24SPEAKERto try to get those numbers up more

11:26SPEAKERand maybe convince more people to get idea.

11:27SPEAKERAnd B, also just what the long-term effect might be

11:31SPEAKERof a significant chunk of the population.

11:33SPEAKERMaybe it's not as significant as it looks,

11:35SPEAKERbut like some chunk of the public just never opts in

11:39SPEAKERif that is gonna cause long-term issues.

11:42SPEAKER- So typically like when we talk about this,

11:45SPEAKERpeople typically talk about the anti-vax population.

11:48SPEAKERI think they're actually not as important

11:50SPEAKERan actor in this situation.

11:52SPEAKERBut estimates in the US of like people

11:54SPEAKERthat we would categorize as anti-vax,

11:57SPEAKERlike people that are like dead set against getting vaccines

12:00SPEAKERis maybe three to 4% of the population.

12:02SPEAKERSo it's not that many people.

12:04SPEAKERBut in surveys going back a number of months

12:07SPEAKERabout COVID vaccines,

12:09SPEAKERthere is a pretty strong set of people

12:12SPEAKERthat have been robust saying

12:13SPEAKERthat they would definitely not get it.

12:15SPEAKERAnd that's been around 15% of the population.

12:19SPEAKERSo the question is, why is that higher

12:21SPEAKERand what are the reasons?

12:23SPEAKERSome percentage of those

12:24SPEAKERare what we would call those anti-vaxxers.

12:27SPEAKERThat they're just know from the get-go based off of history.

12:30SPEAKERThere's a number of people that for various reasons

12:33SPEAKERjust don't believe COVID is a big deal.

12:38SPEAKERA lot of that has been associated to partisan ideology.

12:42SPEAKERBut also there's some people in that group,

12:45SPEAKERfrom what I understand,

12:46SPEAKERthat just live in settings where COVID

12:48SPEAKERhasn't really hit those communities in a significant way.

12:51SPEAKERSo they just don't see it as a ever present threat.

12:55SPEAKERAnd I think one of the ways to understand that

12:56SPEAKERis if you live in a rural community,

12:58SPEAKERif you live in a small community,

12:59SPEAKERif you're young, if you're healthy,

13:01SPEAKERyou might be in a class where you're like,

13:03SPEAKERI'm just not worried about this disease

13:05SPEAKERfor X, Y and Z reasons.

13:09SPEAKERSo there's a class of people there.

13:11SPEAKERThere's a class of people that have had

13:13SPEAKERa terrible experience with the medical system.

13:18SPEAKERWhether it be racism in the medical system,

13:21SPEAKERlack of healthcare.

13:23SPEAKERThey just have no reason to trust that this thing

13:25SPEAKERthat's being given is a thing they want.

13:27SPEAKEREspecially when it's coming from a institution

13:31SPEAKERlike the government, which they already have low trust in.

13:34SPEAKERSo there's this amalgam of people.

13:36SPEAKERAnd what we're seeing is that 15%

13:39SPEAKERisn't really changing a lot right now.

13:42SPEAKERSo we shouldn't expect that 15% to go down to 5%.

13:46SPEAKERIt's just not reality.

13:47SPEAKERAnd those people tend to be really, really hard to convince.

13:51SPEAKERWhat is a bigger proportion is what is called

13:54SPEAKERthe wait and see group.

13:56SPEAKERThat they're not enthusiastic about getting vaccines.

13:58SPEAKERSo like the three of us, we're basically like,

14:02SPEAKERthe first time it was available, we're out there,

14:04SPEAKERwe're weeping in the parking lot.

14:06SPEAKERYou know, like we're the caricature of vaccine enthusiasts.

14:10SPEAKERBut there's a whole set of people that are like,

14:13SPEAKERyeah, I'll get it, but it has to be convenient.

14:15SPEAKERIt has to kind of work with my schedule.

14:18SPEAKERI think a lot about workers that don't get paid time off

14:22SPEAKERto go get a vaccine and they can't take time off from work

14:26SPEAKERbecause it's literally the difference

14:27SPEAKERbetween like food on the table

14:29SPEAKERor people across a digital divide.

14:31SPEAKERHow can they even get an appointment?

14:33SPEAKERThere's a lot of seniors that don't have internet access.

14:38SPEAKERLike there's a whole lot of people in that category

14:41SPEAKERthat have access issues.

14:42SPEAKERAnd then there's people that are like,

14:44SPEAKERyou know, maybe side effects will come up.

14:46SPEAKERI'm just gonna wait like another extra month or two.

14:49SPEAKERAnd for those people,

14:50SPEAKERthere's different interventions that need to happen.

14:54SPEAKERFor access, it's literally, we have to make it low barrier.

14:57SPEAKERWe have to bring the vaccines to them.

14:59SPEAKERIf that means going door to door,

15:01SPEAKERthat's setting up mobile clinics.

15:03SPEAKERIf that's empowering members of their community

15:06SPEAKERto go talk to them and like give them rides,

15:10SPEAKERthat's what we have to do.

15:11SPEAKERAnd there's a bunch of campaigns out there doing that.

15:14SPEAKERFor those people that are like, wait and see,

15:16SPEAKERwe just need a lot of engagement with them

15:19SPEAKERso that they get comfortable with the idea.

15:21SPEAKERAnd there has to be a lot of transparency

15:23SPEAKERabout what's happening with the vaccine.

15:26SPEAKERThose efforts are ongoing.

15:28SPEAKERThat's really gonna be the challenge

15:29SPEAKERover the next couple of months

15:30SPEAKERis getting those numbers of that wait and see

15:33SPEAKERdown as close as we can to zero.

15:35SPEAKER- And what number?

15:37SPEAKERSo what's the breakdown do you feel like

15:41SPEAKERof the hopeless, never gonna vax, the wait and see,

15:46SPEAKERthe institutional skepticism and like how,

15:52SPEAKERlike where do we need to get the population

15:55SPEAKERfor things to have a return to normalcy

15:58SPEAKERand how close are we gonna be able to get

16:01SPEAKERdo you think in the US?

16:03SPEAKER- So the latest data I saw, the wait and see

16:05SPEAKERis down to about 17% just because we've been vaccinating

16:08SPEAKERso many people that were in that category.

16:10SPEAKERThey've moved to already vaccinated.

16:14SPEAKERWhat you're really talking about is when can we get

16:16SPEAKERto herd immunity when this thing will die out?

16:19SPEAKERAnd it's a tough question because herd immunity

16:24SPEAKERis like essentially like a calculation across a population

16:28SPEAKERof when we think the virus just won't have anywhere

16:31SPEAKERto go to replicate.

16:32SPEAKERBut in the real world, that's not really how it works.

16:35SPEAKERLike the virus is gonna just look for any host it can.

16:40SPEAKERAnd vaccinations won't be evenly spread.

16:43SPEAKERIn the city we live in, San Francisco,

16:45SPEAKERwe think vaccination rates are gonna be super, super high

16:48SPEAKERfor lots of reasons.

16:50SPEAKERSo if we get a town that has 85, 90% vaccinations

16:54SPEAKERwhich is eminently possible in San Francisco,

16:56SPEAKERthe virus is gonna be dead here.

16:58SPEAKERLike it's just gonna have nowhere to go.

17:00SPEAKERAnd then there's gonna be a town in Louisiana

17:02SPEAKERthat's gonna have 50% coverage.

17:04SPEAKERAnd you may like mash them together nationally

17:07SPEAKERand you'd be like, oh, we've reached that 70% number

17:10SPEAKERbut you still have this localized area

17:13SPEAKERthat has a lot of vulnerability.

17:17SPEAKERSo I think what we're moving to

17:19SPEAKERis not what we would call herd immunity

17:21SPEAKERbut a stage of this disease where there's enough immunity

17:25SPEAKERin the community to prevent breakouts in most areas

17:29SPEAKERbut we'll have localized breakouts

17:30SPEAKERwhere we haven't reached those vaccination levels

17:33SPEAKERand we'll have to surge in those areas to address it.

17:38SPEAKERLike the common parlance is we have to get

17:40SPEAKERbetween 70 and 80% of the population vaccinated

17:45SPEAKERto get to a level where the virus is going to die out.

17:50SPEAKERThat is both not realistic for the reasons of

17:54SPEAKERwe have a lot of children in this country

17:56SPEAKERthat are not eligible to be vaccinated.

17:58SPEAKERSo there's a whole vector of people out there

18:03SPEAKERthat aren't qualified and then we know

18:05SPEAKERthere's just people not gonna get it.

18:07SPEAKERSo when you combine those, there's no way the math works

18:10SPEAKERthat we'll get to that 75, 80% number in the country

18:14SPEAKERin the next couple of months.

18:15SPEAKERBut what we will get to

18:16SPEAKERis because this is an incremental process

18:18SPEAKERis we'll see the virus come down.

18:21SPEAKERAnd I actually think the number that I'm looking for

18:23SPEAKERis less about the herd immunity target.

18:27SPEAKERI wanna see the vaccination rates

18:29SPEAKERget as high as possible everywhere.

18:31SPEAKERWhat I'm looking for is new cases

18:33SPEAKERto decline to about 10,000 a day.

18:36SPEAKERRight now in the US we're at a plateaued stage

18:39SPEAKERaround 70, 80,000.

18:40SPEAKERAnd for reference, that's where we were in July of last year

18:44SPEAKERwhere we were absolutely panicked.

18:47SPEAKERNow the difference is in July of last year

18:48SPEAKERwe had no treatment regimen.

18:50SPEAKERSo we're like, we know a lot of people

18:52SPEAKERare gonna die because of this.

18:54SPEAKERRight now we see most of those cases in younger people

18:57SPEAKERthat tend not to get hospitalized and die.

19:00SPEAKERAnd we have a potential treatment

19:03SPEAKERboth in hospital and with the vaccines.

19:05SPEAKERSo I think that's the target I think is important.

19:09SPEAKERThat's what Dr. Fauci's been saying for a long time

19:11SPEAKERand a lot of other public health efforts.

19:13SPEAKERIf we can get down to 10,000 cases a day

19:15SPEAKERit's gonna feel like a really, really, really bad flu season

19:19SPEAKERin the US where people are getting sick

19:23SPEAKERbut it's gonna be at a low enough level

19:25SPEAKERthat we can go about most of our daily activities

19:30SPEAKERwithout worries that it's going to overwhelm our hospitals.

19:35SPEAKER- Do you know, excuse me, off the top of your head

19:38SPEAKERjust for some context here

19:39SPEAKERand I know this is kind of apples and oranges

19:40SPEAKERbut what the long-term presence or occurrence has been

19:44SPEAKERof some of the previous outbreaks

19:46SPEAKERwe've seen over the last 15, 20 years,

19:47SPEAKERthe previous SARS viruses like Avian flu, that type of thing

19:50SPEAKERlike years out from there.

19:52SPEAKERAnd again, I don't know if they're directly comparable

19:54SPEAKERto the situation, but like I'm curious,

19:57SPEAKERsix months, a year or two years from now

19:59SPEAKERlike is it still circulating in the population?

20:02SPEAKERDo we ever get to that kind of zero point?

20:05SPEAKERAre we getting COVID boosters in the fall every year?

20:09SPEAKERLike we get flu shots?

20:09SPEAKER- Yeah, like what's the long-term projection

20:11SPEAKERfor how much this lingers, I guess.

20:13SPEAKER- Yeah, so the public health way of asking your question

20:15SPEAKERis like, is this virus gonna be endemic?

20:18SPEAKERSo endemic means it's just omnipresent.

20:22SPEAKERIt's gonna be a thing that happens every year.

20:24SPEAKERWith SARS-OG, I like calling viruses OG for some reason

20:28SPEAKERbut like with the first SARS-

20:30SPEAKER- Is that the scientific name or is that a-

20:31SPEAKER(laughing)

20:33SPEAKER- I don't think it's a IUPAC naming convention.

20:36SPEAKERBut with SARS-OG, it just died out.

20:39SPEAKERAnd so it was gone.

20:41SPEAKERIt never became, well, first of all,

20:43SPEAKERSARS never really became a pandemic

20:46SPEAKERand it never reached the levels that would make it endemic

20:49SPEAKERbut it just disappeared.

20:51SPEAKERH1N1 was really part of a seasonal structure

20:55SPEAKERalready that existed.

20:56SPEAKERSo we've seen ways of H1N1.

20:58SPEAKERSo H1N1 still exists out there,

21:01SPEAKERbut it comes and goes in a seasonal nature

21:06SPEAKERthat's very hard to predict.

21:09SPEAKERSo it is constantly circulating.

21:13SPEAKERThe projections are very difficult in this way

21:16SPEAKERbecause vaccinations and the speed of vaccinations

21:19SPEAKERactually matters here.

21:20SPEAKERBecause what we're doing is like,

21:22SPEAKERwe've essentially pushed the virus into a corner

21:25SPEAKERby doing this.

21:26SPEAKERAnd so two things happens.

21:28SPEAKERLike the virus is trying to go host to host

21:31SPEAKERand like doing everything it can to survive.

21:35SPEAKERAnd by putting in a corner,

21:37SPEAKERwe're putting it under this evolutionary pressure

21:40SPEAKERto adapt as quick as it can.

21:43SPEAKERAnd adaptations that are going to allow it to survive

21:47SPEAKERare likely going to replicate faster.

21:49SPEAKERSo we're gonna see mutations probably emerge

21:52SPEAKERthat may be able to evade some of the vaccines

21:56SPEAKERthat we generate unless we go super fast

21:59SPEAKERand outpace the evolutionary pressure on it.

22:02SPEAKERAnd so this is why it's important

22:03SPEAKERnot to just vaccinate in the country you're in,

22:05SPEAKERbut vaccinate everywhere as fast as you can,

22:08SPEAKERbecause then you eliminate the ability of the virus

22:10SPEAKERto evade your vaccines.

22:15SPEAKERAnd so it won't matter what the rate is in the US.

22:17SPEAKERWhat matters is the rate in the world.

22:20SPEAKERAnd so likely, because it is not possible

22:24SPEAKERto do the vaccinations worldwide

22:27SPEAKERat the rate we're gonna need,

22:28SPEAKERthat a lot of people are preparing for booster shots

22:31SPEAKERthat are gonna have reprogrammed instructions

22:35SPEAKERto deal with the dominant circulating strain

22:39SPEAKERof the virus at that time.

22:41SPEAKERAnd so that's already in process

22:43SPEAKERbased off the dominant strains that are existing right now.

22:46SPEAKERThe good news is that the dominant strains

22:49SPEAKERthat are circulating right now,

22:50SPEAKERwhether you call them the UK variant,

22:51SPEAKERwhich has now sort of become the dominant strain here

22:54SPEAKERin the US or even- - That's B117?

22:57SPEAKER- Yeah, or the South African one, which is 1351,

23:02SPEAKERwe're still seeing pretty high efficacy,

23:04SPEAKERat least in terms of hospitalizations and deaths

23:07SPEAKERwith the current vaccines.

23:09SPEAKERSo hopefully, we'll never get to the point

23:12SPEAKERwhere we need a booster,

23:13SPEAKERbut they're preparing as if we'll need one.

23:15SPEAKERIt's just gonna depend on the rate

23:18SPEAKERof vaccinations worldwide.

23:20SPEAKERAnd that is really, really hard to predict

23:22SPEAKERbecause it's about supply chain.

23:24SPEAKERIt's about human behavior.

23:25SPEAKERIt's about implementation in every single country.

23:28SPEAKER- Are there proactive efforts for outreach and distribution

23:32SPEAKERin kind of the global South and less privileged countries?

23:35SPEAKERI mean, are there like institutions pushing for that,

23:38SPEAKERor is that just sort of trickling down slowly

23:41SPEAKERfrom your view? - Brad, let's talk about IP

23:43SPEAKERand patents on vaccines, actually.

23:45SPEAKERLike this is a massive issue. - Oh, we have IP here.

23:47SPEAKERIt's our favorite.

23:48SPEAKERSo if you were just like thinking about this

23:51SPEAKERin a purely tech way and you're like,

23:53SPEAKERhow do I get this thing, this piece of code

23:56SPEAKERthat I've written out as fast as I can to everyone

23:59SPEAKERso they can make like a real product,

24:00SPEAKERyou'd be like, I would just open source it.

24:03SPEAKERAnd I would give like every country the ability to do that.

24:07SPEAKERWell, we have patents and IP structures in the way.

24:11SPEAKERSo the companies that have made this

24:13SPEAKERreally wanna protect their investments.

24:16SPEAKERAnd so they have maintained those rights.

24:18SPEAKERAnd this is a complicated thing that goes back

24:20SPEAKERto a lot of things that have been developed

24:24SPEAKERover the last 20, 30 years.

24:26SPEAKERThere's a really good New York Times Daily episode

24:29SPEAKERwhere they talk about Bill Gates addressing this problem

24:32SPEAKERthrough the Gates Foundation, going back 20 years.

24:35SPEAKERAnd the solution that came up with

24:37SPEAKERwas something called COVAX,

24:40SPEAKERwhich is rather than eliminating IP

24:42SPEAKERand just open sourcing these vaccines,

24:45SPEAKERso any country can manufacture them.

24:47SPEAKERWhat we'll do is we'll pool our doses

24:50SPEAKERand have them be sort of distributed evenly

24:53SPEAKERamongst countries in the global South.

24:55SPEAKERAnd the US last year under the Trump administration

24:59SPEAKERpulled out of that deal.

25:01SPEAKERAnd then Biden went back in and said,

25:03SPEAKERhere's like $4 billion into the fund,

25:05SPEAKERso you can go out and distribute them everywhere.

25:08SPEAKERIt's pretty clear that if we pulled the IP,

25:12SPEAKERevery country would be able to spin up manufacturing.

25:15SPEAKERAnd it would be faster, but it's also not realistic

25:19SPEAKERunder the current sort of late stage capitalism world

25:24SPEAKERwe live in.

25:24SPEAKERSo I think COVAX is our best bet right now.

25:28SPEAKERAnd working with countries to spin up manufacturing

25:31SPEAKERfor distribution, I think this is an ongoing challenge.

25:37SPEAKERI think even though we've put in four to $5 billion,

25:40SPEAKERit's not gonna be nearly enough.

25:41SPEAKERWe have to put in a ton of effort going well past

25:45SPEAKERthe pandemic feels over here in the US

25:48SPEAKERin order to get these vaccines out there

25:50SPEAKERbecause we won't be safe until the world is vaccinated.

25:54SPEAKER- As a lay person, this seems like a situation

25:56SPEAKERwhere a penny spent upfront is worth 20 spent later on.

26:02SPEAKERDo you think that's fair or not so much?

26:04SPEAKER- This seems like one of those things where it's like,

26:06SPEAKERif you can't appeal to people's sense of humanity

26:09SPEAKERand decency, you can at least appeal

26:10SPEAKERto their sense of rational self-preservation

26:12SPEAKERbecause it's like, hey, it's good for you

26:13SPEAKERas well as them if you help them.

26:16SPEAKER- But if there's a lot more variance,

26:20SPEAKERthen they can sell a lot more vaccines, Brad.

26:22SPEAKERYou got to think about that.

26:26SPEAKER- I do think the investment upfront makes a difference.

26:30SPEAKERAnd you also have to look at what the perception is.

26:34SPEAKERSo here in the US we're saying, okay,

26:37SPEAKERwe had stockpiled a bunch of AstraZeneca vaccine,

26:40SPEAKERand right now it's not approved in the US.

26:43SPEAKERAnd so one of the things we did is they're like,

26:45SPEAKERhey, Canada, Mexico, you can have our AstraZeneca.

26:48SPEAKERAnd think about what it feels like

26:50SPEAKERif you're in one of those countries where you're like,

26:52SPEAKERoh, so the US is giving me the vaccine they don't want

26:57SPEAKERto me while protecting their populace.

27:00SPEAKERThis is what's traditionally called vaccine nationalism

27:03SPEAKERwhere you hoard supply for your own population.

27:07SPEAKERAnd then when you do distribute,

27:08SPEAKERyou distribute something that might be seen as inferior.

27:12SPEAKERAnd so there's a lot of countries

27:14SPEAKERwhere there hasn't been a dose of vaccine administered.

27:18SPEAKERAnd they're watching other countries, richer countries,

27:22SPEAKERadminister half of their population with vaccine.

27:25SPEAKERThis is a monumental challenge to overcome.

27:28SPEAKERSo not only do you have to just do the work upfront

27:31SPEAKERto get these doses administered

27:34SPEAKERfrom the public health standpoint,

27:35SPEAKERit's also like the inequity standpoint

27:38SPEAKERthat really hampers everything from global trade

27:41SPEAKERon down to relations in these countries

27:43SPEAKERthat can really damage stability of the world long-term.

27:50SPEAKER- I mean, honestly, when you put it that way,

27:51SPEAKERit's shocking to me that we aren't having

27:54SPEAKERpeople screaming at each other in the UN

27:56SPEAKERand people amassing armies on borders and stuff like that.

27:59SPEAKER- Dude, the vaccine wars is like the most dystopian

28:02SPEAKERcyberpunk concept I've ever heard.

28:04SPEAKER- I mean, you say that,

28:05SPEAKERbut if I'm one of the countries that has no vaccine

28:08SPEAKERand I border a country that has a shitload of vaccine,

28:12SPEAKERlike there's an economic fallout

28:15SPEAKERto not being able to vaccinate your population

28:17SPEAKERthat is going to impact countries' levels of success.

28:21SPEAKER- I mean, the sad reality is the country

28:23SPEAKERthat can afford the vaccine also probably can afford

28:25SPEAKERa much larger military, so the problem cancels itself out.

28:29SPEAKER- You don't even have to compare these

28:30SPEAKERwildly different structures.

28:32SPEAKERIf we compare the U.S. to the EU,

28:34SPEAKERthe EU, if we were there, if we were podcasting from there,

28:38SPEAKERwe'd be like, "The world is falling apart,"

28:40SPEAKERbecause of how far behind they are on vaccinations.

28:43SPEAKERIn reality, they're about two months behind

28:46SPEAKERwhere the U.S. and the UK are

28:48SPEAKERin terms of their vaccination rates,

28:49SPEAKERbut what that's resulted in

28:51SPEAKERis literally tens of thousands more people dead

28:54SPEAKERbecause they're going through another surge

28:56SPEAKERat a level that the U.S. and the UK aren't.

29:00SPEAKERNow, maybe that surge is still coming to us

29:02SPEAKERand we can't avoid it and it's a time situation,

29:05SPEAKERbut their experience on the ground looks very different.

29:08SPEAKERSo it's not even just comparing countries

29:11SPEAKERof vast different wealth status.

29:14SPEAKERIt's ones that are considered oftentimes common colleagues.

29:18SPEAKERSo it's one of those things,

29:20SPEAKERlike two months makes a world of difference here.

29:22SPEAKERSo every dose of vaccine that we can help administer

29:26SPEAKEReverywhere is going to, I think, lead to better stability.

29:30SPEAKERReality is that's not how it's gonna work.

29:33SPEAKERIt's just not politically solvent

29:35SPEAKERto basically send all of your doses overseas.

29:39SPEAKERBut I think the commitment that most people are looking for

29:42SPEAKERis 5% of your doses get distributed elsewhere.

29:46SPEAKER- There's a vaccine gap, basically.

29:47SPEAKER- Yes, for sure.

29:49SPEAKEROne more quick question about the IP issue.

29:52SPEAKERIs it jaded of me to assume that these vaccine designs,

29:54SPEAKERwhich are privately held, were developed

29:57SPEAKERpartially with public money?

29:59SPEAKER- No, that's not my, that's totally how that was done.

30:01SPEAKER- Is that exactly what happened?

30:03SPEAKERGreat. - Yeah, of course.

30:04SPEAKER- Great, great.

30:05SPEAKER- Yeah, I mean, the one thing that's complicating

30:07SPEAKERabout that is it was used,

30:09SPEAKERit was developed by public money from multiple countries.

30:12SPEAKERSo it's not just something that was developed

30:15SPEAKERhere in the US.

30:17SPEAKERAnd there are some limitations on the product

30:20SPEAKERin terms of that public funding, in terms of how it's used,

30:24SPEAKERbut there's still these IP arrangements

30:28SPEAKERthat are limiting manufacturing elsewhere.

30:31SPEAKER- Of course.

30:32SPEAKER- So let's get to the real, you know,

30:34SPEAKERif you're sitting out at home

30:35SPEAKERand you haven't gotten vaccinated yet,

30:37SPEAKERand you're looking at appointments for Johnson & Johnson

30:39SPEAKERand Moderna and Pfizer and Bob Jones's old snake oil

30:43SPEAKERvaccine shop down the street,

30:47SPEAKERwhich is the good vaccine, Kishore?

30:49SPEAKERWhich one do I want?

30:50SPEAKER- So I'm gonna tell the line.

30:54SPEAKER- It's the first one available to you.

30:56SPEAKER- Yes, that's the one.

30:57SPEAKER- The one that's available to you

30:59SPEAKERis the best vaccine to get.

31:01SPEAKERNow, going beyond that,

31:02SPEAKERbecause everyone's heard that at this point.

31:05SPEAKER- Yeah.

31:06SPEAKER- So the concerns about Johnson & Johnson

31:09SPEAKERand AstraZeneca right now are about a rare clotting issue.

31:14SPEAKERWe're recording this on a Wednesday.

31:16SPEAKERHere in the US, the CDC is convening

31:18SPEAKERan emergency meeting this afternoon

31:21SPEAKERto address the pause that's been instituted

31:24SPEAKERbecause of six blood clotting events in the US.

31:28SPEAKERIn the UK-

31:29SPEAKER- Out of 7 million doses administered

31:31SPEAKERor something like that, right? - 6.8 million doses

31:33SPEAKERadministered.

31:34SPEAKERIn the UK, there was,

31:36SPEAKERI think there was 32 blood clotting incidents

31:38SPEAKERwith the AstraZeneca vaccine.

31:41SPEAKERThe pause has been reported on pretty widely.

31:46SPEAKERTo me, when I heard the pause and I heard them say it,

31:49SPEAKERit was really about,

31:51SPEAKERthis is a very specific type of blood clot.

31:54SPEAKERYou might have heard it called CVST,

31:57SPEAKERcerebral venous sinus thrombosis.

32:00SPEAKERAnd what's weird about this clotting incident

32:03SPEAKERis that it doesn't involve a high platelet count.

32:06SPEAKERSo it's not this kind of typical coagulation.

32:09SPEAKERSo when you get a blood clot

32:10SPEAKERand you end up in the hospital,

32:11SPEAKERthey typically put you on a drug called heparin,

32:14SPEAKERwhich is an anticoagulant that kind of thins your blood

32:17SPEAKERand kind of circumvents the blood clot

32:20SPEAKERcausing a stroke or something worse.

32:23SPEAKERAnd heparin doesn't work in this case.

32:25SPEAKERIt's actually the wrong course of treatment.

32:28SPEAKERAnd so what the pause is about primarily to me,

32:32SPEAKERbeyond the safety issue, beyond like the,

32:35SPEAKERwe got to review the data,

32:37SPEAKERis like a shot to all the doctors saying like,

32:41SPEAKERhey, if somebody comes in with a blood clot,

32:43SPEAKERask them what vaccine they took.

32:45SPEAKERMake sure they didn't get Johnson & Johnson

32:47SPEAKERso before you put them on heparin,

32:49SPEAKERlike you can actually make sure

32:51SPEAKERwhat the source of the blood clot is

32:53SPEAKERso you can treat it properly.

32:55SPEAKERTwo, make sure that we're capturing

32:58SPEAKERall of the blood clotting events that might be associated

33:01SPEAKERto the vaccine properly in the system.

33:03SPEAKERWe have something in the US called

33:05SPEAKERVAERS vaccine adverse event reporting system

33:08SPEAKERthat captures all of these things.

33:10SPEAKERSo they're really trying to see,

33:11SPEAKERdo we have six or is it a lot more?

33:13SPEAKERAre we only capturing the super, super,

33:18SPEAKERsevere cases of this or are there minor issues

33:20SPEAKERof blood clots that are being underreported?

33:23SPEAKERSo they're really doing the pause to be like,

33:25SPEAKERokay, let's see where we're at.

33:27SPEAKERBecause the rarity of this as it stands,

33:30SPEAKERif it stands that it's only six cases,

33:32SPEAKERis much rarer than if you were on birth control

33:36SPEAKERor other drugs, they have a much higher incidence.

33:39SPEAKERBut I'm not saying that six is the number.

33:42SPEAKERSo I think it's natural in this intervening period

33:46SPEAKERto be like, I'm not gonna take the Johnson & Johnson vaccine.

33:49SPEAKERNow, for virtually everyone,

33:52SPEAKERyou shouldn't be able to get it right now.

33:54SPEAKERThe CDC recommended putting a pause on it,

33:57SPEAKERand that means it's, but it's up to the states

33:59SPEAKERto actually implement that.

34:01SPEAKERAnd I think virtually every state is following the guidance.

34:05SPEAKERBut I wouldn't take a Johnson & Johnson during this pause

34:08SPEAKERwhile they're sort of figuring it out

34:10SPEAKERif it was available to me.

34:13SPEAKERWhat it means long-term,

34:14SPEAKERI'm gonna wait and see what they say.

34:17SPEAKERLike they paused for a reason out of extreme caution.

34:21SPEAKERAnd I think that's probably the right move long-term.

34:24SPEAKERI'm not overreacting to it right now.

34:27SPEAKERThere's not a ton of information.

34:29SPEAKERIt's hard to do prognostication.

34:31SPEAKERWe don't know why.

34:32SPEAKERWe don't understand the science of this.

34:34SPEAKERBut the one thing that AstraZeneca

34:35SPEAKERand Johnson & Johnson vaccine have together

34:38SPEAKERis they both use the same basic structure.

34:40SPEAKERThey use an adenovirus to deliver the information

34:43SPEAKERon the spike protein.

34:44SPEAKERSo is there something about that structure

34:47SPEAKERthat's causing this weird platelet clotting issue?

34:49SPEAKERWe don't know.

34:51SPEAKERAnd so in a weird, we don't know situation,

34:53SPEAKERI'm just gonna wait.

34:55SPEAKERAnd there's no use predicting anything

34:57SPEAKER'cause the chance that you're right is very, very low.

35:00SPEAKER- I know you, I'm sorry.

35:02SPEAKERI know you said you came on here intending

35:04SPEAKERnot to scare the daylights out of me,

35:06SPEAKERbut as someone who did get the Johnson & Johnson

35:08SPEAKERabout a week and a half ago,

35:10SPEAKERwhat would you say to a person like me?

35:12SPEAKER- So two things.

35:15SPEAKEROne is there's a set of symptoms to keep an eye out for.

35:19SPEAKERIt's like severe headaches, severe abdominal pain.

35:24SPEAKERAnd the thing is like this kind of clot

35:27SPEAKERis eminently treatable.

35:29SPEAKERIf you end up in the hospital,

35:31SPEAKERlike tell them that you took the Johnson & Johnson vaccine

35:34SPEAKERand there's treatments for it and you will likely be fine.

35:37SPEAKERSo far of the six, one person died

35:40SPEAKERand one person's in critical condition.

35:43SPEAKERThe likelihood that you're gonna get sick from this

35:45SPEAKERis very low after about a two to three week period.

35:48SPEAKERAfter that, you're pretty much free and clear.

35:52SPEAKER- Okay.

35:53SPEAKER- So I don't think you should be scared.

35:54SPEAKERI think you should just be aware.

35:56SPEAKER- Right.

35:58SPEAKER- It's interesting because there was a widely shared thread

36:01SPEAKERon Twitter last night from an internist

36:02SPEAKERor an ER admitting doctor who basically said,

36:06SPEAKERlook, the good thing about this pause

36:08SPEAKERis that it means that every ER doctor in the country

36:12SPEAKERand most of your general practitioners now know

36:14SPEAKERto look for these five symptoms

36:16SPEAKERand to ask if you've had the Johnson & Johnson

36:18SPEAKERor AstraZeneca vaccine.

36:20SPEAKERAnd as a result, they'll be able to treat this complication

36:24SPEAKERthat affects a really small number of people.

36:26SPEAKER- Like that's a great point

36:27SPEAKERbecause I came into this feeling like,

36:29SPEAKERwell, I'm certainly no expert in a position

36:31SPEAKERto say this was an overreaction,

36:32SPEAKERbut like you did see this,

36:33SPEAKERyou saw the small number of cases

36:35SPEAKERthat have been indicated versus the total number

36:39SPEAKERof vaccinations and you thought like,

36:40SPEAKERboy, this is really potentially doing damage

36:42SPEAKERto the public information outreach efforts

36:45SPEAKERof scaring a public that is already somewhat skeptical

36:48SPEAKERof this thing into maybe avoiding it.

36:50SPEAKERBut like when you put it that way,

36:52SPEAKERthat does sound like a worthy benefit

36:54SPEAKERto incur that potential damage.

36:57SPEAKER- There's a lot of people that have come out and said like,

36:59SPEAKERthis is gonna increase rates of vaccine hesitancy.

37:01SPEAKERThis is gonna cause a lot of people not to get the vaccine.

37:05SPEAKERLike I understand why your thinking is along that way,

37:08SPEAKERbut we don't have evidence of that at all.

37:12SPEAKERWe, I think there's no way of knowing

37:15SPEAKERwhat the response is gonna be.

37:16SPEAKERNow, I think what's important

37:19SPEAKERis that the federal government takes some proactive steps

37:23SPEAKERand really increase communication and transparency

37:26SPEAKERabout what's happening, particularly with this vaccine

37:29SPEAKERto hedge against that kind of stuff.

37:31SPEAKERBut we don't know.

37:32SPEAKERI mean, so much about this entire response

37:34SPEAKERhas been about just managing your own risk as an individual

37:39SPEAKERand then managing the risk of the population

37:42SPEAKERas done by our state and federal governments.

37:45SPEAKERAnd we have gotten that so out of whack

37:47SPEAKERwhere we try to treat things as a binary,

37:50SPEAKERlike am I a yes or no to this?

37:53SPEAKERLike if it doesn't work perfectly, do I get it or not?

37:59SPEAKERAnd it's really like, I think about it this way.

38:01SPEAKERThis is a very crude analogy,

38:03SPEAKERbut just walking around, just like existing,

38:07SPEAKERI have some risk of getting COVID.

38:09SPEAKERNow I take that risk way down

38:11SPEAKERby doing the kind of hermit lifestyle

38:13SPEAKERthat I live and Will lives.

38:17SPEAKERWhere I basically, I don't see any other humans.

38:20SPEAKERWhen I interact with anyone, it's basically outside.

38:24SPEAKERI wear a mask everywhere I go.

38:26SPEAKERThat takes my risk down pretty far,

38:30SPEAKERalmost virtually to zero, to be honest.

38:34SPEAKERBut then when I encounter people, my risk goes back up.

38:37SPEAKERThe vaccines take that risk when you interact with people

38:41SPEAKERback down to where it was when you're wearing a mask

38:45SPEAKERand not seeing people.

38:46SPEAKERIt doesn't take it all the way to zero,

38:47SPEAKERbut it takes it so far down.

38:50SPEAKERAnd what we're doing is sort of managing

38:53SPEAKERthat intermittent risk between almost nothing

38:58SPEAKERby not interacting with anyone

39:00SPEAKERand a little bit when we interact with some people.

39:03SPEAKERAnd so I'm gonna keep using things that I know that work,

39:06SPEAKERlike washing my hands, wearing a mask,

39:09SPEAKERto keep my personal risk relatively low in this period

39:15SPEAKERwhen we're trying to vaccinate as many people as possible.

39:19SPEAKERAnd I'm gonna get a vaccine

39:20SPEAKERbecause I know it's one of the biggest things I can do

39:23SPEAKERto keep my risk low over a long period of time.

39:27SPEAKERAnd so that's how I think about it.

39:29SPEAKERThe J&J vaccine fits into that system of managing risk.

39:34SPEAKERI have a very, very, very minor risk,

39:38SPEAKERas it currently stands, of developing a blood clot.

39:42SPEAKERBut to me, getting COVID is worse than that risk,

39:47SPEAKERas it stands now.

39:48SPEAKERNow, the data might change, but that's how I think about it,

39:51SPEAKERis like managing my risk.

39:52SPEAKERNow, as like the state and federal governments,

39:55SPEAKERthey look at it across a population.

39:56SPEAKERIt's a different sort of calculus.

39:59SPEAKERThey're going to unpause this vaccine, I would bet,

40:04SPEAKERbased off of the limited data we have.

40:07SPEAKERUnless a stream of new data comes in

40:10SPEAKERsaying that the blood clots is a lot more prevalent

40:12SPEAKERthan we think, I think they'll unpause this.

40:15SPEAKERAnd I think you might be surprised

40:17SPEAKERat how many people prefer the single dose.

40:21SPEAKERBut more importantly, that Johnson & Johnson vaccine

40:23SPEAKERis critical to getting supply out to developing nations.

40:29SPEAKER- Because it doesn't have the infrastructure requirements.

40:32SPEAKER- Yeah, it just has to be normal refrigeration.

40:35SPEAKER- Yeah, like I got mine in, like Will described,

40:38SPEAKERlike something out of some kind of like a pandemic movie

40:40SPEAKERor something, parking lot full of cars and stuff.

40:43SPEAKERBut I went to Walgreens and there was one person

40:46SPEAKERin front of me and it was basically

40:47SPEAKERjust like getting a flu shot.

40:48SPEAKERLike it was extremely mundane

40:50SPEAKERfor how profound it is to receive this thing.

40:54SPEAKER- I read a book about 15 years ago that was written,

40:58SPEAKERI can't remember who wrote it, but it was a person,

41:00SPEAKERthe gist was the way our monkey brains work,

41:04SPEAKERwe worry about the edge case things, right?

41:07SPEAKERLike we worry about getting hit by an asteroid

41:10SPEAKERor having, even in the United States,

41:13SPEAKERhaving being shot like in a mass shooting incident

41:16SPEAKERis a pretty low percentage.

41:18SPEAKERWhen in reality, if we really wanted to avoid

41:20SPEAKERthe things that were dangerous,

41:21SPEAKERwe would always use the handrail

41:22SPEAKERwhen we go down the stairs

41:23SPEAKERand we'd be really careful getting out of the shower.

41:25SPEAKER- And like never get in an automobile.

41:27SPEAKER- Yeah, because those are like the three most dangerous

41:29SPEAKERthings that anybody does and we do them all every day.

41:33SPEAKERSo, yeah, managing the personal and community safety stuff

41:39SPEAKERis challenging in this because of the way our brains

41:43SPEAKERare fundamentally designed, like monkey brains,

41:45SPEAKERwe worry about the lion coming up to eat us in the tree,

41:49SPEAKERnot the falling out of the tree and getting a concussion.

41:52SPEAKERAnyway.

41:53SPEAKER- Talking about irrational fear seems like the perfect time

41:55SPEAKERto bring up general efficacy rates because that's the thing,

41:57SPEAKERlike I am that person that Will was describing earlier

42:00SPEAKERprior to the news of this week with the blood clots and stuff

42:03SPEAKERI was the guy a week and a half or two weeks ago now

42:06SPEAKERstaring at the only appointment I could find

42:08SPEAKERand seeing that it was the Johnson and Johnson

42:10SPEAKERand like wringing my hands for a day or two going like,

42:12SPEAKERshould I just go ahead and get it?

42:13SPEAKERShould I, that number, that one number sure is bigger

42:16SPEAKERthan this other number, maybe I should wait,

42:17SPEAKERwhich I did not, I ended up taking your advice

42:19SPEAKERand getting the one I could get.

42:21SPEAKERBut do you wanna comment on that?

42:24SPEAKERLike I've done what I think is the reading about,

42:27SPEAKERthese were studied under very different conditions,

42:30SPEAKERlike the numbers that came out the other end

42:32SPEAKERare not in any way directly comparable,

42:35SPEAKERlike you would have needed to study them all side by side

42:37SPEAKERin identical conditions for those numbers

42:39SPEAKERto be relevant against each other.

42:40SPEAKERLike, is that the basic gist?

42:42SPEAKERIs there much more to say than that?

42:44SPEAKER- You got it, there isn't much more to say than that.

42:46SPEAKERI would say the one thing I would layer on top

42:48SPEAKERis the one thing that all three vaccines

42:52SPEAKERthat are approved in the US are really good at doing

42:54SPEAKERis preventing hospitalization and death.

42:55SPEAKERThey're near 100% across the board.

43:00SPEAKERNow, there are things about contracting COVID

43:03SPEAKERwith long COVID that we really don't understand.

43:07SPEAKERThere's been some kind of scary studies

43:09SPEAKERthat have come out in recent weeks

43:11SPEAKERabout long-term effects of people that have COVID.

43:14SPEAKERBut even the people that have gotten COVID

43:16SPEAKERthat have received these vaccines

43:19SPEAKERseem to in the early days be reporting

43:22SPEAKERa much milder form of the disease.

43:26SPEAKERSo to me, that's what's important.

43:28SPEAKERLike the number one thing I'm scared about with COVID

43:31SPEAKERis risk of hospitalization and death.

43:35SPEAKERAnd all these vaccines work at reducing that risk

43:39SPEAKERclose to zero or as close to zero as you can get.

43:43SPEAKERThe next level is like, I just don't want COVID.

43:46SPEAKERAnd all three of these seem to be doing pretty well

43:51SPEAKERat preventing people from getting and transmitting COVID.

43:57SPEAKERAnd then when you go even a step below that,

43:59SPEAKERlike how severe COVID would it be if I get them,

44:02SPEAKERthey seem to be not terribly severe across the board.

44:06SPEAKERWe're gonna learn a lot more in the real world

44:09SPEAKERas these are administered.

44:10SPEAKERYou have to remember like these have only been administered

44:13SPEAKERfor about two and a half months at this point.

44:16SPEAKERSo we just don't have enough data to say,

44:19SPEAKERbut everything that we see now, both here and in the EU

44:22SPEAKERsays like you should just get any of them.

44:24SPEAKERThey're the same effectively.

44:28SPEAKER- I'm guessing it's gonna be hard for you

44:29SPEAKERto give a qualitative answer to this question.

44:31SPEAKERBut when you say a person who is vaccinated gets it

44:33SPEAKERand it's not kind of a very severe case,

44:37SPEAKERdoes not very severe mean like,

44:38SPEAKERoh, it's like a pretty major flu

44:40SPEAKERor it's like a common cold or that,

44:43SPEAKERI'm sure that's all over the place, right?

44:45SPEAKER- It's all over the place.

44:46SPEAKER- Okay.

44:47SPEAKER- It means not hospitalized, right?

44:49SPEAKER- Yeah. - Well, of course.

44:50SPEAKER- Definitely not hospitalized.

44:52SPEAKERBut Dave, first of all, the number of people

44:56SPEAKERthat have gotten immunized and gotten COVID

45:00SPEAKERis very low, it's not zero.

45:02SPEAKERIt's not going to be zero just because like,

45:04SPEAKERthat's not how vaccines aren't 100% effective.

45:08SPEAKERThat's not, just not how they work.

45:10SPEAKERBut what we're seeing is cases from like,

45:13SPEAKERI have a very achy body, mild fever, cough.

45:18SPEAKERThere's a lot of people that are asymptomatic

45:21SPEAKERthat emerge from it.

45:22SPEAKERSo it's a range.

45:26SPEAKER- So, okay, this is my next question.

45:29SPEAKERA lot of people live with people

45:31SPEAKERwho either can't get vaccinated

45:32SPEAKERbecause they have health conditions

45:33SPEAKERthat prevent them from getting vaccinated,

45:34SPEAKERbut more likely, they're just under the age of 16.

45:38SPEAKERAnd, you know, schools are going back.

45:40SPEAKERYou know, the kids, while the common wisdom

45:44SPEAKERis the kids haven't been particularly affected by COVID

45:47SPEAKERor they get minor cases,

45:49SPEAKERit's definitely not the universal case.

45:51SPEAKERAnd we're looking at, I mean,

45:53SPEAKERI think we're looking at 12 to 16s

45:55SPEAKERbeing able to be vaccinated shortly, but not under 12s.

45:59SPEAKERSo, you know, what happens when my wife and I are vaccinated

46:04SPEAKERand, you know, our unvaccinated daughter,

46:06SPEAKERlike, can we infect our unvaccinated daughter

46:08SPEAKERif we go out in the world

46:10SPEAKERand come back with the asymptomatic COVID?

46:13SPEAKERLike, how likely is that?

46:14SPEAKERIs it something we should be concerned about?

46:16SPEAKERShould we continue staying bubbled like we have been?

46:19SPEAKERYou know, what's the, what's the kind of,

46:21SPEAKERI know, I know if we're vaccinated,

46:22SPEAKERwe can go hang out maskless

46:24SPEAKERwith a bunch of our vaccinated friends,

46:26SPEAKERbut I'm much more concerned about my daughter

46:29SPEAKERat this point than I am, than about me.

46:31SPEAKER- Yeah, so I am somebody with an under 12 at home.

46:36SPEAKERThere aren't super, super clear answers here.

46:39SPEAKERSo I just want to acknowledge, like,

46:40SPEAKERthe data is changing pretty constantly.

46:43SPEAKERLike, and if you do take away one thing from this episode,

46:46SPEAKERit's like, it is a changing landscape

46:47SPEAKERand your advice and action should change

46:50SPEAKERwith that landscape of information as it comes in.

46:54SPEAKERSo what we have seen is that yes,

46:56SPEAKERchildren can get infected at COVID.

46:58SPEAKERIt's at a much lower rate than adults do.

47:01SPEAKERBut if you live in an area

47:02SPEAKERwhere community transmission is high, kids can get COVID.

47:07SPEAKERNow, typically what we see is the adults are the ones

47:11SPEAKERthat tend to infect them rather than kid to kid.

47:14SPEAKERThere's been, outbreak is too strong of a word,

47:17SPEAKERbut there's been a set of cases in Minnesota

47:20SPEAKERin recent weeks that are associated to a school.

47:25SPEAKERAnd we know that it seems like the adults transmitted

47:30SPEAKERto the kids in the school.

47:32SPEAKERSo this is a situation where it's like,

47:34SPEAKERlet's talk about risk again.

47:36SPEAKERSo us getting vaccinated is the first step as the adults,

47:39SPEAKERright, because it lowers the risk for the kid overall,

47:42SPEAKERbecause now we're much less likely to transmit

47:46SPEAKERunder any circumstances to the kid.

47:49SPEAKERBut then your question of like,

47:50SPEAKERwell, if I go out in the world,

47:52SPEAKERI can still get COVID and asymptomatically transmit

47:55SPEAKERto the kid.

47:57SPEAKERSo that's why I'm gonna still take some precautions

48:00SPEAKERout in the world, like wearing a mask

48:03SPEAKERand doing some like somewhat distant activities.

48:07SPEAKERSo like, to me, I'm not gonna go sit in a restaurant

48:10SPEAKERright now indoors and eat, even when I'm vaccinated.

48:15SPEAKERBut I might be open to doing the outdoor eating

48:18SPEAKERat a restaurant when I'm vaccinated

48:21SPEAKERand I'm two weeks afterwards.

48:26SPEAKERUnder the right circumstances and the food is good.

48:28SPEAKERI think that's actually underrated.

48:30SPEAKER- Like, yeah, I went through In-N-Out the other day

48:32SPEAKERand through the drive-through, I looked at the patio,

48:34SPEAKERI was like, you know, I would maybe do that when it's windy.

48:38SPEAKERWhy not? - Yeah, for sure.

48:40SPEAKERAnd like, it has to be food that stands up

48:43SPEAKERto being able to eat outside.

48:45SPEAKERThere's not a lot of food that, there's certain restaurants

48:49SPEAKERthat I think like having noodles outside or pho outside

48:53SPEAKERfeels weird to me for some reason.

48:55SPEAKER- It's funny walking around here and seeing, you know,

48:57SPEAKEReverybody's have erected their, you know,

48:59SPEAKERcart, wooden shelters outside the restaurant.

49:03SPEAKERYeah, right.

49:04SPEAKERIt's funny seeing specific types of restaurants

49:06SPEAKERand their custom adaptations.

49:07SPEAKERLike you'll see like a hot pot place where like, you know,

49:10SPEAKERthey had to saw like a big hole in the middle of the table

49:12SPEAKERwhere they could drop the pot into for everybody

49:13SPEAKERthat comes through and it's a pretty bespoke situation

49:18SPEAKERfor a lot of businesses.

49:19SPEAKER- But back to your question, Will, like,

49:22SPEAKERI'm going to keep wearing stuff that doesn't bother me,

49:26SPEAKERlike wearing a mask, doing some distance activities

49:30SPEAKERand maybe I'll be more aggressive about doing like picnics

49:34SPEAKERin the park with friends once we're fully vaccinated

49:38SPEAKERand stuff, because that will keep the risk to my kid low.

49:42SPEAKERAnd the other thing I'm going to monitor is what community

49:44SPEAKERtransmission looks like and alter my behavior based on that.

49:48SPEAKERSo right now where we live,

49:50SPEAKERcommunity transmission is really low.

49:51SPEAKERLike in San Francisco, there's about 30 new cases a day,

49:55SPEAKERwhich is relatively low.

49:56SPEAKERHalf the population has,

49:59SPEAKERhalf the adult population has gotten a vaccine.

50:01SPEAKERSo we know it's going to be safe here,

50:03SPEAKERbut if those cases start going up,

50:05SPEAKERI'll probably like pull back a little bit.

50:07SPEAKERSo like the thing to say is there's no way to keep your kid

50:11SPEAKERperfectly safe, especially if they're going to school,

50:15SPEAKERbut you just got to take steps in your own life to keep that

50:19SPEAKERrisk relatively low and manage that risk for your kid.

50:22SPEAKERBut as it stands,

50:23SPEAKERyou getting vaccinated is a massive step to keeping them

50:27SPEAKERsafe. Like that is a,

50:30SPEAKERprobably the biggest thing that you you've done.

50:32SPEAKERSo the, the risk of you as an adult going to,

50:38SPEAKERgoing to, you know, outside and interacting with somebody

50:42SPEAKERand bringing back COVID and infecting your kid is relatively

50:45SPEAKERlow, even if you didn't take those precautions.

50:47SPEAKERAnd by you taking those precautions,

50:49SPEAKERyou're even lowering the risk.

50:51SPEAKER- Can I,

50:52SPEAKERcan I ask you some common human activities and you give me a

50:55SPEAKERyes or no on them for you personally.

50:57SPEAKER- All right, lightning round.

50:58SPEAKER- I'm very curious, Brad, can we,

51:01SPEAKERand as a sidebar rate,

51:02SPEAKERwhat Will thinks are common human activities.

51:07SPEAKER- Okay, go into the grocery store versus ordering groceries

51:10SPEAKERonline.

51:11SPEAKER- I think it's fine.

51:12SPEAKERI personally have no issues with going to the grocery store,

51:17SPEAKERespecially when you're vaccinated.

51:19SPEAKERLike, are we talking post vaccine?

51:21SPEAKER- Yeah, post vaccine, like you post vaccine,

51:23SPEAKERyour kid isn't, you're going to the grocery store.

51:25SPEAKERLike if you need to, if you need,

51:26SPEAKERif you run out of eggs,

51:27SPEAKERyou swing by the grocery store, grab some eggs, no problem.

51:30SPEAKER- No problem, still wearing a mask,

51:32SPEAKERstill going to try to be relatively quick in there.

51:34SPEAKERSo no, like two hour Trader Joe's run.

51:38SPEAKER- We already hit no indoor dining,

51:40SPEAKERbut we did hit outdoor dining and probably outdoor dining is

51:43SPEAKERa yes, if the food is appropriate for you.

51:45SPEAKER- It's a yes for me personally.

51:46SPEAKERThese are all personal choices, but yeah, it's a yes for me.

51:49SPEAKERYeah.

51:49SPEAKER- Of course.

51:50SPEAKEROkay, what about going to a movie?

51:54SPEAKER- So I am not going to a movie indoors

51:59SPEAKERuntil we hit probably a case rate that's in like the,

52:05SPEAKERyou know, when we hit that case rate

52:06SPEAKERin the country of like 10,000 cases a day,

52:09SPEAKERor we hit cases in San Francisco that are like nearing zero,

52:13SPEAKERI think I would be much more open

52:14SPEAKERto going and see a movie indoors.

52:17SPEAKERI think the thing about movies indoors

52:19SPEAKERthat scares me just a little bit is like,

52:22SPEAKERit's not like a situation where I can like wear a mask

52:25SPEAKERwhile doing it because like people are eating popcorn

52:28SPEAKERand like, you know, that's how I want to enjoy a movie.

52:31SPEAKERAnd if I'm not comfortable eating indoors,

52:34SPEAKERlike going to a movie indoors is the same thing.

52:37SPEAKER- What about using a public restroom?

52:41SPEAKER- So, wow, that's a tough one.

52:46SPEAKERSo I think using public restrooms is fine.

52:49SPEAKERI usually wear a mask, wash my hands

52:52SPEAKERand generally be quick about it.

52:55SPEAKERAnd this is not grounded in evidence,

52:58SPEAKERbut I'm just gonna say it.

52:59SPEAKERI'm all about like peeing in public restrooms,

53:02SPEAKERbut I'm not a number two guy in public restrooms right now.

53:08SPEAKERAnd that's all because of like amount of time.

53:10SPEAKERLike I just want to minimize the time in public restrooms.

53:14SPEAKERSo I think public restrooms is fine,

53:17SPEAKERbut I'm also like a nervous pooper.

53:21SPEAKER- Yeah, yeah.

53:22SPEAKERLook, we don't need to get into your personal abilities here.

53:24SPEAKER- Well, these are personal questions.

53:28SPEAKER- I also started to bring up some of the gnarlier ways

53:31SPEAKERthat the virus can be expunged from the body

53:33SPEAKERthat people have talked about.

53:34SPEAKERYou know, like it shows up in sewage and stuff like that.

53:37SPEAKERI don't know if there's more risk.

53:39SPEAKER- Bathrooms are covered in fecal matter, Brad,

53:40SPEAKERwe know that. - In the air.

53:41SPEAKERYeah, but fecal matter doesn't put you

53:42SPEAKERin the hospital necessarily.

53:44SPEAKER- Yeah, there is some evidence of fecal oral transmission

53:47SPEAKERfrom like plumes of air that come off in bathrooms

53:51SPEAKERand bathrooms aren't always really well ventilated

53:54SPEAKERand that's kind of the issue.

53:56SPEAKERWhat we're seeing in sewage is obviously just viral fragments

53:59SPEAKERand it's just a way of tracking.

54:01SPEAKER- Oh, that's true, okay. - Over our population, yeah.

54:02SPEAKER- Okay, sure.

54:04SPEAKER- Okay, what about getting your teeth cleaned?

54:07SPEAKER- Oh, so dentist, dentist, I'm pretty comfortable.

54:11SPEAKERSo the place I'm most uncomfortable at the dentist's office

54:13SPEAKERis the waiting room because the waiting room

54:16SPEAKERis like a place that is typically not super well ventilated

54:20SPEAKERand you could be there for a long period of time

54:22SPEAKERwith people you don't know.

54:24SPEAKERBut the dentist themselves, you know,

54:27SPEAKERhave developed a lot of procedures,

54:29SPEAKERespecially here in the Bay Area,

54:31SPEAKERgoing back to the AIDS epidemic around protective procedures

54:35SPEAKERaround transmission.

54:37SPEAKERSo from what I've heard, I haven't gone to the dentist,

54:39SPEAKERthis is like high on my list of things

54:41SPEAKERthat I wanna do post vaccination,

54:44SPEAKERis they'll typically wear like face shields,

54:48SPEAKERmasks underneath that and I've heard a number of dentists

54:53SPEAKERare doing a lot more procedures around ventilation

54:57SPEAKERin those areas and limiting the number of people

55:00SPEAKERthat come in contact with you.

55:01SPEAKERSo they're treating it like any medical professional would.

55:05SPEAKERSo from that standpoint, I think it's safe.

55:07SPEAKERAnd so the thing I'm nervous about is a waiting room,

55:10SPEAKERbut I think there's easy ways to mitigate that.

55:13SPEAKER- Gosh, first of all, I'm feeling positively reckless here

55:16SPEAKERbecause like we never stopped going to the grocery store.

55:18SPEAKERI've been to the dentist, I think three times

55:20SPEAKERsince the pandemic started,

55:21SPEAKERincluding one major dental procedure.

55:24SPEAKERAlthough like to my dentist's credit,

55:25SPEAKERlike I have never seen another patient in that dental office

55:27SPEAKERthe all three times that I went,

55:29SPEAKERincluding the 90 minutes I was in there for that procedure.

55:32SPEAKERLike they are really spacing those appointments out,

55:34SPEAKERthey're like face shields all over the place.

55:36SPEAKERLike it's pretty intense, but...

55:39SPEAKER- My dentist is in like 120 year old building downtown.

55:42SPEAKERSo you have to climb six flights of stairs

55:44SPEAKERand like there's no way in hell I'm going in there.

55:46SPEAKERI gotta find a new dentist.

55:47SPEAKER- Okay, yeah, this is a tiny office open to the street

55:50SPEAKERwith two chairs in it, it's not a...

55:51SPEAKER- Grocery stores have always been fine.

55:54SPEAKERI just think the idea of spending a long time

55:58SPEAKERin a grocery store is where I would get nervous

56:00SPEAKERand like post-vaccine I'm not terribly nervous.

56:03SPEAKER- What about the eye doctor, Kishore?

56:06SPEAKER- No problem, so...

56:07SPEAKER- They're looking at you right on your...

56:10SPEAKER- I did that close.

56:11SPEAKER- I did that last week, yeah.

56:13SPEAKER- So just as an update to listeners,

56:15SPEAKERwe've learned that Will can't see,

56:17SPEAKERhe's worried about his teeth,

56:19SPEAKERhe needs to go to the bathroom.

56:21SPEAKER- And he's starving, he's also starving.

56:23SPEAKER- And he's starving, yes.

56:24SPEAKER- Look, I gotta get into a theater for Fast 9, Kishore,

56:27SPEAKERthat's where I'm at.

56:29SPEAKER- No problem, go to the eye doctor.

56:30SPEAKER- Yes, that's the hierarchy of needs,

56:32SPEAKERseeing Fast 9 in a theater is right there at the top.

56:34SPEAKER- It's number four on the list after food and dentistry.

56:42SPEAKEROkay, so I think, let's see,

56:44SPEAKERwe've gone down most of the questions.

56:45SPEAKERMy daughter had a question for you.

56:48SPEAKERShe said, "When are things gonna be back to normal, Kishore?"

56:51SPEAKER- You know, an easy question.

56:52SPEAKER- Yeah, I'm sorry for springing this on you also.

56:56SPEAKER- So there's, I have two answers to this question.

56:58SPEAKERLike, I think I was on your stream not too long ago, Will,

57:04SPEAKERand I was talking to you and some of your PUBG pals,

57:09SPEAKERand I said, I think I would see a movie

57:11SPEAKERin the theater this summer.

57:14SPEAKERAnd I think I'm sticking to that,

57:15SPEAKERand I think that's like a sign

57:17SPEAKERof things returning to normal.

57:18SPEAKERLike, things are gonna be open,

57:20SPEAKERpeople might be wearing masks,

57:22SPEAKERpeople might be more cautious,

57:24SPEAKERbut we're gonna like walk down the street

57:25SPEAKERand feel like activity looks like it was in 2019.

57:32SPEAKERI think we're gonna get there in three to six months,

57:37SPEAKERsomewhere in there.

57:38SPEAKERI would say we're gonna see activity feel like that.

57:41SPEAKERI think we are going to live in a new normal

57:45SPEAKERwhere there's gonna be localized outbreaks,

57:47SPEAKERwhether it be this summer with a potential surge

57:50SPEAKERin some areas, we're already seeing that kind of in Michigan

57:53SPEAKERand some states in the Northeast.

57:55SPEAKERWe're gonna see localized outbreaks

57:57SPEAKERprobably going into the fall and winter

58:00SPEAKERif we don't get vaccination coverage where it needs to be.

58:04SPEAKERAnd that's just gonna be a reality

58:06SPEAKERwhere there's just gonna be periods

58:08SPEAKERwhere we're like see cases rise

58:10SPEAKERand we like pull back a little bit.

58:11SPEAKERSo there'll be like a little push and pull,

58:13SPEAKERbut it won't be nearly as severe

58:17SPEAKERas what we saw going in the past.

58:20SPEAKER- I don't know, the last thing I'll say

58:21SPEAKERis like normal wasn't great for everybody.

58:24SPEAKERNormal was bad for a whole host of people.

58:27SPEAKERAnd so I hope we don't go back to normal.

58:29SPEAKERI really hope that we focus on getting back

58:31SPEAKERto the new normal, especially here in the US.

58:34SPEAKERThe weight of this pandemic and deaths

58:38SPEAKERreally fell on the shoulders of communities of color.

58:41SPEAKERSo we can't just say, let's go back to normal

58:44SPEAKERfor those communities that bore an undue burden

58:49SPEAKERwhen it came to the impact of this virus.

58:51SPEAKERSo I hope normal is redefined to something

58:55SPEAKERthat is much more thoughtful about health disparities

58:59SPEAKERand health equity in that context.

59:03SPEAKER- I'm gonna paraphrase and TLDR something you said,

59:07SPEAKERbut like, I mean, it seems like your strategy

59:10SPEAKERon what's safe and what isn't

59:11SPEAKERis to kind of look at local community spread

59:13SPEAKERfor where you live and base your decisions

59:16SPEAKERbased on how those numbers are looking.

59:19SPEAKERAre you getting those from like county health boards?

59:21SPEAKERAre you getting from the state?

59:22SPEAKERAre you getting from the CDC?

59:23SPEAKERWhere do you get your data on that stuff?

59:25SPEAKER- So the CDC tracker is excellent.

59:28SPEAKERIt is the, I think it's the gold standard right now

59:32SPEAKERof case level data.

59:33SPEAKERYou can look on county.

59:36SPEAKERHere in San Francisco, our county has been reporting data

59:40SPEAKERon a dashboard since the first week of the pandemic.

59:44SPEAKERAnd it's a good source of data.

59:46SPEAKERSo I look at that.

59:47SPEAKERNew York Times also has a really good case count

59:51SPEAKERvisualization for where you live.

59:53SPEAKERI mean, I think those are the sources I would go to.

59:57SPEAKERWhatever is the most usable for you is honestly the choice.

1:00:02SPEAKER- Bob watcher, if you're in San Francisco

1:00:04SPEAKERon Twitter is real good.

1:00:07SPEAKERDo we have to keep wiping groceries when they come in?

1:00:09SPEAKER- No.

1:00:10SPEAKER- I did that once in the first like week.

1:00:13SPEAKER- I see it every time.

1:00:14SPEAKER- I think a year ago I was telling you guys, stop that.

1:00:18SPEAKER- Yeah, I thought pretty early on they got out there

1:00:20SPEAKERand said surface transmission was not really a concern.

1:00:22SPEAKER- Look, now it's just like taking your shoes off

1:00:24SPEAKERwhen you come in the house.

1:00:25SPEAKERI don't want outside filth in the house.

1:00:27SPEAKER- It took so long.

1:00:29SPEAKER- The one caution I would give people is people,

1:00:31SPEAKERI've heard people discuss like when can I take my mask off

1:00:35SPEAKERas a sign of normal?

1:00:36SPEAKERI think that's a bad marker for it.

1:00:39SPEAKERBecause masks obviously help you.

1:00:43SPEAKERIt lowers your risk out in the world.

1:00:46SPEAKERI also see them as important social cues

1:00:50SPEAKERbecause like you two are vaccinated, I'm not.

1:00:54SPEAKERYou could probably be pretty safe going out into the world

1:00:59SPEAKERwithout a mask on, especially if you're outside

1:01:03SPEAKERand not spending indoors and licking people's faces

1:01:06SPEAKERand that kind of stuff.

1:01:08SPEAKERBut if you're out there not wearing a mask

1:01:10SPEAKERand you're like, "Hey, I'm vaccinated," flaunting it in my face

1:01:13SPEAKERit creates these, I think, weird social dynamics.

1:01:17SPEAKERAnd so I'm keeping my mask on partially

1:01:19SPEAKERuntil we all get to the place

1:01:21SPEAKERthat we feel comfortable taking off our mask

1:01:25SPEAKER'cause we've reduced the threat to everyone.

1:01:29SPEAKERAnd it really doesn't affect my life

1:01:31SPEAKERwhen I wear a mask outside.

1:01:33SPEAKERI'm fine with it.

1:01:34SPEAKER- That's the thing is if we can avoid getting the flu

1:01:37SPEAKERevery year by wearing a mask and getting colds all the time

1:01:40SPEAKERI am 100% down to wear...

1:01:43SPEAKERI don't anticipate ever going to a trade show again

1:01:45SPEAKERwithout a mask on.

1:01:47SPEAKER- I have wondered if this actually does have

1:01:49SPEAKERa normalizing effect on just the general wearing of masks.

1:01:52SPEAKERI mean, I think like even in cultures where it is very normal

1:01:55SPEAKERlike it's still a pretty sort of situational thing, right?

1:01:59SPEAKERI don't know that there's that much like preemptive

1:02:02SPEAKERmask wearing going on generally, right?

1:02:05SPEAKERIsn't it a lot more of kind of I don't feel well

1:02:08SPEAKERso I can wear a mask

1:02:09SPEAKERor like I'm gonna protect the people around me

1:02:10SPEAKERor there is a surge of something going on.

1:02:13SPEAKERMaybe now's the time, but...

1:02:14SPEAKER- Yeah, but if you're going to...

1:02:16SPEAKERYeah, if you're going to Comic-Con though

1:02:19SPEAKERwhich is a high-risk area unto itself.

1:02:22SPEAKERJust like when you literally named diseases

1:02:25SPEAKERafter comic conventions.

1:02:28SPEAKER- Pax East flu is the worst flu I have ever had in my life.

1:02:33SPEAKERLike I could see wearing it under those circumstances

1:02:37SPEAKERif it doesn't bother you.

1:02:39SPEAKERYou know, maybe I might.

1:02:42SPEAKERLike I think it depends on the circumstances

1:02:45SPEAKERwhen you go to that convention.

1:02:48SPEAKERI'm not gonna wear it as rigorously as I wear now

1:02:51SPEAKERwhere it's like every time I go outside, I'm wearing one.

1:02:53SPEAKERBut sure, I'm gonna normalize utilizing a mask in my life

1:02:58SPEAKERwhen it makes sense, especially during cold and flu season

1:03:03SPEAKERbecause you know what I've learned?

1:03:05SPEAKERI don't like getting the flu.

1:03:07SPEAKERIt's great not having the flu.

1:03:08SPEAKERIt's great not getting sick for a lot of reasons.

1:03:12SPEAKERAnd so, and again, I'm one of those people

1:03:16SPEAKERwhere a mask just doesn't bother me.

1:03:18SPEAKERIt just feels like a thing.

1:03:20SPEAKERI do.

1:03:21SPEAKER- Do you wanna talk about convention health initiatives?

1:03:24SPEAKERLet me tell you about my campaign against the handshake.

1:03:28SPEAKER- I thought that's done. - Good news, Brad.

1:03:29SPEAKER- That's done.

1:03:31SPEAKER- I bought a car yesterday without shaking hands.

1:03:32SPEAKER- This is the first time that's ever happened.

1:03:34SPEAKER- I've been, I mean, we've been to a lot of paxes

1:03:36SPEAKERto be clear.

1:03:38SPEAKERAgain, I've gotten sick from multiple ones,

1:03:40SPEAKERbut we were trialing the elbow bump.

1:03:44SPEAKERI think even the fist bump is a little too much

1:03:45SPEAKERhand contact for me. - The elbow bump we did

1:03:47SPEAKER12 years ago, 11 years ago.

1:03:49SPEAKER- We were doing the elbow bump a decade ago.

1:03:51SPEAKERI feel like as far as--

1:03:54SPEAKER- The foot shake, you gotta have good balance for that,

1:03:57SPEAKERthough.

1:03:58SPEAKER- Skin-to-skin contact that can spread pathogens around.

1:04:00SPEAKERMaybe the handshake has outlived its usefulness.

1:04:03SPEAKERI don't know, you tell me.

1:04:04SPEAKER- I think the fist bump is fine.

1:04:06SPEAKERFirst of all, it's like a vector of disease transmission.

1:04:10SPEAKERWith all of the stuff that we're emerging from this,

1:04:14SPEAKERjust watch your hands.

1:04:16SPEAKERYou can shake people's hands.

1:04:17SPEAKERJust watch your hands afterwards.

1:04:18SPEAKER- Well, sure, I do that religiously, but I don't,

1:04:21SPEAKERsome people, again, we go back to public bathroom behavior.

1:04:25SPEAKERYou can observe that some people are not so fastidious.

1:04:27SPEAKER- True, and I think the handshake's dead.

1:04:29SPEAKERI'm fine with the fist bump.

1:04:30SPEAKERI'm fine with whatever conventions emerge from this.

1:04:33SPEAKERLet the innovation spring forth

1:04:36SPEAKERon what our conventions will be.

1:04:38SPEAKER- Can we get the Spaceball salute,

1:04:40SPEAKERwhere it's like, you know.

1:04:47SPEAKERSo what are good sources for news and stuff?

1:04:50SPEAKERWhere should you go?

1:04:51SPEAKERCDC, obviously.

1:04:55SPEAKER- Honestly, what's important is finding a news outlet

1:05:01SPEAKERthat you trust for various reasons.

1:05:04SPEAKERLike, are they speaking to you

1:05:06SPEAKERin a language that makes sense to you?

1:05:09SPEAKERLike, that's really important.

1:05:11SPEAKERI should back up and say, okay,

1:05:14SPEAKERthere are certain sources that are actively

1:05:16SPEAKERtrying to sow disinformation

1:05:19SPEAKERand sow chaos

1:05:23SPEAKERand essentially generally get you scared or outraged.

1:05:27SPEAKERI tend to avoid those outlets

1:05:29SPEAKERthat drive emotional reactions to me,

1:05:32SPEAKERbecause they're less about informing me

1:05:35SPEAKERand more about capitalizing on my emotional state.

1:05:43SPEAKERBut moving past that, once you get into these areas,

1:05:46SPEAKERI think it's important that the outlet you read

1:05:49SPEAKERcontextualizes the information in a way that you understand.

1:05:52SPEAKERSo for me, I tend to read a lot of papers.

1:05:55SPEAKERI really like "The Atlantic,"

1:05:56SPEAKERbut I'm like your traditional coastal liberal elite.

1:06:01SPEAKEROf course I like "The Atlantic."

1:06:03SPEAKERBut for some people, that's gonna be like "The New York Times."

1:06:08SPEAKERSome people just use Twitter and really follow their list.

1:06:12SPEAKERI really like Bob Wachter, who you mentioned.

1:06:14SPEAKERHe's chief of the division of medicine at UCSF.

1:06:17SPEAKERHe has a lot of locally pertinent information

1:06:20SPEAKERin a really accessible way.

1:06:23SPEAKERI follow a lot of epidemiologists on Twitter.

1:06:25SPEAKERBut at the end of the day, I think for a lot of people,

1:06:28SPEAKERgo local is what I have to say.

1:06:31SPEAKERGo to your local paper, go to a local outlet,

1:06:34SPEAKERfollow a local reporter,

1:06:37SPEAKERbecause I think you're gonna find

1:06:39SPEAKERmore contextually important information from them

1:06:43SPEAKERwith less of the world is falling type rhetoric in there

1:06:50SPEAKERthan from other outlets.

1:06:51SPEAKERSome of the best recommendations I've gotten

1:06:55SPEAKERis from people that live in communities

1:06:58SPEAKERwhere sports writers and entertainment writers

1:07:02SPEAKERhad to get pushed onto a COVID beat.

1:07:04SPEAKERAnd so all they did was this report the facts

1:07:07SPEAKERwithout a lot of prognostication on top of that.

1:07:10SPEAKERAnd they said that it's been really great

1:07:12SPEAKERbecause it's been informative.

1:07:14SPEAKERIt put the onus on them to manage their risk.

1:07:18SPEAKERAnd they never really got too hyped

1:07:22SPEAKERaround what was going on.

1:07:25SPEAKER- I have a couple more hypotheticals for you.

1:07:29SPEAKERGet on an airplane.

1:07:31SPEAKER- Yeah, if I'm vaccinated, sure.

1:07:34SPEAKER- So bus, muni, BART, all that's fine then too, presumably.

1:07:38SPEAKER- Yeah, I mean, it's definitely higher risk.

1:07:42SPEAKERAnd the reason it's higher risk

1:07:43SPEAKERis you're just in touch with more people.

1:07:46SPEAKERSo it's not zero risk.

1:07:48SPEAKERSo I'm not taking flights for without reason,

1:07:51SPEAKERbut a flight to see my parents.

1:07:53SPEAKERYeah. - Yeah.

1:07:54SPEAKERWhat about a cruise?

1:07:56SPEAKERWould you go on a cruise with your parents?

1:07:58SPEAKER- I wouldn't go on a cruise before.

1:08:00SPEAKER- Yeah, let's be reasonable here, man.

1:08:05SPEAKERI have one last question for me before we wrap up here

1:08:08SPEAKERrelated to, or as a follow up to Will's question

1:08:11SPEAKERabout where to get your information.

1:08:12SPEAKERI'm sitting here looking at this CDC tracker

1:08:14SPEAKERthat you linked, which appears to be great.

1:08:16SPEAKERLike it's very dense with information.

1:08:19SPEAKERThe phrase "variance of concern"

1:08:22SPEAKERis becoming rapidly familiar.

1:08:25SPEAKERIs that something I should be keeping my eye on

1:08:27SPEAKERor is that just a way to drive yourself crazy

1:08:28SPEAKERand you should just ignore it until something is bad enough

1:08:30SPEAKERthat you hear about it normally?

1:08:31SPEAKER- I generally think you should ignore it.

1:08:33SPEAKERThe fact that we're using terms like variance

1:08:36SPEAKERas common parlance is not great to begin with.

1:08:40SPEAKERWhat we've found this year

1:08:42SPEAKERis a lot of scientific discussion.

1:08:45SPEAKERLike between scientists, between public health experts

1:08:48SPEAKERis just in public forums right now for good or bad.

1:08:51SPEAKERThere's no sort of value judgment.

1:08:53SPEAKERAnd like we've picked up that language and started using it.

1:08:55SPEAKERSo variant of concern is really like a public health phrase

1:09:00SPEAKERthat is really just like, hey, we spotted this strain

1:09:03SPEAKERthat has shown these, you know,

1:09:06SPEAKERsomewhat like interesting effects on transmissibility

1:09:10SPEAKERor infection and like we got to keep track of it,

1:09:13SPEAKERbut we have nothing solid necessarily to say about it.

1:09:16SPEAKERAnd then there's variant of interest too.

1:09:18SPEAKERThat's also like a thing, you shouldn't worry about that.

1:09:22SPEAKERWhat's important is the vaccines being effective

1:09:26SPEAKERagainst those things.

1:09:27SPEAKERSo the news will break through

1:09:30SPEAKERif there is a variant or a strain

1:09:34SPEAKERthat is evading the vaccines, trust me, it will get to you.

1:09:38SPEAKERAnd that's the thing to be concerned about.

1:09:40SPEAKER- Johnson and Johnson blood clotting thing broke through.

1:09:42SPEAKERIt's not an issue.

1:09:45SPEAKERAre we testing enough in the US now

1:09:47SPEAKERto know what's actually going on?

1:09:50SPEAKER- I do believe like we've kept testing rates high enough

1:09:55SPEAKERto have a good understanding of community spread.

1:09:59SPEAKERMore testing, especially rapid testing can be helpful,

1:10:04SPEAKERespecially in contexts where we're like going back to school,

1:10:08SPEAKERgoing back into offices.

1:10:11SPEAKERI think those are gonna be useful figures.

1:10:13SPEAKERSo I wanna see a ramp up of like the at home

1:10:16SPEAKERand those rapid tests that can help people

1:10:18SPEAKERmake decisions on the fly.

1:10:22SPEAKERWhat we don't do enough of is the genomic epidemiology,

1:10:27SPEAKERlike the genomic surveillance of potential new strains.

1:10:32SPEAKERWe need to get more of that up.

1:10:34SPEAKERThat's more of an issue for state and federal governments

1:10:37SPEAKERto increase the capacity to do that.

1:10:39SPEAKER- Okay, is there anything we forgot to ask you about

1:10:41SPEAKERthat you think is important to share?

1:10:45SPEAKER- I think what's important to share is like,

1:10:47SPEAKERI feel optimistic, you know?

1:10:50SPEAKERAnd it's okay to feel optimistic about the future.

1:10:58SPEAKERI've had a hard year,

1:10:59SPEAKERnot nearly as hard as so many out there.

1:11:03SPEAKERI've been--

1:11:04SPEAKER- I think everybody's had a hard year.

1:11:05SPEAKERLike even if you were relatively untouched,

1:11:07SPEAKERit's been an awful year.

1:11:08SPEAKER- Yeah, and I am allowing myself based off of the evidence,

1:11:14SPEAKERbut also just based off of things that we're seeing

1:11:18SPEAKERout in the world to be celebratory in this moment.

1:11:22SPEAKERSo every time I see somebody post a picture

1:11:24SPEAKERof them getting vaccinated, I feel joyous

1:11:28SPEAKERbecause it's like one step closer

1:11:31SPEAKERto us really moving past this and that's great.

1:11:35SPEAKERAnd I think people should have the license

1:11:39SPEAKERto feel good about things.

1:11:42SPEAKERIt feels almost weird to say that

1:11:45SPEAKERas somebody that like works in science communication,

1:11:47SPEAKERbut I think it's important

1:11:49SPEAKER'cause I don't think we scratched the surface

1:11:50SPEAKERon like some of the mental health outcomes

1:11:53SPEAKERfrom this pandemic.

1:11:54SPEAKERAnd so it's important to start shifting that mindset

1:11:59SPEAKERif that's where you're at.

1:12:01SPEAKER- I think, I mean, I think that is the one,

1:12:03SPEAKERtalking to parents and friends,

1:12:05SPEAKERI think that is the one thing

1:12:06SPEAKERthat nobody is really prepared for now

1:12:09SPEAKERis how hard this is gonna be on,

1:12:12SPEAKERlike how challenging it is.

1:12:14SPEAKERLike it's weird going out in the world

1:12:15SPEAKERand seeing 50 people in one place now after a year of this.

1:12:20SPEAKERAnd there's mental health implications

1:12:22SPEAKERfor all of that stuff, so.

1:12:24SPEAKERAnyway, thank you so much, Kishore, for coming by.

1:12:27SPEAKER- It's always fascinating to get your expertise.

1:12:30SPEAKER- We'll let you go and wrap up our other business,

1:12:33SPEAKERbut is there anything you'd like to plug?

1:12:34SPEAKER- I'm on the Tested podcast.

1:12:37SPEAKERThis is only a test pretty much every week,

1:12:40SPEAKERso you can come there and hear me opine about science,

1:12:43SPEAKERbut mostly go into conspiracy theories

1:12:46SPEAKERabout the latest Marvel show.

1:12:48SPEAKERAnd I'm also on a Winnipeg Jets hockey podcast

1:12:52SPEAKERthat literally dozens of people listen to

1:12:54SPEAKERif you want to hear me really get animated

1:12:57SPEAKERabout things that are of little or no consequence.

1:13:00SPEAKER- What's the name of the podcast

1:13:01SPEAKERand where can people find you on the internet?

1:13:03SPEAKER- It's called the Jet-Centric podcast

1:13:05SPEAKERand I'm @ScienceKish on the Twitter and stay cum bless.

1:13:11SPEAKER- Well, all right, with that said.

1:13:13SPEAKERThank you, Kishore.

1:13:14SPEAKERThank you so much for coming by.

1:13:15SPEAKERAnd next time we'll have to have you on

1:13:16SPEAKERto talk about something that's really super duper fun

1:13:18SPEAKERinstead of just like we're gradually improving, so.

1:13:23SPEAKERAnd as always, thanks to all of our fabulous patrons

1:13:27SPEAKERwho support the tech pod every single month.

1:13:31SPEAKERWhether you're in the $2 tier

1:13:34SPEAKERand just hanging out in the discord and chatting,

1:13:35SPEAKERwe've had a lot of people come in this month, Brad.

1:13:39SPEAKER- Yeah, it's been nice.

1:13:40SPEAKERAn influx, you might call it.

1:13:42SPEAKER- Yeah, and as we'd hinted at,

1:13:45SPEAKERwe're going to be changing the tiers before too, too long.

1:13:47SPEAKERSo if you want to lock in at that $2 rate for the discord

1:13:50SPEAKERor the $5 rate for the patron only episode,

1:13:53SPEAKERthat was the time.

1:13:55SPEAKERYou can find out more at techpod.com/...

1:13:59SPEAKERI'm going to do that part over again.

1:14:00SPEAKER- Nope, come on, you got it.

1:14:02SPEAKER- You can find out more at techpod.content....

1:14:06SPEAKERNope, that's not a leader.

1:14:08SPEAKER- Now you definitely can't take this out.

1:14:11SPEAKER- You can find out more at patreon.com/techpod.

1:14:14SPEAKERThat's patreon.com/techpod.

1:14:18SPEAKERWe added a new channel the other day.

1:14:20SPEAKER- Is that the exercise channel?

1:14:23SPEAKERI think I called it...

1:14:25SPEAKERHang on, I saw it this morning.

1:14:26SPEAKERI thought it was a pretty good name.

1:14:27SPEAKERDon't tell me.

1:14:30SPEAKER- Get swole or something, something.

1:14:32SPEAKER- Get swole or something, something.

1:14:33SPEAKERYes, exactly.

1:14:34SPEAKER- Yes.

1:14:36SPEAKER- But yeah, so like this morning there was a conversation

1:14:38SPEAKERin general about cars.

1:14:40SPEAKERWe're not, we're trying to like not add too,

1:14:42SPEAKERtoo many more channels.

1:14:44SPEAKER- Really got a lot now.

1:14:45SPEAKER- I mean, but they're active.

1:14:47SPEAKERSo I don't, I kind of don't feel bad about having them.

1:14:51SPEAKERIt's a lovely place.

1:14:52SPEAKERI love coming in and hanging out on the mornings

1:14:55SPEAKERwhen I have a moment free and can dip in

1:14:57SPEAKERand see what people are chatting about.

1:14:59SPEAKER- I was sitting there at 6 a.m. this morning

1:15:01SPEAKERtalking to somebody about retrobriting.

1:15:04SPEAKER- Wait, what's retrobriting?

1:15:05SPEAKEROh, like flashing somewhere on a retrode?

1:15:08SPEAKER- No, it's a chemical bath.

1:15:10SPEAKER- What?

1:15:11SPEAKER- That you put your old yellowed video game consoles in.

1:15:14SPEAKER- Oh, but they just redo yellow immediately, don't they?

1:15:16SPEAKER- Is it immediate though?

1:15:17SPEAKERLike a few months.

1:15:18SPEAKER- Yes, it can recur, but it's not,

1:15:20SPEAKERI don't think it's instant.

1:15:21SPEAKER- We did a bromide.

1:15:23SPEAKEROne of the early huge hits on Tested was a bromide story

1:15:28SPEAKERthat I think Wes Fenlon wrote.

1:15:29SPEAKERI can't remember.

1:15:30SPEAKERIt might've been Matt Braga or Jason

1:15:31SPEAKERor somebody else I can't remember, but.

1:15:34SPEAKERYeah, so anyway, thank you to everybody for listening.

1:15:36SPEAKERThanks for supporting the podcast.

1:15:37SPEAKERThanks for telling your friends.

1:15:39SPEAKERAnd as always, a super special thank you

1:15:41SPEAKERgoes to our executive producer, Level Patrons,

1:15:45SPEAKERThe Bunny Fiend, Jacob Chappell, and James Kamik.

1:15:47SPEAKERThank you all so much.

1:15:48SPEAKERWe appreciate it.

1:15:49SPEAKER- Yes, very much so.

1:15:51SPEAKER- And I guess that'll do it for us this week.

1:15:52SPEAKERWe will be back next Sunday with more TechPod.

1:15:57SPEAKERBrad, do you have any closing wisdom for the folks at home?

1:16:00SPEAKER- Oh my God, eat your Wheaties?

1:16:03SPEAKERWait, they didn't pay for a spot.

1:16:04SPEAKER- Yeah, no.

1:16:08SPEAKEREating fiber is healthy.

1:16:09SPEAKER- Yes, eat your nondescript generic fiber cereal of choice.

1:16:15SPEAKER- Perfect.

1:16:16SPEAKERSee you all next week.

1:16:17SPEAKER(upbeat music)