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Things Discussed on Episode:
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Things Discussed on Episode:
You're listening to the pandemic podcast. We equip you to live the most real life possible in the face of these crises. My name's Matt Boettger and I'm joined with not one but two good friends. Dr. Stephen Kissler and epidemiologist, the Harvard school of public health and Dr. Mark Kissler, a doctor at the university of Colorado. Hello, U2. How is it going? Good to see you, buddy.
Mark Kissler:Thanks. Yeah, it's good to be back. It is. It's good
Matt Boettger:to have you back. It's good to have you back. And Stephen, good to see you as always a, Hey, you guys, miss men, a few words, which is usually not the best people to slate for a podcast.
Mark Kissler:What are the many reasons really
Matt Boettger:it's us. It's like, it's like, yeah, anyway, I'm not even going to go there, but anyway, nonetheless, it's great to have you guys there's a lot to talk about. I mean, some of it's kind of the same old stuff from last week, it's the Delta and all this kind of frightening stuff with the surge and all these infections. And. But I think we're gonna start with mark and just a couple of minutes, because since we haven't had him for a few weeks and mark, you just got off the coast, the rounds. So I think you have a pretty unique perspective that we haven't been able to give to our listeners for quite a few weeks, if not months. Cause even, even when you were back with us a few weeks ago, I don't think you were on the COVID team at that point in time. And so maybe you were, I don't remember. So we'll talk about that in just a second, but before. Before we get started just a couple small, normal things. If you can support us, we greatly appreciate that. Greatly appreciate that patrion.com/pandemic podcast as little as$5 a month. Cause along the way, or just a one-time donation, Venmo, PayPal. Those are all in the show notes and get them right there. And please, please leave a review. It encourages us. It keeps us going. We like to read them ourselves and we'd like to read them on the podcast as well. So please do that if you can. And if you wanna reach out to us, let us know how you are doing. If you have questions for us, Matt, at living the real.com and I promised to forward those on to mark and Stephen. So let's get going, mark. I want to give you the floor right away, because this is our second take because we've had some technical technical issues. It's we kind of surprise. They're really surprised mark on
Mark Kissler:chronic chronic listeners are gonna be shocked,
Matt Boettger:becomes complicated. So mark, why don't you go ahead and just kind of tell us what's been going on at the hospital and how that's been kind of. How you've been dealing with that psychologically, emotionally, and just as, as a team in the hospital as well.
Mark Kissler:Yeah. I mean, I think I have a lot of thoughts. It was, it was quite a week and I, I, I'm sensitive to the fact that you know, there's so many things sort of swirling around, you know, as I leave the COVID team this week. There's a little bit of disappointment and a little bit of frustration. I really don't want our narrative on this show or our narrative, you know, in general to be one of perpetual crisis. You know, like here comes here, comes another crisis here comes this. Here's what you need to worry about. Everybody's got to stay super safe, you know? And has never really been the goal of, you know, what I want to communicate. Ideally, we're, you know, we're just talking about what's going on, but I have to say, you know, here we are you know, August, 2021 and w and we're starting to see some of the same patterns that we were seeing last, you know, last fall With some very distinct differences. And the, the biggest difference. And I think the thing that if I'm completely honest is really affecting sort of morale and the sense of what, you know, what we're doing in the hospitals, that a significant portion of the morbidity that we're seeing a significant portion of the severe disease. Okay. It feels preventable at this point in a way that it didn't earlier in the pandemic. And you know, and I think I'm You know, as we've talked about it, you know, I am sensitive to want to be sensitive to sort of all the reasons why there's complexity hesitancy around these vaccines and at the same time, the subjective experience of being in the hospital and seeing preventable disease over and over and over again, and seeing it begin to increase, you know, being on the COVID team a month ago and having us have a real low, you know, slump and patients feeling like we're getting back into the communities. And then to feel right now as if we might be on the verge of, you know, needing to do some distancing again at the communities, you know, and this and that, and perpetually, you know, having the same conversations over and over and over again. And while there's different variations, you know, different reasons for not getting the vaccine and different that they're there. Wishing for a, sort of an internal consistency amongst those narratives. And it's just not, there's just a tremendous amount of fragmentation that seems to me to be really expressing at the core. What is kind of this feeling, you know, this uneasy uneasiness that I'm not at least in, in what I've encountered, hasn't born up to the kind of rational scrutiny that I. You know, to, to make a really serious decision that affects one's own health one's family's health and the community's health. Does that make sense? Am I talking around this too much? That at the end of the day, I'm, I'm frustrated, I'm tired. And so are a lot of my colleagues and I don't think that it's just frustration at other people, you know, or just frustration, apt people who are don't have the vaccine. It's a little bit of frustration at the S the situation and yeah. And, you know, seeing this you know, yet again, you know, here we are 18 months in. And, but also feeling a little bit like a puzzlement is how do we get, how do we get some more traction? You know, how do we get a little bit more more of this conversation out to communities who, who need it, because in some ways it feels like maybe we're just talking to people who agree.
Matt Boettger:Yeah. I, I'm glad you bring this up mark. Cause I don't even know how to. You know, talk about this without, you know, I know everybody has their own way, they're processing these things, but throw it to you, Stephen, like, I would imagine this is somewhat of a discussion piece among your colleagues and what's going on like how do we, you get the message out of, or what's broken and what's going on by which. It seems so obvious now with, well, over 90% of the people coming to the hospital being unvaccinated, does it go, that's just the case, right? So for your own self preservation, you know, you just want to compare to the, you know, what the side effects of getting vaccinated. It's not even, it's not even not even close. So like, is there a talk about among you guys right now? Like what, what on earth do we do to help people? Yeah, she does see it, the safety
Stephen Kissler:of it. I mean, it's yeah. It's, it's such a. Yeah, it's a complex and nuanced issue. I mean, I know that a number of months ago we had one of Mark's colleagues on who's an expert in vaccine hesitancy. So there are people who devote their entire research careers to understanding exactly this phenomenon. But I mean, Mark was speaking about as well that this is also really a moving target. And the thing that constitutes vaccine hesitancy can look different in different places at different times in different people, depending on the vaccine, depending on the political climate, depending on, you know, all sorts of different things, depending on the perception of risk And so that makes it really hard to study and to understand vaccine hesitancy as such. I think that there are some common themes that run throughout these different aspects of vaccine hesitancy that have you know, really Been a consistent part of the public health dialogue over the last, you know, even decades. But really, I mean, the, the, the way that vaccine hesitancy looks has changed the people who are prone to vaccine hesitancy as it to some degree shifted in some ways And and so, I mean, just, just for an example, you know, one of the big issues with vaccine hesitancy for the measles vaccine prior to the COVID pandemic was generally sort of very well off. Families in California who weren't vaccinating their kids. And it was sort of associated with you know, almost this sort of, if we're, if we're looking at the political spectrum, it was sort of on the far left, in some sense, if we're speaking in very broad strokes that like vaccine hesitancy was the greatest problem. And that seems to sort of be shifting and swaying as, as time goes. And I think really what that's getting to is that the political spectrum is really not a good yardstick for measuring whether or not a person is going to be vaccine hesitant. And I think that's one of my big frustrations about the conversation right now is that it sort of digs into this broader discussion about what does it mean to be vaccine hesitant this lens that we seem to apply to everything about left and right. Red and blue, whatever. It doesn't seem to hold up here. Totally. There, there are trends for sure, but those trends aren't consistent over time. And so there's something else going on here that we really need to understand that it doesn't just boil down to political preference. And so I think that's the thing that is interesting to me. And that's the thing that's still remains a big, a big mystery. It would be potentially interesting to, you know, talk about some of the specific elements of vaccine has a tendency that we've talked about or that I've heard arise. That includes No, the ethics of receiving the vaccine, the ethics about the ways in which it was. Developed and produced the safety profile as well as, you know, different degrees of, of misinformation about past vaccines and their effects on a person's longterm health and these kinds of things. So I think there are all of these different sort of aspects to it, and it might be valuable at some point to dig into each of those objections at some point. But I think also one of the things that mark was talking about is that it, that that can be valuable, but, but I also don't know if that's. Issue here. I think that there's, there's something about ticking off each of these arguments that that's still wouldn't necessarily be sufficient to convince a person who is vaccine hesitant to then receive a vaccine. So there's something even deeper going on here. That, that I don't claim to understand, certainly. People are thinking a lot about, but it would be interesting to discuss with you guys.
Mark Kissler:Yeah. And I think, you know, thank you. I would love to hear and just kind of sit in on an episode where we go through some of the major, you know, I know that there's been some some of this done and in the broader media too, about like engaging in dialogue with people who haven't gotten the vaccine and what are their reasons. And there's actually. Lot of different reasons and a lot of different motivations and kind of going through maybe some of the big ones of that and discussing. Those affect different people in our communities and families, you know, all over the board. On the other hand, I don't want to harp too much on some level. I think, yeah, I think that this vaccine hesitancy issue is maybe a second layer to that. There's underneath that. There's a bigger conversation around trust of, of the medical system and like what's going on there. And I think there's some definitely, definitely some valid critiques about the way that, you know, medicine. Has seen too to overreach in certain ways you know, with certain communities and different historical locations. And I think there's a lot of a feeling of that, you know, I've, I've read some interesting articles that are coming. They're sort of framing the pandemic. And what I'm saying, being up to here is the sense that you know, we, I think we can focus on vaccine hesitancy as, as a phenomenon in itself, but I think there's another phenomenon that that's nested within, which is how. What do we think about the relationship between medicine, science, society, and culture? That's a very big question, right? But I've seen some interesting articles that, that have sort of framed the shutdowns of the last year and recommendations of public health experts as a S as a certain sort of power grab, you know, that there's this, there's this medical industrial machine that saw the pandemic as a chance to exert control. Over society or to like broaden, you know, the reach of these, these forces that want I don't know. I don't know exactly understand what these hidden motivations are. The people are, are feeling and, and it seems to paint medicine and you know, in is a little. Organized and I think it really is. And so I, I do agree. I mean, I think there are ways that medicine can be, you know, like I like the word totalizing, are you familiar with that term or that idea that, that there are ways of thinking about kind of medicine and science that sort of take all elements of human existence and put it under this frame. And in that way, that kind of. You know, I think there's good. There's, there's good. You know, we've got to be able to think outside of, you know, purely kind of a utilitarian calculus of like, what's going to give the most number of life years, you know, there's other goods, we've talked about this a million times, right. And there's ways that, that a purely kind of medical scientific frame might flatten other elements of human existence, you know? Goodness relationship, things like that, but I'm not convinced that this, this, this pandemic to me seems to be a different case. You know, a lot of people I think are framing this as like, this is a lot more of the same and that there's this kind of systematic overreach. And from the inside, that's not how it feels, you know? And, and it's hard for me to not at this point, start to take some of those arguments personally. It's hard for me to not start to feel as if this, you know, this perpetual, like, you know, oh, they, you know, big, big government, big medicine. They want us, they want to control us. They want to take away our freedoms. You know, when I, and my colleagues have been putting our families at risk for the last 18 months, you know, and, and not to be overdramatic. You know, particularly at the beginning of the pandemic, when we didn't have a clue about what was going on, but we knew that this was real. You know, and, and that we're, you know, and we're still engaging in the same, same thing. And so much of this is preventable, you know? It's hard for me to not take some of these, these arguments deeply personally, you know, and say, that's not what's going on. You know, this is not a big power grab. This is a deep misunderstanding about what we're trying to do. And, and it's a misunderstanding that has affects on people's lives.
Matt Boettger:I don't know. I mean, this is, I'm glad you're saying this mark. I've been feeling for you and for doctors and nurses all around the country. I remember a kind of goes back to. They said to me, one of my memories is like maybe last April or when we were talking, I was talking to a friend of mine too, was dismissing hospitals being overloaded in saying, oh my gosh, I know all these people, these nurses, doctors, they're saying there's nothing going on in the hospitals. This is all just conspiracy theory. And, you know, Stephen, you broke it down for us to explain, this is the complexity of the situation where like, you're right, depending on what hospital you go in, it may be full and it may be not, but doesn't matter. Does it change the fact that there are a lot of hospital overrun and doctors and nurses being, putting their lives at stake, being exhausted, can't even care for the patients that are non-covered related and it's tapping the system. I feel like it's kind of this, this whole thing all over again and hearing your voice mark. I think I'm hoping it helps like to realize that there are real people, real doctors, real nurses in hospitals sacrificing their families too. And it's different, right? I mean, last fall. It was scary and the future was unknown, but there was like, there was a, there was a lack of control in some sense. Now there's like really a large sense of advocacy and, and, and it's not being used, which makes it all the more like, Kind of goes back to Abraham and he's talked about how, if there's one thing we learned from this pandemic is that we will, hopefully we'll realize we're, we're way more connected than we'd like to give credit for. And that anybody's decision to do something. Not to make a grave, but needs to have consideration of who would impacts theirs. And I think that that's been the greatest thing that you guys have been doing for us. And for me, particularly about when it comes to the vaccine, it's not just my own health. It's a, it's a bigger picture that I had to put in consideration.
Mark Kissler:Right. Yeah. It's amazing to me how much. And I don't know why I'm surprised at this, but I. It helped much their anecdotal, this anecdotal evidence for this personal experience continues to matter for people. So I have, you know, I care for a lot of folks in the hospital who are like, man, if I only knew if I, if I had only known, you know, I would have gotten the vaccine. And it's just surprising to me because it's not as if this information is not available. And, and similarly, you know, there's the, the conversations around like, oh, well now, now I'm going to take it seriously. Or now I'm going to, you know, now, now I understand I guess I'm not convinced that it needs to come to that point, that you need to experience it in your own body. In your own family, you know, and, and the shame of that, right, of course, is that who bore the brunt of so much of this early in the pandemic or these communities that are hidden away that are not, you know, not as mainstreamed or, you know, or vulnerable in other ways. And, and now all of a sudden. The realization is hitting communities that had been previously more sheltered from the effects of the pandemic. And it just seems to me that such a shame to not be able to enter into the experience, you know, the real experience of of other people in our communities and to change our behavior as a result of that, you know, and I recognize that there's, there's so many layers and I'm sure that I'm oversimplifying and I'm speaking out of my own, you know, limited experiences. And you know, not arguing necessarily, but it's more valid, et cetera, et cetera, but it's very hard. It's just very hard for me to, to dismiss what I've seen my own anecdotal evidence, what I've seen with my own eyes for the last 18 months. And but I don't think that that's, that there's like some, I have privileged access in the sense that I work in a hospital, you know, but it's not a secret.
Matt Boettger:I mean, I I'm, yeah. I'm, I'm, I'm speechless. I don't even know how, you know, where, where I've worked in the past and the hesitancies. And I, I can't explain it. I don't understand it. And it's frustrating to
Mark Kissler:know it. Yeah. And I don't want to, and I think maybe we can pivot a little bit, cause I don't want to just give, give vent to my own. But part of the reason that I wanted to be sure to come on today though, you know, it's just to speak a little bit out of the, the, the. The run of the experience of being on the words yet again, you know, and, and and, and really kind of attesting testing to this very significant difference in the morale and how it feels. And that I think has felt kind of across the board at least in my conversations and just sort of the general air and, and, you know, we take care of people all the time. Very rightfully so. All of us, you know, all of our diseases, every disease that you and I, and everybody's going to get has some relationship to choices we've made to our individual genetic makeup, where we, where we grow up and then things we do, you know, things we do to ourselves. That's, you know, that that's just the fact of life. So I'm not, it's not as if I, you know, I think that anybody deserves different care, you know, as a result of choices they made, that's, that's very fundamental that it doesn't matter, you know? And that, but, but at the same time I don't know. There's, it's just I can really sympathize in some ways with some of the doctors in, you know, in fiction that I've encountered in books, you know, over the years who have, who, who get this certain kind of world weary. And it's, it's very pragmatic, you know, it's, it's a very like, and I recognize the limitations of a suit of a super pragmatic outlook, you know, because sometimes we need our idealists and we need our, you know, big idea think thinkers and stuff. But man, I really sympathize with that and just feeling,
Matt Boettger:You know, doing a slight pivot but still on the same theme, like given what's going on and what you've experienced, how have things changed for you mark? Like now living this new kind of surge scene at the hospital. Clearly the idea of Lord have mercy. Please get vaccinate. That's clearly at the, at the forefront of your mind, are there other things by which, you know, you're now at, you're a family man, right. And you have kids going to school. And how are things been changing for you if at all, as you see this new surge coming on four, has your lifestyle changed a little bit or how school and the interest of school coming, coming along? How are things changing for you in that
Mark Kissler:area? Yeah, so you're, you're kind of asking about how does this affect kids going back to school and things like that. So we're getting our kids. My youngest is going back. This week he went, he went back and the big news here is that he is no longer a napper at school. And so he was a napper previously, and now he's a worker. This is why this sort of thing. And which means that he cruises on through nap time and crash is hard when he gets home. He was so tired. So tired last night. Yeah, I know. It's really cute. But We were fortunate in the sense that we were able to do a significant amount of in-person schools. I'm worried about how this school year is going to be. I think, I think it might be a little bit of a disaster because of how prevalent this Delta variant and how, how transmissible it is. And so if we shut down classes every time somebody gets. And I think, and this is another, you know, complexity because if every, if for the families who are able to be vaccinated having an index case within the classroom is not that huge of a deal necessarily. And I'm wondering if it's worth it to education and continuity to shut down an entire classroom of kids. You know what I mean? I think there's there's conversation. I, I'm not the public health expert in the room here, so I'm not. Go out, but, but at the same time, it feels a little bit from an educational standpoint, you know, we saw the ways that educational disparities widened massively over the course of the last year. And so then going into another school year and feeling like we might be lining up for the same thing again is a little bit daunting. And so, you know, I felt very, very fortunate both with our school community and our ability to kind of shuffle and move things around. You know, help our kids kind of continue to, to do, do stuff. But not everybody has that flexibility. A lot of people are working two jobs at this school. You know, a lot of, a lot of families at the school, we go to have a lot of just different constraints and shutting down school and keeping kids home is a very different prospect for them. And so yet again, you know, here we are at, at another kind of semi semi reversible or some like something we have control over in terms of how do we protect communities. School or school-related exposures. And I don't know, I don't know what's going to happen, you know,
Matt Boettger:and I mean, I'm curious for you mark, and then we can ask questions for Stephen as well, but I'm sure parents are out there are worried in some level as well of like taking their kids and going to school with a Delta. Okay. With your experience. I think it's good. Just to hear from you arc of like, how do you feel feeling with that and taking your kids, kids
Mark Kissler:school and, yeah, I dunno. It's always been much on my mind this year. And I think even though we know that the, that the severe diseases. Young kids is not near what it is in adults. It's always been something that has, I just have wanted to be extra careful about. And I've seen news articles about like, you know, now children's hospitals are seeing more cases and we're seeing a lot more kids getting it, coming down with it. I dunno. And this is another instance where I really don't want to be alarmist and say like, oh, it's a crisis. We got to stop everything. You know, cause kids are getting sick now. And you know, here we are in the world's on fire. And so I, but at the same time, I think, you know, it makes us think, you know, and think about ways that that, that our actions are just here, you know, who they are affecting real people again. Yep. I don't think, I, I don't know. I'd be interested to hear Stephen's opinion on, you know, if kind of what this means in terms of overall burden of disease in, you know, in, in pediatric populations and things like that on the whole, I don't feel panicked about Delta. And my kids you know, I don't feel as if it's, it materially changes a lot of things, you know, I think that some common sense masking here and there you know, common sense kind of being judicious about where we go and what we do but not being, you know, over scrupulous about it. Is it that's going to be the state of our lives through much of 20, 23. If we believe what the gentleman on the left here has written, you know, in the past. And so that's fine, you know, that's fine. To me, I'm more concerned. I think about some of these bigger picture implications and the ways that we might react and overreact to increasing cases in different pockets among kids.
Matt Boettger:Yep. Stephen, anything to say about that? Of like, I mean, here's the thing, like I see the same thing, increase hospitalization with children, this kind of stuff. And like our, all of our podcast episodes, I feel like Stephen, you can give insight to this, but it's probably just complicated because there's so many nuances to, to different culture. Now we have vaccinated parents with unvaccinated children dragging their children to places probably it's summer it's. I mean, there's just. It's it's, it's, it's a radically different Plainfield than last August, like radically. So seen 48% of children, you know, maybe getting infected of the, of those who'd be infected, not hospitalized, not hospitalized, but just infected. I'd imagine it's the complexity of this mixed bag of vaccinating and vaccines in summertime, right?
Stephen Kissler:Or, yeah, exactly. As far as we can tell. That's the story. It's, it's really interesting because my, many of my colleagues are, are sort of split on, you know, what we should be doing about schools. And to what extent we can safely reopen them. I, I tend to fall in line more with The ones who sort of seem to be also in line with what mark was saying, which is that there, there are at this point, some very common sense measures that we can take to keep schools pretty safe. Certainly the risk of severe acute disease in young kids is much lower than it is for adults. And that is not to minimize the fact that there is, there are absolutely risks to kids associated with this virus, for sure. And I think we need to, I mean, we, we need to remain mindful of those. It, the situation now is different than it was. Six 12 months ago a case no longer means the same thing that it did then because vaccination rates are much higher. The odds that a kid will spread disease to older family members is lower assuming that those people are vaccinated. And, and so I think that we're really, you know, the playing field is. Shifting layered on top of the fact that, you know, we, we know a lot more about masking. We know a lot more about ventilation and the importance of that. We, we have a much better sense of sort of how to. Control COVID in these situations. So, and, and as mark was saying, you know, closing schools is, is a massive disruption. It's you know, it, it, there, there are also public health implications for that too. That, that are very long lasting in the sense of more vulnerable populations falling behind in their education of adults who are working multiple jobs, not being able to take care of their kids. You know, there's, they're huge, huge issue. That we should be addressing on the side as well. You know, we should be thinking about, you know, how do we provide childcare for families who need it who can't afford it? You know, these things are also public health issues that we need to be thinking about. But in the meantime, you know, we don't have those structures in place. And so, so I think that it's, you know, it's, it's a complex landscape, but I do think that you know, shutting everything down for a single case in a school probably doesn't make sense anymore. If there's a major outbreak, then we can maybe start thinking about that for sure. But I think that, you know, schooling is so incredibly important. And I think that we do know how to really improve our odds at keeping that safe that we can just sort of move forward, even, even in the context of Delta. One last sort of point that I wanted to add to that is, you know, you're talking about rising hospitalizations and young kids, and there's been a lot of talk about, you know, does this mean that the virus is more severe. For young kids It's really hard to disentangle, but the same narrative was arising with the alpha variant B 1 1 7 earlier, too. And as far as I can tell, all of the patterns are consistent with it just being mortar infectious across the board. And so when that happens, you're going to expect to see more infections across all populations. But now with the differential in vaccination, between older kids, between older adults and young kids who aren't vaccinated, we expect the relative proportion. If people end up in the hospital with young kids to rise and we expect the overall number to rise just because it's so much more infectious. So everything that I'm seeing is consistent with just the Delta being more infectious and not necessarily being like targeting kids, particularly. And so I think that's all consistent with mark was saying too, is that it's worth it. Okay. Yeah, wearing masks in grocery stores and sort of being mindful of how many, how many people were seeing and how much time we're spending in doors with other people. The Delta is more infectious. And I think that that's really the bottom line is that we're just dealing with the virus. That's the same thing we've been dealing with. It is more transmissible for sure. And that causes issues, but not, not time to panic about it suddenly, you know, changing its entire age profile in terms of who it's infecting and who it's causing more severe disease in, I think
Matt Boettger:it. Go back to Mark's point and just, just shows you the complexity of all this, you know, I, and every day I'm in the news looking at what's, what's the highlights. What can we talk about this week? What's going on? And I see these highlights of like, you know, six-year-old, seven-year-old hospitalized, right? I'll get these like headlines. Right. And it's even hard for me, hard for me to be like, oh, is that propaganda? Or is that a real, like, you know what I mean? Like, like, are you, how are you trying to make it worse than it is to get people, to prepare them, to take the, and so I, you know, there's some level, some level of empathy, those people who I also has headlines of like, oh, you know, a 45 year old man, 50 year old man regrets, not getting the vaccine. He's done. He's in the ICU. It's a headline. It's powerful. But I wonder sometimes like, okay, why did, why is that there? Is it, is it there to persuade people? You know, is it an outlier? It just makes things complicated. Right. And it's like, it makes it, then I feel like it's a political issue and I'm on this side of the pandemic. Like I'm on this side, like it's, so it's just, the media makes it really hard. Even messes with my head. This is why I have to be with you guys every Monday or Tuesday now, so I can get clear. So, one thing I had a transition to, cause I think this is really, really. And this is like miscommunication misunderstanding. And I was going to go straight to this because it's the, the Rogan show, right? Where is it at here? Joe Rogan is getting this completely wrong. As the title, put this in the show notes, it says the scientist who conducted the vaccine study. So I want to give the floor to you, Stephen. Cause you just. Saw a talk with this, this read fellow who Rogan took is like a 2004 15 vaccine study. And basically to put it in a quick synopsis, for all those who are listening, who hasn't read, haven't read or listened to Joe Rogan, he, Joe Rogan used this vaccine study to suggest that those were getting the vaccine may be actually harboring environments for the vaccine to create multiple variants and make our life Indian worse. That's the conclusion that Joe Rogan is making from this vaccine study, the scientist himself says, Gerald got all wrong. Stephen, you want to help give us some clarification of what this site, the, this, this, whatever this study was. And what's the real implication, how it's related or unrelated to the COVID vaccines.
Stephen Kissler:Yeah. So this is this study was by a colleague named Andrew Reed. And who was it? Very highly respected you know, in the field, but also by me personally I think he's done really great work and he's very clear I had about the findings of his studies. And, and I think that actually the, so the, I was recently in a workshop in which he. Spoke about this exact study that Joe Rogan was talking about. And, and I think that was really exemplary of how he was able to dive into the nuance of the study. I mean, he was, he was very clear about the fact that, so, so let's give some background to this study, right. So, so first of all, this is a study that was done in chickens. Okay. And so chickens get infected with viruses like humans. They have immune systems like we do their immune systems differ from ours. And but we were looking, they were looking at a vaccine that prevented severe disease and death from a virus that infects chickens no critically, you know, they, they ran this study. They were looking at this vaccine and they did find that concurrent with vaccinations, some new variants of the virus emerged. That were both more transmissible and, and I think slightly more clinically, clinically severe, I don't know if chickens have clinics, but so, but either way, so, but the important thing about this is there is really two things. So first of all, the vaccine had no effect on transport. So if you have a vaccine that can reduce the severity of illness and provides, you know, some testing against the progression of illness, but provides no protection against transmission, then sometimes you can get new variants that emerged that that do some of these strange things. But the most important finding about all of this is that the. Vaccinated chickens were still protected against severe disease and illness. Even from the variants, even though their risk increased with the variants, that risk was still much lower than the risk that the chickens that were unvaccinated were facing. And so in some ways that's very consistent with what we're seeing with COVID is we are seeing new variants emerge. But still the risk that vaccinated people face from these variants is much lower than the risk that unvaccinated people face from the variants. Now there comes, the issue of is getting vaccinated, driving the development of these variants. There've been a lot of sort of studies around this and, and I think that there's, there's some confusion because it's. It is, it is, you know, the, there it is true that intermediate rates of immunity in a population under certain circumstances can contribute to the evolution of new variants that are more transmissible. And sometimes that are more severe, but really what the virus wants to do is to be able to spread more easily it's yeah. Necessarily trying to become more severe. And I know I'm speaking as if I'm giving this virus agency, but that's, you know, roughly speaking sort of, you know, we can talk about the evolutionary things that lead to that. But, but the key thing here too, is that If that happens with natural infection. I mean, it's, it's not that being vaccinated is going to be any worse than getting infected with COVID that both of those things are going to select from more infectious variants. And so actually the best thing you can do is, is get vaccinated. Even better at preventing infection and severe disease than a natural infection with COVID because that actually pushes us towards the edge where it keeps the viral population much lower and it gives, it gives it fewer chances to evolve. That's very clear that's that? That's true in the chicken study. That's true in human studies that we've, that we've conducted in the modeling studies that, you know, It's not vaccination per se. That's, that's selecting for these variants. It's just the fact that there's intermediate rates of immunity in the population that can select for the variants and the best way to prevent that is to get vaccinated, frankly. And, and that's, that's been a very consistent finding across many different studies with different approaches. And so it's, you know, it prevents disease. It prevents the virus from mutating and evolving in the ways that we don't want it. To the extent that we're able, especially with vaccines, like the ones we have for COVID that do prevent infection. So
Matt Boettger:great. No, thanks. Thanks for bringing light to that. I really appreciate that. You know, I think that might get to the end. Any last words for you guys before we wrap this up and we're good. Well, thank you all for listening. Mark, thanks for coming on and just telling us like what's going on in your world and how you're processing this. And I really hope for those who are listening to share this particular episode, because I think more than anything, it's one thing to hear it from CNN. It's one thing to hear it from Fox or whatever, but to hear it from just somebody who is just on a podcast, this is their profession. This is what they're experiencing to help people who are unvaccinated, who are hesitant. Don't really know what to do, just to hear a bigger picture of the story that, you know, like, like, like mark said, that we don't get to see it's a maybe unfortunate privilege that mark has to able to see and hope to encourage other people, to take the leap, get vaccinated and help reduce this so that we can live a more, more normal life. Hope you guys have a wonderful week, take care, and we'll see you guys next Monday. Bye-bye.