Joe Rogan Experience #1439 - Michael Osterholm

1. 0:00 – 15:00

   All right, here we…

   1. JRJoe Rogan0:02

      All right, here we go. Uh, so what you said when you sat down was absolutely perfect, that the timing could not have been better. Well, tell everybody what you do, Michael.

   2. MOMichael Osterholm0:11

      Well, thank you. I'm a, for a lack of a better term, a medical detective. I've spent my whole career tracking infectious diseases down, trying to stop them, trying to understand where they come from so we can make sure they don't happen in the first place, but most of all, trying to respond to situations just like this.

   3. JRJoe Rogan0:27

      Just like this. And, um, just o- off the bat, how serious is this? Is this something that we need to be terrified of or is this overblown or... ho- how do you stand on this?

   4. MOMichael Osterholm0:37

      Well, first of all, you have to understand the timing of it in the sense that it's just beginning. And so in terms of what hurt, pain, suffering, death has happe- happened so far is really just beginning. Um, this is gonna unfold for months to come yet and that's, I think, what people don't quite yet understand. Um, what we saw in China, uh, I'm convinced as are many of my colleagues, as soon as they release all of these, uh, social distances, these mandated stay in homes, haven't left their home in weeks and weeks kind of thing, when they go back to work, they're on planes, trains, subways, buses, crowded spaces, manufacturing plants, even China is gonna come back again. And so this really is acting like an influenza virus, something that transmits very, very easily through the air. We now have data to show that you're infectious before you even get sick and in some cases quite highly infectious. Just breathing is all that you need to do. So from this perspective, I can understand why people would say, "Well, wait a minute, flu kills a lot more itself every year than this does." And I re- remind people that this is just the beginning. Probably the best guesstimate we have right now on what limited data we have would say this could be at least 10 to 15 times worse than the worst s- seasonal flu year we see.

   5. JRJoe Rogan1:46

      10 to 15 times worse in terms of fatalities or...

   6. MOMichael Osterholm1:48

      Yeah, yeah. And, and just illnesses. In fact, I just, I brought some numbers. We, uh, conservatively estimate that this could, in, uh, require 48 million hospitalizations, 96 million, uh, cases actually occurring, over 480,000 deaths that can occur over the next three to seven months with this situation. So this is not one that to take lightly, and I think that's what I can understand if you say there's only been 10 deaths or 20 deaths or 50 deaths. Just remember, two weeks ago, we were talking about almost no cases in the United States, and now that we're testing for it and watching the spread as it's unfolding, uh, those numbers are going up astronomically. Three weeks ago, Italy was just living life just fine. Now they're literally in a virtual shutdown in the northern parts of Italy. And that's the challenge with an infectious disease like this. It can spread very quickly and it also can infect people. I think maybe to put this into modern terms, because this is something we think of often when we think of, of, you know, pre-antibiotic days, you know, the old time medicine. Um, we have an employee at our Center for Infectious Diseases Research and Policy at the University of Minnesota, and she has a dear friend who lives in Milan, Italy, and she works at a hospital there. And she texted us to... this employee of ours last night, and this was an email that came out yesterday from one of their physicians in Milan at the largest hospital there. He said, "I just got a very disturbing message from a cardiologist at one of the Milan's largest hospitals. They're deciding who they have to let die. They aren't screening the staff anymore because they need all hands on deck, and they have very small areas of the hospital dedicated to non-COVID patients where they still screen doctors. Everybody else is dedicated to COVID patients, so even if they're positive, meaning that they're sick, they don't... and, but they don't have a severe cough or fever, then they have to work." Uh, he says that, that they're seeing an alarming number of cases in the 40-something range, and it's h- these are horrible cases. So we need to stop thinking that this is only an old person's disease. This is what's going to unfold not just in Wuhan, it's unfolding in Milan, it's unfolding here in, in Seattle, and this is what's gonna continue to rollingly unfold throughout the world.

   7. JRJoe Rogan3:59

      Yeah, where did this rumor come from that it's, uh, an old person's disease? Is it just because the majority of the people that have died from it so far have been older?

   8. MOMichael Osterholm4:07

      Yes, in fact, that's the primary risk factor for dying is being old and then having certain underlying health problems. For example, in China, uh, those men over the age of 70 who also smoked were 8 to 10% of them died. 65% of older Chinese men smoke. The, uh, case fatality rate or the percentage of people who die in women in that same age group was only about 2%. In that case, w- very few women smoke. Now, the challenge we have is that that's the Chinese data, but there are a series of risk factors that we worry about that if they overlay on this disease are gonna cause bad outcomes, and we happen to be right at ground zero for one of the major ones here in this country, and that's obesity. Uh, we know that obesity is just like smoking in terms of its ability to really cause severe, life-threatening disease and 45% of our population today over the age of 45 in this country are obese or severely obese, and it's men and women. So one of the concerns we have is we're gonna see more of these, uh, what I guess I would call very serious and life-threatening cases occur in our country because of the set- different set of risk factors than we saw in China.

   9. JRJoe Rogan5:16

      Now, y- you mentioned that there's some sort of an incubation period before people become sick, they're still contagious. What is this incubation period and how do we know about it?

   10. MOMichael Osterholm5:27

       When we call something an incubation period, we're talking about from the time you and I got exposed, meaning I was in a room breathing the air that somebody else who was infected, uh, with the virus was expelling out, I breathed it in. How long from that time period till the time period that you get sick...And what is that? It's, that's what we call the incubation period. So that's when case numbers can double or triple in every so many days. In this case, it's about four days. So... And we actually have data there from people who are exposed one time or one time only, and we know when they were exposed, where they were exposed, and how soon do they get sick afterwards. So the chauffeur in the car where an individual was sick or showing symptoms, then the chauffeur gets it four days later. You know, they were there one time and one time only.

   11. JRJoe Rogan6:10

       And if the chauffeur does not show any symptoms, he's still contagious? He could still give it?

   12. MOMichael Osterholm6:14

       He could, he could also-

   13. JRJoe Rogan6:14

       ... give it.

   14. MOMichael Osterholm6:14

       ... be contagious too or he... And that's one of the things that's challenging here, is you and I might get exposed to somebody who is totally asymptomatic, no symptoms. That virus that appeared, "Well, that's not a very strong virus." But in fact when it infects us, it could kill us. So we've seen cases of, of fatal disease that were exposed to people that had minor symptoms themselves.

   15. JRJoe Rogan6:34

       Wow.

   16. MOMichael Osterholm6:35

       And this is what's unfolding here, and, you know, and this is where I think is such an important... And, you know, I said why the timing is so important 'cause, you know, Joe, we've really gotta get information out to the public. There is so much misfor- information right now and, you know, we're gonna be in this for a while. This is not gonna happen overnight and I worry... I keep telling people we're handling this like it's a corona blizzard, you know, two or three days-

   17. JRJoe Rogan6:55

       Mm-hmm.

   18. MOMichael Osterholm6:55

       ... we're back to normal. This is a coronavirus winter. And we're gonna have the next three months or more, six months or more, that are gonna be like this. And, you know, so far this thing has been unfolding exactly as we predicted it. We in our center put out a piece, uh, on January 20th and said this is gonna spread worldwide. At the time people said, "Ah, no, it's just China." We put out a piece the first week of February and said this is gonna pop probably the last week of February, first week of March 'cause what happens is it has what's called an R naught or a doubling time of, of, of these every four days. So two, two... The increase is doubling every four days. So if you go from two to four to eight to 16, it takes a while to build up. But when you start going from 500 to 1,000 to 2,000 to 4,000, that's what we're seeing happen in places like Italy, we're beginning to see it in some ways up in Seattle, it's what happened in China. And, uh, you know, when people are confronted with that, suddenly this low risk phenomena that everybody talks about isn't so low anymore. And that's what we need to prepare people for.

   19. JRJoe Rogan7:52

       Now what can be done? Like, what, what can the average person do? I see people walking around with masks on, wearing gloves. Is that nonsense?

   20. MOMichael Osterholm7:59

       Largely. Yes.

   21. JRJoe Rogan8:00

       Yeah.

   22. MOMichael Osterholm8:01

       First of all, um, let's step back. The primary mechanism for transmission is just the respiratory route, it's just breathing. Um, in studies in Germany which just have been published literally in the last 24 hours, um, they actually followed a group of people who had been exposed to somebody in a automobile manufacturing plant, and then they had nine people that, with this exposure, they said, "If you have any symptoms at all, contact us. We wanna follow up." And they all agreed. Well, they got infected and so in the very first hours, just feeling bad, sore throat, they went in and sampled their throats, their, their saliva, their nose for virus, they did blood, they did stool, they did urine, and they found that at that very moment when they first got sick, they had incredibly high levels of virus, sometimes 10,000 times that what we saw with SARS, in their throats, meaning they were infectious at that point already and they hadn't even had symptoms yet of really any nature. They weren't coughing yet.

   23. JRJoe Rogan8:52

       Wow.

   24. MOMichael Osterholm8:53

       And, and that's where we're concerned because that's the kind of transmission that's tr-... You know, I always have said, trying to stop influenza virus transmission is like trying to stop the wind. You know? We di-... We've never had anything successfully do that other than vaccine and we don't have a vaccine here. So what's happening is that people in public spaces are getting infected and the way you need to address that is, unfortunately, if you're older, over 55, you have some underlying health problems which, unfortunately, a lot of Americans do, we have, uh, obesity, then right now you don't wanna be in large public spaces and trying to potentially get infected. So you can take care of that part. As far as what can public health do, we're not gonna... We can talk about this, we're not gonna have a vaccine any time soon. That's happy talk. Um, what we... You know, we can close schools. One of the big challenges we have right now, if we close schools, what do we accomplish? In influenza virus, when you, we close schools during outbreaks because it turns out kids are, get infected in school and they're like little virus reactors. You know, they come home and they transmit it to mom and dad and brothers and sisters and, uh, so we close schools sometimes and s-... Christmas breaks are always great for kind of putting a dampening effect on flu. In this case, kids are not getting sick very often at all, which is one of the really good news features of this disease. In Ch- China, only 2.1% of the cases were under age 19 years of age. And-

   25. JRJoe Rogan10:11

       Why is that?

   26. MOMichael Osterholm10:12

       You know, we don't completely know. Uh, and, and I'm gonna come to that in a second because they're getting infected, it turns out. One study showed that they still get infected with the virus but they don't get sick. And we have that happen. There's a disease called infectious hepatitis, hepatitis A, where we have outbreaks in daycares. And the way we know we have an outbreak is 'cause it's transmitted through the stool, fecal-oral, is mom and dad and the daycare providers all get sick and the kids, those symptoms, we go in and test the kids, they're all positive. So some diseases will manifest mi- primarily when you're an adult but not as a child. This one appears to be the same. So do we close schools or not if we're not really spreading the disease? Because it turns out that if we close schools, we... A recent study done showed that 38% of nurses today in this country who are working in the medical area have kids in school and if suddenly we're closing schools for two or three months, who's gonna take care of those kids? One fourth of the American population has no sick leave. If we close schools, they don't get paid if they have to stay home. So when you ask what can we do, we have to really be thoughtful about what we do. Are we doing more harm than good by closing schools, for example, even though everybody will say, "Oh, we gotta do everything we can." Or do we just tell people, "You know, it's gonna be limiting your contact as much as you can." And that's really about what we can do.

   27. JRJoe Rogan11:27

       And limiting the contact, is that really gonna help?

   28. MOMichael Osterholm11:29

       It does because it's like putting rods in a reaction. If you, if you don't have as much close contact, you can, you know, not transmit as much. If I'm, if I'm sitting in a room with 100 people and we're kind of sharing air, the transmission's remarkable.... right here, you know, off the coast of California, you've got your cruise ship. Cruise ships are-

   29. JRJoe Rogan11:46

       Mm-hmm.

   30. MOMichael Osterholm11:47

       ... notorious for recirculating air inside the inner cabins. We've had a number of outbreaks, a lot-
2. 15:00 – 30:00

   Jesus. You're making me…

   1. MOMichael Osterholm15:00

      system is rigged up to be and what this virus does once it gets into it.

   2. JRJoe Rogan15:04

      Jesus. You're making me nervous.

   3. MOMichael Osterholm15:08

      Well, but that's... Before we get done here, we're gonna talk about what we can do to get people not nervous, because this is-

   4. JRJoe Rogan15:12

      What? It's too late. (laughs)

   5. MOMichael Osterholm15:14

      No, no, no. What I mean is we're, we're gonna, we're gonna bring you around to take... You know, it's, my job is not to scare you out of your wits, it's to scare you into your wits.

   6. JRJoe Rogan15:20

      Let me ask-

   7. MOMichael Osterholm15:20

      What can we do about it?

   8. JRJoe Rogan15:21

      Sorry. Let me ask you something-

   9. MOMichael Osterholm15:23

      (laughs) .

   10. JRJoe Rogan15:23

       ... about sauna use. One of the things that I read was that, uh, if you are in contact, that 20 minutes in a sauna, in a, a really hot sauna is, uh, very good for killing some of the virus. Is that bullshit?

   11. MOMichael Osterholm15:38

       Yes.

   12. JRJoe Rogan15:38

       Jesus Christ, these people. Yeah. There was a, some sauna facts thing that was being, um, pushed around that it's great for flu and all sorts of infectious diseases.

   13. MOMichael Osterholm15:50

       Actually, it's great for you. I mean, it makes you feel good, but we don't have any evidence that makes any difference in infectious disease.

   14. JRJoe Rogan15:55

       Why is... So it doesn't have any impact at all? The, the idea was that the breathing in of the very hot air, uh, 180-degree air for 20 minutes will kill some of the virus.

   15. MOMichael Osterholm16:06

       See, if that temperature of 180-degree air got really into your lungs, your lungs would be fried. You'd be dead.

   16. JRJoe Rogan16:11

       Well, how does it... Where does it go?

   17. MOMichael Osterholm16:12

       So, so, so what happens is, just from the time you breathe it in and what, you mix it with the air there-

   18. JRJoe Rogan16:16

       Mm-hmm.

   19. MOMichael Osterholm16:16

       ... it's kind of like taking a, a cup of hot water and putting it into a bathtub of cold water.

   20. JRJoe Rogan16:20

       Ah.

   21. MOMichael Osterholm16:21

       And so what happens by the time you get done, it's not that hot. And so in this case, your lungs couldn't stand even 110 to 20-degree heat without causing really severe damage. And so it doesn't kill the virus at all.

   22. JRJoe Rogan16:34

       So it would... The virus would have to be, like, just in your mouth or something like that? Even then, no?

   23. MOMichael Osterholm16:38

       No. No. Wouldn't-

   24. JRJoe Rogan16:39

       Jesus, Michael. That's unfortunate because that was, uh, that was exciting. I was reading that and I was like, "Wow."

   25. MOMichael Osterholm16:47

       Don't stop using the sauna. It's a good thing to use-

   26. JRJoe Rogan16:49

       Oh, sure.

   27. MOMichael Osterholm16:49

       ... for your skin and everything else, but, uh, yeah, but it's not gonna help you with this one.

   28. JRJoe Rogan16:53

       So how does it cool the air down? What's, what's happening? Can you-

   29. MOMichael Osterholm16:57

       I- in terms of when you, when you ingest it?

   30. JRJoe Rogan16:57

       It's going right into your lungs, right?
3. 30:00 – 45:00

   Well, what happened was…

   1. JRJoe Rogan30:00

      the jump to humans, I mean, it has made the jump to, I believe mice. Is that the case?

   2. MOMichael Osterholm30:04

      Well, what happened was e- originally it didn't, and so that was some of the data that was used to support, "Ah, it's not a problem."

   3. JRJoe Rogan30:10

      Right.

   4. MOMichael Osterholm30:11

      Now, these are what we call humanized mice or mice that are basically much more like a human, we're now seeing that jump occurring. And these new strains, see, the strains that, again, were around 20 years ago are not the same ones today, 'cause as these prions continue to pass from animal to animal to animal, they go through these little minor mutations and they're getting more and more and more like what a human transmissible prion might look like. So in these mice studies now that are really made to mimic a human, we're starting to see that jump.

   5. JRJoe Rogan30:41

      Yeah. And folks, if you've never seen a deer with CWD, you should go and Google it 'cause it's terrifying, the idea that that could make that jump to human beings and-

   6. MOMichael Osterholm30:50

      Yeah.

   7. JRJoe Rogan30:50

      ... people pouring saliva out of their mouths and their whole body w- just wasted away to skin and bones.

   8. MOMichael Osterholm30:56

      Right.

   9. JRJoe Rogan30:56

      That's what we're looking at. I mean, that's why it's called chronic wasting disease, 'cause the animals literally waste away.

   10. MOMichael Osterholm31:02

       We actually have a major resource center on our website, free of charge, open, and it's all on chronic wasting disease, so people wanna go there. It's www.cidrap, C-I-D-R-A-P, .umn.edu, and you can go there and all these pictures, all the kind that I can-

   11. JRJoe Rogan31:17

       Can you repeat that again? What is it again?

   12. MOMichael Osterholm31:17

       Ww.cidrap, C-I-D-R-A-P.

   13. JRJoe Rogan31:21

       Cidrap.

   14. MOMichael Osterholm31:22

       Yup, just Center for Infectious Diseases Research and Policy, cidrap.umn.edu.

   15. JRJoe Rogan31:27

       .umn.edu. Okay.

   16. MOMichael Osterholm31:29

       And we have a lot of information.

   17. JRJoe Rogan31:30

       There it is. Chinese guy.

   18. MOMichael Osterholm31:31

       There it is. That's it. You got it right there.

   19. JRJoe Rogan31:32

       Chronic wasting disease research center.

   20. MOMichael Osterholm31:33

       That's it. Yup. And we've got a lot of information on there also about coronaviruses. We have a whole resource center just for the coronaviruses too.

   21. JRJoe Rogan31:39

       Novel coronavirus.

   22. MOMichael Osterholm31:41

       There you go.

   23. JRJoe Rogan31:42

       Mm-hmm. Um, so for the average person that is, uh, sitting around reading these, uh, articles that say, "Don't worry," or reading these ar- these articles that say, "This is the end of humanity," what, w- what, what could these people do? Like, what, what could they do and what do they do if they get infected?

   24. MOMichael Osterholm32:02

       Well, first of all, uh, neither of those kind of articles are correct.

   25. JRJoe Rogan32:06

       Right.

   26. MOMichael Osterholm32:06

       And we have to make sure that we get that message out to people that it's there. We need straight talk right now, you know, and, and part of it is, it's so hard to... you hear from people who suppose experts, "Well, is this gonna happen or not happen?" You know, uh, and, and let me just give you an example because we've heard a lot about, "Well, it's gonna go away with..." The, the coro- uh, the coronavirus, with the seasons, okay? When it warms up, it'll go away. Well, you know, the other coronaviruses that we have, that we've had to worry about was SARS, which appeared in 2003 in China. And when that came out of China in February 2003, it took us a little while to figure out that these people really aren't that infectious till day five or six of their illness, and then they really crash and burn and many of them would die. Um, but what we did was basically, by knowing that, identify these cases and their contacts quickly, and so if they had symptoms, brought them in, put them in these isolation rooms so they wouldn't infect anybody else, and it took until June to bring that under control. That had nothing to do with the seasons. MERS, which is another coronavirus that's in the Middle East, it's in the, um, Arabian Peninsula, uh, the natural reservoir for that is, is camels. In China... and by the way, SARS, it was palm civets and we... a type of animal food, the rodent, that we got out of the markets there. In the Arabian Peninsula, we're not gonna euthanize, uh, 1.7 camels, you know, to try to get rid of MERS. And there, it's 110 degrees out and this virus is transmitted fine, thank you. I mean, it goes from animals to people, it goes in the hospitals. It... there's no evidence it's seasonal there.

   27. JRJoe Rogan33:39

       So that's a good myth to expose right away. This is not something that's gonna cure up when it gets warm.

   28. MOMichael Osterholm33:44

       Uh, it, you know, if it does, it won't be because there's a model for it, it-

   29. JRJoe Rogan33:48

       What will it be? Because how does a... how does something like SARS run through a population and then stop being around anymore?

   30. MOMichael Osterholm33:54

       Well, it wouldn't have but had we had good public health. Had we had, uh, you know, the same kind of transmission we're seeing with this coronavirus where you're infectious before you ever get sick, where you're highly infectious... Remember, with SARS, now, you didn't really get infectious till you were in sixth or s- you know, sixth day of illness and you knew that you were in trouble, and then you could isolate you. And we didn't understand that at first and we trans- you know, the virus transmitted. So that's why SARS stopped. MERS stops because we don't get rid of the camels so it keeps hitting humans day after day, but then when they go to the hospital, we no longer allow those individuals to transmit to others in the hospital because we do what we call good infection control. As soon as they get there, they're in special rooms with special masks and all this kind of thing. And so in that regard, uh, these coronaviruses can be stopped. This one's not. As I said at the b- top of the program, this is, uh, like trying to stop the wind. With influenza transmission, you never hear anybody saying in a bad flu- seasonal flu year, um, "You know, we're gonna stop this one." If you don't have a vaccine that works, you don't. Um, it's just breathing, that's all it is.
4. 45:00 – 1:00:00

   Right. …

   1. MOMichael Osterholm45:00

      into your wound.

   2. JRJoe Rogan45:01

      Right.

   3. MOMichael Osterholm45:01

      And it was never made to protect you from bugs coming in. So those little spaces on the sides, that's not a problem if I'm breathing into the cloth right in front of my nose. But in terms of the air coming in on the side, they're not, they're not effective at all. So people wear them, they look like they're doing something, they're not. Now, if you are sick, they may help a little bit from you transmitting because if you cough, then you cough right into that cloth and it will, some of it'll embed in there and not get out or around. The other one, though, is called an N95 respirator, but for all intents and purposes, looks like a mask. It's just tight face-fitting. It has a seal even at the nose, et cetera.

   4. JRJoe Rogan45:36

      That's an apocalypse mask.

   5. MOMichael Osterholm45:38

      It could be. I don't know what those are, but that could be.

   6. JRJoe Rogan45:40

      (laughs)

   7. MOMichael Osterholm45:40

      Okay?

   8. JRJoe Rogan45:41

      Yes. I'm just saying that that's how I look at it.

   9. MOMichael Osterholm45:43

      Okay. Okay. Well, they're ... Actually, we use them all the time in healthcare all the time and, and they use them in, actually about 90% of them are used in industry. So when they're grinding things or asbestos, et cetera, you know, they don't breathe in all these parts.

   10. JRJoe Rogan45:55

       So if we have one of those, that'll do something.

   11. MOMichael Osterholm45:57

       They're very effective. They're very effective. The problem is we have a big shortage. Um, you know, right now we have hospitals that are down to just a couple days' worth of these masks, the, the s- the respirators, and it's because we don't stockpile anything in this country. You know, we don't have ... Hospitals don't have the money to do that.

   12. JRJoe Rogan46:13

       Those preppers right now are so excited.

   13. MOMichael Osterholm46:15

       Yeah.

   14. JRJoe Rogan46:15

       All the preppers across the co- "I knew it. I knew the day would come."

   15. MOMichael Osterholm46:18

       Yeah. Well, they are. They are.

   16. JRJoe Rogan46:19

       They got like bottled peaches and-

   17. MOMichael Osterholm46:21

       And, and ... Well, and you know, but, well, this is really important because how healthcare workers go is how the country, I think, will see we're going. You know, there've been over 4,000 healthcare workers in China who are infected, many of them on their job, and, uh, a number of them died. And if in this country we have a real challenge delivering healthcare because we're overwhelmed, and then we have healthcare workers picking up the infection, like we talked about the group in Milan, um, and we don't have the protection for them, I really believe that's when the public will say, "Wait a minute. What's going on here?" And, and that's where I think the challenge. So we really have to protect our healthcare workers. They are the frontline people. And, and the biggest problem we have is a lot of these cases need intensive care medicine, which we only have a limited number of beds for. Um, but this is really sophisticated medicine. So when one of those people get infected, a doctor or nurse working intensive care, it's not like you just took out another soldier. You took out a special forces person, and you just can't bring somebody in from family practice or wherever and put them in there. And so we've got to protect these workers, and w- I'm really concerned that that's one of the areas we've not done. Nobody stockpiles. Uh, we have no, uh, you know, capacity to make lots of them all of a sudden. You know, n- the, prior to this event, the hospital purchasing agent would go online, click a button, send me 5,000 of these, and it would be there the next morning.

   18. JRJoe Rogan47:42

       Has anyone contacted you, uh, before this or since, m- in particular, and asked for your advice as to how they can better prepare? Like in terms of like-

   19. MOMichael Osterholm47:54

       All the time.

   20. JRJoe Rogan47:54

       ... the president.

   21. MOMichael Osterholm47:55

       Uh, the president hasn't, but I know a number of the people who are working in the White House. Uh-

   22. JRJoe Rogan47:59

       And they've contacted you?

   23. MOMichael Osterholm48:00

       ... and they're working ... Oh, yeah. We ... Well, you know, uh-... I've served roles in the last five presidential administrations. I worked for two Republican governors, two, uh, Democratic governors, as you appreciate, one independent wrastler I worked for too when he was governor, Jesse.

   24. JRJoe Rogan48:13

       Oh.

   25. MOMichael Osterholm48:13

       (laughs) And- and-

   26. JRJoe Rogan48:14

       That's right.

   27. MOMichael Osterholm48:15

       Yeah. And so, you know, I- I've never had a partisan... You know, I've, I'm just a private in the public health army-

   28. JRJoe Rogan48:21

       Right.

   29. MOMichael Osterholm48:21

       ... and so I actually serve as a science envoy for this administration in the State Department last year, you know, still, uh, my, my full-time job at the university. And so I've never been... I mean, I'm there to give the best advice I can. And so I've talked to a lot of these people there at the CDC, um, at, uh, at Health and Human Services, et cetera. So yeah, we've given a lot of advice.

   30. JRJoe Rogan48:42

       And do you think there's anything that you could do now that could help them make sure that we don't have these shortages of masks and shortages of medicine and IV bags and something that could be done to... I mean, you obviously, you've laid out all these problems-
5. 1:00:00 – 1:08:33

   You know what? And…

   1. JRJoe Rogan1:00:00

      percentage of us that lean towards conspiratorial thinking and they- they lean towards thinking that there's, uh, some sort of a plot against them or the government's against them and it's just ...... (sighs) You gotta listen to the medical experts.

   2. MOMichael Osterholm1:00:15

      You know what? And I, I hope that if there's any good to come out of this terrible coronavirus situation is that there's a wake-up call. If we'd had a vaccine for this, or one that even worked partially-

   3. JRJoe Rogan1:00:26

      Yeah.

   4. MOMichael Osterholm1:00:26

      ... think how different we'd be. And you know what? We got new, other ones coming like this. We have to use our creative imagination. You know, as I said in the, in the book, I, the chapter on coronavirus is, the title is SARS and MERS: A Harbinger of Things to Come.

   5. JRJoe Rogan1:00:38

      Yeah.

   6. MOMichael Osterholm1:00:39

      I mean, we don't, we can use our creative imagination to say we should be funding these things almost like we pay for our fire department. Imagine if we had to go out and buy a firetruck when the 911 call came in.

   7. JRJoe Rogan1:00:49

      Yes.

   8. MOMichael Osterholm1:00:50

      We need to do it now.

   9. JRJoe Rogan1:00:52

      It's kind of disturbing that it's chapter 13 though.

   10. MOMichael Osterholm1:00:54

       I know, it was. Well, actually, would you do me a favor? I, you're gonna really like this.

   11. JRJoe Rogan1:00:58

       Yeah.

   12. MOMichael Osterholm1:00:58

       Okay, open up to chapter 13, okay?

   13. JRJoe Rogan1:01:00

       Okay.

   14. MOMichael Osterholm1:01:00

       And when you look at, it's towards the end there, uh, when... Yeah.

   15. JRJoe Rogan1:01:04

       I'm just trying to find it.

   16. MOMichael Osterholm1:01:05

       When you... Re- read the quote that goes with it.

   17. JRJoe Rogan1:01:08

       Okay. 125, yeah.

   18. MOMichael Osterholm1:01:11

       Okay. So every chapter started not with just a title but a quote.

   19. JRJoe Rogan1:01:17

       Oh, no.

   20. MOMichael Osterholm1:01:17

       And, and, uh, I think you'll find this one quite interesting.

   21. JRJoe Rogan1:01:21

       "Bioterror opening Pandora's box."

   22. MOMichael Osterholm1:01:25

       That's not it. That's not the chapter.

   23. JRJoe Rogan1:01:27

       That's not it? Oh, that's close.

   24. MOMichael Osterholm1:01:28

       Yes, chapter 13. You're close.

   25. JRJoe Rogan1:01:34

       Hang on. There it is.

   26. MOMichael Osterholm1:01:35

       Okay, read the-

   27. JRJoe Rogan1:01:36

       "SARS and MERS: A Harbinger of Things to Come."

   28. MOMichael Osterholm1:01:38

       But look at the quote underneath it.

   29. JRJoe Rogan1:01:39

       Do I need glasses? Oh, wait a second.

   30. MOMichael Osterholm1:01:43

       (laughs)

Episode duration: 1:34:10