Jay Bhattacharya: The Case Against Lockdowns | Lex Fridman Podcast #254

1. 0:00 – 3:43

   Introduction

   1. LFLex Fridman0:00

      The following is a conversation with Jay Bhattacharya, professor of medicine, health policy, and economics at Stanford University. Please allow me to say a few words about lockdowns and the blinding, destructive effects of arrogance on leadership, especially in the space of policy and politics. Jay Bhattacharya is the co-author of the now famous Great Barrington Declaration, a one-page document that, in October 2020, made a case against the effectiveness of lockdowns. Most of this podcast conversation is about the ideas related to this document. And so, let me say a few things here about what troubles me. Those who advocate for lockdowns as a policy often ignore the quiet suffering of millions that it results in, which includes economic pain, loss of jobs that give meaning and pride in the face of uncertainty, the increase in suicide and suicidal ideation, and, in general, the fear and anger that arises from the powerlessness forced onto the populous by the self-proclaimed elites and experts. Many folks whose job is unaffected by the lockdowns talk down to the masses about which path forward is right and which is wrong. What troubles me most is this very lack of empathy among the policymakers for the common man, and, in general, for people unlike themselves. The landscape of suffering is vast and must be fully considered in calculating the response to the pandemic with humility and with rigorous, open-minded scientific debate. Jay and I talked about the email from Francis Collins to Anthony Fauci that called Jay and his two co-authors fringe epidemiologists, and also called for devastating published takedown of their ideas. These words from Francis broke my heart. I understand them. I can even steel man them. But nevertheless, on balance, they show to me a failure of leadership. Leadership in a pandemic is hard, which is why great leaders are remembered by history. They are rare, they stand out, and they give me hope. Also, this whole mess inspires me on my small individual level to do the right thing in the face of conformity, despite the long odds. I talked to Francis Collins, I talked to Albert Bourla, Pfizer CEO. I also talked, and will continue to talk, with people like Jay and other dissenting voices that challenge the mainstream narratives and those in the seats of power. I hope to highlight both the strengths and weaknesses in their ideas, with respect and empathy, but also with guts and skill. The skill part, I hope to improve on over time, and I do believe that conversation and an open mind is the way out of this. And finally, as I've said in the past, I value love and integrity far, far above money, fame, and power. Those latter three are all ephemeral. They slip through the fingers of anyone who tries to hold on, and leave behind an empty shell of a human being. I prefer to die a man who lived by principles that nobody could shake, and a man who added a bit of love to the world. This is the Lex Fridman podcast. To support it, please check out our sponsors in the description. And now, here's my conversation with Jay Bhattacharya.

2. 3:43 – 33:14

   How deadly is Covid?

   1. LFLex Fridman3:43

      To our best understanding today, how deadly is COVID? Do we have a good measure for- for this very question?

   2. JBJay Bhattacharya3:52

      So, the- the best evidence for COVID, the deadliness of COVID, comes from a whole series of seroprevalence studies. Seroprevalence studies are the studies of- of antibody prevalence in the population at large. I was part of the, you know, the very first set of seroprevalence studies, one in Santa Clara County, one in LA County, and one in, uh, th- with Major League Baseball around the US.

   3. LFLex Fridman4:13

      Uh, if I may just pause you for a second. If people don't know what, uh, serology is in seroprevalence, it does sound like you say zero prevalence. It's not. It's sero, and serology is antibodies. So, it's- it's a- it's a survey that counts the number of antibodies-

   4. JBJay Bhattacharya4:30

      Specific to COVID, yes.

   5. LFLex Fridman4:31

      ... uh, people that have antibodies specific to COVID, which perhaps shows an indication that they likely have had COVID, and therefore this is a way to study how many people in the population have been exposed to or had, uh, COVID.

   6. JBJay Bhattacharya4:45

      Exactly. Yeah, exactly. So, the- the idea is that, um, uh, we don't know exactly the number of people with COVID just by counting, uh, the people that are, that are, that present themselves with symptoms of COVID. Um, COVID has, it turns out, a very wide range of symptoms possible, ranging from no symptoms at all to this deadly viral pneumonia that's killed so many people. And the problem is, like, in, if you just count the number of cases, the people who have very few symptoms s- often don't show up for testing. We just don't, they're outside of the can of- of public health. And so it's really hard to know the- the- the answer to your question without understanding how many people are infected. 'Cause you- you can probably tell the number of deaths, that's even though there's some controversy over that. But, uh, that, so the- the numerator is- is possible, but the denominator is much harder.

   7. LFLex Fridman5:33

      How much controversy is there about the death? We're gonna go on a million tangents. Is that... Okay, we're gonna... I have a million questions. So one, I love data so much, but I've, like, almost tuned out paying attention to COVID data 'cause I feel like I'm walking on shaky ground. I don't know who to trust. Um, maybe you can comment on different sources of data, different kinds of data. The death one, that seems like a really important one. Can we trust the reported deaths associated with COVID, or is it just a giant messy thing that mixed up, and then there's this kind of stories about hospitals being incentivized, uh, to report a death as a COVID death?

   8. JBJay Bhattacharya6:14

      So, uh, there's some truth in some of that. Uh, let me just... So...... let me just talk about the incentives. So, in the United States, we passed this CARES Act that was aimed at making sure hospital systems didn't go bankrupt, in the early days of the pandemic. A couple of things they did. One was they provided incentives to treat COVID patients, tens of thousands of dollars extra per, per COVID patient. Um, and the other thing they did is they, they gave a 20% bump to Medicare payments for elderly patients who were treated with COVID, but the idea is that there's more expensive to treat them at, I guess, the early days. Um, so that did provide an incentive to, sort of, have, have a lot (laughs) of COVID patients in the hospital, because it... Your financial, uh, success of the hospital, or, or at least not fi- lack of financial ruin depended on having many COVID patients. The other thing on the death certificates is that reporting of deaths is a separate issue. I don't know that there's a financial incentive there, but there is this, sort of, like, complicated... You know, when you fill out a death certificate for a patient with a lot of conditions, uh, like let's say a patient has diabetes, a patient ha- where that, while that diabetes could lead to, to, h- h- uh, heart failure. You know, you have a heart attack, heart failure, your lungs fill up, then you get COVID, and what, and you die. So what do you, what do you write on the death certificate? Was it, was it COVID that killed you? Was it the, the lungs filling up? Was it the, the he- heart failure? Was it the diabetes? It's really difficult to, like, disentangle. Um, and I think a lot of, a lot of times what's happened is they, people have, like, erred on the side of signing it, it's COVID. Uh, now what's the evidence of this? Uh, there's been a couple of, of audits of death certificates in places like Santa Clara County, where I live, and Alameda County, uh, California, where they, they carefully went through the death certificate and said, "Okay, is this reasonable to say this was actually COVID, or is this, is- was COVID incidental?"

   9. LFLex Fridman8:00

      Mm-hmm.

   10. JBJay Bhattacharya8:00

       And they found that about 25%, 20、25% of the deaths were in- i- m- more likely incidental than directly due to COVID. I, I personally don't get too excited about this. I mean, it's a philosophical question, right? Like, ultimately, what kills you? I, which, which is an (laughs) odd thing to say (laughs) if you're, if you're, if you don't, you're not in medicine, but like really, it's, it's a, um, it's almost always multifactorial. It's not always, not always just the bus hits you. If the bus hits you that, you, you get a brain bleed. Was it the brain bleed that killed you? Would it have burst anyway? I mean, you know, the bus hit you and killed you, right?

   11. LFLex Fridman8:32

       The way you die is a philosophical question, but it's also a sociological and psychological question, 'cause it seems like every single person who has passed away over the past couple of years, kind of, the first question that comes to mind-

   12. JBJay Bhattacharya8:44

       Was it COVID?

   13. LFLex Fridman8:45

       ... was, was it COVID?

   14. JBJay Bhattacharya8:46

       Was it COVID?

   15. LFLex Fridman8:46

       Not, not just because you're trying to be political, but just in your own mind.

   16. JBJay Bhattacharya8:49

       No, I, I think, uh, there's a psychological reason for this, right? So, um, you know, we have, we spent, uh, the better part of a ha- at least a half century in the United States not worried too much about infectious diseases, and we, the notion was we'd essentially conquered them. It was something that happens in faraway places, uh, to other people. And, and that's true for much of the developed world. Life expectancies were going up for, you know, decades and decades, and for the first time in living memory, we have a disease that can kill us. I mean, I think we're effectively evolved to fear that. Like, the, the, the panic centers of our brain, the lizard part of our brain takes over. And our central focus has been avoiding this one risk. Um, and so it's not surprising that, that people, when they're filling out death certificates or thinking about what, what, what led to the death, this most salient thing that's at the front of everyone's brain would, would jump to the top.

   17. LFLex Fridman9:42

       And we can't ignore this very deep psychological thing when we consider what people say on the internet, what people say to each other, what people write in scientific papers, what... Everything. It feels like when COVID has been, um, has been brought onto this world, everything changed in the way people feel about each other, just the way they communicate with each other. I think the, the level of emotion involved, I think it, in many people, it brought out the worst in them, uh, for sometimes short periods of time, and sometimes it was almost therapeutic. Like, you were waiting to get out, like, the darkest parts of you, just to say, "If you're angry at something in this world, I'm going to say it now." And, um-

   18. JBJay Bhattacharya10:32

       Mm-hmm.

   19. LFLex Fridman10:32

       ... I think that's probably talking to some deep primal thing that, um, fear we have for, um, for maladies of all different kinds, and then when that fear is aroused and all the deepest emotions, it's like a Freudian, uh, psychotherapy session, but across the world.

   20. JBJay Bhattacharya10:51

       It's something that, that, uh, (laughs) psychologists are gonna na- have a field day with for a generation, trying to understand. Um, I mean, I think that on- uh, pi- I mean, I think what you say is right, but piled on top of that is also this, sort of, uh, this impetus to empathy, to empathize compassion toward others, essentially militarized.

   21. LFLex Fridman11:10

       (laughs)

   22. JBJay Bhattacharya11:11

       Right? So-

   23. LFLex Fridman11:11

       Yeah.

   24. JBJay Bhattacharya11:11

       ... I'm protecting you by, by some actions, and, uh, those actions, if I, if I don't do them, if you don't do them, well, that must, must mean you don't miss- you hate me. Um, it's, it's created this, like, social tension that I've never seen before, and we s- and we, and we start- have started... Have we started? We, we looked at each other as if we were just simply sources of, of germs rather than people you get to know, pe- people to enjoy, people to get, you know, so- to learn from. Um, it- it- it coloreds basically almost every human interaction for every per- every human on the planet.

   25. LFLex Fridman11:47

       Yeah. The basic common humanity. It's like, you can wear a mask, you can stand far away, but the love you have for each other when you look into each other's eyes, that was dissipating, and, and by region too. I've experienced, having traveled quite a bit throughout this time, it, um, it was really sad. Even people that are really close together, just the way they st- stood, the way they looked at each other, and I... It made me feel, for a moment, um, that the fabric that connects all of us is more fragile than I thought.

   26. JBJay Bhattacharya12:19

       ... I mean, if you walk down the street, or if you ever, if you did this during COVID, you- I'm sure you had this experience where you walk down the street, if you're not wearing a mask, or even if you are, people will jump off the- off the sidewalk that you walked past them.

   27. LFLex Fridman12:31

       Mm-hmm.

   28. JBJay Bhattacharya12:32

       As if you're poison. Even though the data are that COVID spreads, you know, indifferently outdoors, if at all, really, out- outdoors. But it's not simply a biological or infectious disease phenomenon, or epidemiological phenomenon. It's- it is a- it is a- it's a- th- it is a change in the way humans treated each other, I hope- hope temporary.

   29. LFLex Fridman12:53

       I- I do wanna say on the flip side of that, so I was, um, mostly in Boston, Massachusetts when the pandemic broke out. I think that's where I was, yeah. And then I got- w- came here to Austin, Texas to visit my now good friend, Joe Rogan, and he was the first person, without pause, this wasn't a political statement, this wasn't anything, just walk toward me and give me a big hug, and say, "It's great to see you." And I can't tell you how great that felt because I, in that moment, realized the absence of that connection back in Boston over just a couple of- over a couple of months. And, um, it's- w- we'll talk about it more, but it- it's tragic to think about that distancing, that dissolution of common humanity at scale, what- what kind of impact it has on society, just across the board, political division, uh, and just in the quiet of your own mind, in the privacy of your own home, the depression, the sadness, the loneliness that leads to suicide. And forget suicide, just low-key suffering.

   30. JBJay Bhattacharya13:55

       Yeah. No, I think that's- that's the suffering, that isolation. We're not meant to live alone. We're not meant to live apart from one another. But that's, of course, the ide- ideology of lockdown is to make people live apart, alone, isolated, so that we don't spread diseases to each other, right? Um, but we're not actually designed as a species to live that way. And that, uh, what you're describing, I think, if everyone's honest with themselves, have felt, uh, especially in places where the- where that lock- where lockdowns have been, uh, sort of very militantly enforced, has felt deep into their core.
3. 33:14 – 39:07

   Covid vs Influenza

   1. LFLex Fridman33:15

      compare influenza, the flu, and COVID in the context of the discussion we just had, which is, um, how deadly is COVID? So you mentioned COVID is a very particular kind of steepness, uh, i- where the x-axis is age. Uh, so in that context, could you maybe compare influenza and COVID? Because a lot of people, um, o- outside of the folks who suggest that the, th- the lizards who run the world have completely fabricated and invented COVID, outside of those folks, kind of the natural process by which you dismiss the threat of COVID is say, "Well, it's just like the flu," the flu is a very serious thing, actually. Um, so in that comparison, where does COVID stand?

   2. JBJay Bhattacharya34:03

      Yeah, the flu is a very serious thing. It kills, you know, 50, 60,000 people a year, something like on that order, depending on the, th- s- the particular strain that goes around, uh, that's in the United States. The primary difference, to me, are the m- uh, there's lots of differences, but one of the most salient differences is the age gradient in mortality risk for the flu. So the flu is more deadly for ch- to children than COVID is. Uh, there's no controversy about that. Children, thank God, h- have much less, uh, severe reactions to COVID infection to, than they do to flu infections.

   3. LFLex Fridman34:40

      And rate of fatalities and stuff like that.

   4. JBJay Bhattacharya34:42

      Rate of fatality, all of that.

   5. LFLex Fridman34:42

      I think you mentioned, um... I mean, it's interesting to maybe also comment on... uh, I think in another conversation you mentioned there's a U shape to the, um, to the flu curve, so meaning, like, there's actually quite a large number of kids that die from flu.

   6. JBJay Bhattacharya34:59

      Yeah. I mean, the 1918 flu, the H1N1 flu, the, the, the Spanish flu, in the US killed millions of, of, of, uh, of younger people, and, um, that is not the case with COVID. More than, um... ah, g- I'm gonna get the number w- wrong, but something like 70, 80% of the deaths are people over the age of 60.

   7. LFLex Fridman35:21

      Well, we've talking about the fear the whole time really, but my interaction with folks... now, I wanna have a family, I wanna have kids, uh, but I don't have that real firsthand experience, but my interaction with folks is, at the core fear that folks had is for their children, like, that s- somehow, you know, I don't wanna get infected because of the kids, like, I... 'cause God forbid something happens to the kids. And I think that o- obviously that makes a lot of sense, this kind of, the kids come first no matter what, that's the one priority, but in, for this particular virus, that reasoning was, um, not grounded in data, it seems like, or that emotion and feeling-

   8. JBJay Bhattacharya36:07

      Yeah.

   9. LFLex Fridman36:07

      ... was not grounded in data.

   10. JBJay Bhattacharya36:08

       It wasn't. Uh, but at the same time, f- uh, this is way more deadly than the flu, just overall, and especially to older people.

   11. LFLex Fridman36:15

       Yes.

   12. JBJay Bhattacharya36:16

       Right? So-

   13. LFLex Fridman36:17

       The numbers, when, when the story's all said and done, uh, COVID would, would take many more lives.

   14. JBJay Bhattacharya36:24

       Yeah. So, I mean, .2 is, sounds like a small number, but it's not a small number worldwide.

   15. LFLex Fridman36:29

       Yeah. What do you think that number will be by the en- you know, let's not, let's not, like, make... but would we cross... I think it's, in the United States, it's, um... the way the deaths are currently reported, it's like 800,000, something like that. Do you think we'll cross a million?

   16. JBJay Bhattacharya36:44

       Seems likely.Yeah.

   17. LFLex Fridman36:46

       Do you think it's something that might continue with different variants? What, uh-

   18. JBJay Bhattacharya36:50

       Well, I think, um, so we can talk about the end state of COVID. The end state of COVID is it's here forever. Um, I think that there is good evidence of immunity after infection, such that you're protected both against reinfection and also against severe disease upon reinfection. So the second time you get it, it's not true for everyone, but for many people, the second time you get it will be milder, much milder than the first time you get it.

   19. LFLex Fridman37:18

       With the long tail, like, uh, that lasts for a long time?

   20. JBJay Bhattacharya37:22

       Yeah. So just, there's studies that, uh, that follow cohorts of people who were infected for a year, and the reinfection rate is something like, somewhere between .3 and 1%.

   21. LFLex Fridman37:32

       Yeah.

   22. JBJay Bhattacharya37:33

       Um, and, like, a pretty fantastic study out of Italy found that. There's, there was one in Sweden, I think. There's a few studies that found similar, similar things. Um, and the reinfections ti- tend to produce much milder disease, mu- much less likely to end up in the hospital, much less likely to die. Um, so what the end state of COVID is, it's circulating in the population forever, and you get it multiple times.

   23. LFLex Fridman37:56

       Yeah. And, and then there's, I think, studies and discussions like, the, the best protection would be to get it, and then also to get vaccinated, and then a lot of people push back against that for the obvious reasons from both sides, because somehow this d- discourse has become less scientific and more political.

   24. JBJay Bhattacharya38:14

       Well, I th- I think you wanna ... Like, the first time you meet it is gonna be the most deadly for you.

   25. LFLex Fridman38:20

       Right.

   26. JBJay Bhattacharya38:20

       And so the first time you meet it, it's just wise to be vaccinated. The vaccine reduces severe disease.

   27. LFLex Fridman38:25

       Yeah. We'll, we'll talk about the vaccine-

   28. JBJay Bhattacharya38:27

       Okay.

   29. LFLex Fridman38:27

       ... 'cause I wanna make sure I address it carefully and properly and in full context. Um, but yes, uh, sort of, uh, to add to the context, a lot of the fascinating discussions we're having is, um, in the early days of COVID, and now, uh, for people who are unvaccinated. That's where the interesting story is. The policy story, the sociologic- uh, sociological story and so on. But let me go to something really fascinating, just because of the people involved, the human beings involved, and because of how deeply I care about science and also kindness, respect and love and human things.

4. 39:07 – 59:45

   Francis Collins email to Fauci

   1. LFLex Fridman39:07

      Francis Collins wrote a letter in October 2020 to Anthony Fauci and I think somebody else. I have, um, the letter. Oh, it's not a letter. Email, I apologize. Uh, "Hi Tony and Cliff. Cgbdeclaration.org. This proposal ..." This is the Great Barrington Declaration that, uh, you're a coauthor on. "This proposal from the three fringe epidemiologists who met with the secretary seemed to be getting a lot of attention, and even a co-signature from Nobel Prize winner Mike Leavitt at Stanford. There needs to be a quick and devastating published take down of its premises. I don't see anything like that online yet. Is it underway? Francis." Francis Collins, Director of the NIH, somebody I talked to on this podcast recently. Okay. A million questions I wanna ask, but first, how did, uh, that make you feel when you first saw this, uh, email come to, uh, uh, to light? Which, when, when, when did it come to light?

   2. JBJay Bhattacharya40:20

      Uh, this week actually, I think, or last week.

   3. LFLex Fridman40:22

      Oh, okay. So this is because of Freedom of Information?

   4. JBJay Bhattacharya40:25

      Yeah.

   5. LFLex Fridman40:26

      Which by the way, s- sort of, um, maybe 'cause I do wanna add positive stuff on the, on the side of Francis here. Um, boy when I see stuff like that, I wonder if all my emails leaked-

   6. JBJay Bhattacharya40:40

      (laughs)

   7. LFLex Fridman40:41

      ... how much embarrassing stuff ... Like, I think I'm a good person, but I don't ... (laughs) I haven't read my old emails. Maybe, I'm pretty sure sometimes late- I could be an asshole.

   8. JBJay Bhattacharya40:53

      Well, I mean, look, uh, he's a Christian and I'm, I'm a Christian. I'm supposed to forgive, right?

   9. LFLex Fridman40:57

      Yeah.

   10. JBJay Bhattacharya40:57

       I mean, I think he was looking at this GB- uh, Great Barrington Declaration as a political problem to be solved, as opposed to a serious alternative approach to the epidemic.

   11. LFLex Fridman41:10

       So maybe we'll talk about it in more detail, but just for, for, in case people are not familiar, Great Barrington Declaration was, was, was a document that you coauthored that basically argues against this idea of lockdown as a solution to COVID, and you propose another solution that we'll talk about. But the point is, it's not that dramatic of a document. It is just a document that criticizes one policy solution that was proposed.

   12. JBJay Bhattacharya41:38

       But it was the policy solution that had been put forward by, uh, Dr. Collins and by Tony Fauci and a few other, few other sci- Not, uh, I mean, I think a relatively small number of scientists and epidemiologists in charge of a- the advice given to governments worldwide, and it was a challenge to that policy that said that, look, there, there is an alternate path. That th- that the path we've chosen, this path of lockdown with an aim to suppress the virus to zero, effectively, I mean, although that was unstated, um, cannot work, and is causing catastrophic harm to large numbers of poor and vulnerable people worldwide. We put this out in October 4th, I think, of 2020, and, uh, it, it went viral. I mean, I've never actually been involved with anything like, like this where I j- I just put the document on the web and tens of thousands of doctors signed on, hundreds of thousands of regular people signed on. It, it really struck a, a ch- a chord of, uh, people 'cause I think even by October of 2020, people had this sense that there was something really wrong with the COVID policy that we'd been following, and they were looking for...... reasonable people to give an alternative. I mean, we're, we're not arguing that COVID doesn't, isn't, isn't a serious thing. I mean, it's, it is a very serious thing, this is why we, we had a policy that aimed at addressing it. Um, we were, we, uh, but it w- we were saying that the policy we're following is not the right one. So how does a democratic, uh, government deal with that challenge? Uh, so to, to me, that, you asked me how I felt, I was actually frankly just, I was, I- I suspected there'd been some email exchanges like that, not necessarily from Francis Collins, uh, around the government around this time. Uh, I mean, I felt the full brunt of a propaganda campaign almost immediately after he published it, where newspapers mischaracterized it in a- in the sa- the same way over and over and over again. Um, and sought to, to characterize me as sort of a, of a, as a, as a mar- a sort of a marginal fringe figure or whatnot, and me and Sunetra Gupta, Martin Kulldorff, one of the tens of thousands of other people that signed it. I, I felt the brunt of that all year long. So to see this in black and white in, you know, with the handwriting essentially of, uh, I mean, the, the, the metaphorical handwriting of Francis Collins was actually frankly a disappointment 'cause I'd, I've, I've looked up to him for years.

   13. LFLex Fridman44:05

       Yeah, I've looked up to him as well. I, um, I mean, I, I look for the, the best in people, and I still look up to him. What troubles me is several things. The reason I said about the, the asshole emails that I send late at night is, um, I can understand this email. It's fear, it's panic, not being sure. The fringe, three fringe epidemiologists.

   14. JBJay Bhattacharya44:37

       Like Mike Leavitt, who won a Nobel Prize (laughs) . I mean...

   15. LFLex Fridman44:40

       But using fringe, maybe in my private thoughts, I have said things like that about others, like, a little bit too unkind. Like you don't really mean it. Now add to that he recently, this week or whatever, uh, doubled down on the fringe. This is really troubling to me. That, like I can excuse this email, but to see the arrogance there. I, that, Francis honestly, I mean, broke my heart a little bit there. This was an opportunity to like, especially at this stage, to say, just like I told him, um, to say I was wrong to use those words in that email. I was, I was wrong to not be open to ideas. I still believe that this is not a, like say it's, like actually argue with the, with the propos-

   16. JBJay Bhattacharya45:33

       Policy.

   17. LFLex Fridman45:33

       ... with the policy of the proposed, uh, solution. Also, the devastating published take... devastating takedown. Devastating takedown. As you say, somebody who's sitting on billions of dollars that they're giving to scientists, some of whom are often not their best human beings because they're fighting with each other over money. Not being cognizant of the fact that you're, um, challenging the integrity, you're corrupting the integrity of scientists by allocating them money. You're now playing with that by saying, "Devastating takedown." Where do you think the published takedown will come from? It will come from those scientists to whom you're giving money. What kind of example would they give to the academic community that thrives on freedom? Like this, this is... I believe Francis Collins is a great man. One of the things I was troubled by is the negative response to him from people that don't understand the positive impact that NIH has had on society, how many people it's, it's helped. But this is exactly the... So he's not just a scientist. He's not just a bureaucrat who distributes money. He's also a scientific leader that in a time, in difficult times we live in, is supposed to inspire us with trust, with love, with the freedom of thought. He's supposed to... You know those fringe epidemiologists? Those are the heroes of science. When you look at the long arc of history, we love those people.

   18. JBJay Bhattacharya47:15

       (laughs) I mean, I, the thing is-

   19. LFLex Fridman47:15

       We love ideas, even when they get proven wrong.

   20. JBJay Bhattacharya47:18

       That's what always had attracted me to science. Like some- somebody, you know, with the lo- the, the lone voice saying, "Oh no, the, the, the Moon of Jupiter does move." (laughs) .

   21. LFLex Fridman47:27

       (laughs) . Yeah.

   22. JBJay Bhattacharya47:28

       I mean, you know, but the funny thing is, you know, Galileo was saying something truly revolutionary. We were saying that what we proposed in the Great Barrington Declaration was actually just the old pandemic plan. It wasn't anything really fundamentally novel. Um, in fact, there were s- plans like this that locked down scientists had written in late February, early March of 2020. So we were not saying anything radical. We were just calling for a debate, effectively, over the, the existing lockdown policy. Um, and this is a disappointment, a, a really, truly a, a big disappointment, because by doing this, you are absolutely right, Lex, he sent a signal to so many other scientists to just stay silent, even if you had reservations.

   23. LFLex Fridman48:15

       Yeah. Devastating takedown that people... You know how many people wrote to me privately? Like Stanford, MIT, how amazing the conversation with Francis Collins was. There's a kind of admiration because... Okay, how do I put it? Um, a lot of people get into science 'cause they wanna help the world. They get excited by the ideas and they w- and they, they really are working hard to help in whatever the discipline is. And then there is sources of funding which help you do help at a larger scale, so you admire those, the people that, uh, um...... are distributing the money because they're often, at least on the surface, are really also good people. Oftentimes, they're great scientists. So like, it's amazing. I- I- That's why I'm sort of, um... (inhales deeply) Like sometimes people from outside think academia is broken some kind of way. No, it's, it's a beautiful thing. It's a, it really is a beautiful thing, and that's why it's so deeply heartbreaking when this person, um, is, um... I don't think this is malevolence. I think he's just incompetence at communication, uh, twice. (laughs)

   24. JBJay Bhattacharya49:31

       Well, I think, I think there's arri- there's also arrogance at the bottom of it too.

   25. LFLex Fridman49:33

       Yes.

   26. JBJay Bhattacharya49:33

       So like, you know-

   27. LFLex Fridman49:34

       But all of us have arrogance at the bottom.

   28. JBJay Bhattacharya49:35

       Yes, but there's a particular kind of arrogance, right? So here, it's, it's of the same kind of arrogance that you see when Tony Fauci gets on TV and says that, uh, that, "If you criticize me, you're not simply criticizing a man, you're criticizing science itself."

   29. LFLex Fridman49:50

       Right.

   30. JBJay Bhattacharya49:50

       Right? That is at the heart also of this email. The so- the certainty that the policies that they were recommending, Collins and Fauci were recommending to the President of the United States were right, not just right, but right, so, so far right that any challenge whatsoever to it is dangerous. Um, and I think that, that is really the heart of that email. It's, it's, um, it's this idea that my position is unchallengeable. Now, to, to be, to be completely, to be as charitable as I can be to this, you know, I, I believe they thought that, I believe they, some of them still think that. That, that there was only one true policy possible in response to COVID, every other policy was immoral. And if you, if you come from that position, then you write an email like that. You go on TV, you say, effectively, La science c'est moi. 　 Right? I mean, that, that is, that is what happens when you have this sort of unchallengeable arrogance that the policy you're following is correct. Um, I mean, when we wrote The Great Barrington Declaration, what I, what I was hoping for was a discussion about how to protect the vulnerable. I mean, that was the key idea, to me, in the whole thing, was better protection of the older population who were really at really serious risk if infected with COVID. And we'd been doing a very poor job, I thought, to date, in many places, in protecting the vulnerable. And what I wanted was a discussion by local public health about better methods, better policies to protect the vulnerable. So when, when I was, when we were met with, instead, a series of essentially propagandist lies about it, so like, so for instance, I kept hearing from reporters in, in those days, "Why do you want to let the virus rip? Let it rip. Let it rip." The words "let it rip" does not appear in The Great Barrington Declaration. The goal isn't to let the virus rip, um, the, the goal is to protect the vulnerable. To let society go as, you know, open schools and do other things that it functions as best it can in the midst of a terrible pandemic, yes, but not let the virus rip w- where no, the, the most vulnerable aren't protected. The goal was to protect the vulnerable. So why let it rip? Because it was a propaganda term to hit the fear centers of people's brains, "Oh, these people are immoral, they just want to let the virus go through society and h- hurt everybody." That was the, that was the, that was the idea. There's, it, it was a way to preclude a discussion and preclude a debate about the existing policy.
5. 59:45 – 1:07:14

   Francis Collins

   1. LFLex Fridman59:45

      Let me ask you about just Francis Collins. I don't know if you ... I had, I had a, I had a chance to talk to him on a podcast, I don't know if you maybe by chance gotten a chance to hear a few words-

   2. JBJay Bhattacharya59:53

      I heard some of it, yeah.

   3. LFLex Fridman59:54

      Um, well, I have a kind of a question, uh, to that, because a lot of people wrote to me quite negative things about Francis Collins, and like I said, I still believe, uh, he's a great man, a great scientist. Um, one of the things when I talked to him off mic about the vaccine, the excitement he had about when we were recollecting when they first gotten an inkling that it's actually going to be possible to get a vaccine. Just he wasn't messaging, just in the private or our own conversation, he was really excited. And why was he excited? Because he gets to help a lot of people. This is a man that really wants to help people, and there could be some institutional, self-delusion, arrogance, all those kinds of things that lead to this kind of email. But ultimately the, the goal is, this is what ... I don't think people quite realize this. The reason he, he'll call you a fringe epidemiologist, the reason there needs to be a devastating, uh, published take down, he, I believe, really believes that this ... it could be very dangerous.

   4. JBJay Bhattacharya1:01:05

      Yeah.

   5. LFLex Fridman1:01:05

      And it's a lot of burden, uh, to carry on his shoulders, because like you said, in his role where he defines some of the public policy-... like, you know, depending on how he thinks about the world, millions of people could die because of one decision he make.

   6. JBJay Bhattacharya1:01:22

      Yeah.

   7. LFLex Fridman1:01:22

      And that's a lot of burden to walk with.

   8. JBJay Bhattacharya1:01:24

      Yeah. No, I think that's right. I don't, I don't think that he has bad intentions. I think that he was basically put, was put or maybe he put himself in a position where th- this kind of conflict of interest was going to create this kind of a, this, this kind of a reaction.

   9. LFLex Fridman1:01:41

      Yeah.

   10. JBJay Bhattacharya1:01:42

       Right? The kind of humility that you're calling for is almost impossible when you have that dual, dual role. This, that shouldn't, you shouldn't have, have as, as funder of science and also setter of scientific policy.

   11. LFLex Fridman1:01:53

       I agree with everything you just said except the last part. The, the humility is almost imposs... The, eh, humility is always difficult. I think, I think there's a huge incentive to, for humility in that position. Look, look at history. Great leaders that have humility, um, are popular as hell. So if you like being popular-

   12. JBJay Bhattacharya1:02:16

       (laughs)

   13. LFLex Fridman1:02:16

       ... if you like having impact, legacy, uh, these descendants of apes seem to care about legacy, especially as they get older in these high positions, like, I think the incentive for humility is pretty high. (laughs)

   14. JBJay Bhattacharya1:02:28

       Well, I mean, th- the thing is, is like, there's a lot that he has to be proud of in his career.

   15. LFLex Fridman1:02:32

       Yeah.

   16. JBJay Bhattacharya1:02:32

       I mean, like the, the human genome project wouldn't have happened without him. Uh, and he is, he is a great man and a great scientist. But it, so it is tragic to me that his career has ended in this particular way.

   17. LFLex Fridman1:02:44

       Can I ask you a question about, um, my podcast conversation with him? By way of advice or maybe criticism, there's a lot of people that wrote to me, kind words of support, and a lot of people that wrote to me, respectful, constructive criticism. How would you suggest to have conversations with folks like that? And maybe, um, I mean, 'cause there's, I have other conversations like this, including, I was debating whether to talk to, uh, Anthony Fauci. He wanted to talk. And so, what kind of conversation do you have? And sorry to take us on a tangent, but almost from an interview perspective of how to inspire humility and inspire trust in science, or maybe give hope that we know what the heck we're doing and we're gonna figure this out.

   18. JBJay Bhattacharya1:03:35

       I mean, I think, uh, you're, ev- I've had, been now interviewed by many people. Um, I, I think as, the, the style you have really works well, Lex. You have to, uh, 'cause you're not, I don't think you're gonna be ever an attack dog tryin' to go after somebody and, and force them to, to, like, you know, so admit that they were wrong or about, or whatever about it. I mean, that's, I also actually find that form of journalism and podcasting really off-putting. It's hard to watch. Um-

   19. LFLex Fridman1:04:02

       Also, it's a whole other tangent, is that actually effective?

   20. JBJay Bhattacharya1:04:05

       I don't think so.

   21. LFLex Fridman1:04:06

       Do you wanna ask-

   22. JBJay Bhattacharya1:04:07

       You want-

   23. LFLex Fridman1:04:07

       ... uh, Hitler, and I think about this a lot actually, interviewing Hitler. I've been studying a lot about the, the, the rise and fall of the Third Reich. I think about interviewing Stalin. Like, I put myself in that mindset, like, how do you have conversations with people to understand who they are so that, not so you can sit there and yell at them-

   24. JBJay Bhattacharya1:04:27

       Yeah.

   25. LFLex Fridman1:04:28

       ... but to understand who they are so that you can inspire a very large number of people to be the best version of themselves-

   26. JBJay Bhattacharya1:04:33

       Well, that's the thing, I think-

   27. LFLex Fridman1:04:34

       ... and to avoid the mistakes of the past?

   28. JBJay Bhattacharya1:04:36

       I believe that everyone, uh, that's involved in this debate has good intentions. They have their, they're coming at it from their points of view. Uh, they, they don't, they have, um, uh, they have their weaknesses, and if you can paint a picture in your questioning by, sympathetic questioning, of those strengths and weaknesses, and their point of view, you've done a service. Um, that's really all you, I, I personally like, like to see in, in those kinds of interviews. Um, I don't think a gotcha moment, uh, is really the key thing there. The, the key thing is understanding where they're coming from, understanding their thinking, understanding the constraints they faced and how did they manage them. That's gonna provide a much... I mean, for me, that's what I look for when I, when I listen to podcasts like yours, um, is, is an understanding of that, of that, uh, of that person and the moment and how they dealt with it.

   29. LFLex Fridman1:05:26

       I mean, I guess the hope is to discover in a sympathetic way a flaw in a person's thinking together.

   30. JBJay Bhattacharya1:05:33

       Yeah.
6. 1:07:14 – 1:14:11

   Vaccine safety and efficacy

   1. JBJay Bhattacharya1:07:14

   2. LFLex Fridman1:07:14

      Well, let's talk about the vaccine.What are your thoughts on the safety and efficacy of COVID vaccines at the individual and the societal level?

   3. JBJay Bhattacharya1:07:22

      Okay. So for the, the vaccine safety data, uh, it's, it's actually challenging to convey to the public how this is normally done. Like, normally, you would do this in the context of the trial. You'd have a lo- a lo- a long trial with large numbers, re- relatively large numbers of people. You'd follow them over a long time, and the trial will give you some indication of the safety of the vaccine, and it did. Um, I mean, but, uh, you, the, the, the trial, the way it was constructed, when it was, came out that it was protective against COVID, it was no longer ethical to have a placebo arm. And so that placebo arm was vaccinated, lar- large part of it. And so that meant that, from the trial, you were not going to be able to get data on the long-term safety profiles of the vaccine. Uh, and also, the other thing about trials, uh, though there's tens of thousands of people enrolled, that's still not enough to get... When you, when you, when you deploy a vaccine to the pop- at population scale, you're gonna see things that weren't in the trial, guaranteed. Populations of people that weren't represented well in the trial are gonna, are gonna be given the vaccine, and, and then that they're gonna have things that happen to them that you didn't, wouldn't, didn't anticipate. So, um, I wasn't surprised when people were a little bit skeptical when the trial was done about the safety profile. It just, the way, the nature of the thing was gonna make it so that it was gonna be hard to get a complete picture from the trials itself. And the trials showed they were pretty safe and quite effective at preventing, um, both you from getting COVID... Uh, like I said, I think the main end point of the trial itself was, uh, symptomatic COVID.

   4. LFLex Fridman1:08:56

      Mm-hmm.

   5. JBJay Bhattacharya1:08:57

      Right? So, um, uh, so that was like, that was qu- you know, I mean, it was really, um... To, to me, like, it was about as amazing a- achievement as anything, organizing a trial of that scale and running it so quickly. Uh-

   6. LFLex Fridman1:09:10

      And the final results being so surprisingly high.

   7. JBJay Bhattacharya1:09:14

      So good, so good, right?

   8. LFLex Fridman1:09:15

      Yeah.

   9. JBJay Bhattacharya1:09:16

      Um, and, um, so the, but the problem then was, normally, it would take a, a, a long time. The FDA would tell Pfizer to go back and try it in this subgroup, they'd work more on dosing, they'd do all, all these kinds of things that kind of didn't, we really didn't have time for in the middle of a pandemic. Right? So you have a, you have, um, a, a basis for approval that it's less full than normally you would have for a population-scale vaccine. But the results were good. The results l- looked really good. And actually, I should say, for the most part, that's been borne out when we've given the vaccine at scale in terms of protection against severe disease.

   10. LFLex Fridman1:09:56

       Yep.

   11. JBJay Bhattacharya1:09:56

       Right? So people who have got the vaccine, um, for a very long time after they've had the, the full vaccination, have had great protection against going, being hospitalized and dying if they get COVID.

   12. LFLex Fridman1:10:08

       Let's separate, 'cause this seems to be, um... There's critics of both categories, but different. Kids and kids and, uh, o- old- not older people. Like, uh, let's say five years old and above or something, or 13 years old and above. So f- uh, for those, it seems like the reduction of, uh, the rate of fatalities and, and serious illness seems to be something like 10X.

   13. JBJay Bhattacharya1:10:38

       I mean, for older people, it is a godsend, this vaccine. It, it transforms the, the problem of focused protection from something that's quite challenging, possible, I believe, but quite challenging, into something that's much, much more manageable. Because the vaccine, in and of itself, when deployed in older populations, is a form of focused protection.

   14. LFLex Fridman1:11:00

       Yes. We'll, by the way, we'll talk about the focused protection in one segment, 'cause it's such a brilliant idea for this pandemic, of future pandemics. I thought the sociological/psychological discussion about the letter from Francis Collins is, um... Because it was so recent, it has been so troubling to me, so I'm glad we talked about that first. But, so the, there seems to be... The vaccines work to reduce deaths. It's-

   15. JBJay Bhattacharya1:11:27

       Yes.

   16. LFLex Fridman1:11:27

       ... and that has the, especially the most transformative effects for the older-

   17. JBJay Bhattacharya1:11:31

       Yeah.

   18. LFLex Fridman1:11:32

       ... older folks.

   19. JBJay Bhattacharya1:11:32

       So, so, Nah, let me give you, I've told you one thing that I got wrong in the pandemic. Let me tell you the second thing I got wrong, for sure, in the pandemic. In January of la- of this year, 2021, I thought that the vaccines would stop infection.

   20. LFLex Fridman1:11:48

       Yes.

   21. JBJay Bhattacharya1:11:48

       Right? It would, uh, would make it so that you were much less likely to be infected at all. Because the, the, the antibodies that were produced by the vaccines looked like they were neutralizing antibodies that would s- would essentially block you from being infected at all.

   22. LFLex Fridman1:12:01

       Mm-hmm.

   23. JBJay Bhattacharya1:12:02

       Um, uh, that turned out to be wrong. Right? So I think, uh, it, and it became clear as data came out from Israel, which vaccinated very early, that they were seeing surges of infection, even in a very highly-vaccinated population, that, that, that the vaccine does not stop infection.

   24. LFLex Fridman1:12:21

       So you're a used car salesman and you're selling the vaccine, and, uh, the features you thought a vaccine would have... I mean, I have a similar kinda sense when the vaccine came out. Vaccine would reduce, uh, if you somehow were able to get it, it would reduce rate of death and all those kinds of things. But it would also reduce the chance of you getting it, and if you do get it, the chance of you transmitting it to somebody else. And it turns out that those latter two things are not as, uh, definitive, or in fact are... I mean, I don't know to what degree they're not

   25. JBJay Bhattacharya1:12:57

       ... I mean, I think, I think it's, it's a little complicated, 'cause I think the first two or three months after you're fully vaccinated, after the second dose, um, you have pr- uh, 60, 70% efficacy peak against infection.

   26. LFLex Fridman1:13:09

       Yeah.

   27. JBJay Bhattacharya1:13:10

       So, uh, that, which is pretty good. I mean, right? But by six, seven, eight months, that drops to 20-... percent. Some, some places, some, some studies, like, th- there's a study out of Sweden that suggests it might even drop to zero.

   28. LFLex Fridman1:13:21

       But, and then you're also infectious for some period of time if you do get it, even though you're vaccinated.

   29. JBJay Bhattacharya1:13:27

       Correct.

   30. LFLex Fridman1:13:27

       Although there seems to be loosely data that the period of time you're infectious is shorter.
7. 1:14:11 – 1:30:46

   Vaccine hesitancy

   1. LFLex Fridman1:14:11

      uh, where does the vaccine hesitancy come from, in terms of, it seems like, obviously, a vaccine is a powerful solution to let us open this thing up.

   2. JBJay Bhattacharya1:14:22

      Yeah, so I wrote a, uh, Wall Street Journal op-ed with Sunetra Gupta in December of last year-

   3. LFLex Fridman1:14:27

      Yes.

   4. JBJay Bhattacharya1:14:27

      ... uh, a very ni- with a very naive title, which says, "We Can End the Lockdowns in a Month."

   5. LFLex Fridman1:14:32

      Mm-hmm.

   6. JBJay Bhattacharya1:14:32

      And the idea was very simple, vaccinate all vulnerable people, and then open up.

   7. LFLex Fridman1:14:40

      Open up.

   8. JBJay Bhattacharya1:14:41

      Right? Uh, and the idea was that, uh, the, the, the lockdown harms, this is related, this is directly related to the Great Barrington Declaration. The Great Barrington Declaration said the lockdown harms are devastating to the population at large. There's this considerable segment of people that are vulnerable, protect them. Well, with the vaccine, we have a perfect tool to protect the vulnerable. Which is, I still believe, I mean, is, is true, right? You vaccinate the vulnerable, the older population, and as you said, there's a tenfold decrease in the mortality risk, um, from getting infected. Which is, I mean, amazing. So that was the strategy we out- we outlined. What happened is that the vaccine debate got transformed. So fir- first, there's pa- there's... So you're asking about vaccine hesitance. I think there's, there's first, there's like, there's, there's the inherent limitations of how to measure vaccine safety, right? So we were, we talked about, a little bit about it by the trial, but also after the trial, there's a, there's a, there's a mechanism, and I, this is the work I've been involved with before COVID, on, on, on tracking and, and, and identifying and checking whether the vaccines actually are safe. And the central challenge is, uh, one of causality. So you no longer have the randomized trial, but, but, uh, but you wanna know, is the vaccine, when it's p- deployed at scale, causing adverse events? Well, you can't just look at people who are vaccinated and see what adverse events happen.

   9. LFLex Fridman1:16:01

      Mm-hmm.

   10. JBJay Bhattacharya1:16:02

       'Cause you don't know what would have happened if the person had not been vaccinated. So you have to have some control group. Now, what happened is, there's several systems to do, to check this in, that the CDC uses. One of, one very, very, very commonly known one now is called VAERS, the Vaccine Adverse Event Reporting System. There, anyone who has an adverse event, the either, either a regular person or a doctor can just go report, "Look, I had the vaccine, and two days later, I had a headache." Or whatever it is.

   11. LFLex Fridman1:16:29

       Mm-hmm.

   12. JBJay Bhattacharya1:16:30

       The person died a day after they had the vaccine, right? Um, now you're vaccinate, uh, the vaccine was rolled out to older people first, and older people die, sometimes, with or without the vaccine. So sometimes you'll see someone's vaccinated and two- a few days later, they die. Did the vaccine cause it or something else caused it? It's really difficult to tell. In order to tell you, need a control group. To, for that, um, the, there are other systems the FDA and CDC have. Uh, like there's one called VSD, Vaccine Safety Data Link. Um, there's another system called BEST, uh, I forget the ac- what the acronym is, to tr- to essentially, to track, uh, cohorts of people, vaccinated versus unvaccinated, with as careful a matching as you can do. It's not randomized but it's b- and, and see if you have safety signals that pop up in the vaccinated group relative to the control group unvaccinated. Um, and so that's, for instance, how the, the, the, the, the myocarditis risk was picked up in young, young, especially young men. Uh, it's also how the, uh, higher risk of blood clots in middle-aged and o- and older women in, in, with the J&J vaccine was picked up. There, what you have is, are, are situations where the baseline risk of these outcomes are so low, that if you see them in the con- in the vaccinated arm at all, then it's not hard to understand that the vaccine did this, right?

   13. LFLex Fridman1:17:57

       Right.

   14. JBJay Bhattacharya1:17:57

       Young men should not be having myocarditis. Middle-aged women should not be having huge blood clots in the brain, right? Um, so when you see that, you can say it's linked. Now, the rates are low, so young men, maybe one in 5,000, one in 10,000 of the vaccine, of c- my- my- vaccine-related myocarditis, pericarditis. Um, young women, or v- uh, middle-aged women, I don't know, I don't, I, I'm not sure what the right number might be but, like, I'd say it's, like, in the, you know, one in hundreds of thousands, something like that. Um, so these are rare outcomes, but they're, they're, they are vaccine-linked outcomes. How do you deal with that as a messaging thing? I think you just tell people. You tell people-

   15. LFLex Fridman1:18:35

       Yeah.

   16. JBJay Bhattacharya1:18:35

       ... "Here are the risks." You transparently tell them, and just, you're not, you're not, the- so they're not getting into something that they don't know.

   17. LFLex Fridman1:18:41

       Yeah. And, um, don't treat people like they're children and need to be told lies because they won't understand the full complexity of the truth. Uh, people, I think, are pretty good at, um... Or actually, n- you know, people with time are good at understanding data, but better than anything, they're, um, they're, uh, better at, they're extremely good at detecting arrogance and bullshit. And- (laughs)

   18. JBJay Bhattacharya1:19:09

       Yeah.

   19. LFLex Fridman1:19:09

       ... you give them either one of those-

   20. JBJay Bhattacharya1:19:10

       I mean, I'll, I'll give you one that's, where I think it's greatly undermined vaccine hesi- uh, uh, great- greatly undermined the demand for the vaccine is this weird denial that if you r- recovered from COVID, you have extremely good...... immunity, both against infection and access to-

   21. LFLex Fridman1:19:25

       Yeah. That's really strange.

   22. JBJay Bhattacharya1:19:27

       And that denial leads to people distrusting the message given by, like, the CDC director, for instance, in favor of the vaccine.

   23. LFLex Fridman1:19:35

       Mm-hmm.

   24. JBJay Bhattacharya1:19:35

       Right? Why would you deny a f- a thing that's such an obvious fact? It, like, you can look at the data and it, it just, uh, I mean, it just, just pops out at you that people that are COVID recovered are not getting infected again at very high rates, much lower rates.

   25. LFLex Fridman1:19:50

       After these kinds of conversations, um, I'm sure after this con- very conversation, I often get, um, a number of messages from Joe, Joe Rogan, and from Sam Harris, who to me are people I admire, I think are really intelligent, thoughtful human beings. They also have a platform and, uh, I, I believe, at least in my mind about this COVID set of topics, they represent a group of people. Um, each group has smart, thoughtful, uh, well-intentioned human beings, and I don't know who is right, but I, uh, I do know that they're kind of tribal, a little bit, uh, those groups. And so the question I wanna ask is, like, what do you think about these, uh, two groups and this kind of tension over the vaccine, um, that sometimes, it just keeps finding different topics, uh, on which to focus on, like whether kids should get vaccinated or not, whether there should be vaccine mandates or not, which seem to be often very kind of specific policy kinds of questions that miss the bigger picture.

   26. JBJay Bhattacharya1:21:06

       I, I think it's a symptom of the distrust that people have in public health. I think this kind of schism over the, the vaccine does not happen in places where the public health authorities have been much more trustworthy. Right? So you don't see this vaccine hesiency in Sweden, for instance. Um, what, what's happened in the United States is that the vaccine has become, um, uh, f- f- first because of politics, but then also because of the scientific arrogance, this sort of touchstone issue, and people line up on e- on both sides of it, and the different language you're hearing is structured around that. So before the election, for instance, I did a, uh, I was, uh, I did a, uh, testimony in the House on, on measurement of vaccine safety, and I, I was, I was invited by the Republicans. There were, I think, uh, four other experts invited by the Democrats or three other experts invited by the Democrats, each of whom had a lot of experience in measuring vaccine safety. I, I was really surprised to hear them each doubt whether the FDA would do a reasonable job in assessing vaccine safety, including by people with who have long records of working with the FDA. I mean, these are professionals, great scientists, whose main, you know, sort of goal in life is to make sure that safe vaccine... That, that, that, that unsafe vaccines don't get released into the world, and if they are, they get, they get pulled. And they're casting doubt on the vaccine, the ability to track vaccine safety before the, the election. And then after the election, the, the, the rhetoric switched on a dime. Right? All of a sudden, it's Republicans that are cast as if they're vaccine hesitant. That kind of political shift, p- the public notices. If, if all it takes is an election to change how people talk about the safety of the vaccine, well, we're not talking science anymore, many people think, right? I think that creates... Created this hesitancy. The other thing, I think the, um, the, the hesitancy, some politicians viewed it as a political... As sort of like a political opportunity to sort of demonize people who are hesitant, and that itself fueled hesitancy. Right? Like, that if you're, if you're telling me I'm a rube that just doesn't want the vaccine 'cause I want everyone to die, well, I'm gonna, I'm gonna react really negatively. Um, and if you're talking down to me about my legitimate r- you know, sort of, uh, concerns about whether this vaccine is safe to take... I'm, you know, I, I've, like, heard from women who were thinking about getting pregnant, "Should I take the vaccine? I don't know." I mean, there are all kinds of questions, legitimate questions, that I think, um, should have good data to answer that we don't necessarily have good data to answer. So what do you do in the, in the face of that? Well, one reaction is to pretend like we, we know for a fact that it's safe when we don't have the data to know, know for a fact in that particular group with that particular set of clinical circumstances you know. Uh, a- and that, I think, breeds hesitancy. People can detect that bullshit. (static) Um, whereas if you just tell people, "You know, I don't know."

Episode duration: 2:21:48