By playing, you agree to uListen's Terms and Privacy Policy and YouTube's Terms of Service.
Peter Attia MD#100 – Sam Harris, Ph.D.: COVID-19—Comprehending the crisis and managing our emotions
Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.
CHAPTERS
- 0:11 – 7:43
A Crisis Unlike Any Other and Our Short-Sighted Risk Focus
Sam Harris and Peter Attia open by noting that the pandemic has no real analogy, not even 9/11. They discuss how predictable it was and worry that we will forget again, as with climate change. Harris describes the layers of denial he sees in people around him.
- •Both agree that 9/11 is a poor analogy for this crisis
- •Harris notes Bill Gates called this perhaps the most predictable disaster
- •Harris fears resources for virus detection won't be sustained once the crisis passes
- •Climate change is more abstract, while the pandemic's toll on hospitals is visible
- •Harris describes confirmation bias and denial among smart people in his life
- 7:43 – 16:20
Error Bars, Intuition, and the Flu Comparison
Attia explains how poorly people handle uncertainty ranges and argues that error bars should be part of communication. Harris describes a personal anecdote that makes flu comparisons feel wrong to him. Attia counters that flu is a known, steady quantity while this virus is in exponential growth.
- •Attia describes a 95%-confidence-interval game that people rarely pass
- •Harris suggests betting and prediction markets sharpen probability sense
- •Harris explains how knowing a group of skiers who fell seriously ill shaped his view
- •Attia says flu mortality is spread uniformly across a year while COVID-19 growth is geometric
- •Attia asks how to address future outbreaks locally without global economic calamity
- 16:20 – 22:35
Is the Cure Worse Than the Disease?
Harris raises the argument that the lockdown is worse than the virus and the idea that we should let everyone get sick. He points out that no one offers equivalent happy talk about the economy. Attia adds an analogy comparing flu to traffic deaths and the nonlinearity of terrorism.
- •Harris shares concern about depression and loss of social cohesion
- •Harris notes people assume hospitals won't be overwhelmed and the virus will fade on its own
- •He points out that no one dismisses economic fears the way some dismiss health fears
- •Attia compares flu to traffic deaths and 9/11's non-linear threat
- •Harris asks about herd immunity and whether shelter-in-place can last for months
- 22:35 – 26:33
Why Not a Short Total Lockdown? Treat Each City as Its Own Country
Harris asks why a brief total lockdown hasn't been better communicated. Attia says it's a political rather than scientific solution and argues for treating each city as its own country, citing wide differences within Italy.
- •A total lockdown of about four weeks could burn out the virus, as happened in China's second wave
- •Attia doubts such a lockdown is feasible in a free society like the US
- •Per-population deaths in Milan were 40 times higher than in Rome and 300 times higher than in Sicily
- •The cars-heading-for-a-cliff analogy illustrates different starting points and braking
- •Attia wishes policymakers had focused on supply-demand mismatches earlier
- 26:33 – 34:48
Modeling New York: ICU Capacity and the Outlook
Attia walks through his team's modeling of New York, starting from known positives and an assumed multiple of unknown cases. Even under very conservative assumptions, ICU demand exceeds capacity. He attributes New York's situation to a head start, density, and bad luck.
- •Known positives in New York were about 11,000–12,000, with estimates of actual infections from 5x to 40x
- •Even at 5x with R-nought of zero, about 50,000 infections would be present
- •New York has about 1,000 ICU beds, perhaps expandable to 1,500–2,000
- •At roughly 4% needing ICU care, demand exceeds 2,000 beds
- •Other cities like Miami, San Francisco, Los Angeles and Seattle need to push the brakes harder
- 34:48 – 38:09
Collateral Health Risks and Everyday Caution
Harris asks whether the mortality from deferred non-COVID care is being modeled. Both describe how they avoid risks that could land them in a hospital, from delayed procedures to kids and a new puppy.
- •Attia says his team hasn't modeled non-COVID deaths but sees effects in his patients
- •Attia's practice has postponed labs and weighed a patient's dental procedure
- •Harris treats daily life as if he were far from medical help
- •Attia worries about his kids and a puppy leading to an urgent care visit
- •Both note others cycling and scootering without such accommodations
- 38:09 – 50:20
Mindfulness and Managing Anxiety
Attia asks how Harris copes with an anxious mind and disturbing dreams. Harris describes mindfulness as clear attention to experience, practiced like a physical skill, which shortens the lifespan of negative emotions. He says anxiety is useful only briefly, as a goad at the boundary of the known and unknown.
- •Understanding anxiety from the first-person side lets you step off the ride
- •Progress is about getting faster at puncturing emotions, not banishing them
- •Feeling anxiety in the body without reaction strips its psychological content
- •Fear is useful when it prompts action, but most moments of negative emotion are wasted
- •Attia notes the mind's forward-looking anxiety is often worse than the present moment
- 50:20 – 52:16
Silver Linings and Talking Honestly with Kids
The two discuss the unexpected benefits of quarantine, including less travel, more family time, and a reset of values. Harris explains how he talks with his daughters, committing to honesty without sharing everything.
- •Both dislike travel and find value in the pause
- •Many people report a hard reset of their values and more family time
- •Harris acknowledges that those able to work from home are lucky
- •Harris never lies to his daughters but doesn't tell them everything
- •He teaches his older daughter tools for dealing with probability and risk
- 52:16 – 1:03:00
Irritability, Self-Awareness, and Spousal Support
Attia asks about irritability, and Harris says he still gets angry but can drop it quickly when called on it. His stress peaks when a conversation about a decision is shut down. Attia describes losing his temper with his kids and how his wife's cue to take a breath helped.
- •Harris says mindfulness lets him stop on a dime when called out
- •His kryptonite is when the door closes to solving a problem he sees as urgent
- •Harris wants to be a calm operator rather than a panicked one
- •Attia recounts blowing up at his kids and then withdrawing in shame
- •A spouse's cue to pause can help where practice alone falls short
- 1:03:00 – 1:09:37
Shame, Apology, and Repairing Relationships
Harris frames shame as another chance to see through the self and as a signal to repair relationships. He explains his view of free will as shaping an aspirational apology. The discussion closes on shame's risks, including its absence in some meditation teachers.
- •Shame can prompt an apology that leaves a child better off than before
- •Harris says thinking you should have done otherwise is really aspirational, aimed at the future
- •Toxicity comes from how long you stay stuck in shame
- •A mind incapable of shame risks sociopathy
- •Harris says shamelessness has been the downfall of some meditation masters
- 1:09:37 – 1:14:40
Optimism: Expertise, Government, and Lessons to Capture
Attia asks what Harris is optimistic about. Harris hopes the denigration of expertise and the anti-vax movement will fade and that we recognize government's necessary role. Attia emphasizes local decision-making, and Harris says lessons from institutional failures must be captured.
- •Harris hopes expertise regains respect, though he isn't sure he's truly optimistic
- •Harris says minimal government can no longer be a sacred principle
- •Attia sees public-private partnership as essential, with cities taking on more risk planning
- •Harris suggests a shared document for the crisis's lessons
- •Harris notes how failures in institutions look thin and unnerving
- 1:14:40 – 1:21:07
Holding Two Truths: China, Politics, and the 'Chinese Virus'
Harris argues that people must hold apparently incompatible thoughts at once, using the phrase 'the Chinese virus' as an example. He says China should be held responsible for wildlife practices and concealment, while racial animus makes no sense. Attia says he is less hopeful about that area.
- •Harris says Trump uses the phrase to bait Democrats into ignoring his more serious failings
- •He faults wildlife-eating practices and the authoritarian government's concealment
- •He says the virus is now global and most Chinese people bear no responsibility
- •Harris says politics and journalism show little aptitude for threading such needles
- •Attia says he is more hopeful about the scientific community
- 1:21:07 – 1:28:40
Vaccine Prospects and Talking Honestly About Risk
Harris asks what if a vaccine proves hard to make. Attia says coronaviruses may be harder to vaccinate against, with a riskier risk-reward trade-off. They discuss the difference between legitimate vaccine safety debates and anti-vax claims, and the need for sophisticated public talk about risk.
- •Attia says coronaviruses behave somewhat like RSV, making vaccines potentially riskier
- •Large clinical trials would give clear safety profiles, unlike anti-vax fears
- •Harris says everything, even ibuprofen, carries some risk, and people know when they are lied to
- •Attia says he would love to dedicate a life to teaching risk management
- •Harris says public policy must follow statistics even when psychology diverges
- 1:28:40 – 1:32:33
Closing Thoughts and a Pledge to Revisit
Attia and Harris wrap up, noting the conversation was more about processing information than new information. They agree to talk again if the situation changes materially.
- •The aim was to help people process information without overreacting
- •Both expect to have updates in a week
- •Harris expects his own story to change little, while Attia's medical view may change
