How Scientists See the Same Data Differently

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Things Discussed in Episode:

• There’s No Justifying Our Children-Last COVID Policy
• Mask Mandates Don’t Need to Make Sense - The Atlantic
• ‘We’re doing everything we can to survive’: As the US looks to move on from Covid-19, high-risk and disabled Americans feel forgotten
• We’re Entering the Control Phase of the Pandemic
• Talk to the Public Like You Would Talk to a Patient - The Atlantic
• THE MILLIONS OF PEOPLE STUCK IN PANDEMIC LIMBO
• Peyton Manning on SNL (Emily in Paris)

Transcript

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Matt Boettger 0:00

You're listening to the pandemic podcast. We equip you to live the most real life possible in the face of these crises. My name is Matt Boettger and I'm joined with once again. My great, good lovely friend, Dr. Stephen Kissler.

Stephen Kissler 0:11

Lovely. That's wonderful. That's not what I get there, especially when I look like I'm like emerging from the cane as I often do

Matt Boettger 0:18

so you can watch it live or watch it later. I'm here with Dr. Stephen Kissler, an epidemiologist at the Harvard school of public health. How are you doing fine, sir?

Stephen Kissler 0:28

Hey, I am doing all right. It's it's good to see you. It's you know, it's, the weather here is finally warming up a little bit, which is great. And yeah. With COVID cases are going down, which has even greater. So Sue things are

Matt Boettger 0:39

great, right? You can go outside and the COVID is going down. It's crashing here and all the good news. You're going to get a cold wintry blast. Next couple of days. I know it's gonna hit a lot of people. It's going down like 10 degrees tomorrow. Yeah.

Stephen Kissler 0:52

Yeah. It's it's I think so. So yeah. Yeah.

Matt Boettger 0:56

It's not over. So we had a beautiful day here. It's like 60 degrees to the boys at walking. They were not used to it. They were like sweating. Like it's so hot. I'm like, it's 59 degrees. We're not quite hot yet, but nonetheless, so that was good. One bit of fun news. I wanted to tell everybody, this sounds like a shock. So we're almost two years into this pandemic podcast. I think it's like March 4th or fifth or six would be two years. And I got to see. Kissler for those of you who have not been, you know, been listening only recently. He was a long time guest for a while. Stephen's brother, he's a doctor at university color hospital. And I haven't seen him since before the pandemic. So it was like two weeks ago or what a week and a half ago, I got to see him in face, face to face at a coffee shop for the first time. And it was really, really awesome. So didn't get to see Stephen, you're still way up in the Northeast, but hopefully sometime we'll reconnect. So it was good to see him. And I think there's a number of things, so we've got another great. Five-star is by far the best covet podcast. This is from. Cat 2 7, 8, learn something new every time. Thank you. Cat 2 7, 8. I really appreciate it. Here's my goal. We have 13 left to get to 200. We'd love to get there by March 6th or fifth, whenever our two year anniversary. So if you can get five minutes, two minutes, one minute, leave a little review would greatly help. If you want to support us financially $5 a month or a one-time gift, you can do that on patrion.com/pandemic podcast or one-time gift Venmo, PayPal, all in the show notes. So, what do we talk about now? I mean, it's like, it's, COVID cases are plummeting. Everybody's going back to normal. You have mass mandates released everywhere, I think, except for Hawaii, at least for the U S we're talking about the us here who Hawaii is to the long kind of the holding strong on that. But I would imagine they'll probably release those relatively soon. There's a lot of stuff. So I think maybe we need to focus on the transition and talking about, we've mentioned this a handful of times, right? But now it's like serious, unless something else happens. I'm hoping that's not the case of this actually is a transition to some sense of normalcy for an, you know, a period of time. And I want to start with this. There was a email from a lady named Wendy. So thank you for. Us and it was a great, great, I'm assuming you're from the UK, Wendy. I have no idea. It sounds like that. Cause it was really focusing on the scientists kind of basically epidemiologists the scientific community in the UK versus that of the U S so I want to pitch this cause I think this might be a good segue into. Talking about what's next? How do we live with this? Because there's always a bit of confusion about what to do with do next. And Wendy's email really there's much more to this, but she kind of showed how well the UK scientists for example, are pretty hesitant when it comes to discussing. Really advocating for vaccines for children. Right. And kind of, there, these are more hesitant apparently than the U S is the U S a little bit more for it and really strongly kind of advises it, whereas UK doesn't and clearly both are looking at the research. Clearly, both are trying to make the best sense of out of all of this in light of what's what's going on right now and what might be next. And I want to just throw it to your way. I mean, I know without a doubt, I'm sure you've talked, spoken to email texted, tweeted, who knows some UK scientists. And how, w you know, where does this kind of discrepancy come from? It's not really huge. It's literally just one is advanced. Advancing the cause for vaccines ones, he's like, ah, sure. Get it if you want to, but we're really not recommending it because we think that they think that the costs might weigh, outweigh the small benefit for that demographic. So start with that. Let's just talk about how those two camps, how do you guys relate to one another? What's this discrepancy coming from? Talk to us about.

Stephen Kissler 4:36

Yeah. So there's, you know, there are a couple of things that come to mind with us, you know, and the first is that when we've talked about this, a number of times on the podcast before, but how the recommendations that are given for public health. Are rooted in science, but not exclusively based in science that they're, you know, they, they, they have a foundation in science, but then they also reflect a given societies preferences and tolerance of risk. And. Just the different ways that you weigh things that really can't be quantified very easily. And so, you know, I, I can sort of talk subjectively to this a little bit because I mean, I lived in the UK for about five years. And so I got pretty sort of an intuitive sense for you know, in very broad generalizing strokes, the sorts of differences culturally, when it comes to Facing a medical risk that exists between the U S and the UK. So, you know, one of the things that really struck me when I moved to the UK is that health and safety is is like a top priority in anything that you do. So, when I went to the UK, started my PhD I went to like two full days worth of training about Research safety basically. And some of it had to do with lab work, but most of it, I mean, I, you know, I type at a computer all day. Right. And so we had like seminars about ergonomics and about like how to like, just be, keep yourself safe and healthy about like, you know, the different possibilities for fires. If you like. Hit your computer up too much. If you plug too many things into the wrong outlet or whatever. Right. And so, so it's interesting because it's like far from being like cavalier that I, I found my experience in the UK to actually have sort of like health and safety sort of at the forefront of their minds. But a lot of that was from a preventive mindset. There's this real deep sense of, of the need for pre. And I can trust that some to my experience here in the U S where you know, and again, again, this is like super generalizing. This is totally subjective and not based in any sort of evidence other than my own life, but but I feel like, you know, here we do sort of like sometimes play into the stereotype of kind of shooting from the hip a little bit. And it's like, okay, well, you know, you want to do that. All right, good luck, you know, Godspeed and see how that turns out for you. And then, you know, the flip side of that is that I think that we often rely on interventions in the sense of like, Drugs and pharmaceuticals. We really like taking something when something goes wrong. And so, so, so it's interesting because I think that in a sense, the, the, the UK, my experience there was that they seem, they tend to be a little bit more conservative in terms of prescribing things including like drugs and antibiotics, and then also like, recommending vaccines. And they tend to weigh these things a little bit differently. Whereas here in the U S I think that we're Yeah. I tend to be a little bit quicker to say like, yeah, give him the drug, give him the vaccine, you know, this is what we should be doing. And just like really having a lot of faith that, that administering some kind of pharmaceutical intervention is probably going to be a good thing. So, so part of it is, I think is probably rooted culturally to some extent. The other thing, you know, thinking about what's happening, you know, with the UK is recommendations is also this element of time. And I think that this is something that we could probably pay a little bit more attention to. Here in the U S which is the. The recommendations are really based on an understanding of where the pandemic is right now. As you mentioned, the, the, the recommendations may well change. If we get a new variant, if case will start to increase because that's when the cost benefit ratio is really going to shift, kids do have a high risk of biochem. From COVID-19. But the issue is that if you give all kids a vaccine, and if COVID cases are very low than the relative, like the absolute risk of it, getting myocarditis is higher for the vaccine than for COVID. But if we start getting a major COVID outbreak that completely flips on its head, and then it makes a lot of sense to give kids to that. And so, with that in mind, you know, we're no longer in a situation where vaccine supplies are scarce, especially in the U S and the UK. And so they have a lot of trust that like, if a new variant emerges chances are they'd be able to reverse this recommendation, get it administered as quickly as they need to, to protect those kids from serious outcomes from COVID-19. But right now I think the, the assessment is, is that it doesn't make sense. And that's a pretty nuanced statement to send. And so I think here, they're sort of like, tending towards, you know, just saying, yeah, it's recommended everybody should get it. It seems like it is safe and effective and it very much is. But there's a little bit more of a bias here, I think, towards that kind of intervention. So that's perfect. And

Matt Boettger 8:50

that's a great segue, Stephen, could we talk about. Before we started recording about these two articles coming from the Atlantic, which I thought it was somewhat comical, but also, Hey, it's journalism. It's fabulous. And this is two articles was there's no justifying our children last COVID policy. So in, in a nutshell, I'll put these in the show notes, read them. I think they're really, really great articles. Just really saying, Hey, the, the, the idea of imposing masks. On children at school and then releasing them everywhere else makes absolutely no sense. There's no logic behind it. And so, and they tried to look for the logic and they said it was illogical. And then there was another article within, I think days later that said mass mandates don't need to make sense, same place the Atlantic in a really fascinating article. The reason why I think at the segue is that one of the, one of the first article about they just couldn't find a logical reason to keep mass for children. They use an example of the CDC in how. Where you were, where you were saying is where I think nuance may be, could be placed back into the CDC more, a little bit more available talking about how, like, when they recommended, you know, boosters for, I think 12 and older, they just made it universal and how, like they were saying, well, you know what? The ad that seems almost discredit a number of things and discredits, maybe the efficacy of the first. By just saying it. So it kind of makes that kind of scare like a, wait a minute, the first two don't count, not understand the nuance of maybe individuals of like saying, well, it depends on your circumstances where we have, like you were saying, Stephen, like, where are we at in a wave or lack thereof. And so that lack of nuance seems to maybe make that credibility fall apart for the CDC. And so you're saying, well, that may be something we could learn from, from the UK of adding a little more nuance to our, to our public policies. So,

Stephen Kissler 10:30

yeah, absolutely. Yeah. So I think, I mean, I, and I, and it's so tricky because the, that nuance can get lost at so many different layers. I mean, sometimes it just never exists in the first place, you know, from, from the ones who are making the recommendations. But a lot of times it also just gets filtered through the media or through, you know, social media or whatever. And a lot of the nuance that is, is in fact, there just gets filtered out. And so the message that we end up hearing. It's not nearly as complex as it should be. So I think, you know, the, the, the responsibility for this doesn't really just rest on any single person's or single institution's shoulders. But I think, you know, the fact is that there is a lot of nuance that, you know, we can, we can do a lot better with both communicating and accepting nuance. And I think, you know, this, this question of masks in schools is a really interesting one because what it also points to as another sort of, logical approach to addressing issues during the pandemic that I've seen repeat itself again and again which is. Something some issue like masks or a certain type of vaccine recommendation and point out an inconsistency. And then but what often happens is that you say you, you know, the, you point out the inconsistency and then you argue for. One change. But in fact, there's almost always two changes that are possible. So in this case, you know, you could say that and I agree that it's, it's kind of inconsistent to say, we need to have masks in schools, but we're not going to have masks anywhere else. And so, you know, one option is to say, okay, well, we shouldn't have masks in schools then either because if we don't have anywhere else than what's the deal, but also this might be pointing towards. Well, maybe, you know, maybe we should be thinking about masking at certain times in other places too. And maybe, maybe schools are sort of the last thing that are helping to remind us that actually this is, you know, this is a useful thing in certain places at certain times. And we should be bearing that in mind and we should be having an open discussion as to when are masks appropriate and when aren't, they absolutely it's inconsistent, but how do we make it consistent? There's a lot of different ways to do that. And so trying to be really open-minded about, about what those possibilities might be. So I think, you know, for me, that's, that's real, the main upshot of this is that as we are making this really important transition from sort of crisis management into at least a period of time when we're probably going to be in more of a sort of control and management phase of the pandemic and who knows how long that will last, but may it last forever. And but. Inevitably, we're going to have inconsistencies. We're going to have decisions that were being made for reasons we ourselves don't fully understand. And it's only by reflecting upon the state of things as they are. And then starting to think about how we should adjust to those things that we will finally reach that consensus. We don't, I think holding ourselves to like consistency at the societal level. At all times it's just much too high of a bar and I think it's something we should always be striving towards for sure. But. It's okay. If it's not, because that's where, that's where creativity comes from. That's where creative social solutions come from is when people do things in different ways. And you say like, Hey, that's working and that's not, and this is how we can sort of reconcile what's going on for a more. Sort of policy. So I think we're, we're still sort of in the, in the, in the evolution phase of these policies, we're still trying to figure out what they're going to be as we transition into this next stage. So all of the diversity that we see in how different people in different institutions or approach are approaching it, I think is actually really important. And.

Matt Boettger 13:41

That's helpful. I think a good, good piece of advice of, I mean, he's looking at my own life of how inconsistent I am in my own personal life of, I try to be reasonable. I try to think through things, but nobody can be this way. Nonstop. We all are this complex web of emotions and intellect and, and history and environment and all kinds of stuff. And so on an individual level of it's that. To maintain consistency in your own life. It that's on an exponential level and he talked about on a society and a societal level. So I think that's helpful to kind of give some compassion towards the CDC and other places are striving to give that as much as possible. Going back to mass mandates. Don't need to make sense again. I love this article. One thing I loved about this is it really kind of focused on the point of. These masks in schools mandates, or like the last place by which we can, it can be imposed. Right. And that's probably one of the reasons why it's maybe still being done and not arbitrarily this, this author to know is he or she, I need to look at that and mentioned how well it does kind of make sense, even that's the title. Whereas, you know, bars, restaurants, they're letting go of all their mass mandates and schools are this last place that that's kind of Harbor of mask in whether it's illogical or not. But the fact of the matter is there is a truth to be said that if you're having somebody who is like a grandma or grandpa, more than likely, they're going to be in more contact with the school than a bar. Right. And so just by that level of loan shows that this still is a place by which we can have a discussion and talk about. Utterly irrational makes sense. And like you said, the fact that it's still, there is a reminder that we're not fully out of everything yet know granted, we want to move towards normalcy, but it is a reminder that we still need to have these discussions because once all that is gone, I would imagine we're so frustrated. So burnout, so exhausted out of sight, out of mind, right? In until something happens and then we just look for a pill to fix it as soon as possible. So that's helpful. That's helpful. Okay. So a quick update on the, the, the, the little, the BA two variant, you know, I read an article just a few days ago up in the show notes that it could be more dangerous. It sounds like this is a credible research. It was done on like a lab. Right or mice or durable. I'm not sure what it was. So this is me being the lay person and I just read it, thought it was interesting. And when to throw it back to you to say, is there any kind of word on your end about. What BA two might be looking like kitten propose any kind of hiccup in the spring or summer or not.

Stephen Kissler 16:09

Yeah, so, I mean, I think this is another one of those areas where thinking about reaching scientific consensus is really important. So as, as you said, there was that study that suggested that in. And I'm, I'm not actually sure which kind of fuzzy animal it was, but it two generated more severe outcomes of disease. But that actually contrasts with a lot of evidence that's coming from places where BA two is currently spreading in humans a lot. And there's actually really no discernible difference in rates of hospitalizations and deaths with versus. The a one being the sort of original Omicron variant. And so, you know, there's, there's, there's a lot that separates you and me from a durable and a hamster. And you know that yeah. And I, I believe it or not, you know, that's not just on the physiological scale, but but with physiology, you know, it's like there's these viruses are constantly changing the, their receptors, the things that make them stick to cells and enter into them. And just by random chance, you might, you know, get something that works really well for one species and really poorly for another species. And so, while those kinds of studies are valuable, That translating these things across species is, is notoriously difficult. And so, so, you know, I think that the, the weight of evidence is that even if there is a difference in severity, it's probably slight and is probably not going to make a huge difference on the population scale, you know, we'll have to keep watching it for sure. But I I'm not too too concerned about that at the moment. Now it does look like BA two is probably a little bit more transmissible than BI one, which is just mind blowing to me. I mean, like how much more can this thing ramp up? Infectiousness it's unreal. But the leap and infectiousness is much, much smaller than the leap from Delta to Omicron. And that's part of why, you know, we've seen BA two bubbling along here in the U S for months at this point, but nowhere hasn't really taken off to become the dominant lineage. We're starting to see upticks especially here in the Northeast. And I expect to see that around much of the rest of the country, but it is. Utterly different than the invasion of the initial Homer crown wave. Right. Which was just like this absolute explosion of cases. And so, so yeah, so I mean, it, it sort of seems like, you know, between Delta and Omicron the virus like replaced its engine from like a lawnmower engine to like a Hemi, you know, super-duper V8, whatever. Whereas this is just sort of like doing some. Yeah, it took it in for a tune-up and you know, it was as a little bit more infectious, but that's kind of what we're dealing with right now. Furthermore, you know, in, in South Africa we saw a huge wave of BA one another, starting to see some BA two. And even though BA two is increasing there, the overall number of cases I believe is still declining. It's declining at a slower rate than it was before, but they're still going down and we'll have to watch that closely. But again, like none of the indications that I'm seeing are suggest that BA to. It's going to be catastrophic, the more severe or catastrophic, the more infectious it's just kind of like, the SQL you know, the

Matt Boettger 18:55

good, good. And I heard, I would imagine since it is kind of like, well, at least it doesn't have its own Greek alphabet yet. Right. It's just a, that it means it's similar enough to those who maybe got BA one that they'd be relatively immune to.

Stephen Kissler 19:09

That's right. Yeah. And you know, there is one of the things that I have seen in a lot of labs have been looking at the antibody cocktails, the sort of neutralization antibodies that are sometimes administered to people who go to the hospital and BA and BA to do different, some important ways for that. There are some things that were effective against BI one that are not against BA two. And actually I think vice versa that some of the things that weren't effective against BA one now, Effective against BA two again. But by and large, it seems like the immunity from BA one does seem to, you know, on the whole transfer over to BA two as well. So it doesn't mean you can't get reinfected. We know that that's, you know, that happens all the time with SARS cov two. But you know, each exposure gives you some protection and it seems like, you know, they're very closely related. And so BA one does seem to give you at least a pretty decent amount of time.

Matt Boettger 19:55

Great. Great. Now, as we move into the transition to just living with this and making it become an endemic and just becomes part of, you know, kind of like living with the flu, when the articles that I read, as well as, as, as us pushes to a pre COVID reality high-risk and disabled Americans feel forgotten. So I read this and it was a really powerful article that I read. But, you know, my question is this is, this is not something new. Clearly there's been other diseases. Before 1918, where we're mass, the last time we were mass all everywhere as a, as a, you know, and so I guess my pitching this back to you, like, what do we do as a transition? I feel like this is less maybe descript descriptive than prescriptive, or I don't know which way to say it, but it's the flu I would imagine has the same kind of intensity for people who are vulnerable, who are on the, you know, who have immune compromised systems. Is this more of like, okay, It's not necessarily a COVID question or is it more just a wake up of like, oh, what have we been doing the past 20 years with all these things? And maybe this is something we need to address as a public policy to help these people who suffer greatly. And I'm sure during the winter season feel a little bit more unnerved

Stephen Kissler 21:04

than we. Yeah. Yeah. So, I mean, I would in, in my mind this, this was one of the most valuable and important sort of like media articles that's come out in recent months. So once again, ed young from the Atlantic knocks it out of the park. You know, he's been one of my favorite science writers throughout the pandemic and and this one is nice because it's, it's also actually compared to some of his previous ones. It's relatively short. It's pretty quick read. And, and super illuminating. And so, you know, I, I sympathize and agree a lot with, with, with what's been presented in this article. I think it's just super important because you know, you're, you're right. There are there are a lot of people with compromised immune cells. Who have been facing, you know, like an increased risk from everything for ages. And I think, you know, it's so easy to forget about disability and about vulnerability and all of these different things. In many ways. I think our society, especially in the Western world, especially in the U S has just completely structured around shielding us from death, from suffering, from disability. And And that's, you know, that's, that's not good. And, and, and one of the things that COVID has done is it's really brought some of these things to the forefront and some really important ways. So, you know, as, as you mentioned, like we, there's, there's part of the question of like, you know, we haven't really. Done much in terms of public policy to protect these groups in the past, you know, is, should we be doing anything now? And I think, you know, it, again gets back to that idea that like, you know, there's, there's this inconsistency and there are two routes, you know, one is that like, oh, well we didn't do anything before. We probably don't need to do anything now. Or it's like, well, maybe we should have been doing something before. And you know, maybe, maybe that's the way to correct the inconsistency. And so, you know, I, in the article. Yeah. It says that, you know, precisely none of these people who are interviewed, who are immunocompromised suggested that we should be going into any sort of like permanent lockdown. You know, they, they recognize that they have a medical condition that puts them at greater risk from literally just living life. But but there is really the sense, you know, the thing that really stood out to me was the sense of just being forgotten of people just not really caring. And, and it's, I've seen this all the time and that drives me up a wall, but this sort of like, using sort of like the elderly and immunocompromised to sort of this throw away line for the exception to everything of COVID and it's like, well, okay, like when did we, when did we stop caring about the elderly and the immunocompromised, right? Like when did they become an asterisk that we can sort of no longer. You know, that we can just sort of say, oh, well for this group over there, you know, these things might differ, but we're not going to necessarily say how they differ. We're not going to say, you know, what the actual change in risk is going to be. We're just going to sort of do our due diligence by saying they exist and then sort of move on with our lives. And I think, you know, I think that's just is a, is a huge, huge injustice. So with that said you know, we make the comparison between COVID and flu as well. And you can think about it from, you know, for a person who's immunocompromised. It's basically like being unvaccinated to a large extent. And so. COVID is a lot more severe than a flu for, for somebody who's totally immune naive. And so the risks that they're facing is now not just from flu, but also from this additional risk of COVID-19. And I think that's important, you know, that, that there's, you know, this just sort of ratchets up that risk of being out in the world for people whose immune systems are compromised. And so. So I think that, you know, I don't know yet what the answer is to this. Once again, I mean, I don't think it's realistic to say that we're going to be able to eliminate all risk from everyone or even to distribute risk equally among individuals. I mean, it's just the sad reality of the world that like people face different risks in life for all sorts of different reasons. You know, w we should always be striving to improve the lives of, especially the people who are most vulnerable, but you know, that's, that's yeah, that's that that's, that's the project of the entire human project, you know, that's not the project of a couple of years. But in the meantime, I think just like recognizing that there are a lot of people who are immunocompromised, and even if you're not, you will be one day, you know, that's what happens when you get older. And so just recognizing this is not something abstract, this is not something rare, even, you know, that there are a lot of people who we probably don't even know who are around us, who are immunocompromised. And just recognizing that they're an integral part of our world and trying to be a little bit more mindful of, of. The risks that they suffer going around the world from day-to-day. So, yeah, read the article that articulates all of this about a thousand times better than I was able to just now, but

Matt Boettger 25:18

yeah, that's great. And I mean, sorry, for those of you who are hearing a bunch of sounds in the background of mine boys got raised cars yesterday, and so I was slower. So I apologize, but that's the nature of where I'm at right now. I'm in the basement. We have wood floors above. So I think that puts it in a great perspective. And thanks for sharing that. Just the idea of that. I mean, it's. You know, let's move to this idea of controlling COVID in the future. What am I look like? You know, I mean, just as a side note, I totally just, this has probably no relevance, but it has saddened me. I'm a person, you, you as well, a person of faith and come from particular tradition and the tradition has a longstanding hold, you know, being me being Catholic and, and of really caring for those in the margin. And it was, it was, it was hard for me in, in, in many circles around me who didn't feel that same way to consider. As a, as a place where we could really double down and care for those in the margins. And elevate them and protect them. I'm at costs that might, that actually might cost a little bit of suffering on ours. So there was a big, it was a big eye-opening moment. I'm not saying that was shared by every institution or every Catholic, but it, but it wasn't my circles and it was hard to swallow. So I, I appreciate you bringing this up to the surface that this should be a universal focus for so many people. But coming into the, into the sense of, of control and how to begin to control COVID as we move this to an endemic, what do you think this looks like now? I think for you, or maybe I'm pitch it to you as maybe more like in the U S cause I feel like it's a dummy, a very different world, not to be like Peyton Manning joke, but like, you know, I don't feel the SNL where you talking about Emily and Paris and then it went viral and anyway, it was hilarious. He was, it was the interview. Peyton Manning, like, what'd you think of the Superbowl? I was like, oh, I heard it was great. And they like, well, you heard it was great. Like, well, I got caught up in Emily and Paris. And so it's, it's a huge joke, but nonetheless, we, so we started watching Emily and Paris and it was like, it's, it's an awesome show. And like you said, it really opened my eyes to the cultural difference of even like France and how they think of like, like, oh yeah, we really do us Americans really. Don't like to talk about death or hard things and we like to escape it. Right. Entertainment. It's a very different reality. So it imagine how. Control our environments and be shaped largely by our culture. Like you said, like also when the sense of we maybe are not so into prevention, maybe why we have diabetes and in a very unhealthy way, we have a tendency, right. Generalizing to focus on after the matter and how do we fix it and how do we get medicine and that kind of stuff. So. And the U S particularly, how do you look like the next best steps for controlling this? Now, given that there is a large amount of people who are not going to want to do much of anything, because we're kind of done with this. So we want to push it to somebody else or something else.

Stephen Kissler 27:53

Yeah, gosh, you know, it's I think that this, this question sits on all sorts of different levels. You know, we can talk about epidemiologically, which, you know, we have to some extent in previous episodes too, about, you know, what, what does control mean? And like, how do we think about you know, relative risk and comparing the risk from COVID to the risks of other things that we face. Day-to-day like the risk of flu and car crashes and different sorts of things. Like how do we sort of bring that into. You know, probably ideally a similar level because in a way, you know, we've, we've gotten used to living with a certain level of risk. And part of the difficulty of COVID-19 is that it's increased our risk of. Dying of hospitalization. And and so, you know, again, the, the options before us are to control COVID until it comes sort of falls back in line with the risks that we were already accepting, sort of bring it back down to the status quo or to think about like what it means to live now in a world. It's just a riskier place to be than it was before. And I don't think that those are necessarily exclusive. I hope that they're not, you know, I think that, you know, that we still have a lot of work to do to prevent COVID cases where we can and to bring, you know, the, the The impact of COVID down as much as we can, both at the individual and at the societal level. But also, you know, seeing this as a much more general kind of wake up call of precisely this, this issue. And I think, especially this is common in America where it's like, we don't, don't really want to think about death and about dying and about risk and about, you know, and in many ways that's sort of seen as like a morbid or a tablet. Kind of thing, but you know, just kind of recognizing it, trying, trying to take this as an opportunity to readjust our our own relationship with suffering and death and dying. And to recognize that like, you know, we've, we've been living in a time in history that is just absurdly Different than anything that has come before in terms of the reduced risk from dying from infectious disease or, you know, like, even just accidents and toxins and things, you know, we have so much more knowledge that we've really been living in this, you know, hugely privileged time in history. We can frequently forget about our own death and the death of those around us and, you know, and it's wonderful, you know, like I'm not, I'm like, that's great. And that's, you know, that's, that's what I've thrown my entire professional weight behind is sort of furthering that progress. You know, that's, that's really good, but I think that, you know, we can get, get caught in the in the trap of Just because we've made so many strides to pretending, or at least, you know, living as if none of these difficult things exist at all. And I think that this has really shown us that that's not the case. And that, you know, we may well be living in a decade or two, you know, like the coming decades may, will be more risky for all of us than the previous two decades. And that's going to be one of the first times in recent memory that that's been the case, you know, and that's a really hard pill to swallow, but But but you know, as, as we think about transitioning to this endemic relationship with COVID, I think there's, you know, there's a lot from the policy perspective, from the epidemiology perspective, but I, the thing that really interests me right now is sort of like, how do we all know. Sort of bear this, this new reality and sort of from like a psychological spiritual perspective, how do we understand that transition and what does it look like for our society to sort of, just response to this crisis that we've just been through and that in many ways is an ongoing and will continue to go on at some level for probably years to come.

Matt Boettger 31:23

Yeah. I mean, to have that kind of awakening of a mortality, and I would feel like just practically speaking. You know, even though I would, I would say prime generally the most, the world probably looks at us in some sense of, you know, I feel like kind of infants and our, the way we behave at times. And they think that the advantage, I guess, is kind of, you know, I'm thinking like of the Tesla, right? The Tesla was, was created it's battery, it's automated. You can, you can send the car can drive now, granted, you can't just like fall asleep. I'm not trying to advertise any kind of stuff, but it kinda, it kind of a rings to the American ears. Like, oh my gosh, a Tesla, I can drive. I can go to the bar and get wasted still, and then it's still drive home. Right. You know? So it's like, And again, we're not advertising, we're not, we don't want that to be the case, but like, there's this temptation again, you know, everything that fixed so we can still maintain our life and something else. I mean, I think that's a hardship and a difficulty, and I don't think really it's, it's ethically the correct way to pride process things. However, the gift, I think the opportunity in this is maybe like, okay, we're America and nobody wants to wear masks anymore. Maybe nobody will care anymore. And we'll just walk around. What do we do now? You know? And I think putting I would imagine. There to be a lot of resources being put into technology that does it for us, right. Air filtration, all these kinds of things, and, you know, really advancing these kinds of things beyond measure to at the cutting edge so that we can still be in a bar and restaurant and then feel as if nothing's going to happen to us. Because guess what, we, we developed the filtration that we can actually go with COVID and it'll suck it out of us. Right. And and we don't have to worry about a thing, you know,

Stephen Kissler 32:48

Yeah, exactly. I, you know, and this is maybe, you know, going going off, you know, further on something that I have absolutely no qualifications to talk about at all. But but I do think, you know, going back to some of the themes that we were talking about at the beginning of the pandemic about some of the cultural differences between different places, I think, I think you're right. That certainly living in the UK, being in Europe, there was sort of this deeper sense of a rootedness of a Yeah. Even just a acknowledgement and mortality in the sense that, you know, there, the, for example, the memorials to the people who are lost in world war one and world war II were just everywhere. And and, but, you know, yeah, you were saying that like the, the, the view of America's is sometimes sort of childish. And I have to say that like, Probably my perception of the us and its sort of global standing was probably more critical before I left for the UK. Then when I lived there and came back in the sense that, you know, I was I sort of saw that youthfulness as kind of a negative thing, but after being there, you know, I came to really appreciate that. Like for, for all of the traps that our youthfulness as a nation causes us to fall into. There's also this really remarkable. Energy and edginess and swagger that kind of comes with, you know, being a relatively young nation as well. But we're sort of like on the cusp of our maturity as a country, I think, you know, especially, you know, if you think about relative to some of the political systems that have been set up in Europe for, for such a long time. And so, you know, I think that, that, that's another thing that I think as a country, this pandemic sort of offers a new reckoning for us, where it's like you think of about our personal lives and our, our maturing, you know, happens sort of. Start since usually brought forward, especially by crises, you know, when something awful happens or when something great happens, but when there's major turning points in life, you know, that's when we, as individuals really mature. And I think that that sort of like, forces us to question now, you know, we, we have been sort of this. Scrappy young nation for a while. And now there's sort of this really critical point where we have to kind of decide what we're going to be about and what is the process of our maturing going to look like? And there are a lot of different ways that it can look and, you know, people can mature well and can mature poorly, but The fact is they do one way or another there's no, you know, and and so I think that's, that's really the question that's facing us now is that you know, what do we, what do we do with these pieces, recognizing you know, who we are, who we've been, and that it's different than anywhere else in the world. But, and so our path forward needs to be also different than anywhere else, but also needs to reflect like who we are and who we want to be in relationship as we move forward. So that's great. Yeah, maybe I had too much coffee this morning. There's

Matt Boettger 35:18

give me some of that coffee. That's awesome. That's great. No, that's a great way to end on. I remember. I mean, I love my dad and enslaved. I remember when I was really, really young. I had all this enthusiasm and energy about, oh, I'm gonna do this, we need this and this. I remember we were, I was in the back of the car. I was like, one day you'll get older and you'll see things more clearly or whatever. I don't know, wasted it. Like, that'd be like that. I think. There's clearly some wisdom in that, but like, I kind of really echo to me what you just said is like, oh yeah, there. Yeah. The U S is a scrappy young energizing, and here's the older folks, older countries looking at us and either a encouraging us because after all our energy provides some really cool advancements, but also there's some pitfalls to are, are, are a little blinded towards looking at the things that scare us. And, but we've been, we're being faced with a huge moment right now and we are being forced to grow up. And we don't want to lose who we are, but bring it, we'll bring to the table and become something even more mature. So. That's awesome. Stephen. I hope a level of listeners get value. I got a lot of value from what you just said. So I appreciate a lot of food for thought for the next couple of days. So we will end on that fabulous note. These scrappy young dudes are gonna sign out. And we'll be back in a couple of weeks, but in the meantime, if you want to reach out to us matt@livingthereal.com, do you have an email like Wendy? Did. I love them for Dawn to Stephen and even mark, even though he don't know who he is, maybe. And he'll be back on. I know he'll be back on at some point in time, and then if you want to get a hold of Stephen S T E P H E N K I S S L E R in Twitter. I really recommend you following him on Twitter and his. That he has a tailored, it's been fun to, to in really eyeopening to follow those, those tweets. If you wanna support us patrion.com/pandemic podcast, or Venmo PayPal on the show notes. And if we could get 13 more people deliver review by March six, I think that's the date. That'd be our two year anniversary. That'd be cool. That'd be awesome. I think. That's good. So the next time we're on, we'll be around the two year mark. So won't be as fabulous and as intense as our first year, that was too much work for me in a super fund, but we'll just keep on carrying on. All right. Have a wonderful two weeks and we'll see you all. Or you'll hear from us in two weeks. Take care and bye-bye.