Pandemic: Coronavirus Edition

Is scientific publishing a joke and variants are no match (so far) for vaccines!

• Dr. Stephen Kissler and Matt Boettger • Season 1 • Episode 74

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Matt Boettger:

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, a good friend, Dr. Stephen Kissler an epidemiologist at Harvard School of Public Health. How are you doing

Stephen Kissler:

buddy? Hello? I'm doing all right. How are you?

Matt Boettger:

Good happy mother's day to your mother. Thank

Stephen Kissler:

you. On behalf of her,

Matt Boettger:

you're so welcome. Mark's getting out here. He was, I thought were going to get him, but he got a little swamped. I think he's teaching now. So we're going to try to redo our schedule a little bit. Let's see if we can fit him in more often next couple of weeks, and maybe we'll find a way to get him next week. Something like that. So, Let's see what's going on. It's cold here once again, but I'm hopeful. This is the last stretch that I think by Wednesday, we'll be fully in spring mode. I hear birds chirping and your neck of the woods in the background. So that's awesome. That's great. Sounds wonderful over there. Yeah, we are going to do a little bit of a speed round today because I got a late start. It's always post holidays and this family just wrecks us. No matter what Stephen. It was mother's day. It was a first time that my mother-in-law came into our house. I was just talking to you, Stephen off the record, before we start recording that I just realized the first, the last time she had come in, I was wondering like, Oh gosh, when was the last time she came into our house? I didn't know. I didn't have any pictures. And I think it was March 1st because. Of 2020, right? Our oldest had to get a surgery just to get a skin tag removed. And I saw the cases starting to ride, like we've got to commit to this. So we did it March 1st and she came over to watch the boys, the other two boys while we were gone. And that's the last time she's been over since then. And we barbecued, we got a free grill from one of our families. So thank you, Ashley. I know, I don't think she listened to this, but it's nonetheless, we got a free grill from her, so we grilled out. It was an awesome time. Good smells. We can't wait. We have a bouncy castle that was given to us last year. The boys went crazy on it, so we had a great time. So it was a good stuff. Let's get into this stuff before. We ran out of time. So same things reviews. We love them to keep them coming. You can do that Apple podcast. There's a couple of the directories as well. If you can support us, that'd be helpful. patrion.com/pandemic podcasts. As little as$5 a month goes a long way or one time gift pay bell, then Mo all in the show notes. If you wanna check it out, hugely be grateful. Living the real podcast came with a new one last Wednesday. So getting ready to do another one. Another fun one that I did. I'm super excited about the woman to record today about two crazy words that I realized need to be more in our life, and that is waste and what is a waste and friction because I've realized in my own life, I try to live a frictionless life and I've realized, I think that's like the epitome of living the life and it really has no. That actually bites you in the butt a lot. So we're gonna talk about friction and adding it to your life and waste it. If you can really appreciate come, it's subscribed to it, download it because here's the deal I want to bring on guests and more people. I love Stephen. I love Mark, but he, but when the numbers get higher and the subscribers get higher, then I get better guests that comes. So check it out, download it, subscribe. If you can, it'd be a great help to me and to move forward to the next level. Okay. So let's get going into all the great news. I want to start with this, Stephen. So before we get into COVID related stuff, I saw this from the Atlantic. This is beyond my pay grade when it comes to I'm not into this stuff, academic journals, all these kinds of things. When it comes to side the science realm, I just, it just piqued my interest or it talks about this like science paper meme. Nails academic publishing. So you said, when I said this to you, that you've seen this meme going around, it's been going crazy in your neck of the woods. I have never seen this up until this point. What, take us along this ride of academic publishing and maybe what the Atlantic is trying to propose about its faults and where you might agree, and maybe disagree a little bit with the direction of the Atlantic went on publishing because clearly it's been a huge significance with COVID. There's been so much more going on and we've been mining that, or particularly you and Mark have so guide us on this and what's

Stephen Kissler:

going on with this. Yeah. So I think, this gives us a nice opportunity to take a step back and look at one of the themes that has been a part of a lot of the conversations we've had over the past year, which is this question of academic publishing, what role it plays in our scientific knowledge, in our cultural knowledge, in our political systems, all of these kinds of things. There's it's it's really profound. And so the idea here is that This past week there's this famous comic it's especially famous among nerdy people like me scientists and scientists and engineers. I first came across it when I was in the engineering dorm back at CU Boulder. And it's the comics called XKCD it features generally stick figures and like really like rudimentary drawings of things, but it's really quite funny. And this. Particular comic. It was called 12 types of, I think, 12 types of scientific papers. And it's a really tongue in cheek sort of, portrayal of scientific publishing. And so it, it gives these false titles of a bunch of different articles that, that sort of give themes of how, of certain types of scientific articles that you tend to come across Like why I'm a good scientist and all of my colleagues are not, or like we applied CRISPR to this one thing again, and like, how did it, so it's like these kinds like tropes that you come across. And so this it's interesting because this comic really took off Amongst scientists. I've seen it on Twitter which is actually a remarkable forum for scientific communication. There's been a lot of communication on Twitter during the pandemic. But people I knew in different fields have been making their own version of this comic sort of substituting the titles that are in the comic for things in their own fields that are sort of field specific. But you know, funny ways of talking about the themes that arise in their field And so w what the Atlantic article was pointing out. And I think this was an editorial from from a scientist himself who had seen the circulating in his own field talking about, what what does this say about academic publishing? And on the one hand, there's this cynicism, right? Where what, and the tack of the Atlantic article was saying that, it's sort of like, in a way, lifting up the veil on scientific publishing and showing how petty and repetitive and incremental some a lot of scientific so-called progress or certainly scientific articles can be, I think there's some truth to that. The. Academic scientific institution is a human institution, like all others. And within those human institutions, this is this is a part of our livelihood. We support ourselves that our families based off of our scientific output. And so sometimes those incentives aren't aligned in, in the best direction and it really takes a great amount of, or at least, a sufficient amount of. Virtue and honesty and courage to, to make sure that those incentives that aren't aligned towards robust, clear principled, scientific reporting to make sure it, to make sure that you're doing that and not just publishing for the sake of publishing. So I think that there are, there are incentives that need to be really examined and realigned. But I think we also need to recognize that we're never going to have a perfect system here either. And that was one of the things that I took issue with to some extent with the article is that, it's there, I do think that there's value in some incremental scientific progress. That's historians and philosophers of science have written extensively about how that's just how science works. It's built off of a sort of exploring this space in these very incremental ways and a lot of. Scientific research actually doesn't really end up bearing fruit, but it's the work of this entire community that does finally find these corners of thought and of existence in reality, that finally do, it's Oh, we finally stumbled upon something new. And it takes all of this effort, all of the fringes of science to really get there. And that does lead to a certain feeling of futility. Sometimes, where that can give rise to articles like this, where it's like, Oh my gosh, there's another article. With this same sort of theme, it's absolutely true that these things arise. But I think that, there are absolutely issues and mixed incentives in scientific research. But I do think that there's there's some value to the system as well. And just because this thing was humorous, does not necessarily mean that scientific publishing is is a worthless act. Sure.

Matt Boettger:

Where's the rub coming from this? I'm curious because it's just, is it just like the numerous amount of. Like re articles being published that then real scientists have to wait more through it. And so it's just exhausting for the real scientists to go over to the me to quote reload. The site is looking for good information to have like junk, junk, junk, junk. Is that the issue of just trying to it's just psychologically overwhelming for the amount of crap that comes your way? Is that the big rub or is it actually is it causing an actually, and maybe it's a both and situation or is it causing a problem to actually advance. Scientific research. That's the problem,

Stephen Kissler:

right? Yeah, it's a couple of things and I think, this is a good spot to bring it back to COVID where especially during the pandemic these scientific articles have had a sort of. Cultural and political valence that they normally don't have. News outlets will pick up on pre-prints before they've been published or peer reviewed and we'll take them and, explain and all of a sudden they become common knowledge all around the world. And that's, I think that's where, especially some of the rub comes in here where if these things aren't being done. With a great deal of scrutiny and reflection and honesty and all of these kinds of things that, you know if there's any temptation to fudge your statistics, which is really, really, really bad. And I want to make clear, like that's not, I don't think that's something that people are doing in a very, widespread manner. But but it will happen sometimes. And if that does happen, then I think we need to realize that. Lives can be at stake. Livelihoods can be at stake, with that information. Really does carry a lot of real world impact. And in some ways we're the producers of that Vanguard of information. We're right at the edge and trying to inform the rest of our community, the rest of our world of what is, what is the case and what is not. So we run the risk of, for example, supporting treatments that aren't effective or Or proposing interventions that that don't actually work, something like that. In addition to making it harder to Wade through the thousands and thousands and thousands of papers that have been published on COVID for example and it's, to some extent, it's just a waste of time, there's like we have like people who have received a lot of academic training, do we really want them just sort of like, Hmm. Producing things that aren't actually, that valuable. And so there's an element of waste. There's an element of risk and there's an element of just distraction and that's where the issues arise. So it's certainly not a victimless crime, if it, to the extent that there is this this phenomenon going on in science But again, I think that it's I don't have the solution necessarily, and we'll never have sort of a, a pure scientific field that has you know every step of the way is generating this sort of earth shattering new revelation about how the world works either. Yeah. Yeah.

Matt Boettger:

Okay. I was just curious is it something that you guys just have tolerated for quite a long time? It seems like it's, this is not like a new revelation. But this is coming to the surface. It sounds to me what you're trying to say is because of COVID, it seems like now we have quote, lay men and women peeking into your system more. I'm sure it was before I could write these things are all publicly available. Once you've put it up to a pre-print pretty much anybody could read them. That's why the media is picking them before. COVID it was kinda like all you nerds had it. And there's other people who were like lay nerds, right? Like looking into Washington, but now. It's become the focus of attention of all these people who don't have the credentials to actually cipher through things. So is that probably one of the biggest reasons why maybe this article is coming out? Now we look like idiots because we have all this stuff and now all these, like these laypeople are peaking. You're like, Oh, that's a good one. That's neat. Let's just put that on. And then we're like, ah, come on. That's not, we'd have never chosen that article to elevate to the top as some kind of. No information to give to the public.

Stephen Kissler:

Right. Right. Yeah. I think there are a couple of things here, it's true that there's, there've been a lot of big shifts in the practice of science and not certainly not all of them have been for the better it may be true. And I think, I think our. It's some pretty compelling arguments have been made that, the average quality of research has maybe been going down in some ways, or like we're publishing smaller units and not having these bigger stories, but you're right. And we've talked about this before, but like what exactly is science? What are we doing here? And the goal is to build consensus. It's not usually a single article. It's not a single finding that revolutionizes. A field it's the sort of building evidence. And when we finally find a consensus and then we say, we've seen this from a bunch of different angles. And so we can really believe that this is true, but that's a very different angle than the news cycle that picks up a pre-print. We haven't had a chance to discuss this, to reflect on it, to weigh it in light of other types of evidence. And so it's taking sort of the scientific progress and removing it from its context. And when you do that, I think really dangerous things can happen.

Matt Boettger:

Yep. Absolutely. And curious for you or maybe your colleagues, how do you pick stuff out? Because I haven't actually mind this stuff. This is more people who've never seen this database. I just imagine there's just tons of stuff being thrown into it. And even now with COVID just constantly inundated with news. Quote, new information. How do you then pick out like the sweet stuff, the gold, do you typically look at okay, this is by done by this group of people. I trust them. So I'm gonna read them first, which then of course then I'll, I think of it as like the mom and pop shops suffering. Then the little groups are suffering because they're not connected to a big. Credible and because there's so much tough, you got to pick something, right. The utility go to like just who your trustworthy sources are and just start there and sort that way.

Stephen Kissler:

Yeah. So that's, that's a really difficult element, right? So this is where some of the human side of the scientific yeah. No body can really make it difficult, especially for people who are trying to establish themselves. And this is always an issue for early career researchers, but certainly for people who are like bridging into a different field, it's very difficult because you're right. So oftentimes you gravitate towards certainly groups and people who you trust. Who've done good work in the past, and it's not always a guarantee of good work. In the future. Yeah. But it can help sift through some of this To a large extent, this is the role that journals play. So we start with these pre-prints that are just posted on that archive and everything looks like everything else. But journals by going through the editorial and the peer review process, then help sift through some of this and bring some of those things to the surface and say, we've reviewed this with a team of editors who are looking for relevance and a team of peer reviewers. We're looking for accuracy. And we can say that this is. Trustworthy, and this is worth paying attention to, of course, that's very imperfect as well because oftentimes those editors and peer reviewers are looking for those same people who they recognize or, or methods that they're familiar with or are trying to promote their own sort of biases in the field. So that's an issue but as part of the way that it works yeah, so it can be very tricky. But that's part of it. And when I'm. When I'm reading through things like this I usually. Pay attention to all of these things. So things that have been published things that are coming from people that I know, but then I also try to pay attention to the pre-prints that are out there. Just whatever comes up by searching for specific keywords and just to just seeing what's there and just trying to at least, give the benefit of the doubt to papers from people who I don't recognize. And I've been really pleasantly surprised by a number of them over the course of the pandemic. So there's, in addition to this sort of virtue of. Scientific publishing. I think that there's also this virtue of scientific reception in a way of the ability to read and consume scientific information that also takes quite some real principles. Yeah,

Matt Boettger:

absolutely. Okay. My last question for, go on. I know we're going along in this, but I'm just fascinated by this. So you said peer review and then there's journals, right? So the journals who do their own sloughing processes, which that makes sense. That's how you got yours into the science journal makes sense that there's peer review. Is that like, is that separate where you can just have peers, you go out, find a number of peers, ask them to review it, they review it publicly or something. Does that give it then more weight? Does it go up the little med journal system or,

Stephen Kissler:

yeah. So this is interesting. Not that wasn't true until very recently. So normally the way that it worked was that you had submit your paper to a journal, the editors would then decide if it was maybe worthwhile and then they would send it out to peer reviewers, and then they would review it. And then they would, they would then communicate with the editor and then they would accept it or not depending certain revisions, but now with more and more papers being posted on these preprint servers there have been groups that have been going and Basically using algorithms to identify papers within certain topics. And they've been taking it upon themselves to send them out for peer review, like to solicit peer reviewers without going through an editorial process with a journal. And then two, I've gotten a couple of emails about this. My self about both as an author and as a potential peer reviewer, where they're like, Hey, we found this paper. We think it's interesting. We'd really like to get it peer reviewed, but we know that the publishing process is very slow. This information we think is really important. Would you be willing to provide a review or we want to notify you that we're doing this with your paper. Let us know if you have any, anything you want to say about that. And so there's this almost like crowdsourcing of the peer review process, that's just starting to take shape and I think it's, it may well change some of the way that scientific publishing is done in the future. I think it'll be really interesting to see how that plays out.

Matt Boettger:

That's cool. It's like the Uber of scientific published that's right. The old system was a taxi and now you're just like, we got our own system. Okay. That's awesome. Great. All right. We don't have a lot of time. Let's get into some good stuff here. Fowchee says that we're in mass might actually be something that's seasonal. So it could be something that stays with us for the rest of our life. At least in season. That's the, to pick your brain on this because I get the concept of it. At least under the, you have if variants arise. Definitely that could be at any point in time, but again, this seasonal thing goes back to flu and it makes me think of that and how it's seasonal. So then there's a little sense of fear of man, the flu gets intense. So then as every winter, where are we going to be really going to be concerned about we're in mass, even if there's not a variant, which seems to be not necessarily the case, because you can walk us through this, but again, it's the same thing with the vaccine. The reason why it's crazy is because it's so hard to pin the pinhole. A vaccine for the flu, whereas COVID right now, we're rocking it at this point in time, Lisa MRN ones, and things could change the drop of a hat, but still, it's what do you think Fati Fowchee like suggesting this is that a kind of a possibility is, but is it more on variants or could it just be even just in general without variants is going to be a real

Stephen Kissler:

possibility? Yeah. I think that I think that in some places this will happen regardless of recommendations or whatever. I think that that there will at least be large numbers of people who do choose to wear masks during the wintertime. We did see, the flu really was Yeah. It's, historically low levels this past year is probably attributable to distancing and masking and all of the other things that we've been doing. And so think we've learned something there. I think that, so this coming winter I anticipate that there will be another surge of COVID in. Sort of our hemisphere. And in some ways I see it as what is likely to be sort of the, the last sort of surge of what we'll properly call the pandemic. And then after that, it may enter your sort of more seasonal circulation. We'll see how vaccination goes and, there's, there are different factors that can play into that. But what I imagine is that what Fowchee is talking about here is that There will probably be another resurgence of COVID that could cause a lot of issues in a number of different places across the U S this winter and masking will be one of the ways that we can help mitigate that. After we get past this next winter, hopefully there'll be enough vaccination enough population immunity that even with the resurgences of COVID. Hopefully we'll be able to manage them reasonably well. And then, then masking can be sort of left up to more of the individual communities and those kinds of things. But many places in the world are already do this, when there's a, when they're in the midst of their flu season. And certainly when anybody is feeling any sort of respiratory symptoms you put on a mask, like, that's just that's like washing your hands and covering your cough when you are like, covering your face with your arm when you sneeze. That's just part of what you do. It's you're putting on a shirt when you go outside, and so I. I could see something like that. Taking place here too. Yeah,

Matt Boettger:

maybe the U S has struggles because we just were, we were convinced. We're really convinced that we're really good looking people. We're just, somehow we think we, we think we are always keeping mask. Okay. So Biden team, this is something we talked about a few weeks ago and this is good news. Buying teams has a supports waiting patent protections on COVID 19 vaccines. This could be a game changer, especially obviously for India and other places around the world as well. Any insight to this because. It again, it says supports it. So clearly this is an obviously a automatic switch that is that this unleashes patent waiting patent protections. But have you guys been talking about this and the pros and the cons and the nuances of all this and the complexities?

Stephen Kissler:

Yeah. To some extent, and the, and this is something that I admittedly am not as informed on as I would like to be, but, there's been a lot of people who have been pushing for this. But at the same time, there's been a lot of the questioning, whether, to what extent this will be helpful. I imagine that it could be in a lot of ways, by releasing the or, relaxing the patent rules on these things, then you can essentially give the formulas for making these vaccines and allow them to be produced more rapidly. With the MRN vaccines there, these are really new technologies already and they take some pretty specialized equipment to produce. So there's been some question it's will that actually be very helpful or should we just be ramping up the production of these vaccines and focusing on, distributing them? And, with, and that depends very much on who we're envisioning we're going to help. India is one of the top vaccine manufacturers, I think the top vaccine manufacturer in the world. So they, they have the ability to make these kinds of things. So it could be incredibly beneficial for them might be much less beneficial for some other places. And so I think there's a lot of complexity there. And then of course, all of the. Economics and corporate rights sorts of things playing into this as well. And It hits it's really complex. I tentatively welcome it for sure. But that's, that's caveated hugely with that. I don't even begin to say that I understand all of the elements that are in play with this. I am certainly a proponent of just getting vaccines to the people who need them as quickly as possible, whatever we can do to make that happen, I think is a very good thing. And I think it's just. A matter of how

Matt Boettger:

yep. Yeah. I I don't know anything about this and how the logistics and the economic implications to people that had done the research and actually brought this about. But I would say even if it doesn't even pan out, just the nod of the hat is a huge symbol of solidarity that goes a long way. Even if nothing really manifests from it, besides the India, I would imagine just the gesture. It goes along with it. We're willing to make that sacrifice because we believe in

Stephen Kissler:

a common, common goal. Yeah. And thankfully, it's backed up by, it's this, isn't the only thing that the U S and other countries are doing. There's, we're talking about releasing this patent law, but we talked previously about, sending oxygen and PPE and vaccine supplies and other vaccines that have already been approved and those kinds of things. So as long as it's backed up with that, like real, tangible support as well, then yeah, I think you're right. Yup.

Matt Boettger:

Great. few more things, small things, quick ones. Just, we mentioned couple weeks ago at home testing found an article from a technology website that kinda reviewed three of them. So I'll put that in the show notes. If you're looking to, I was just working with a CA with a camp is looking for a bunch of these proud of this one camp and working with camp with Tiwa they're awesome. A nonprofit camp and they submitted their COVID. It's crazy the amount of stuff you have to submit, like COVID policies and how are going to run your camp. And they were the first ones. Submit it in the state of Colorado, a full, comprehensive COVID how they're gonna deal with it. And the state of car's gonna use it as an example to other, all other camps in the state of Colorado is how to do it. Yeah. So I had nothing to do with this. I'm not patting myself on the back. I just watched it from a distance and I'm so proud of them. Huge, huge congratulations. Cause it was a lot of work. You guys and gals thinking about these camps. Keep them in your heart and your prayers and fund them if you can. Cause there's things where young adults where if they get Kobe that can't be there to be quarantined and then there's all these policies by which then the parents. So then they can't go back home. So in there in the, the 14, so then all of a sudden they're no longer able to come home. So the parents or the fly and take care of them while they're in quarantine. I There's a lot of complications it's still tons of moms and dads still committing to it, excited about it. Cases who read this, the cat, the country may be turning a corner and covered 19, which seems to be pretty well in place. I Colorado is still wavering a little bit here. We could see cases and deaths plummet. Again, the guests, a tipping point is about 60%, right. Stephen, like of young adults, if we can get. At that point, there's an expectation. I don't know if this is true. What you're seeing that if we get over 60% of us, adults can be vaccinated. We expect a pretty significant plummet in cases. Is that what you're feeling as well?

Stephen Kissler:

Yeah. That's and that's really based off of what we've seen in other places that have Reached to that level of vaccinations. So Israel, for example and it was roughly around that threshold that we really did start to see cases coming down, especially among young adults. We're beginning to see that here in Massachusetts, for example, where we really plateaued for a long period of time. But now vaccine uptake has really begun ramping up in the younger age groups. Because we opened up on, I think it was April 19th. And so we've had a couple of weeks for people to start to get vaccinated. And now that plateau is just starting to go straight down, which is great. And so hopefully, hopefully that will continue around the country. And this has been consistent for much of the pandemic that it's a generally. Older people who are at most severe risk of the severe disease outcomes, but it's generally younger people who are have the highest case counts who are doing a lot of the spreading of COVID. So that's why I think it's really important, we needed to start vaccination with the most vulnerable to severe disease first, for sure, to protect them as quickly as possible that really driving cases down, it's going to be important to build up vaccination in the younger age groups. And I think we're starting to see that now. And so I think that's one of the things that's really helping us to begin to get control of this pandemic now.

Matt Boettger:

And, I'm going to go on a little tangent here. This is a related, so we didn't talk about this, but this is on my heart and my mind obsessively. And maybe you can guide me and guide other people who are, I I know there's millions of people having the same question, Stephen, this is we're adults. I'm vaccine. My wife's vaccinated. Things are plummeting. So we're opening the doors for vacationing, right? And so we want our parents to come. My parents come to see our boys and they're fully vaccinated, but they live far enough away that they'll fly. Okay. Is there any kind of like policy or recommendations for this situation? Is it safe for my parents? I'm okay with them then flying, but then coming to visit us fine. But our boys are young enough where they're not even on the ticket to be vaccinated till maybe September. Are there any recommendations? Oh, it's okay. The risk is so low. No big deal. Is there any advising the guys we're talking about? How would you deal with this situation, which I'm guessing this is pretty common. There's a lot of grandmas grandpas who wanted to fly and see their little five-year-olds, who aren't vaccinated, but they are fully vaccinated. Any recommendations. Is it just safe to do that? If they wear their masks on the airport? Okay. Or,

Stephen Kissler:

yeah. I think that these These vaccines are very good. And it's, nothing nothing of course will be zero risk. Sure. We'll always be running some risk of of spreading COVID someone getting COVID. But I think I think the best way to think about it as think through, like what, what could happen here. At this point, the concerns would either be that one of the vaccinated adults. Gets COVID or one of the kids gets COVID. And so I think those like the two classes of things. Okay. So what has to happen for one of those things to happen? So either, if one of the adults gets COVID, then you know, they get it while traveling or they get it, maybe from one of the kids, who's gotten it somewhere else. But they're vaccinated. And so their chances of severe disease and certainly mortality are very, very low. Mitigated there with kids, their risk of severe disease and illness is pretty low. Anyway. I think you need to factor in, are they going to school? Are they going to camps? Will they be exposed to other people who you don't want to spread COVID too. And that's something to think about, but. If you can have the visit and, keep the kids relatively distanced for, at least two weeks, make sure that they don't develop symptoms, don't develop COVID in the meantime, then you've all I think it's a pretty, pretty safe scenario for that particular gathering that you mentioned. And then the goal is to also protect the community around you. Recognizing that with what the kids, especially, the biggest concern is onward spread. But again with the vaccines. That risk really diminishes by quite a lot.

Matt Boettger:

Okay, great. Yeah. With our kids, I know it varies, they're not going anywhere, so they're stuck with us, so they're okay. And just kinda, that's helpful. And I know one of the one option, but I don't think this would actually would really work. Right. Stephen. If you want an extra insurance policy to get an at-home kit, And then have my parents take it when they get home. But then again, it probably doesn't, it's not in everyone's head that sensitive. And if they already gone in the airport, it's not like you can take it when they get home really quickly. And then you have, it takes probably a few days before it

Stephen Kissler:

even would. It does take a few days. Yeah. If they were positive than the test would, it would. Pretty pretty confidently show it, but only once, only once they had developed enough virus to show it. So it would have to wait a couple days. So it doesn't hurt to have a couple of those tests on hand, DMT about getting some yeah, they're available. I got one mostly cause I'm just kinda curious how they look and how I want to hold one in my hand finally. But you know, it's worth having, and so that way, if there is any concern, you can just kind of like. Give it a go. And again, they're not perfect, but it's one more piece of information. Yeah. It helps you decide what to do. Sorry. Yeah.

Matt Boettger:

It's that Swiss cheese layer. Okay. One last question. I know you have to go in a few minutes, but I want to hit this one. Why the world's most vaccinated country has so many new coronavirus cases that we didn't know how to say this whatever this country is never heard of it. Is there anything behind this? It should be a concern or is there something that's anomaly to this country?

Stephen Kissler:

Yeah. There are a number of smaller countries like this, that that have achieved really high vaccination rates, which is great. And and so there's been some concern around the Seychelles in particular where, there's a lot of tourism. And we've seen cases start to rise. But they have some of the highest vaccination rates in the world. So what's going on here? Part of the story is the amount of turnover that there is, right? So there's, there's the native population, but there's a lot of tourists coming in. Who are bringing infection. And there's also just like a lot of turnover in terms of who is actually residing in the country at any given time. So actually getting a clear estimate of how many people are vaccinated in the country at any given time. It's really difficult. And then I think the other main thing is that No, there's a lot of variation in the vaccine effectiveness. The vaccines that they've been using in the Seychelles I think are some of the ones that were originally developed in China are I need to double check, but yeah. Which particular vaccines they are, but they aren't the same vaccines that have been approved in the United States. And one of the issues with those vaccines is that they are similarly protective against severe diseases and death. So they're very good against that, but they don't seem to be as effective in preventing. The transmission of disease, like the MRN vaccines are. And so you can get a lot of spread, but, while we don't want to have a lot of COVID spreading, because again, that puts people at risk who may not be vaccinated. It puts other communities at risk. For the community that is vaccinated. That's not necessarily a too alarming thing because if everybody is protected against the most severe manifestations of the disease, then all of a sudden it becomes something more like a respiratory illness that we're familiar with. And that sort of this thing, that's turning our worlds upside down. So even with a lot of spread. It's still worth trying to keep control of spread because we're still very much in this pandemic period. But for this country in particular, as long as people are protected from hospitalization and death, it's okay. And it's not an indication that the vaccines are useless or not doing the job that they're intended to do.

Matt Boettger:

Great. Great. We're in this step right here, quickly to saw here. FDA is seeking approval for 12 to 15 year old, so that should be coming out maybe this week. Huge, great news. Hopefully if you guys feel safe to get your 12, 15, year-olds vaccinated shortly, if you're still feeling a little hesitant, I'll put this back in the show notes. It's an incredible article. COVID 19 vaccines. COVID 19 vaccine safety as well. Awesome charts. Awesome comparisons. It really put me at ease. So I'll put that as shown as check it off your phone a little bit weary. I that'll help you get, take the edge off. I think that's it for now. It's all we have time for. Stephen has a lot of things. He's got to save the world. We'll let him go do that. We'll save the rest of that for next week. Again, if you can leave a review, please do so if you can support us patriot.com/penn debit podcasts,$5 a month, or one-time payment, Venmo PayPal in the show notes and check out my live in the real podcast. All in the show notes, have a wonderful week. And we will see you hopefully with Mark Dr. Mark next Monday, take care. And bye-bye.