Transcript for Special Episode: Dr. Paul Offit & Tell Me When It’s Over

Well, thanks for asking me. It's my pleasure.

What was cathartic? I mean, I, you know, the virus came into the US early 2020. In April, Francis Collins, who was then head of the NIH, asked me to be part of this public-private partnership called Act of ACTIV, which stood for accelerating COVID-technological innovations and vaccines. And so, you know, we were essentially advising pharmaceutical companies on how best to test vaccines and potential, uh, it evolves. And I'm on the FDA's Vaccine Advisory Committee. So I really got to watch this up close. And in many ways, the book was cathartic. I don't know if you remember where the way it played out in 2020 aside from having nothing, right? We didn't have antiviral stock. However, we didn't have monoclonal steel November. We didn't have vaccines till December. So it nothing other than avoiding human to human contact. And then in April, the Trump administration was convinced that hydroxychloroquine was our ticket out, right? This was going to be the magic medicine that was going to make it all go away. And so the government bought almost 30 million doses of hydroxychloroquine and successfully twisted the arm of the FDA to authorize it. with that any evidence that it worked, with that any evidence that it worked either treat or prevent the disease. You certainly need already knew about the safety issues, which were potential hardware demands. And so they approved it. And that's scared people. It's scared me. I wrote an op-ed for the New York Times saying fearing an October surprise here that Trump administration successfully Twisted the arm of the FDA to approve a drug that didn't necessarily work to treat a preventive disease. That's their job. I mean, the job of the FDA is stand to stand between pharmaceutical companies and the public and protect the public. You know, you're scared about how the vaccine's going to play out, right? I mean, the Trump pulled Stephen Hahn into his office and in an convective late in tirade said, I want this vaccine out before the election, which was the beginning of November. And were that to be true, then you wouldn't have that two month safety follow-up that you have for pretty much every vaccine after the last dose, which wouldn't be till December. So to Han stuck up to his credits, stood up to him, put it on their website, this is what we're going to do. But people still didn't, now you really had a critical loss of trust in the FDA. Country after state after state. stood up and said, we're going to have our own vaccine advisory committees. They didn't trust us. They didn't trust the FDA vaccine advisory committee. And so it was a really turbulent time and and between that and a number of what I think were communications errors, including not trivial ones that occurred after that. I just this was a catharsis. I just had to get this book out. I feel much better now. Thank you for letting me write it.

Now, I think it's the same, I think it's the same for my book. I guess the audience will decide that, but it's for a general audience. It's kind of What happened? I think in many ways the book is a story of two remarkable contrasting things. One is that we isolate of ours in January of 2020. We sequence it. So now you can potentially make a vaccine. It's an unusual virus. It had an interesting sort of biological and clinical characteristics. And then 11 months later, using a technology, messenger RNA that we never used before. We had no experience with that technology. We're with the vector virus, you know, approached by Johnson and Johnson. You had two large clinical trials, and then the in February of 2021, you had a large J&J Johnson and Johnson trial. The show that the vaccines were effective. remarkably effective, and then over a period of six or seven months, we immunize 70% of the US population, who's a million people a day, two million people a day, three million people a day, and then, and I think that, I think that was the most significant scientific and medical accomplishment in my lifetime. And I'm old, so my lifetime includes the development of the polio vaccine. I think it was amazing, actually. Then we hit a wall. And by mid 2021, 30% of this country did not want to get vaccinated. Ultimately, 300,000 people lost their lives because they didn't trust us. They didn't trust the FDA, they didn't trust the CDC, they didn't trust other public health agencies. Why? What happened? How did we lose that trust? And I think that's why wrote the book. What happened? How did we lose it? And how can we get it back?

Well, I would have imagined the opposite was true. I mean, typically, what anti-vaccine activists will say is, give me a pandemic. Then I get the idea of being vaccinated or even mandating vaccine vaccines. Give me show me a pandemic. Well, this was a pandemic. We had more than 1.1 million people dying. This country people were dying right in front of us. I think all of us at least know someone who was at least seriously ill and died of it. My aunt died of this virus and so you didn't have to convince people I would think that it was real and the vaccine clearly worked and it was safe it wasn't absolutely safe but it was pretty darn safe the mRNA vaccines it was my carditis within four days of dose two which was generally self resolving and short lived but in the scheme of things considering there was a novel technology for a novel virus we I never really saw the other shoe drop So so you had, you had your ticket out of this pandemic and nonetheless people will reject it. And I think the reason was because you're right, I think the anti-vaccine movement is stronger, they're better funded and they're stronger. And I think it all has to do with this, which is politics. I think there, although there's always a political implication for vaccines because they require support, you know, that they You're going anything I think that requires funding. Public funding is going to be political, but it doesn't have to be partisan. But this was partisan. You know, on the left it had vaccine activity was always, you know, just don't inject me with anything with a chemical name, you know, so, which is pretty much water, of course, has a chemical name. And on the right it was this libertarian, I don't want the government to tell me what to do. That is the current politics, which is federal government off my back. And so that's where all the money came from. Eric Trump at Donald Trump's son stood up at one of the Braalies and said, if you don't want to get a vaccine, know that the Republican party has your back, which is amazing because it was the Trump administration that created this vaccine with Operation Warp Speed. And yet, if anything, Donald Trump distance himself from arguably his greatest accomplishment. So they're very well funded. They're more active than ever. And I think that at the heart of it is mandates. I think when we mandated that vaccine and people lost their jobs and people couldn't go to the bar, they wanted to go to the restaurant, they wanted to go to the sporting events closed down. You know, schools closed, travel was restricted. People felt they, you know, they were mandated to make wear masks, mandated to get a vaccine and not leaned into this libertarian left talk and this is what you have. A well-funded sort of libertarian anti-vaccine campaign that has now been embraced by the right.

Right, you can very easily find awful information about vaccines that will fit any conspiracy theory. If you're hesitant about getting a vaccine, it's understandable that you would be hesitant. I mean, you're asking people who are otherwise healthy to inject themselves with a biological. In this case, the biological is something which we had no experience and it's a genetic vaccine. And the minute you say that word, genetic people are thinking, It's going to alter my genes and that's part of the argument that people have made, right? There's DNA fragments in this vaccine that will alter your genome and we're that the mRNA can enter your nucleus and get reverse transcribed and then enter your DNA and That would be the best news for Gene therapy ever if that actually was possible with this mRNA vaccines. But it's very easy to get that notion out there that this vaccines can do harm. The CDC director in 2009 was a man named Richard Besser, and that's when we had this wine flu pandemic. And he was great. He was out there every other day. Every third day in front of the media answering their questions. This is what the vaccine is. This is how we're distributing it. This is how it's made. This is what the virus is doing. This is where the virus is now. There's where we expect the virus going to be. He was the model of how you communicate what we were doing and why we were doing it. So I saw him at a national foundation of infectious disease meeting a couple of months ago. And I said that to him. I said, you were great. You were a model. He said, thank you. I could never do it today. Two reasons, politics and social media.

No, that's a really good point. I haven't thought of it that way. But you're right. I mean, what exactly is the financial motivation here? Assuming there's always a financial motivation. And I think it's just an expression of this notion of autonomy, sort of personal freedoms, and that Uber Alas, I think that's just sort of become the mantra of the Republican right, and I think that's why, or especially although the right, I'll just say, and so that's their current mantra. I think it just fits into their zeitgeist. I'm not sure that there is any financial motivation, but there's certainly a lot of money to support it. I mean, more so than ever, there is, you know, there was an article, Ramana Graf by a group called the Center for Countering Digital Hate. And they had what they called the disinformation dozen. And so it was 12 people or groups that a counter for about 70% of the misinformation it was out there. Their funding was often the same. They all got pretty much funding from the same source, which was the dietary supplement industry, which in many ways is the same thing, because there are two as a matter of medical freedoms. We don't want the FDA telling us what we can or can say. because when we say things like, you know, this will make your prostate smaller or this will make your immune system better, we want to be able to say that even though we have no evidence that that's true. And so the FDA sort of pushes back and doesn't really let you say that you have to be vague or right, it supports prostate health, neon health, you know, heart health, whatever. And so they really are in many ways aligned with this group, which also likes to make claims that are unsupported.

I think our training is scientists is the opposite of the training that we need to educate the public and the media about scientific issues. Because when you write a scientific paper, or publish a scientific paper, the biggest sin you can commit is to ever go beyond the data in front of you. So you are a good scientific paper is one that theory draws a conclusion. And then the discussion section is full of caveats, right? I'm really can't say this or this or this because my data limit me in terms of what I can say about that. And so we're always very careful. That's number one. That doesn't come off well at least in a popular press or in the media because it sounds like you wish you washer. It sounds like you're not sure of what you're saying. The other thing is it's just the nature of the scientific method, which is that you formulate hypothesis and then you can do two things with that hypothesis. You can reject it or not reject it. But you can never accept it, which is to say you can never prove never. Because the null hypothesis is paramount, and you can't ever accept the null hypothesis. So I mean, as an example, as a little boy, I watched TV show Superman, which was black and white, and Christopher Reeves, it was before Chris Reeves, George Reeves, and he flew. And when you're five years old and you're watching TV, TV does not lie. And so he had his cape and his hair would fly and he would look at the city below and he would he would fly. So what I did was I went into backyard and on a small chair I stood up and I put a towel around me and put my hands in front of me using the inner locking thumb grip which I thought was critical to the whole experience because that's what he did. And I jumped a few times and didn't fly. at this, you know, spoiler alert, I didn't fly. Now, I could have done it a million times. That wouldn't have proven that I couldn't fly. It would only have made it almost statistical and likely. I could have done it a billion times, 10 billion times. Because the scientific method does not allow me to say, I can't fly, at least not without a plane. But I can't fly. And so I can say that. And I think you have to get used to that. So for example, you can't say the MMOR vaccine doesn't cause autism. All you can say is that there are 18 studies that have been done on seven countries, on three continents and bobbling hundreds of thousands of people at the show that you're no more likely to develop autism if you've gotten the vaccine. If you have, that's what you can say. And so I had a test by once in front of Dan Burton's committee office of government reform. about that issue. Andrew Wakefield had just published his paper. He was on the other side. I was on the side of good trying to explain what we knew about MMR vaccine or we knew about autism. And Colleen Boyle, who was great from the CDC, you know, she got up and she explained what the early data showed in terms of there was no association, no statistical association with those two things. But then Burton heard weakness in that. And he said, so you can't tell me. You can't tell me it doesn't cause it. Do you? Could you have, and I quote, an out in the back of this thing. And so that, you know, it's hard that you have to get used to that at some level that you are saying things that at some level scientifically can't say. And for scientists, that's hard.

Well, conspiracy theories are easy to understand. They explain something clearly. They give you a handle on it, even if it's not true. I mean, I think the best example at the beginning of this pandemic was a notion that it was a lab leak. This wasn't a lab leak. I mean, it was, I was actually just on morning, Joe this morning at like quarter ten, and that was his question. He said to me, I use it thoughtful, smart man, he said, you know, I've had people say to me, people in the medical field are in the scientific field, say to me sort of on the side, as if this is our secret, you know, that we're trying to hide this, that, you know, this, what this may have well have leaked from a lab. And, you know, it's, it's, first of all, it's never happened. Never has a pandemic virus ever been created in the laboratory. Two is all the evidence is on the other side, right? I mean, you hear you have the Western section of the Hunan seafood market where there were dozens of animals that were sold illegally and very close on sanitary conditions. And the kinds of animals, you know, red foxes, red condolves that can catch and transmit a virus like SARS-CoV-2. I mean, source one was an animal to human spill over event 2002. MERS was an animal to human spill over event 2012. I mean, you know, it's not like the black plague was, you know, created in a medieval bio-containment lab. You know, these things are invariably animal to human spill over. And you have, you know, this sort of pictures that were taken of that western section of the market that were sent to to people in the United States, media people in the United States, so you see how unsanitary those conditions were, and the Chinese really did look at for genetic evidence of this virus, SARS-CoV-2 virus, in things like the machines that kill the animals, the brushes that brush the animals, or the tables in which the animals were sacrificed or the cages themselves, and found evidence of SARS-CoV-2 virus there. So it was creating a lab that the laboratory person had to do was then travel nine miles to where this Wuhan seafood market was across the Axi River and then deposit it in a place exactly where you would expect an animal to human spill over ventricre. So this is not a scientific kind of reason. You don't have You know, the clear smoking gun. I mean, you don't have like a raccoon dog standing up like at the end of crime and punishment and saying, it was me that killed the seafood vendor, right? So you don't have that. But you have a confluence of evidence that tells you it's all on one side. And actually my best, the best comment I've heard is that this is a promiscuous virus. I mean, it's not if you were trying to target it to humans, it's targeted to at least three dozen other animal species. And so the lime was, if this was created in the lab, it was created by an underperforming graduate student. I think that's unlike that.

But I think part of it is we definitely lost trust. And I think that there's a few reasons for that. One is that there's just a general anti-institutional bias. So it's not just the FDA and CDC that's lost trust and Department of Justice, FBI, etc. There is this flood of disinformation at a level, I think we've never seen before. It's never been better funded before. But the third is that I think we did make communications mistakes. And that's one reason why you lost stress. And therefore, those conspiracy theories become more attractive. So for example, to me, the biggest one occurred in July of 2021 when thousands of men go to a problem-style Massachusetts to celebrate the July 4th holiday. 79% were already vaccinated. Nonetheless, there's a COVID outbreak. So 346 men who were in attendance got COVID all of whom had been vaccinated, four were hospitalized. So that's a hospitalization rate at 1.2%. That's a vaccine working very, very well. Right? I mean, the vaccines are the one you wanted to do keeping out of the hospital. The other 342 had milder asymptomatic infection, which when the CDC reported this, the headline and MMM morbidity and mortality weekly report was, breakthrough infections. They call these asymptomatic and mildly symptomatic infections breakthrough infections as if this vaccine had failed. I mean, breakthrough was a very negative word. Whereas the goal of this vaccine was to keep you out of the hospital. The goal of this vaccine was to prevent serious infections and the vaccine was doing exactly that. I mean, if you, if you watch Brett Kavanaugh, for example, Supreme Court justice, you know, he's entering the Supreme Court chamber. He's routinely screened and found to be positive around the same time. And they called that a bit of breakthrough infection. If you watch the way that the scene and carried that story, you would thought the man was fighting for his life. I mean, Lindsey Graham actually had, again, because this is mid 2021, two-dose vaccine time. He got two-dose vaccine. He had a three or four-day illness that was characterized by sinusitis. And he said, and I quote, this would have been much worse if I hadn't been vaccinated. Right. Lindsey Graham got it exactly right. And how often do you get to say that?

This upsets me more than anything else. I mean, it's a shooting innovation period, new coastline faction. Mild infection is prevented by high levels of virus-specific circulating neutralizing antibodies at the time of exposure. And antibodies don't last that long. They will fade over 46 months. I think we were fooled in a sense in December of 2020 when those two large clinical trials were presented with Pfizer, Moderna, Pfizer, 40,000 person, Moderna, 30,000, placebo, post-bacter, placebo control trials. The efficacy was 95% against severe disease. It was also 95% against mild disease. And the reason is, is those were three months studies. Those participants had just gotten their second dose. That's why it was so good. So six months later, five studies showed that protection against severe disease was holding up well in the 90% range. But protection against mild is it had faded to 50%. That had to happen and see that in combination with mandating vaccines, you have to get this vaccine or else you don't get to go to work. And then people would, would did it. They got the vaccine. Then they had a mild illness to said, say, the CDC told me that this vaccine was going to protect me. Now, I didn't. I'm having this breakthrough illness. I mean, it really angered people. Actually, if you watch away, for example, Rhonda Santas, doing his stomach speeches would often say, you all know the CDC told us this vaccine was going to work and it didn't. Well, it did. It worked to prevent severe disease. Actually, if you look at the way that they're currently messaging the flu vaccine, the CDC, it's exactly right. Their slogan is, wild to mild.

Right, I think probably the most telling studies were that those who chose not to get a vaccine often had little contact with the healthcare system, which I think is an underlining kind of the sorry state of healthcare in this country. I mean, we don't have a national healthcare system, so not everybody easily gets healthcare. And so therefore there's that deficit of knowledge because you aren't able to ask that your doctor, you know, should I get this vaccine? There was a story I tell in this about a nurse named or an intensivist named Brittany Kobe in Alabama who, you know, who would often see people come into the hospital had unvaccinated, you know, suffering and dying. And she said the question that I always asked was did you talk to somebody about this? Somebody in the healthcare profession and the answer was invariably no. And so I think You know, if you look at, for example, people over 65, they're certainly more likely to, it's the older you are, the more likely you are to be Republican. Two, the older you are, the more like over 65, you're more likely to work as much, much, much. But misinformation isn't destiny. I mean, they're also very likely to be vaccinated. There's 95% of people over 65 are vaccinated because we have Medicare in the United States. And so they often can get health care. And I think that's, That's key, but I think it is fixable. And the story I tell is one of A.L. Stanford, who's an African-American surgeon in Temple at Temple University with her own money, formed something called the Black Doctors COVID Consortium. So with many of her colleagues, She went into North Philadelphia, a predominantly black and brown community with little contact with the healthcare system other than an emergency basis. And she just sat in people living in rooms and tried to convince them of why they should get the vaccine. So they're seeing someone who looks like her, who they're there for trust. And eventually, you know, they didn't, if they said, no, she'd come back again, or she'd come back again. And she ultimately vaccinated 50,000 people in North Philadelphia, this, this, but she's a hero. She is an American hero. I just wish that there were a thousand, a list of anthrets. who could get out there and do what she did. Because I think that's the solution. I mean, yes, the CDC and the FDA should explain and detail what they're doing and why they're doing it. And yes, I think local and state government should do that. But I think that the, the, the, the, the, a list offered represents the solution to this problem, which is we have to find who those people are in those communities that are trustworthy and then get them the resources they need to get into those communities and tell people why vaccination is important.

Right, well, I think as always, it probably starts at the beginning. I mean, my father since past when he thought in World War II, but he explained to me that as a elementary school in high school student, he was actually taught critical thinking, taught the scientific method. We often don't do that anymore. I think that would help. And I think I do think that so for example, if you see the CDC recently changed their guidelines in terms of how long one should quarantine associated with that being infected and they said something it made a ton of sense which is One AFB all done. Let's see why that makes sense to me is that the virus occurs in two stages. This is true for all viruses, but so the first stage is the virus replication stage, right? We produce itself over and over again. Then what happens is the immune response stage, which is when you get symptoms. It's when you when you make antibodies against this virus or through you have cytotoxid T cells that kill virus infects cells. That's when you have symptoms. So now, as the symptoms increase, because the symptoms are based on your immune response, trying to eliminate the virus, virus replication decreases. So there are argument is, and it's reasonable one, if you have one A-fabrahal Day, if you've been Fabrahal and you had fever, wouldn't it make sense that the immune system is abating? And if the immune system is abating, it doesn't that tell you that virus replication is really not a critical part of the disease process anymore. So you're much less likely to be shedding virus. That makes sense, rather than saying quarantine for seven days, 10 days, 14 days. Because first of all, viruses don't replicate on the basis of the metric system for the lunar month. So it wouldn't make sense. There's just peg it to the person rather than to this arbitrary number. So I like that, but explain it. You know, I mean, get out there and explain it because, or else, you have, you have then other people trying to explain it for you that may not understand it as well.

Um, you're absolutely right. And I think politics has always been part of public health because public health requires resources, and therefore there'll always be a political component, but there doesn't have to be a partisan component, which is what I think has happened here. I don't know what's going to happen. I fear that what's happening is that science is losing its place as a source of truth. mean Kelly and Conway said it best well we have our alternative facts the birth of the term alternative facts which somehow is acceptable and I think With that erosion interest, the road which science is becoming now just sort of another voice in the room, anything is possible. And I think we just saw it. We just saw people denying the impact of this virus when 1.1 million people died. When 300,000 people lost their lives because they chose not to get vaccinated because they chose to lose their lives. I mean, that's a frightening time. Worst, I think, you know, you know how hundreds and hundreds of pieces of legislation that have pushed back one vaccine mandates, masking mandates, isolation or quarantine procedures and vaccines. I mean, these are the important weapons in public health that are being stripped away at some level. We want freedom, but we don't want protection. And I fear that's kind of where we're heading. So what changes all this? I think, again, I'm an optimist. I mean, I'm a Philadelphia Eagle season ticket holder, so by definition, I'm an optimist, but I do think these things have to occur Very early on, where we educate people about science and educate people about, you know, how to think critically. And I think some of that is gone. I don't, maybe, I think I became a better critical thinker as a scientist than when I was an MD. When I was just doing clinical work, I think I was more of an anecdotal thinker, more of a pattern recognized, right? I think once I, moved into a basic scientific working on road viruses. I think I became much better at sort of higher workically establishing burdens of proof, formula to hypothesis, projecting those proofs to analysis. I became a clear thinker somewhere in there. But I'm not sure I learned that in medical school.

You know, it, it, this sort of a quarrel area to your worry. I think science, when I would do scientific studies and then go to, you know, double stranded RNA meetings, you know, to present the science of working rotavirus and so you would draw a conclusion and then you would present your data and people would challenge your data. So it's not really debating science, maybe in the way you mean it, I think, but you know, they would challenge the criteria on which you base your conclusion. Did you do there, was it internally consistent? Was it robust? Did you do the right controls, et cetera? And that's what you wanted that. You wanted to hear that because that's how your scientific studies got better. That does not work well in a public health arena. It doesn't. And I think the best example that for me, well, two recent examples, but one is the byvalent vaccine. I mean, the byvalent vaccine was the thinking was reasonable, right? Oma Cron, BA1, the original Oma Cron came into the country in December 2021. It was an immune-vasive strain, even if you'd been naturally infected, vaccinated with alpha or delta, you weren't particularly protected against mild disease from Oma Cron, so shouldn't we include Oma Cron in the vaccine? Perfectly reasonable. So the thinking was, all right, let's do a half a dose of the ancestral strain, half a dose of one of the Oma Cron variants, which became BA4, BA5. Um, not a bad idea. Didn't work out. I mean, if you looked at the data that were presented to our committee in June of 2022, um, it didn't look like immunologically, you were more likely to develop an immune response, a neutralizing antibody response to this Omicron variant, if you got the monoval vaccine, if you got the bival vaccine, because of imprinting. That's what happened. So I was a no vote. I voted no for that. Now the next day, the government bought 105 million doses of five weeks vaccine, you know, but, remember, I'm an advisory committee. So we just give advice. So, you know, as anybody who's in medicine knows, people don't have to follow your advice. But, and then the clinical studies were done. There was one in the U.S., one in the U.K., one in France showing that you were no better off getting the bivenal effects in their monoval effects. And so I said that. I mean, I said that nationally, I wrote a perspective piece of the New England Journal of Medicine that said that and it was published at the same time that David Ho in Columbia or in Dan Grook in Harvard published their paper showing there was no difference immunologically in those two vaccines in inducing an immune response likely neutralizing a protective immune response against the Omicron variant. Okay, that's okay. It's okay not to get it right the first time you learn as you go there's always a learning curve It's invariably steep with this kind of incident novel virus. It's a novel vaccine strategy. It's a novel disease. We're trying to learn as we go. And so explain that. We didn't get this exactly right, but we've learned. And so you don't see byvel of vaccines anymore. But that's not what we did. What we did was we kept saying it was better because we wanted it to be better. And when I was saying publicly that it's not better, not worse. boosters boost it's a value for people who are in high risk groups you know I was hammered by the by public health officials who were really angry me because what did I done I'd gotten off the bus it's a divisive time you're on the bus or you're off the bus and and they felt I'd be because we wanted people to be vaccinated And I get that, but don't misrepresent the data, because you're only going to lose trust not only the public, but the scientists who see what the data are. So just be honest and know that you're not going to get away. But see that? The fluidity of that, the fluidity of scientific discovery, of learning as you go, is disconcerting to the public. I mean, I think if you ask people, do you think we're going to know more about science or medicine? 50 or 100 years from now that we know now, I think everybody would say yes, but when it comes to your disease or our pandemic, they want to believe you know everything you need to know right now. If you don't, then you got it wrong that I don't believe you anymore.

Well, I think don't be afraid to explain the science. I mean, when this whole thing, there's a surgeon general in Florida, these Florida actually is one of the, I think only four states actually has a surgeon general whose name is Dr. Joseph Ladepo. So he's become famous for his notion that he put out there and sent something to all these sort of healthcare people in Florida that the mRNA vaccines are contaminated with DNA fragments, which First of all, it's a manufacturing residual. It's not also pricing anything that's made from cells and it's certainly the plasma DNA that is the beginning of the process of mRNA vaccines. That doesn't just completely disappear as you go through the manufacturing process. There's nanogram levels of fragmented DNA as it's true in any vaccine that is made from cells. measles, mumps, or bellies, or cellar rotavirus, all those have small fragments of DNA. And in fact, we eat foreign DNA all the time, assuming you eat anything made from plants or animals on this planet, which is pretty much everybody, which ends up in your circulation, by the way. And it fragments much larger, and in quantities much larger that you're ever getting into vaccine. But in any way, see if you put it out there, right? DNA fragments can essentially insert themselves into your DNA and cause cancer. So explain that. Now, you can explain how the site applies and doesn't like foreign DNA, it's hard to get across the nuclear membrane of a non-dividing cell. Then you have to insert yourself into DNA, which requires some sort of enzyme like an integrated. So I was going to see an end, right, with Brianna Killer, and you don't have much time. You got about four minutes to explain why Joseph with Apple was wrong. But don't be afraid to do that. Try and explain the science simply. Don't just say, sort of the FDA when they do. Well, this is fine. I mean, they say, you know, vaccines are carefully tested. Safety, we know, you know, we know that this exists. But so when they do that, when they don't express the science, explain the science they're basically saying trust me. and people don't trust you. So when you give them something to hang on to, even if they don't necessarily understand all those words, they like integrate. You know, an enzyme like an integration, but it is an English sort of sounding thing, right, integrate into something. So just, I say, don't be afraid of that. Don't be afraid to say that people appreciate that. I think they appreciate not being talked down to by making it too simple.

But I think we learned we can make a vaccine quickly and well, and then we can distribute it quickly and well. That was good. I think that the thing that hopefully we've learned is that we need an international surveillance system. You can't, you can't depend on a whistleblower in China to tell you that there's a virus that's circulating that's killing people. And China was xenophobic, they didn't let other scientists come in. That gave rise to conspiracy. theories. I mean, that kind of inability to let foreign other researchers come in. I think it's in us. I do think, as I sort of talk about the end of the book, I mean, when 9-11 happened, we all held each other and hugged and cried. We were all in this together. I think that was also true when Pearl Harbor happened. I think we do, at some level, see ourselves as part of a larger group. And we have to. If we're going to move forward, We have to see ourselves as part of a larger group. There's nine million people in this country who can't be vaccinated. For example, because they're immunocompromised. They depend on those around the protecting. Do we have any responsibility? Then of course we do. And I think we have to just kind of do their best to sort of emphasize that we are part of a whole we benefit from being part of a whole and just make it clear that that's true. So I don't know. I mean, I think we'll see how the next the story of the next pandemic is told, but there will be an experiment. We've had three pandemic viruses in the last 20 years. There's we're not that far from the next one.