A very good interview with the current public health perspectives on the pandemic. I do wish that Dr. Ashish Jha discussed his future visions for public health, which he just briefly mentioned at the end of the interview. We have an outdated and mostly broken public health system, which desperately needs a dramatic overhaul. Most COVID cases have happened unnoticed by our monitoring systems. These are the majority of people who have sickened and possibly died at home without healthcare benefits as happened in India and elsewhere. We need new techniques to reach the home-bound people and families trying to cope with the disease. We need better technologies to update our websites and statistics with the necessary information that people can use to understand the threats and seek help. Help should also entail instructions with how best to care for the home-bound family member, or members, with COVID, and how to best prevent further transmission to other family members. Institutions, such as schools, should become community outreach and resource centers. Public health needs these as well as computer programmers and the latest tech gurus to create reliable information about the ongoing pandemic. These are all necessary to upgrade our current public health systems to meet the demands of future contagion.
Jha is a relief to see/listen to -- he's not a Pollyanna, he tells it like it is (as he sees it), but there's a realistic optimism to his take on this -- "It's going to take a while but things will get better, and the precautions we'll have to keep taking might be a little inconvenient for a while, but we can learn to live with them." No threats of permanent masking or distancing, no immediate "doomsday variants" lurking, no name-calling or ad hominem attacks -- he makes it seem as if we can actually end up having better lives in the long run. A lot of us need to hear that. AND, by the way: The link between "vaccine hesitancy" and healthcare inequalities -- over and above the very real and rational distrust a lot of poor folks and people of color have of "the system" (medical and otherwise), I believe a significant problem is that a lot of folks do not have a regular primary care physician.. That's the person you talk to about your questions, doubts, etc. concerning healthcare/medical care issues. I'm quite convinced that if more folks got their main healthcare advice from a PCP, rather than some online source (or something like Faux News), we wouldn't have as much entrenched anti-vaxx sentiment as we have. We'd also have a lot fewer people with the pre-existing conditions and risk factors that put them at risk for severe cases/hospitalizations/deaths if they do contract COVID.
Great session from at least 2 wise people! One observation: Dr Jha references data and surveys but does not directly present them (unlike Shane Crotty and others from recent Grand Rounds). As I am trying to be an informed layperson within my family and community, how can these public health data and surveys and papers become more transparent? Can someone share the links. (I also have experience in vaccine manufacturing at clinical and commercial/global scale and have many associates in that part of the ‘public health ecosystem’.)
Dr. Jha's masking thought process is easy to follow. The fact that he wan't provoked by his airplane "companion" shows his professionalism. Speaking at a conference in February. I will be a medical professional, but the audience will not. I will be masked throughout. Hope I can behave as he did.
I will disagree w/ him on one thing -- I believe the CDC's messaging went totally off the rails after the Provincetown episode (they reported it poorly, not emphasizing that it was an atypical situation, and also underplaying the fact that actually the vaccines worked WELL in preventing severe cases; they did an even poorer job of fully researching the issue of whether vaccinated people are really at high risk for transmitting the virus before making public statements -- subsequent research has shown that they are at some risk, but it's significantly reduced) -- and in my opinion they've never regained their equilibrium. A lot of vaccine resistance, I think, dates back to this botched messaging.
@@jazzmanchgo I'm reading this a year after you posted it and it's clear you've hit the nail on the head. The cdc panicked after Provincetown and their credibility never recovered.
So much speculation and a cosy chat between buddies. But I haven,t learned anything listening to this. No good studies referenced on the basics: do the vaccinated but infected shed virus? When and for how long? Asymptomatic or symptomatic viral shedding? What other identifiers are linked with these ‘breakthrough’ infections? Link use of rapid test to these situations. eg We in UK do a rapid test before choir rehearsals. Specific application to reduce risk. Surprised he did not call for better studies early in future pandemics to establish these sort of parameters which can inform policy and ultimately messaging. Where are the comparisons of infection rates where eg masks mandated, or optional. Or comparing other NPIs? The 4 nations in Uk all had marginally different approaches, yet rates all worryingly high. One simple observation is that whatever strategy adopted, the virus still gets away. From a Public Health perspective, no reference to underlying levels of poor metabolic health , rates of diabetes etc which correlates to both US and UK high up in the league tables of Covid deaths. No reference to any European comparisons looking at eg Italy, Poland, Denmark, Sweden. Variable rates of Covid and different strategies…. What does this tell us. Who is studying this. You guys having a cosy chat doesn,t address any of my basic questions.
Jha has a very level-headed, rational take on most of these issues. I, personally, want us to get rid of these g@ddam masks ASAP, but I realize that, especially in some areas, things are still too serious for this to happen (nonetheless, I desperately want ALL of us to get there & the sooner the better). Jha's predication that the mask mandates might still be necessary when cases spike, and then on a state-by-state (or maybe even city-by-city or county-by-county?) basis, sounds like a very reasonable, even optimistic, compromise. Let's hope that this, also, remains a temporary situation! I do wish Jha had addressed the issue of masking schoolkids, though. Although I understand the reasons behind it (I'm not an ideologically purist "anti-masker"!), I have concerns about the long-term emotional/cognitive effects of children not learning essential communication skills and empathy-sharing skills by not being able to see one another's faces -- Over 60% of all human communication -- incl. showing and sharing empathy -- occurs through facial expressions. We've evolved that way, it's an inextricable part of who we are, and I think we desperately need to find a way to return to a mentally healthy society in which everyday "face-to-face" human interaction can again be recognized as essential to our social and mental well-being -- and our children need to be a part of this.
@@rosskaske6357 Can we please stop these ideological flame wars and admit that two things can be true at the same time? Yes, masking has been an essential preventive tool during the crisis stage of the pandemic. At the same time, having to live in a world bereft of facial expressions, where we fear one another as toxic, is not mentally healthy and should not be accepted as "normal," now or in the future. Wey need to find a way -- a reasonable, scientifically valid, and SAFE way -- to return to a mentally healthy society in which everyday "face-to-face" human interaction is recognized as essential to our social and mental well-being. This, I think, is what Dr. Jha is saying here (and we hear similar statements from Scott Gottlieb, Dr. Monica Gandhi, and other highly esteemed scientists who've been following the data closely since the beginning). Why is this so difficult for the absolutists and purists on both sides of this debate to understand?
I can pretty much agree on everything he said. We do indeed need vaccine mandate for flying. Or rapid test on airport that one pays for out of his/her own pocket.
turns out threatening to take a person’s job away if they don’t take a shoddily made medical product isn’t very popular. it’s just like a death threat...
Dia duit. 32m mark - guidance on planes. UCSF hosted scholar who served FAA cmte and said horizontal airflow the problem on planes. Wear N95 and eyeshield if next to others - early in pandemic. Interesting to hear ya'll fear proximity to those nonsympto but unvaccinated and no longer as concerned about distancing - which is still the only reliable way to reduce viral loads. Given that it's high risk people who fly during any pandemic. Sickness common postflights. All I ask is clarity from public health. Disaster messaging needs to be targeted, detailed, time-limited.
12:05 Sorry Dr. Wachtel, there is a racial subtext in the joke about awarding a Nobel for convincing majority black NFL teams to be vaccinated or face penalties. Think it through - tell me you don't see it.
I appreciate your authenticity and kindness, sir. You seem to be a truly caring human being. Regrettably, your guest was a disappointment and something of an embarrassment. Why? I contracted covid in December 2020 and received two doses of moderna in April/May 2021. I embrace vaccines but I would never demand that others do the same. The way your guest blithely dismissed the life changing effects of vaccine mandates, is he so callous that he does not care about people who lose their livelihoods, their futures, etc. Sadly, his responses were predictable. BTW, I had never seen or heard of your guest before today.
@@m_miller Much more life changing than Covid. In fact, most ppl I know, the worst sickness they have during the pandemic is the side effect of the vaccine. Some haven’t fully recovered after several months.
@@m_miller Trust. Widening gulf between safety maximalists and individualist maximalists. General alienation: tipping a too large segment of people from thinking they are *part of society* to perceiving themselves as *subjects to authorities*. (Compare historically the difference between being a French subject to being a French citizen.) And that is just a sort of the general effect. The more insidious possibility is public perception and attitude towards vaccines in general. (Masking is another kettle of fish - I really feel that outdoor masking mandates are doing harm to public trust - especially if you allow indoor dining at the same time.) Back in the spring 2021 I railed against the overly cautious attitudes wrt AZ (I would have taken it immediately if allowed, despite being a female
@@m_miller two things come to light : the chaos in a Pfizer testing lab. Also see Peter Doshi on false conclusion in Pfizer efficacy data. Inc in US hearing on vaccine injuries. Link below. Even the results ( before we knew about those missed samples ) did NOT show such gd efficacy. Failure of drug Comp to make data openly available etc th-cam.com/video/lepqvdXoA2E/w-d-xo.html Now we know how many ‘life changing’ injuries have occurred. Time to pause. And CANNOT have vaccine mandates where there is such risk. See Nuremberg Code 1947. Know the history. Btw I,m dbl vaxxed. But declining booster.
Great 👍
A very good interview with the current public health perspectives on the pandemic. I do wish that Dr. Ashish Jha discussed his future visions for public health, which he just briefly mentioned at the end of the interview. We have an outdated and mostly broken public health system, which desperately needs a dramatic overhaul. Most COVID cases have happened unnoticed by our monitoring systems. These are the majority of people who have sickened and possibly died at home without healthcare benefits as happened in India and elsewhere. We need new techniques to reach the home-bound people and families trying to cope with the disease. We need better technologies to update our websites and statistics with the necessary information that people can use to understand the threats and seek help. Help should also entail instructions with how best to care for the home-bound family member, or members, with COVID, and how to best prevent further transmission to other family members. Institutions, such as schools, should become community outreach and resource centers. Public health needs these as well as computer programmers and the latest tech gurus to create reliable information about the ongoing pandemic. These are all necessary to upgrade our current public health systems to meet the demands of future contagion.
Jha is a relief to see/listen to -- he's not a Pollyanna, he tells it like it is (as he sees it), but there's a realistic optimism to his take on this -- "It's going to take a while but things will get better, and the precautions we'll have to keep taking might be a little inconvenient for a while, but we can learn to live with them."
No threats of permanent masking or distancing, no immediate "doomsday variants" lurking, no name-calling or ad hominem attacks -- he makes it seem as if we can actually end up having better lives in the long run. A lot of us need to hear that.
AND, by the way: The link between "vaccine hesitancy" and healthcare inequalities -- over and above the very real and rational distrust a lot of poor folks and people of color have of "the system" (medical and otherwise), I believe a significant problem is that a lot of folks do not have a regular primary care physician.. That's the person you talk to about your questions, doubts, etc. concerning healthcare/medical care issues. I'm quite convinced that if more folks got their main healthcare advice from a PCP, rather than some online source (or something like Faux News), we wouldn't have as much entrenched anti-vaxx sentiment as we have. We'd also have a lot fewer people with the pre-existing conditions and risk factors that put them at risk for severe cases/hospitalizations/deaths if they do contract COVID.
Great session from at least 2 wise people! One observation: Dr Jha references data and surveys but does not directly present them (unlike Shane Crotty and others from recent Grand Rounds). As I am trying to be an informed layperson within my family and community, how can these public health data and surveys and papers become more transparent? Can someone share the links. (I also have experience in vaccine manufacturing at clinical and commercial/global scale and have many associates in that part of the ‘public health ecosystem’.)
When are the less expensive rapid tests going to be available to the general public?
Thanks for sharing real life.
Dr. Jha's masking thought process is easy to follow. The fact that he wan't provoked by his airplane "companion" shows his professionalism. Speaking at a conference in February. I will be a medical professional, but the audience will not. I will be masked throughout. Hope I can behave as he did.
I will disagree w/ him on one thing -- I believe the CDC's messaging went totally off the rails after the Provincetown episode (they reported it poorly, not emphasizing that it was an atypical situation, and also underplaying the fact that actually the vaccines worked WELL in preventing severe cases; they did an even poorer job of fully researching the issue of whether vaccinated people are really at high risk for transmitting the virus before making public statements -- subsequent research has shown that they are at some risk, but it's significantly reduced) -- and in my opinion they've never regained their equilibrium. A lot of vaccine resistance, I think, dates back to this botched messaging.
If we're lucky, by February the metrics might have improved enough that some of those restrictions can be loosened. Let's hope . . .
@@jazzmanchgo I'm reading this a year after you posted it and it's clear you've hit the nail on the head. The cdc panicked after Provincetown and their credibility never recovered.
52:00 Why don't you mention the origin of SARS-CoV-2 when asking about future pandemics? Seems like an important detail.
Don’t ask such a question again, ever!
So much speculation and a cosy chat between buddies. But I haven,t learned anything listening to this. No good studies referenced on the basics: do the vaccinated but infected shed virus? When and for how long? Asymptomatic or symptomatic viral shedding? What other identifiers are linked with these ‘breakthrough’ infections? Link use of rapid test to these situations. eg We in UK do a rapid test before choir rehearsals. Specific application to reduce risk. Surprised he did not call for better studies early in future pandemics to establish these sort of parameters which can inform policy and ultimately messaging. Where are the comparisons of infection rates where eg masks mandated, or optional. Or comparing other NPIs? The 4 nations in Uk all had marginally different approaches, yet rates all worryingly high. One simple observation is that whatever strategy adopted, the virus still gets away. From a Public Health perspective, no reference to underlying levels of poor metabolic health , rates of diabetes etc which correlates to both US and UK high up in the league tables of Covid deaths. No reference to any European comparisons looking at eg Italy, Poland, Denmark, Sweden. Variable rates of Covid and different strategies…. What does this tell us. Who is studying this. You guys having a cosy chat doesn,t address any of my basic questions.
Exactly
Jha has a very level-headed, rational take on most of these issues. I, personally, want us to get rid of these g@ddam masks ASAP, but I realize that, especially in some areas, things are still too serious for this to happen (nonetheless, I desperately want ALL of us to get there & the sooner the better). Jha's predication that the mask mandates might still be necessary when cases spike, and then on a state-by-state (or maybe even city-by-city or county-by-county?) basis, sounds like a very reasonable, even optimistic, compromise. Let's hope that this, also, remains a temporary situation!
I do wish Jha had addressed the issue of masking schoolkids, though. Although I understand the reasons behind it (I'm not an ideologically purist "anti-masker"!), I have concerns about the long-term emotional/cognitive effects of children not learning essential communication skills and empathy-sharing skills by not being able to see one another's faces -- Over 60% of all human communication -- incl. showing and sharing empathy -- occurs through facial expressions. We've evolved that way, it's an inextricable part of who we are, and I think we desperately need to find a way to return to a mentally healthy society in which everyday "face-to-face" human interaction can again be recognized as essential to our social and mental well-being -- and our children need to be a part of this.
What a slave you are. The masks are never going away until you decide for yourself to take them off.
@@rosskaske6357 Can we please stop these ideological flame wars and admit that two things can be true at the same time?
Yes, masking has been an essential preventive tool during the crisis stage of the pandemic. At the same time, having to live in a world bereft of facial expressions, where we fear one another as toxic, is not mentally healthy and should not be accepted as "normal," now or in the future. Wey need to find a way -- a reasonable, scientifically valid, and SAFE way -- to return to a mentally healthy society in which everyday "face-to-face" human interaction is recognized as essential to our social and mental well-being. This, I think, is what Dr. Jha is saying here (and we hear similar statements from Scott Gottlieb, Dr. Monica Gandhi, and other highly esteemed scientists who've been following the data closely since the beginning). Why is this so difficult for the absolutists and purists on both sides of this debate to understand?
Mix n match vax, we do not know enough about efficacy and side effects for mixing adenovirus and mRNA.
There is an ongoing study at Oxford university which has shown that good interim results (basically safe) the pre-print is expected soon.
@@christopherrobinson7541 thanks for this but I’m a bit of a conservative with medical experiments🙂. That said I’m fully vaxed with the adenovirus.
Boosters are needed for blood cancers. Not everyone is in this category.
I can pretty much agree on everything he said. We do indeed need vaccine mandate for flying. Or rapid test on airport that one pays for out of his/her own pocket.
Excellent conversation Dr Jha
turns out threatening to take a person’s job away if they don’t take a shoddily made medical product isn’t very popular. it’s just like a death threat...
Dia duit. 32m mark - guidance on planes. UCSF hosted scholar who served FAA cmte and said horizontal airflow the problem on planes. Wear N95 and eyeshield if next to others - early in pandemic. Interesting to hear ya'll fear proximity to those nonsympto but unvaccinated and no longer as concerned about distancing - which is still the only reliable way to reduce viral loads. Given that it's high risk people who fly during any pandemic. Sickness common postflights. All I ask is clarity from public health. Disaster messaging needs to be targeted, detailed, time-limited.
12:05 Sorry Dr. Wachtel, there is a racial subtext in the joke about awarding a Nobel for convincing majority black NFL teams to be vaccinated or face penalties. Think it through - tell me you don't see it.
I appreciate your authenticity and kindness, sir. You seem to be a truly caring human being. Regrettably, your guest was a disappointment and something of an embarrassment.
Why? I contracted covid in December 2020 and received two doses of moderna in April/May 2021. I embrace vaccines but I would never demand that others do the same.
The way your guest blithely dismissed the life changing effects of vaccine mandates, is he so callous that he does not care about people who lose their livelihoods, their futures, etc. Sadly, his responses were predictable.
BTW, I had never seen or heard of your guest before today.
What are these life changing effects of vaccine mandates?
@@m_miller Much more life changing than Covid. In fact, most ppl I know, the worst sickness they have during the pandemic is the side effect of the vaccine. Some haven’t fully recovered after several months.
@@m_miller Trust. Widening gulf between safety maximalists and individualist maximalists. General alienation: tipping a too large segment of people from thinking they are *part of society* to perceiving themselves as *subjects to authorities*.
(Compare historically the difference between being a French subject to being a French citizen.)
And that is just a sort of the general effect. The more insidious possibility is public perception and attitude towards vaccines in general. (Masking is another kettle of fish - I really feel that outdoor masking mandates are doing harm to public trust - especially if you allow indoor dining at the same time.)
Back in the spring 2021 I railed against the overly cautious attitudes wrt AZ (I would have taken it immediately if allowed, despite being a female
@@ye333 I see, the “most people I know” argument. Nonsense.
The data on vaccine efficacy and safety is clear and compelling.’
@@m_miller two things come to light : the chaos in a Pfizer testing lab. Also see Peter Doshi on false conclusion in Pfizer efficacy data. Inc in US hearing on vaccine injuries. Link below. Even the results ( before we knew about those missed samples ) did NOT show such gd efficacy. Failure of drug Comp to make data openly available
etc th-cam.com/video/lepqvdXoA2E/w-d-xo.html Now we know how many ‘life changing’ injuries have occurred. Time to pause. And CANNOT have vaccine mandates where there is such risk. See Nuremberg Code 1947. Know the history. Btw I,m dbl vaxxed. But declining booster.