In the era we are living through right now, I feel it’s more important than ever to bring you topical conversations based in science, and that’s what we are doing today, and will be continuing to do in the coming months. I have been frustrated by the spread of unsubstantiated information being spread all across the internet about the pandemic.
On the one hand, it’s important to recognize that when we’re dealing with a very new or rapidly changing phenomenon, like we have been with the pandemic, even the “scientific consensus” can easily be wrong because there’s not been much time for the rigorous replicability studies to be conducted or even sometimes to accurately measure the proper effect sizes. However, I also believe it’s important that we don’t create a false equivalency between very fringe ideas that are unsupported by the current evidence base and a scientific consensus that is grounded in rigorous methodology.
This is why I sought out the counsel of Dr. Eric Topol on today’s show. In addition to being one of the top 10 most cited researchers in medicine and being extremely well regarded in his field of cardiology, he’s also been a bright light on social media, shining a light on the best available evidence in the pandemic. He thoughtfully considered all my questions and was very careful to make clear what the current evidence base says without ruling out alternative possibilities in the future in light of new evidence.
In this episode, we cover a number of hot button issues surrounding the pandemic including the potential use of ivermectin to end the pandemic and the potential for increased risk of myocarditis among certain populations after vaccination. We even discuss the role human psychology and human behavior have played in this pandemic. Ultimately, Dr. Topol is optimistic about the future of the pandemic and outlines things coming down the horizon that should give us hope. But as we discussed, the major problems tend to be human problems.
Bio
Eric Topol is a cardiologist, scientist, and author. He is the Founder and Director of the Scripps Research Translational Institute, Professor of Molecular Medicine, and Executive Vice-President of Scripps Research.
As a researcher, he has published over 1200 peer-reviewed articles, with more than 290,000 citations, elected to the National Academy of Medicine, and is one of the top 10 most cited researchers in medicine. Dr. Topol has been voted as the #1 most Influential physician leader in the United States in a national poll conducted by Modern Healthcare. Besides editing several textbooks, he has published 3 bestseller books on the future of medicine: The Creative Destruction of Medicine, The Patient Will See You Now, and Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again.
Website: drerictopol.com
Twitter: @EricTopol
Topics
- What is Emergency Use Authorization (EUA)?
- COVID-19 vaccines are humanity’s greatest medical achievement
- Infection acquired immunity
- Vaccine and COVID induced myocarditis
- The efficacy of booster shots
- Ivermectin studies: what does the data say?
- How to improve pandemic response
- Hope for the future of the pandemic
Thanks for a much-needed podcast! Discussions with folks on LinkedIn about the recent Rogan controversies opened my eyes to how little even many educated folks understand about how to evaluate interventional research. I think every high school student should be required to take a course in basic principles of statistical analysis, and various types of research designs and their limitations, including the levels of evidence. (1st link). It would also be helpful to conceptually understand background (base) rates. (2nd link)
https://s4be.cochrane.org/blog/2014/04/29/the-evidence-based-medicine-pyramid/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936550/
Thank you, Scott, for stepping up to present this balanced, science-based interview. It really is a public service. I’ve shared it with my 20-year-old son, who has been listening to less-reliable online sources lately. I’m going to encourage him to pass it along to his friends.
I really appreciated his recognition of the efficacy of natural immunity and how the refusal of the US public health agencies to recognize its effectiveness in spite of overwhelming scientific evidence damaged the already weakened trust of citizens in public health officials. After the mask silliness….no mask, mandated mask, 2 masks, back to 1 mask and now finally, after 2 years, N95 masks….and taking natural immunity from the gold standard to measure the shots by to something only ignorant, evil folks who are willing to jeopardize others lives believe in. And this all coming from our expert scientists? I’ve had training in biological warfare and knew to wear an N95 2 weeks before the CDC said to so the seeds of doubt were sown the first few days of the pandemic.
He does however continue to oversell the vaccines. I live in Pennsylvania and if you go to the state department of health site you will find that in the month of December 42% of the folks testing positive for COVID were fully vaccinated (many of those were probably boosted as well). For the last several months it has run in the 30s.
As to deaths the last data was for Oct and 31% of the deaths were people who were fully vaccinated. I’ve looked at other states and their data is similar. Mass raw data is often better than a scientific study whose sample may be small and or poorly selected. Studies try to simulate the real world…..when we are actually in a real world event and can use real world data. The CDC has known the shots did not come any where close to 95% effectiveness in preventing illness since April 2021. They stopped tracking non-hospitalized break through cases 1 May to preserve the perception of shot effectiveness. Based on limited county health department data I suspected the issue in April and by May the limited data confirmed the level of breakthrough cases was about 30%.
Protecting the narrative that the shots are safe and effective (just watched another commercial telling me this) has become the priority (propaganda) to prevent vaccine hesitancy. The problem is it is not the truth and the science/data is being hidden or at least not broadcast by the media (only nerds like me go to health department web sites). People are figuring out they’ve been lied to further damaging trust in our institutions to include the scientific community. We have seen anyone who questions the performance of the shots or mentions the effectiveness of natural immunity attacked as heretics. We have public figures threatening to beat up or kill people who have not got the shots.
How many people have ads like this killed? Someone 85 with comorbidities gets the safe and effective shots and thinks they are now safe and resumes a normal life believing they are protected, catches COVID and dies. How many times has this scenario played out?
The shots help. They reduce hospitalization and death but they do not prevent it and they do little to stop transmission. If you haven’t had COVID yet you probably will. If you are vaccinated you will have some protection but if you are in the high risk group there is still a significant likelihood you will be hospitalized and or die.
Unfortunately we have created extreme ideologies around the shots. One is that they are totally effective and that anyone who doesn’t get it is an evil murder. The other that the shots will actually cause you physical harm and only fools take them. Both are causing needless deaths. The truth is in the middle but the middle is the first casualty in an ideological conflict.
You are both right about the terrible performance of our leaders. If only our leaders and media would be honest with us and allow us to make informed choices we would be in a much better place. Instead they have used the crisis to further division for financial and political gain. Heartbreaking.
Scott, when you asked how psychology can help, Dr Topol’s answer was:
“I don’t know if you call this psychology… but it’s human issues and human behavior have been holding us back”
Psychology is the study of human behavior. This is an example of the poor dissemination of even a basic understanding of what psychology is. The other disappointment is the lack of leadership from psychology to change health behaviors. The pandemic was a prime opportunity to use everything psychologists (particularly health psychologists and organizational psychologists) know about influencing human behaviors to “nudge” the population towards effective actions. Perhaps they weren’t invited or afforded that place in the public health response, but it would have made a huge difference to health outcomes if psychology had been involved, given that many barriers have centered around “human issues and human behavior”.