Episode 1 - Covid Discussion

Comrade Uncle is a podcast where I talk to my uncle, who is a smart and good doctor practicing critical care medicine,  about the intersection of politics and health, through a Marxist lens.

In this episode Comrade Uncle Doctor Joe and Comrade Nephew Odysseas discuss COVID, pandemic response, labor struggles, and more.

To help with labor struggles, go here:
https://www.change.org/p/we-support-n...
and here:
https://dsa-la.org/tacos-for-teachers/

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Video available on YouTube

Transcript

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foreign so I'm here today with Joe Lyon my uncle um man I love and respect very much uh I've brought you in to talk uh to me about covid um who are you who are you my uncle well well as as in the oh as in The Odyssey holy shell uh I am no man and I am every man yeah UTIs uh yeah there you go so no I am my uh uh physician um my training was at University of California then at Cook County Hospital then at University of Florida I've primarily been involved in uh Critical Care Burns trauma surgical Critical Care operative anesthesiology but mostly Critical Care I've done um I was the director of emergency medicine at UFO for five years I was a director of critical care for I don't know I don't know 10 years I don't know a while at UF um uh spent was then recruited up to the into the Northeast up to Pennsylvania was a chair of department of Critical Care Medicine uh for a while uh spent time uh sort of in between all of that working in Latin America working in Nigeria with msf um Doctors Without Borders sorry Japan turkey Greece Germany visiting Professor lecture lecturer stuff like that so I've done all that primarily I'm a clinical guy I've been involved with a fair amount of research in writing although it's been mostly on pulmonary physiology infectious disease not really a whole heck of a lot in fact can we rephrase that essentially nothing on virology I'm not a virologist I'm not an infectious abuse person but I have certainly since 19 19 since 2020 and then absolutely intimately involved with the care of coveted patients so both both the the medical issues obviously uh and as well as some of the social and um political issues which have probably been the most problematic I've been involved with so so basically I'm a I'm a I'm a I'm a front line physician I've been an administrator I've been a I've been a division chief of department chair you know I've done all that stuff I've done research taught but right now I'm I'm sort of a front line not sort of I am a Frontline physician uh in intensive care unit and I've got some experience that everybody's got with covet I mean I've got to unfortunately this is the third pandemic I've been uh involved with uh intimately uh uh HIV AIDS initially called grid of course um Ebola and now this one um and each one a little different and each one a little more frightening for different reasons um but uh what else I guess that's me that's that's that's who I am that's what I do yeah um and I'm also a member of Physicians for national health program which probably is all you really need to know yeah absolutely I mean that's the that's part of what we're missing you know a big part yeah yeah so a huge part yeah so you've seen it and you're not you know you you've uh you've been kind of around for a couple of iterations of this of the you know pandemic response uh and you've kind of you've kind of been uh been way steep in this stuff uh for a while you know yeah yeah well that's fantastic I'm just uh thank you so much for um speaking to me and making some time um I know for me uh it's been you know invaluable to be able to talk to you um about stuff and be you know have access to somebody that I can trust and that uh you know I know has my best interest in mind and not a not some like you know not to say I mean there's lots of good doctors out there but you know you look online for any information about covid um and it's just you know it's like a flood right like there's there's so much to parse for you know somebody who's not trained in science and you know isn't going to go and look at the studies or whatever you know just your average Joe like you know they look up you know should I get the booster or whatever I mean okay maybe that one would be a little easier but but uh but you know but some of these questions no no it's been a challenge and we can we can go to the certain to the questions you've got I'd be happy to answer those um but but it's been a challenge so so perhaps the best way to sort of begin to address this is to do a thirty thousand sixty thousand foot view um uh not just of of of of uh SARS Kofi 2 which causes covid-19 which is a pneumonia the virus is uh uh is uh coveted uh it's a family of viruses RNA viruses that um have been seen before uh there was mayor's Middle East Respiratory Syndrome uh it's a disease that's uh primarily as it sounds respiratory pretty severe High mortality uh see in the Middle East I believe transmitted by camels if I remember correctly there was uh the original the original uh SARS severiki Respiratory Syndrome which was seen in China oh 15 years ago or something like that it's reasonably severe um um but not the mortality wasn't quite as bad uh as I remember um I wrote one paper on that with some Chinese colleagues years and years ago um it's not yeah yeah it's not new um but but the response is what's intriguing so with with with so with HIV AIDS initially called grid right gay related immune deficiency um because initially seen in IV drug users and uh gays on both coasts I I will never forget it is as long as I will never forget this is how how wrong a human being can be I had just returned from work that I'd done with the uh in Latin America with a new Nicaraguan government in 1981. I've been there since 1980 just came back to Chicago was in my residency and I remember picking up on my way to what we call Morning Report where we talked about the nights previous night's admissions with the chair of Medicine I picked up a my copy from my box I guess New England Journal medicine and I was sort of glancing at it as I walked toward the chair's office and and there was two the two lead articles about this new unusual disease seen amongst gay men um on both coasts and I remember thinking to myself it's as clear as as can be well this is going to be a nothing Burger as well uh and that boy was I so wrong about that uh so wrong about that but but you know what happened was is of course it was quite serious and the thing that was most impressive about that disease initially was the social stigma associated with it I had now I can't I can't generalize but I know this has happened more than in just my place I was at Cook County Hospital I was a a senior resident a senior resident and um I had faculty who basically said to me you know senior Physicians the guys were supposed to be training me in my residents and medical students who said to me um you take care of it I'm not going to touch this I'm not going to deal with this because I don't want to get it and I will never forget the Furious the how Furious I became at the fact that you know these guys would behave in such a way I mean it was tough enough being at that place it was an institution that was primarily um uh that primarily serves the poor black brown white the poor um uh uh and you know there was a there was some there was some significant disrespect by some of the senior Physicians toward our patient population but that was really remarkable we we we took care of those guys we did it you know I mean again I was a senior resident but I was a resident you know I was a 30 something year old doctor and training and we did we did everything because not again not all not all but many of the senior most doctors said I want nothing to do with that guy he looks gay he looks uh like a drug user he is a drug user don't want anything to do with him so it was it was because it was because people were I mean it was because it was a gay population that there was this kind of like detachment well true and and when when the when it was there was when it became concluded there was some for some reason uh that Haitians Haitian immigrants had a higher incidence as well uh and there was a those some of the again some of the faculty would just say go take care of that I don't want to deal with that I don't want to deal with them same thing now what would the reason behind Haitians specifically there was a whole bunch of reasons some of them really frankly racist uh as to why people thought Haitians might be at risk but I probably had to do with nothing more probably nothing more than uh being gay and not being able to so State you know things like that in other words there's nothing special about Haitians that's for sure right but that was a that wasn't that was a opportunity to to see the failure uh of our health system now I I had and I'm sorry to be talking quite so much but no this is what I want okay I mean I had a fair amount of experience arguing um arguing that our health system was a failed Health System I mean the first discussion the first debate I ever had on that topic was as a 20 year old undergraduate at UC San Diego standing on the quad arguing with one of these Young Americans for Freedom members these really extremely right-wing Republican types at the time now they're even more right-wing but but you know arguing it was a it was a it was a good argument you know you know respectful of the time about why our you know our health system is unequivocally and was at the time unequivocally not the best not the best uh and and has only gotten worse since and I and I say this with all respect from my colleague nurses doctors administrators I mean the system is set up the system is set up to give us the results we get there's not a bunch of stupid administrators there's not there's not a bunch of stupid doctors or nurses there's not frankly oh they say I would argue there's not even a bunch of stupid Insurance Executives you know as much as I detest those companies this is the system and we're getting the results that the systems set up to provide right there's a lot of really good folks but it's a disaster system HIV AIDS brought out was the first maybe this may not be fair I may be understating the truth but it was at least to me the first time it was as clear as can be yes how screwed up this system was and as you remember oh actually as you probably told that uh you know as I know the the yes yes the president was Reagan uh his uh and he uh unequivocally refused to address this pandemic at the time that was killing thousands and thousands of thousands and it was ultimately his uh Surgeon General um I can see his face I'm blocking on his name uh who again this was a guy who was a pediatric surgeon known to people who trained me uh and uh and he was a kind of born-again Christian type didn't want to deal with it and finally could not live with himself and publicly came out uh attack attacking in a polite way his own Administration and say we have to address these issues and those the way we address this is with by addressing the the behaviors that uh lead to to uh to HIV AIDS right who knows yes that was a guy you know an amazing amazing I don't know him personally I don't know what I do know is he stood up and he said we have to deal with this interestingly enough really interestingly enough at the time uh Anthony fauci was at the National Institutes of allergy infectious disease a pretty young guy and then and then and and the and the gay population initially was furious with him because he would not rapidly provide drugs that might uh uh provide some hope for all these people who are dying of HIV and dying quickly Dr fauci and died oh and horribly and believe me believe me believe me I've seen it and horribly uh fauci really quite rapidly changed his tune really and although you know he wanted it wasn't he this wasn't because he was somehow anti-gate or something this was in order for me to provide you a drug I've got to have the studies that prove that it's safe number one and effective efficacious number two and that takes some years and studies randomized controls controlled blinded you know placebos right and that needs to be funded right that needs to be funded too and it should be funded so there was but but but even with funding it takes years the gay population said we're dying we're dying just do something well so so there's two interesting things that come out of this I know we're talking we want to talk about covet but two interesting things come out of this number thing number one is the extreme right in our country that the fascist and I'm sorry it is the fastest right in our country primarily populated in the Republican Party have now have begun a series of attacks on Anthony fauci Anthony fauci made mistakes with covin big mistakes I mean who hasn't I've made a mistake right but but as fast as he realized they were mistakes he corrected right he is a fine physician to my mind a decent man I I don't know him but you know but and and he and trying to do the right thing he did that with HIV AIDS and he did it with covet trying to do the right thing that so thing number one is is trying to do science the way it should be done he's been attacked and attacked and attacked in this latest attack by the right in our country is to bring him in front of Congress and try him that's what they will say they want to do fauci clearly at the beginning of HIV AIDS may I think I think made some mistakes and he rapidly realized he made some mistakes he corrected course and became an incredible Ally of the gay population did he did he speak out against uh did he because okay so was that before or after the Reagan Administration well Reagan you know whatever it decided to acknowledge that it even existed or whatever that it was problem decided to have any response was that before or was that after that like did he tow the political line until uh he got the go-ahead from up above do you think I mean if you remember if you think you know my my I I don't have a clear timeline but my best sense of what fauci does I mean this is a guy unlike your uncle who is politically a pretty smart guy he I'm quite sure he came out and said we've got to do more but he didn't come out and you know as the leader and critique the president he didn't do that I think he did it behind scenes which is actually what he did with covet as well the second thing but the second thing that's that's quite interesting again still staying on HIV AIDS which there were no there were there were no drugs there were no drugs so one of the one of the agents that in fact the first agent that seemed like it showed some promise was this agent called azerothymidine AZT yeah AZT right AZT was a quite quite a poor drug for training AIDS it made you feel horrible made you feel sick it was really bad and it didn't work very well the only reason I mention it is that the is that the um the uh uh some folks who are critical of fauci now related to covet have brought up the fact that he allowed or he pushed I think the word was pushed last time I saw these revisionists historical revisionists he pushed AZT on the gay community and it didn't make them better hardly and in fact the only way you can say things like that yeah is by not knowing any history at all about what really happened yes it's a it's a poor drug yeah it's a it's a very poor drug but yes also it was all he had and we TR and we tried it and I prescribed it and when I got needle stuck I took it and I promise you my uh I I it made me so sick I thought it was of course I'm wrong but I thought AIDS can be worse than this and I stopped taking the drug fortunately for me I didn't get infected but but the point is it's all we had there are now for HIV drugs that anyone who's positives can take and they are effectively normal they are effectively it's not cured zero close to zero viral load yeah yeah High activity antiretroviral therapy it's called heart therapy it's it's so so so that epidemic showed some of the flaws both nationally and locally the the Ebola epidemic is a little different I although I was asked to go to um West Africa with World Health to um take uh to take care of some of these guys and although I was prepared to do it I had a friend a dear colleague at the um at World Health Organization who was writing the guidelines for the care of Ebola victims right and and she called and she because she knew I was going to do this and she said do not under any circumstances do this you will die it is utter chaos oh man everybody World Health msf everybody they're they're it's utter chaos it's a disaster don't do it so I didn't do that um uh uh I'm good for good or ill but I didn't um I had friends who did go and some of them came back relatively ill many of the the some of the ones that I know came back Ill uh but serious PTSD serious seriously yeah and then there's and then there's covet and then there's covet right so covid starts unfortunately while uh uh Trump is the president and you know he he he was worse even than than Reagan was in terms of wanting to ignore the disease for political purposes so first of all he blamed the Chinese it must be military it must be something right again yeah I don't have all those data but everything that I've read suggests that it wasn't a virus that escaped from a lab number one number two there's his followers I don't know that I've heard him say this his followers have argued that fauci funded gain of function research right that and the data on that the data on that is that is just not what happened that is not what happened there were some studies begun by a a a a contracted agency that looked at one of the markers but it just it's just not it's just not it's just not true so but again the the look The the what's what's desired for political purposes right is to find a scapegoat we can blame this on in fact in fact more well actually I should say Let me let me rephrase it not in fact because I don't think we've got all to do but it at least appears that covid uh covid-19 this particular SARS kovi II is probably related to the interface or or as we like to say these days the Youth of today like to say the intersectionality of how about that how about that I like it okay of of sort of climate change and infectious disease yes probably that's probably that's probably what happened probably was from uh one of those live one of those what they call the wet markets probably and it probably jumped from animals to humans probably similarly to the way that HIV AIDS jumped from animals to humans back in the 70s right because that's when it first started um it it is it is fair to say okay I mean I really want to be just as clear as this possible to me so while I think it's absurd to argue that sort of that this came from a Chinese lab military lab and and fauci and NIH funded that's absurd it is true though it is and sadly true that the government of China when they found out that the People's Republic of China when they found out that this was real The Physician that brought it to them was silence he is now a governor I know a little bit more about this part um there's so one of the things is uh okay so part of uh part of this whole thing is that okay you've got uh you know the Chinese government isn't run neces you know it doesn't run exactly from the top down you have your central Council you know kind of like the presidium back in the uh you know the Soviet days or whatever uh and then they kind of they send out mandates to the these different not even mandates actually uh directives to the different Governors or whatever anyway Governors are Performance Based the governor of that Province uh where it first emerges the guy who you know through the uh the guy the researcher or not researcher the doctor whatever he was uh in jail for for you know uh to try and keep so what he was trying to do is he was trying to keep a lid on it he didn't want to look bad when his performance review came up he thought you know whatever who cares what he thought afterwards when when it becomes clear that it's you know it is what it is that it's covered that it's going to be a big deal uh and when when the higher levels find out about it that guy is canned he's in all kinds of trouble uh because because he hit it it'd be like if uh it'd be like if a state Governor tried to hide that um except in the Chinese model there's even more incentive because the they they're rated on performance from above right so it's like you know you have uh you have your department you don't want your your you know your area to look bad your maybe you're kind of corrupt uh uh or whatever you know there's this sort of incentivized thing but it wasn't it wasn't a whole Chinese government policy uh that is what I'm saying once the rest of the country caught on once the the leaders you know of China caught on they immediately have this big response um uh so so that's that's all I wanted to interject okay yeah sure governor and I appreciate I appreciate what you're saying and and I will I along this we might I mean we might have some philosophical difference uh the facts are the facts you're right but and the facts as you've described them is what I've read as well however however as we said about the American Health System the system is set up to get the results that it delivers and material circumstances right I'm enough of a Marxist right I know right Marx once wrote well Marx once wrote that you cannot under any sense in any sense have socialism without democracy now he didn't Define what that means precisely but a top-down system A system that is I mean how I mean I know our Chinese colleagues utilize the words and the symbols of socialism but at least in my mind at least from what I know and have read and have thought about for the last 60 years that I've been thinking about this stuff uh it's uh a pale socialism if that's what it is it is to my mind an authoritarian government that uses our symbols and this and the result they got is the result that you expect from that system now having said that my only point in my pointers our result we can talk about it's horrible we will talk about it right we will talk about the point is is they made there were some mistakes made without a doubt when they realized the Chinese that this was this was an active potential pandemic the phone calls were made people at CDC were informed I mean they did all that stuff that that that part is true the Chinese took a different attack than German U.S took when it came to trying to right trying to control this uh and and for a while it worked now we're seeing in China now that it really is not working so well at all it's it's very difficult to do uh it's very difficult to do um uh uh Healthcare in just one country much like it's difficult to do socialism in just one country uh you know well the Chinese tried to do no it's true with the Chinese did was they thought they tried to to uh isolate people if you isolate you can stop you can stop transmission disease absolutely the right I mean there's no question about that right you can do it that's Public Health one-on-one but the other things that that should have been done to my mind right now again I can be criticized for this because I'm not a a public health guy but to my mind they should have used the time they had and they had time to immunize everybody and they didn't do that they didn't do that yeah so the bottom line though is not to I mean I don't want to really talk much about China it's it they're they're they're we should we shouldn't in the in the future we absolutely should because there's I do want to compare different responses I mean you know right so yes yes yeah we certainly you know we don't want to get too far afield but some sometime I would like to talk to you about uh um sure okay all right yeah anyway we can do that the the the the um there are now so what the Chinese did seem to work and and for at least at the beginning there are now four new Omicron variants that are quite infectious and that do not respond to the monoclonal antibodies and appear to escape from some not all of the vaccine mediated humeral immunity that is that we've got from the vaccine and the boosters and the um and the bivalent uh vaccine that we many of us just got so so so we're now in trouble again but there's but there's a bunch of nuance to that statement thing number Nuance number one is is that that what we measure is humoral media humeral mediated immunity for the most part are there antibodies do they do they neutralize the virus in vitro it's a little harder to look at the other component of the other arm of immunity which is cellular mediated immunity and and that probably still is stronger than the humeral immunity and probably probably still more active than the humeral immunity so that's thing number one thing number two is even with the weaknesses of the vaccines in the face of the present four variants people who are fully vaccinated although they can get infected and although they can transmit they are much less much less likely to get hospitalized end up in the ICU and end up dying without a doubt so so it's worthwhile getting vaccinated fully vaccinated now the people who are there with the booster we should be clear with with the booster with the bivalent booster as well fully vaccinated as well yeah yes and I would argue even if you've had coronavirus even if you had covid-19 maybe you've gotten a number nine who's gotten sick with it after your episode of infection is over I would still get immunized because so-called natural immunity I mean there's no such first of all there's no such thing as natural versus unnatural immunity there is immunity full stop some people have argued some people of good faith but some of not quite such good faith have argued that no natural immunity is what we really want and the vaccine is artificial so we're not going to do that and say are you out of your minds there's only immunity you have it or you don't have it and it's not a one or a zero there's actually gradations but but you know you may be uh you may have been initially infected with the wild type virus when the covet first started and you may have humoral immunity to that and cellular immunity but it may well not help you against the Omicron variant or at least help you as much so what you want whether you've been infected or not is to be vaccinated the full amount up to and including this bivalent latest vaccine it doesn't give Total Protection there's no such thing as Total Protection but it does provide protection against much protection against severe illness hospitalization and death that's that's that piece the second piece is you know what else can you do I mean you know do it what the Chinese tried to do with lockdowns I mean again that's Public Health 101 I it makes sense but how long can you do that and and so they facing that and so are we so I think the thing we have to do and the thing that I personally do is I do not go anywhere without a mask I do not go out now if I'm outside with other people that's okay I mean I try and keep my distance but inside any place when I go to the hospital every day I wear a mask every day because because there's just it's just too risky first of all and what kind of mask what kind of mask we should say that too I mean yeah I can I just wear a regular surgical mask I don't I mean I have them it's just I wear a surgical masks but a kn-95 if that's what you've got that's really that is better it is better and when I go into a room I mean okay so so I do take some chances for me to wear a kn95 hour after hour after hour all the time that I'm in the hospital there's a little it's a little it's a challenge just for me so I wear a surgical mask all the time less of a challenge if I go into a room where there's a known uh covet patient I put on a n95 mask on take off the other mask and then when I come out I put the other one get another one put it on but but I'm always a mask you know my I've gone with friends and with my wife to restaurants you know who try and sit outside but obviously like you're in Wisconsin now you really can't sit outside so what we do is when we're when we we wear the mask inside uh we try and get it if we're inside if we wear the mask we go inside try and get seated as far away from others as we can take it off while we eat put it on when we're not when we're done it's not perfect you know none of this is none of this is perfect as the best you can do yeah you're exactly right you're managing risk so so you know I think that the issue is is that this virus it's like there's a there's a there's a advertisement on the on television that says you know I uh I I run 15 miles a day and uh and the announcer's voice comes over shingles doesn't care uh you know I nothing but natural food shingles doesn't care it's an advertisement for a vaccine the point is coronavirus SARS cov2 doesn't care if you don't believe in it it doesn't not you that's people that anybody doesn't yes it is simply a virus and it will do what it will do and all we can do is try and mitigate response so masks hand washing distancing vaccination um you know and if you get sick if you can't stay home I know this is a this is a statement right it's a free subject problem yeah yeah it is it is because our president you know this is this just happened last week or the week before last just push the bill through that refused to give sorry let me rephrase it you push the bill through Congress that made rail workers stay at work instead of going on strike for sick days right when they have code yes yeah when they have anything yes not just covet right right it's just wrong right and a mantra that was the Mantra was well but but our economy is kind of a little bit of a problem and if these guys go on strike well it might hurt the economy and so my response is dude well actually it's not quite what I said I said [ __ ] if that's the case then take these rich guys including yeah including uh Warren Buffett who owns parts of these railroads and have them pay them to be have sick days it takes a little bit of their profit but who cares big deal I mean I don't care you know and but so so it is a fraught topic there's no question about it there's no question about it and but that's what you if you can that's what you should do you may not be able to no you may not be able to so so so this is not going to go away and my best sense is in fact not only is this not going to go away uh yesterday I was looking at data that suggested the number of uh not suggestions pretty clear that nationally the number of cases is going up a number of deaths is going up God sorry not cases cases two but hospitalizations and deaths are increasing by significant double digits so we're not really practicing cases I mean we're tracking a little bit of cases but we've kind of abandoned that whole model right because with home testing how do you report it you don't report it but hospitalizations and ICU Admissions and deaths oh yes those we you can track and know so those appear to be going up again so one expects that this will become yet again in this um this cycle this is we're now at uh in the winter cycle it becomes uh a problem for us again so you know and and so and so okay so you say okay but you know you've laid out some things we can do and they might work and I do work but you know you I mean I live in the south and every single day I have people I take care of that come into the issue themselves or the love with their loved ones and I you know and ask them you know I ask them are you are you immunized and you know the the so what is today today's Tuesday Sunday morning get called down to the emergency department for a lady who's in respiratory distress needs to be needs to have her breathing supported with the machine blah blah blah blah and her husband's there let's go talk to him you know we talk about we get us y squared away and then I turned him and and asked you know you know have you have you both been immunized and she he says absolutely not not going to I lost three friends to That vaccine and so I said well okay I mean you know look it's not my point to argue with you here I'm here to take care of your wife but but number one you didn't lose three friends and actually you may have lost three friends not to the vaccine though no the vaccine would have saved them could have saved it this may have been effective when it happened you know who knows but but you need to be you know you're you the guy your older Elder older you know you need to be immunized your wife has got multiple comorbidities she needs to be very nice I said and I and I mean and I give them the lecture I mean I talk to them I mean I talked about this uh about why it matters sort of like we've been talking and I then I point to the the turned off television on a wall up in the community and I say the problem is that that idiot box and the and the misinformation that's been distributed I said and I I mean I name names I mean I I name names I said by Fox news by one American News Network by Trump and the people associated with Trump I said you know look I said I tell them I'm sorry I know I don't know you well enough to have a political talk with you but this impacts not only your health but my health and the people that you love and the people that are all around us here in this ER if you in this emergency department if you infect them who's going to be here to take care of you you're not vaccinated you don't wear masks you don't believe in it quote believe it you know shingles doesn't care they're missing right they're misled I mean it's not you know it's and as long as you have these Outlets that are pumping out and and truly in my opinion I I hold not equally culpable absolutely not but I hold uh you know these other you know the the sort of corporate Democrat side of of the media is is not all I mean they're better they're better they're better but they're not that much better they're they're towing a line too and and truthfully it's like uh you know when you let that stuff fly when when there is no I don't know I don't I mean you know I I don't know what the alternative would be but but when you have this flood of misinformation that's coming from the the sources that people trust uh it's it is it's really hard I mean you're you're ex you're simultaneously expecting not you I mean we as a society the greater actually not even weak the ruling Elites are expecting people or if that's even what they expect maybe it's cynical uh uh are you know people are expected to become uh medical experts make these decisions all for themselves oh I'm gonna get the vaccine I'm not going to get the vaccine I'm gonna do this part I'm not going to do that part then meanwhile they have this other thing you know blabbing at them telling them oh hey the vaccine's fake it's going to kill you whatever and then then you know and then we expect them to make a rational decision based on that when when truthfully you know how you know you ask me how to um how to build a bridge got the basic idea but you know if every American had to build their every you know United States citizen had to build their own Bridge anytime they wanted to cross a bridge we'd have a lot of people falling into the dam River uh you know no problem so so I don't know you know that that's the maddening part from for me uh is is if we don't uh you know I don't know what the answer to that is but it's part of the answer I part of the answer is there has to be accountability it's not it is true that people are misled and I'm willing to give wide wide wide birth to our fellow citizens who've been misled on the other hand and they're believe you me there is another hand I have never been threatened with physical harm as much as I've been threatened with this nonsense yeah screamed at and curse that by young women because I wouldn't give their dad Ivermectin to the two daughters of this man uh you know and and and and and and with one other guy you know his dad was dying he was a 30-something-year-old guy a big muscular guy I mean and you know I mean I've been around the block long enough you can kind of tell when when the guy went and the guy is like you know milliseconds from taking a swing right body posture tone everything just the way he stood I mean I've also done martial arts so I sort of know what the position is when you're getting ready and he was ready it's like you know give me a break I mean I'm completely uninterested if you don't want my help do not come to me for help that's fine I understand but the other thing is is you know it's not just but those guys are miss those guys are they are misled and so I do no no no you're right you're right so here's I think two things one one is uh we need public education and and maybe we need to not let you know a major News Network be I don't mean you know I don't know I don't trust necessarily the US government any any more than you know depending on who's in charge right like uh uh any more than than whatever you know the news network to to set that but maybe some bare minimum for God's sakes I don't know I don't know but but but public education if people aren't educated they cannot know they're easier to mislead educated they're much easier to listen and it's true that public education is problematic that's a that's really a different topic but certainly related you're right but the other piece of this is that you know there was a period in our history around the time of Andrew Jackson with the know-nothing movement where people thought that that they knew as much as anybody else now admittedly admittedly medicine in the 1810s 20s was different than it is now for sure right but you know but but but that but the but the movement in the United States that that tendency in our country uh to to think that Elites are just are scum of the earth that they don't know anymore and I've had people tell me that too yeah argue with me about medical therapy well it doesn't matter that you've got you know several degrees I did my research well let me tell you something good I mean not you dude no you're research and you go to the internet you find what you find maybe you're sitting on the toilet while you're doing your research on the internet I mean I am by no means I am by no means the catch me out of academic Physicians but you know I've done major textbooks two of them in multiple editions I've got about 200 papers peer-reviewed you know and abstracts I mean so I've done my show I think I know what research is right right uh you can read a scholarly paper you an easily digest it I can figure it out relatively you can't you just this stuff is not this stuff is not that simple if it was simple yeah it'd be easy but it's not so you do have to at some point have be willing to have confidence in somebody and and and I have way more confidence in Anthony fauci whatever his flaws and the National Institutes of allergy and infectious disease in the CDC who've made mistakes as well you know because when they make the mistakes they tend to try and correct them that's the nature of the scientific method I mean you know there are political pressures there right I'm telling you America's Frontline Physicians that organization headed by this woman whose name I can't think of right now Simone gold or something like that I mean those are not the people that we should be listening to those guys are dangerous and what they do is they is they um spew enough information that is that sounds right and sounds easier uh and and sort of Builds on conspiracy theories that that and people say oh okay this makes sense to me now but but it isn't quite like that anymore anymore as you just mentioned about our Chinese brothers and sisters than it is to say the Chinese did this on purpose the system is set up for the result it produces and if we want to change things that's true here that's true there if we want to change things here we have to think that we have to look systemically and decide how we want to alter things you know you can argue for bad people and I know yeah there are some radicals right but but but it's a system but in general it's a system and that's what we have to use you know marks again I was going to say years ago a little longer than years ago like 107 years ago was this may be an apocryphal story I'm not quite sure back when you were a young man no I'm kidding back when I was young there you go it's just Professor Marx you know you argue that the working class is the motor force of History well if that's true then why don't the workers simply change the world into a better world full stop right now and Marx again perhaps apocryphally uh uh sort of smiled and chuckled and said well my you know it's not quite that simple yes the working class is the motor force of history but in a certain way think of them as like a small dog at the end of a pony cart they can go a little ahead a little behind a little left a little to the right but they're pulled by this Pony cart that's the force That's History that's that's all the other actors in history they can't make all that stop but they can impact it and and so I think you know we've got the same issues we can't we can't make everything stop on a dime change on a dime but we certainly can try and alter things and and materially alter things materially not just ideas but the physical reality of the of the matter you know but creating a National Health Care system for example man I have argued for that I I will go to my grave and we won't have it but I've argued that since I was 20 years old I'm now 70 years old right I mean it's like 50 years I mean I know I've done some good work but it feels like gotten nowhere I mean so the material things that we can do as we approach this next uh surge of covid again because that's that's sort of the right zooming back mask yeah zooming back in right hand wash distance immunize mask when you're inside you know again should you not go out anymore well I don't think so I think you've got to be able to live a life somehow you just can't stay isolated for them it's like this is not the zombie apocalypse yet this is not you know the end of the world yet probably never will be right well most people don't have that you shouldn't have that option for for the vast majority it's like you know what are you gonna do stop going to work no no if you have to work if you have to go to work then you go to work last you wash your hands you do the best all you can do the best you can but you don't ignore the signs and you get immunized that is available for everybody right now and and should be done um so anyway that's that's my that's my that's my plan and I'm sticking to it I look I mean you know uh part part of I think why uh why I I want to do this I think maybe I both want to do this is is um you know to give that that sort of uh that that level of guidance and sometimes it's as simple as being like yeah you should still be doing it you know it is and I think probably a lot of the people that we're speaking to I hope will reach the widest audience possible but but uh you know it's like it's hard to know uh uh what to do but there's a lot of people that want to do it right you know when when they repealed uh when they removed the restrictions um I think there was they did some polling uh maybe something like 45 44 of people uh were like had you know were uncomfortable with the speed at which restrictions were removed um you know uh and uh and I think you know or just worried about it you know I think that those folks you know I mean right now we can't change maybe the macro we can't change the big picture um but but even if we can give some guidance to people uh and how to how to navigate the the world you know you know we're not going to have National Health Care tomorrow um but but if we can uh you know I mean for the for those for everybody for for us living through this um I think there's a really big value uh to to you know to getting to talk to someone like you and uh and and like uh you know get get some direction to be pointed so I think that even this basic stuff like yes you should be wearing a mask I do think that's important I really do yeah well and and the thing I think when you say that I would say is um you know if when this when this gets goes out wherever it goes out and when you're if you're if you put a a a a link on your website so that people who have questions gonna send them to you you can send them to me okay and I mean I'll answer them as rapidly as I can I mean I'm happy to do that I mean you know it's not like I mean again I think most Physicians and most nurses are like this none of us went into this because to get you know I mean everyone's got to have a salary whatever but but to get rich like every time I say something I have to be paid no no no no no I would be happy to do that if that's of help to people um you know and and just with a caveat that you know I'm a reasonably well informed physician I'm not a public health guy and I'm not Anthony fauci but but you know I'm a good chunk of my work does relate to infectious disease because I'm in the ICU I mean that that's a huge swath of what we do and and I have you know been caring for these guys so happy I'm happy to do that if that be of help the other thing I think to point out is we've not really talked about long covet oh yes I want to ask you about that I personally want to ask you about that yeah yeah there's a paper paper was just published uh in um in um I think it was in science I I read it and downloaded I can't remember the citation But but so there's no clear clue why long covet exists right why is what is this well this paper looked at autopsy in 40 patients who died of and and they took you know when you I've done autopsies when I was a student when you do autopsies you you take all the organs out and from every organ liver lungs spleen kidneys name it brain you take tissue samples and then they used they used uh immune studies to look for virus and the virus was present everywhere everywhere it's not just in the lungs everywhere and so and so the issue is long covet is probably again this is just one paper we're really not sure what the hell's going on with local but but it may well be related to an ongoing infection or immune response and so there is now as far as I know I only know of I could be wrong on how many studies are but there's at least one study ongoing utilizing paxilabeth antiviral therapy really we use yeah yeah for chronic covet really don't know how it's going to come out but that's especially sure but it is a huge deal and in fact when people say well you know not people when when the when the only owner Club when the owner class says I can't get people to work where are all the workers what's going on we must have given them too much money my response is dude first of all a million of us died yeah some of them are older but but my youngest patients who died in my arms was was 19 years old that's but two some 20 to 30 percent of people who have covered have long clothing and some good percentage of them cannot function so where are the people you know there's that's part of the answer the last thing I want to say about this if I may yes uh we touched on it and I was thinking about this earlier is uh one of the things that just annoys me and annoys my colleagues nursing Physicians beyond words is this [ __ ] that we're heroes we are often not Heroes we were never Heroes right we were people who knew how to do our jobs and we did our jobs to the best of our ability to try and take care of our people and our people is Broad right Americans non-american we don't care right and and it's administrative types it's corporate types who branded these professors Heroes and now they don't want to give nurses a payroll right right now if if if you know if the people who are saving you from if the people you know the doctors and the nurses and the you know and actually even all of the staff of the hospital from the janitors to the the person at the door whatever right you know like exactly you cannot you can't you're just gonna clap for them like give them you know let them negotiate you know same thing with the train uh workers you know the train unions it's like you know oh oh the the the infrastructure the infrastructure everything's you know okay uh you know you got these people out here doing it take care of them do you at least at least bargain with them in good faith uh and it's not just those of us in hospitals right but it's it's a retail store it's delivery people all these people were called essential and they were Heroes but man as soon as this was over it's like a corporate sector needs its profit so so that it's not so that is is unbelievably painful for all of us to see this happening and and and now it'll likely happen again and so I don't know what the response is going to be but I do know a fair number of nurses who have said I will not be treated this way again by my patients by Administration and if they think they can do that I'm gone and there'll be nobody and that's the key that's the point here there'll be nobody left to take care of you person who's listening to this if this like continues you can threaten me all you want I mean like I'm not I mean I I've had my my issues right I've been shot at I've been this not not for covert probably when I was in Latin America you know but but I mean so it's like but you know there is a point when I'm gonna just say you know what enough is enough I'm just uninterested and stop and that's true of me it's true of nurses is true of everybody so people who really who I mean we we do have really skilled practitioners docs nurse practitioners Pas nurses right I mean all of us and you're right and you're right you know that that the environmental service guys get the short end but but I can be gone and the hospital keeps going and from Environmental Services gone Hospital stops so these are the whole everybody in that hospital is important and if you've got if not you guys not you I don't mean you of course yeah if people think that it's cute to threaten that it's cute to insult like like in August of 2021 at the beginning of August I went into the hospital I didn't leave until September basically you know I mean that was my commitment to our people right it didn't matter I don't expect anything you know but I don't expect anything special but I also don't expect to be threatened because of it or insulted because of it you know what I'm saying right so that's that's the thing I mean there's there's and the problem is this is going to happen again I'm not I'm not again I'm not trying to say woe is me nothing like that I really though worry about my nursing and especially our ju my junior nursing colleagues because they know that fresh out of nursing school they're right and they want to do this and then I get insulted and they get threatened it's like Jesus you can't run a place without them so that's the thing I think we we need to think about to talk about in the future yeah Yes Man uh I'm I'm so with you it's oh it's really frustrating that's uh you know we got our local nurses were we're fighting uh and you know actually let me let me give people something actionable um you know I don't know how or where if there's a label labor struggle uh uh going on I don't know if you can if you have the time if you have the bandwidth if there's anything you can do you know uh do it write them a letter uh right right the hospital email maybe it won't do anything I don't know or if you know find somebody who's working on it if you can support Labor uh do it if there's a way that you can find to pitch in whether it's even just not crossing the picket line a lot of people uh go to uh Starbucks right now um you know and I get it you know whatever it's we all we all make compromise whatever they're having you know they're they're trying to punish their labor unions um and this is much you know again much bigger issue but I don't know man if you can if you can if you have if to not you literally but to the the you know the greater you if you can't support labor do it always you know solidarity right yeah the the exactly the nurses in the National Health System in Britain are striking to try and get a decent weight you know you know in in 2000 in 2000 um 14 I believe was 14. Karen Davis uh professor of Public Health published an article in um uh Healthcare but it was looking at the top 11 Health Systems in the world what was number one what was number 11 and why it was a very detailed beautiful study at the time the British national health system was the number one system in the world now it's Fallen because the conservatives didn't fund it you know they've got all sorts of problems you can be the best one year and not so good three years later if funding goes if there's you know if you don't have adequate Personnel all that stuff so actually and but in that study in 2014 like in 2009 and I forget ten there were multiple studies the U.S was number 11. we are the worst of the worst year after year after year after year the most expensive with some of the some of the worst outcomes again not stupid people not administrators that are stupid not nurses not doctors excuse me yeah it's the system the system is set up to provide to generate profit right and that's what it does not to generate right health care or health which is more than just being in hospital[Music] thank you