EP. 79 — A Coronavirus Update with Dr. Ashish Jha

Adam [00:00:22]  Hello, everyone, welcome to Factually! I’m Adam Conover, and you know what, with the election here and the old U.S. of A.. It’s been a little while since we’ve talked about the coronavirus. So let’s check back in. The pandemic has been with us since March and it’s now November. It’s been a long time. And let me tell you, things are going badly. As I’m reading this yesterday, over one hundred and forty three thousand Americans tested positive for the virus, the highest ever. And nearly 1900 hundred people died yesterday, the highest number since May. You know, we’ve all been talking about when this is all over, you’ve heard that phrase. But right now the trend lines are moving in the other direction. Things are not getting towards over. Things are getting towards, still going on. And, in fact, much, much worse. Now, we do have better treatments for the virus and the hope of a vaccine is finally on the horizon. But the pandemic is still spreading faster and harder than it ever has before. And it’s for that reason that a lot of people are looking around and wondering, why did we ever end the lockdown? What are all these people doing at the restaurants? Oh, my cousin had a wedding, you know, I saw there. But did you see the sports game? There were people in the stands. Why aren’t they staying inside like me? That’s what everybody’s shouting at their televisions. Well, you know, it’s I understand that to a certain extent we have this bizarre, disjointed patchwork of pandemic rules across the country right now. So it’s reasonable to ask, well, if things are so bad, why don’t we just get back into that lockdown state? But here’s the thing that misses the point, because the problem with lockdowns is that they are inherently temporary. There’s simply a limited amount of time that you can keep people inside doing nothing before they say, fuck you, I can’t take this anymore. I got to leave the house. Quite literally. There are certain jobs that cannot be done remotely for that period of time. There are certain sectors of the economy that we need that will grind to a halt. There’s just you can’t do this shit forever, OK? And the truth is, the lockdown was never meant to be indefinite, nor was it meant to be until we could develop a vaccine. That, too, would take way too long. The actual point of the lockdown, if you talk to public health experts, was simply to buy us time to coordinate a national response. What we needed to do during the lockdown was to massively ramp up testing and to install a huge contact tracing system so that when the numbers of infected people got low enough because the lockdown, we could start tracing every time one person infected another and make sure that everyone they came into contact with quarantined until they were no longer a danger. Again, the lockdown was simply to buy us time to get that response ready. And plenty of countries around the world did it and it worked. But we here in America did not. Despite the federal government’s massive resources, it didn’t even make that plan, let alone execute it. And unfortunately, to a large extent, we kind of missed the window on contact tracing. In many parts of the country, there is so much uncontrolled community spread that contact tracers aren’t even able to figure out where outbreaks begin anymore. There’s just covid everywhere. You can’t trace the ocean when you’re standing in the middle of it. So all of this is to say that while social distancing and mask wearing remains very, very important, we were never going to be able to solve the pandemic through individual actions that we police by yelling at our cousins. It needed to be a nationwide mobilization that we simply did not make. And the entire debate about lockdowns, should we lock back down again? Should we not lock down? That is somewhat beside the point, because the entire point of the lockdown was just to buy time for this nationwide effort that we did not make. And now it looks to me like we are in a very, very difficult spot to find out just how difficult and what we need to do to dig our way out of it. Let’s talk to someone who really knows the science. We had him on the show at the beginning of the pandemic. It was one of our highest rated episodes ever because everyone was so hungry for reliable factual information on the pandemic and what the future looked like. So we thought this was the perfect time to bring him in to give us an update on the present and future of this pandemic. Now, I do want to make a really quick proviso before we get to this interview. We recorded it about a week ago, and during our conversation, I asked Dr. Jha about my Thanksgiving plans and what he thought of them, and he said, oh, those don’t sound too bad. In the intervening week, the news has gotten even worse. And we have decided in my family to cancel our Thanksgiving plans. We’re going to have a nice, safe Thanksgiving at home. And you know what, I’m not going to tell you what to do, but if you decide to do the same thing, I approve of that decision. But, you know, I understand this is a confusing, frightening time and it’s so hard to figure out the right thing to do. So that is why it is so wonderful to hear from folks like Dr. Jha so without further ado, let’s get to the interview with Dr. Ashish Jha. Ashish, thank you so much for joining us again. 

Dr. Jha [00:05:45] Thank you for having me back. 

Adam [00:05:46] Well, so we last talked in March, the very beginning of the pandemic. I believe we had been in lockdown for about a week maybe it was our most popular episode ever. Might still take that take that cake because people were so desperate for information. And actually people said to me, oh, this episode made me feel better, help me understand everything that is going on better. It was it was a real gift to our listenership, I think. And so we wanted to have you back to catch up on what’s been going on with the covid-19 pandemic. At the time, you were you know, I think your views were pretty stark, but you also said, hey, we can do this. We know what to do. We need to have the lockdown to buy ourselves time to do all the other things we know we need to do. Have we done the things that you felt we needed to do? 

Dr. Jha [00:06:36] So so not so much. Not as much as we should of. Some places have. So we were obviously we stayed in lockdown for a little while and really did bring case numbers down. But then we opened up a little too fast. We had across large chunks of the country over the summer, as you know, a surge of cases. In fact, hospitalizations and deaths and things got again better by the end of the summer. And now here we are, beginning of November and things are looking really bad. We’re identifying about a hundred thousand new infections a day. About a thousand people a day are dying from this disease. And all of us who are looking at the data are feeling like the next couple of months may be the hardest months of the whole pandemic. And so it’s a little bleak. And I think there are things we can do to make it better. And most importantly, I think 2021 will be much better. And as we get through the winter into the spring, a lot of things are going to get much better. So we have light at the end of the tunnel. But boy, we have a couple of hard months ahead. 

Adam [00:07:46] And why is that? I mean, so talking with the lockdowns, you said we opened up a little bit too fast. I certainly we opened up too fast in Los Angeles and paid the price in cases spiked. And, you know, it was really rough. And I would certainly say that in terms of different states and individual people’s behavior, there’s there’s a lot of ground to make up there. But I believe I believe this is something you said to us before. This is not something that we can treat with just lockdowns. And there’s been this obsessive focus on should we open, should we not open? The end. And I remember hearing at the beginning so much stuff about contact tracing and all these other measures that we should be taking. And I- what happened to them? 

Dr. Jha [00:08:26] You know, we have learned so much about this virus since we last talked in March. And the big things that we’ve learned is that the virus really spreads when large numbers of people gather indoors for extended periods of time and nobody’s wearing a mask. That’s like ground zero for how the virus spreads. And so if you think about that and you apply that to like restaurants, restaurants, you’re not wearing a mask because you’re eating bars are a disaster for this virus. Where people really get into trouble often is like home gatherings. You bring a bunch of friends over. People have drinks, people have meals. It feels very social and maybe it’s eight or ten people, but one of them might have the virus, no symptoms. And boom, five days later, ten people are infected. So those are the risky things. And if we can control the risky things, we don’t have to do lockdowns. Like we can keep much of our economy and our lives going. Like I think we can keep schools relatively open. I think we can you can walk into a bookstore. If everybody’s wearing a mask, it’s pretty safe, especially if there like reasonable ventilation. And it’s not like a super packed bookstore. So I really don’t think we need to be talking about lockdowns. We shouldn’t be doing it. We can get through this if we’re smart. The problem is that we’re not willing to give up those three or four things that we need to get up. 

Adam [00:09:44] Right. 

Dr. Jha [00:09:44] And so then, like, things are getting bad. 

Adam [00:09:48] Yeah, well, let’s talk about those things. I want to ask what else we should be doing nationally. But in terms of those things, we don’t want to give up. You know, people seeing their friends is like, I think for a lot of people feels like the smallest little allowance you can give yourself. You know, hey, like my girlfriend was talking about she’s like, you know, it feels like all my friends are saying they’re in a pod and they’re not really in a pod or there’s or I’m in a pod and my friends in a pod, we can get together and it’s like, but you’re not really in a pod. And then you’re getting you don’t know who those people have seen, you know, like, oh, we’re all in pods, so let’s all get a cabin for the weekend and then we’ll all be in a pod together. It’s like doesn’t sound like you’re in a pod at all at that point. And we’re personally like me and her, a person trying to decide right now, you know, what do we do for the holidays? You know, I go back and forth between, you know, her father’s very old. This is not worth it, like, let’s just skip we can not have Thanksgiving for once in our fucking lives and it’ll be OK. And the other hand, it’s like, well, hold on second what if we go and we get a hotel and then we just have Thanksgiving outside and we don’t go indoors. It’s a five hour drive. But, you know, we’ll we’ll stop and pee on the side of the road and not go any gas stations and, you know, what do we do? And those are the choices that are facing people. And those are choices that it feels like are very hard for us as individuals to make, especially because we don’t seem to have any huge messaging about it. The government is not out there pumping the airwaves with ads saying here’s what to do this holiday. So what do you think about that? 

Dr. Jha [00:11:20] Yeah, this is a huge part of the problem. Like, there is so much confusion about what is safe and not safe, and there has been so that it feels like everything is not safe. And then people say, screw it, I’m going to do everything. Yeah. And like so for instance, on your example, I first of all, I completely agree. Seeing friends is like hugely important. I have been seeing friends and spending time with people who are not in my pod for months, but I don’t do it indoors and I don’t do it without wearing a mask. And so what that means is that I go for walks with people and I wear a mask and that’s totally safe. Now, I’ve had friends over. We sit in the backyard, we sit about 10 feet apart, and then we don’t wear a mask and we have a drink together. And that’s totally cool. It’s not like the ideal. And its going to get harder in New England as the weather gets colder. But the point is, like, don’t not see your friends, you can do it. You just can’t do it in the same way. In the example around seeing people in the holidays, first of all, like, OK, to do that five hour drive, like you can go into a gas station to pee like, just make sure you’re wearing a mask and don’t like lick anything on the surface. That’s something I would have told you like a year ago, like don’t lick stuff in the bathroom. Right. And like wash your hands. But again, a year ago I would have told you to wash your hands anyway. And this time, like, please really wash your hands. But if you’re willing to, like, do that and wear a mask, like, well, nothing bad going to a bathroom in it. So this is the kind of thing where, like, you don’t have to make this that much harder. Now, elderly relative, would I go sit inside for six hours and have a normal Thanksgiving? I wouldn’t. Could you sit outside and see them like that’d be lovely. You should feel free to do that. You know, maybe avoid the prolonged hugs. But like this, there’s some minor modifications. It’s the next three, four months are really going to be the hardest. I do think in early twenty one we’ll start seeing a vaccine rollout. I do think start things will start getting better, like let’s just not blow it on this holiday season. If you treat it as a normal holiday, it’s going to be bad. If you’re willing to make some moderate moderate modifications, I think we can get through it. 

Adam [00:13:30] OK, that’s really good advice. But I want to ask again, just come back to my earlier point. I’ve been struck by how there hasn’t even been consistent like government messaging on this. Like, for instance, if you if you just think about like World War Two posters, loose links, loose lips, sink ships, like just shit like that, you know, hey, conserve rubber. That’s the sort of thing the government’s been great at, you know, since nineteen hundred. And just this kind of message you just told me, it’s not on TV. You know, I watched should have been every between every World Series inning. You know, my girlfriend was like, hold on a second why’s there no app. Why didn’t the government make an app of some kind? Where is just like it feels like there’s a lot of basic stuff that could be done that is unrelated to the lockdown itself or the vaccine and that is missing and I’m wondering if you feel similarly and what else should we be doing from a public health perspective that we’re not? 

Dr. Jha [00:14:28] Absolutely. So there are two sets of related issues. I mean, number one is what we should have been getting the whole time is a daily briefing from a senior scientist at the CDC who could have been answering, who could have been explaining what’s going on and answering people’s questions, like the question you just asked me Adam. Like that should have been happening every single day. Instead, we got these like long political speeches from the president. Like this just has not been helpful. So those those press conferences eventually end up going away. But we still don’t hear from the CDC. The whole point of the CDC is to guide the American people in a pandemic like this. So it’s a huge part of the problem. And then when there is no CDC guidance, what happens isn’t that, oh, there’s no guidance. Then people step in with misinformation. Right. So then people just start making stuff up and you start seeing all this stuff about, oh, it’s just the flu. It’s no big deal at all. And all the other misinformation that spreads because, you know, when you have a vacuum of information, other people will step in to fill it. That’s where we are right now. 

Adam [00:15:34] And there’s also been the new information that we’ve learned has been irregularly rolled out, like, I think about the sort of sea change we had between the focus on surfaces where at the beginning it was like, hey, we got to sanitize our doorknobs, like that was one of the main things that people were saying. I remember being at work and the building literally started sending around guys to scrub the doorknobs twice a day. And now we know it took months. But now we know that aerosols are the big issue. And like you said, that means the main thing is not sharing air with people in an indoor place that’s unventilated for a long period of time. And that’s like a whole sea change. And most people don’t know that happened. Like, again, I’m I’ve talked about on the show many times. I’m in comedy. I’m I wish I could do stand up comedy. And there’s all these clubs that are opening and they’re saying, well, we’ve got everybody six feet apart and we’re wiping down the tables because that’s what we were told in March. And it’s but it’s like, no, it’s fucking November. Now, if you’ve got an audience of people inside, the end. You’re creating a super spreader event. And and so there isn’t even an update on the new science that we know. So people are like all over the place in terms of what month their safety precautions are in. 

Dr. Jha [00:16:55] This is, again, where daily consistent messaging from the CDC would have been so incredibly helpful. The sheer number of schools that are not open where I’m talking to somebody, and the superintendent, I’m like, why? And they’re like, well, we can’t get the deep cleaning company. I’m like, what is deep cleaning? What are you guys doing? Like this thing called deep cleaning that like people are doing because they’re still focused on surfaces. There’s no deep cleaning, like just get some frickin Lysol wipes and just wipe them down every once in a while at the end of the day, like the way you would normally maybe a little extra, but like surfaces are not a major source of spread. It’s all about air. And that message still hasn’t gotten across. And then there are people who then the other side is there’s a bunch of people who say, well, you used to tell us that mass and didn’t matter. And it was all surfaces and now you’ve switched. How can I trust you? I’m like, well, that’s actually how science works. We learn new stuff and then we tell you to change what you’re doing because we’ve learned we didn’t know a lot back in March, it was a new virus. We know a lot more. We should do what we know. 

Adam [00:18:01] Well, I want to press you on schools a little bit. You said a couple of times you feel most schools should be open, but I’m having a little bit of cognitive dissonance there because schools. OK, hold on a second. That’s a lot of kids and they’re in an enclosed space for a long period of time. That’s basically the definition of what a school is. Schools were invented so that they could get kids into a small space away from parents for a little while. So. So what am I missing there? 

Dr. Jha [00:18:25] Yeah no, it’s a great question. So if you and I were talking over the summer, I would have said to you that I’m pretty concerned about opening a lot of schools, especially in places with high levels of transmission. And I still am a little. But what has happened is there was a debate in the among the public health experts about two sets of issues. If everybody’s wearing a mask, does that help a little or a lot? And the second question was, how much do kids transmit to adults? Those were the two big questions and the data that’s coming in over the last couple of months. And I have changed my views because the data is coming in and the data says kids don’t seem to transmit that much to adults. They can transmit to each other, but they don’t, especially younger kids, kids under the age of 10. Second is almost all the data suggests that if everybody’s wearing a mask, it’s pretty safe. Now, could it be that- could like would I want to have assembly hall with all the kids, like no, like that’s a bad idea. Right so there’s stuff that you have to do. And I do think schools need to work on ventilation and like ventilation can literally be open the freakin window. You can open the window. So people are like, oh do I need a Merv 13

Adam [00:19:39] Get a fan in there. 

Dr. Jha [00:19:40] Or a Merv 15. I’m like a window right. Open the window. I don’t know what Merv that is. I just know that they can open the window. And so if place and then they’re like, well, OK, it’s hard to open windows in like North Dakota right now because it’s cold. I get that. And so there are places where you have to do some modifications, crank up the heat. Maybe you won’t be the most energy efficient this fall, spread kids out a little bit. So they’re not super packed together. But the evidence right now is that when schools have opened, they we have not seen spread, certainly not among younger kids. And so it it does go against a little bit the large numbers of people gathered indoors for long periods of time. I think it’s because it’s children, primarily adults are there, but not as many. And second, that everybody’s wearing a mask. Those are the key things. 

Adam [00:20:29] And do we have any idea why children don’t seem to transmit it to adults? Because I think of children as being the most infectious things on the planet. I never want to touch a kid. So what? What? They’re all sticky. And there’s always shit coming out of their noses, so why would that be? Do you have any idea? 

Dr. Jha [00:20:47] So what there’s a lot of debate on this. And the biggest thing basically that people have argued is it’s really just about kids and again, this is this is going to sound funny, but obviously, kids exhale less air, just amount of virus they will put out, smaller lungs. This is why I like I wouldn’t apply this to a 17 year old who might have the brain of a child, but they’ve got the body of an adult. 

Adam [00:21:14] That is the problem is 17 year olds. 

Dr. Jha [00:21:16] Right. So I have I have a 15 year old and she’s terrific. But the point is, like, she is not an adult by brain, but by her physically, like she’s the same size as my wife. So I don’t think of the 15 year old as being any lower risk. Part of it is a smaller amount of air being exhaled and also they’re just physically lower down to the ground. And and there really is like there is a sense of like the airflow issues are. That’s what we’re seeing. That’s what we’re seeing pretty consistently. The younger kids don’t seem to transmit a lot to adults. It’s not zero. But then you throw in mask wearing. And if everybody’s wearing a mask, it really we’re just we’re not seeing cases spread in schools where that have opened. And we’ve had a lot of schools now open for several months. 

Adam [00:21:59] Got it. What about what about public transportation? Do you have any opinion about that generally? Is that is that a big vector? 

Dr. Jha [00:22:06] I think we were super worried about this in March and April in New York. And May I don’t I think the latest data, again says I’m going to sound like a broken record if everybody’s wearing a mask. And I wouldn’t want to do the New York City rush hour in the old days where the subways got super packed. So we can avoid that, keep some of the windows open, et cetera. I think it’s probably pretty safe. I would not I’d be OK with getting on a bus in Boston and traveling. 

Adam [00:22:37] OK, maybe I’ll start thinking about getting back on a bus in L.A. then. I barely that’s how I get around and I’ve barely been taken them, so that’s really good to hear. OK, I want to ask you about the world picture for covid, but we got to take a really quick break. We’ll be right back with Dr. Ashish Jha. 

Adam [00:23:02] OK, we’re back. So Ashish I want to ask you about the international picture, one thing I’ve seen from some people who I would characterize as, you know, coronavirus denialists. Right. The kind of people who make a lot of homemade graphs and shove them in your face and say, explain my graph. Is that there are countries that we use to say were doing a great job, you know, like countries in Europe that, oh, they’ve got a much better handle on it, which is, frankly, what Americans always say about Europe. We say like, oh, my God, the Europeans are so great at everything and we suck. But now we’re seeing new outbreaks in a lot of places where there’s a lot of mask wearing and where the the government maybe had a more aggressive response than we did. And I’m curious if you’ve got any overall picture on why that might be either about specific countries or globally, what we’re seeing with the pandemic. 

Dr. Jha [00:23:56] So let’s talk about Western Europe, because we do often say, oh, if we only could do what the Europeans do. I always a couple of points. I mean, first thing to always remember is that Europe is not a country. And what I mean by that without I’m just not just being a smart aleck. What I mean is, is that the European countries have been a bit different from each other. And so they’ve all seen big outbreaks in the last few weeks. But they’re but some of them are doing much better than others. So let’s talk about what has happened in Europe over the last four or five months. They had large outbreaks in March, February, March, April. They really suppressed their virus. So by the end of March, you had very low levels of virus across much of Western Europe. Then they opened up and basically acted like it was all over. People went on holiday. All the pubs in London started getting filled. Everything opened up like all the way. And sure enough, by early August, you started seeing increases in cases. And this is where I have to say I got it wrong. I assumed that the European countries would look at that and say, case numbers are rising. We got to do something. And instead of doing that, some of them. So Germany reacted aggressively, but UK, France, Spain basically were like, it’s no big deal. It won’t it won’t hit us again. Well, they’re about to go into lockdown because they essentially ignored the virus for two months. And and what I got wrong was I just assumed that they would act more responsibly when the case numbers started rising and they let it go for a long period of time. And Germany, because it is part of Europe and there is so much travel back and forth with other countries, you’re starting to see large spikes as well. So even though I think in general they’ve had a much more sensible policy, they haven’t been able to pull it off. And and they don’t have universal mask wearing. There’s a lot of places certainly over the summer, there was very little mask wearing in lots of places. So I think they’ve got to do the same things that that we’re doing. And I used to point to Europe as like the shining example of what we should do. And let me tell you, that’s not that’s not working out so well. I will say one other thing, though. There are a bunch of countries that are doing a fabulous job, and those are mostly East Asian countries, New Zealand, Australia. They did not let their foot off the brake. When they’ve had outbreaks they didn’t ignore it for two months and case numbers across most of the the Asian continent, certainly the East Asia, New Zealand, Australia are very, very low. 

Adam [00:26:28] Mm hmm. Yeah. I mean, if it weren’t for that, it would almost make me question you know when we started this and talking to you really gave me this feeling, I was like, oh, man, a competent government really can figure this out. You do a limited lock down, you do contact tracing, you do all the public health measures you need. And we really can do it. We know how to do and we can implement it. And the way things have gone here and in Europe, it starts to make me think, wait, is human government equal to the task of dealing with this with this problem? And that’s the question I have about climate change, right. When you look at climate change, can human society actually solve this problem? Are our political organizations capable of it? I think we’re moving in the right direction. But it’s you know, we’re still perhaps an open question on climate change. And I have that wonder about about coronavirus. Again, if if the best examples have have faded a bit, how I mean, are you do you ever feel pessimistic about it in that way? Or do you say, hey, you know, Taiwan is doing great and we still can match that? 

Dr. Jha [00:27:29] I think Taiwan is doing great. Singapore is doing great. Japan’s doing great and New Zealand is doing great. Australia is doing great. Hong Kong is doing great. There are lots of places that are doing well. Vietnam is doing great. So it’s not even and people say, well, is it something about East Asians? I’m like, I don’t think so, because New Zealand and Australia are not East Asians. I do think it’s doable. But guess what? It’s like you have to have sustained effort. You can’t just, like, do it for a little while and then say, ok I’m tired of the pandemic is over. I want it to be over. I’m going to move on. You can’t move on until you have widespread vaccinations like the virus is going to stick around it. The virus doesn’t get tired. 

Adam [00:28:12] But that thing about like we want to move on is, to me, such a human impulse. You know, like, I’ve I, I have this argument with people where they say, oh, my gosh, people are hanging out with their friends and they’re going going for the holidays and like, don’t they know the virus is still out there? They need to keep staying inside, you know, and like we are. And I say, well, you know, we’ve been doing this since March and you can’t do it for that long. Like, we had a really serious lockdown in the US for like three months. And then people started to be like, I can’t fucking do this anymore. And, yeah, you can’t do it anymore. And, you, I believe you described the lockdown as a chance to stall until we can get all those measures in place. And that’s the that’s the issue, is that we’re missing those other measures. I don’t I’m not leading to a question that’s just. 

Dr. Jha [00:28:58] Let me make let me just build on that, though. Exactly right. And the problem was that what all of us said back in April and May is let’s use this time to build a fabulous testing and tracing infrastructure. Where you had widespread testing available, where every time somebody was found to be infected, you could trace your contacts, you could test them, you could isolate people who are infected. That’s how you keep the virus levels very low. That’s what South Korea has done. And what South Korea has pulled off is their society is largely open. People are not in lockdown. So you can go to cafes. Things are working pretty well every time they have an outbreak and they continue to have them, they just they send in the SWAT team. They get, you know, tens of thousands of people get tested immediately. They identify everybody who’s infected and isolate them. And then and then every outbreak comes to an end. Like that’s how you do it. That’s how you keep going. We just haven’t done that. And so if you don’t have that and then you still don’t have people reliably wearing masks, then you are where we are, which is like it’s a slog. And I think we’re all tired of the slog. I think we want something better. We haven’t done what it would require for us to have better. So now we’ve got to get through the next few months. 

Adam [00:30:13] It’s wild, man. I mean, I even remember seeing stuff at the beginning. Like, you know, I saw I read technical papers about here’s how you could do secure contract tracing using people’s phones where the phones would handshake when they got close together in an anonymous way that still let let you do contact tracing. And then you could build a system where once someone gets a positive test, they go say, hey, I got positive on my phone, and then it anonymously alerts everyone who is in contact with a person says you were in contact with someone. And I was looking at that going, OK, great. Like technically you can do it in a way that would be safe and secure. We only have two major phone operating system vendors in the country, both of whom are Tim Cook and whoever is running that part of Google, I think would be open to making that happen. And you just need someone to get them in a room and do it. And it never happened. I like it. No one ever made that phone call. No one ever put that program into place. I’m just complaining now. Let me ask you a question, unless you have a thought on that. 

Dr. Jha [00:31:10] I do no both of those companies, both Google and Apple, were totally happy to do it. They started building out solutions. The problem was you ultimately need a partner in probably the federal government that says, let’s do this together, let’s make sure the privacy stuff is well control lets and then let’s go sell it to the American people of why we’re doing this and how we’re doing it. And and we’re going to keep it. And there was never a partner in the federal government who was really willing to help. And that has been a consistent pattern, is that the federal government has largely just not been interested in trying to tackle the disease. And so you can have the best of intentions among companies and technical solutions. But without a federal partner, we can’t make it work. 

Adam [00:31:56] I mean, I think you said the entire I think that’s the entire interview right there contain and the federal government has not been interested in fighting the disease is basically that’s that’s what I was working my way towards that you put it so bluntly. Let’s talk about a little bit more of the medical side. Herd immunity is a phrase we’ve been hearing a lot. Tell me your view on that. Like, you know, I know that from you know why I would tell people to get a flu shot every year. We want to build up our herd immunity. Now, we are in a different context, which is people are usually saying, let’s all just get the disease and then we’ll all have antibodies and it won’t be able to find purchase anymore. Is that something that makes sense for coronavirus? And if not, why not? 

Dr. Jha [00:32:39] Yeah. So herd immunity is one of those ideas that sounds really good. But the moment you start thinking about what it would take to get there, it’s a disaster. And so here’s why. So there’s disagreement about how many people would need to get infected, but most people think it’s somewhere between 60 and 70 percent, 60 to 70 percent of Americans getting infected is, let’s say, two hundred million Americans. And right now, officially, about nine million Americans have gotten infected. But we think it’s probably the real numbers, probably much higher than that. But even if it’s like 50 million, let’s say five times as many people, we’ve had two hundred thousand deaths with the number of infections. We’re going to have to have like another million Americans die if we try this strategy. Like, that’s crazy. And imagine we say, all right, well, what’s a million Americans die like we’re going to let a million Americans die. It would still be a bad idea because a 60 to 70 percent herd immunity doesn’t mean the virus goes away. It means that the virus, every time it takes off, can’t sustain itself and will peter out. You’ll continue to see little outbreaks during a herd immunity. And then, of course, over time, like immunity might wane. We don’t know how long immunity lasts, might last six months my last year. So then we’ll do it again every year. Like, no. I don’t want to keep doing it. So lots of people will die and it won’t work. Other than that, it’s a great idea. So the much better strategy is protect people for the next three to six months. We’ll have vaccines. They’re coming. I promise. We’re going to have vaccines in 2021. I think we have a couple of them authorized in the next month or so. And when we have widespread vaccinations, then we get people immune and that’s a different form of herd immunity. But you don’t have to kill people to do it. And it’s totally fine to get people revaccinated once a year if the immunity only lasts a year. Right. That’s that’s not a big deal. So the key here is we want to get immunity through vaccines, not by having people get infected. 

Adam [00:34:44] Yeah. I mean, people say people are making this argument often say, hey, you know, people will die from the economy being poor because the lockdowns or that’s bad. You know, the economy is also part of our quality of life, which is true. But also those people tend to take into account the economic hits that we would take from millions of Americans dying, like when one hundredth of your population dies in a year. That’s not good for your economy either. 

Dr. Jha [00:35:11] Right. Like what I’ve said to people is like once you start getting hospitals overwhelmed, once you start seeing large numbers of people dying, like people just aren’t going to be that interested in like let’s go out to a bar. Like, it just it will dampen people’s interest in, like, engaging economically. So and by the way, that’s not a theory we see. So right now, we’re seeing in places that are having really big outbreaks, even though often states are not curtailing indoor dining, reservations in restaurants is falling substantially. And you can see that in the open table data. Well, people are just like things are really bad. I don’t think I need to go out to dinner. Right. I’ll do take out. So people will vote with their own feet. And so, look, absolutely true that shutting down the economy has huge costs. But I’ve just made the case we don’t have to shut down the economy like we can do like 80 percent of what you were doing before. You just can’t go to a nightclub right now, like no nightclubs, no bars, no large indoor gatherings. But everything else should be relatively OK. So I think we can get there. But what people want is they want everything back. We’re in the middle of the biggest pandemic in a century. We can’t get everything back, not right now, we’re going to have to be a little bit patient for some of those things. 

Adam [00:36:28] Do you have any fear when it comes to vaccines that we get the vaccines and they’re a little less effective than we think or the virus mutates in a way? I’m not up on the science of how how much it might mutate. Maybe it gets around the vaccine. And, you know, we our expectations are too high for the vaccines and et cetera. 

Dr. Jha [00:36:48] I do think our expectations are too high, but I’m not worried about mutation. So let’s talk about what I think is likely. I think the first generation of vaccines will probably give us 70, maybe if we’re lucky, 80 percent protection. So not one hundred percent protection. Right. 

Adam [00:37:05] But that’s huge if everybody gets it. 

Dr. Jha [00:37:07] That’s the thing. So if like two thirds of Americans get it and 70 percent or 80 percent protection, it’ll make a massive difference, like it will bring the levels of virus in the community way, way down. And that means that the things that we think of as kind of medium risk right now will become pretty low risk, like indoor dining. But things that are super high risk right now, like going to a Broadway show, packed theater or small indoor space. Nobody wears masks or nobody did a year ago like that probably isn’t going to be possible even with the first generation of vaccine. 

Adam [00:37:43] Oh, no. You’re talking about stand up comedy shows, too. 

Dr. Jha [00:37:47] So then. Right. Right. So the question is, well, what can you do in that situation? So here’s where we need more than just vaccines. One of the things I’ve been pushing for and we’re making slow progress, we’d make faster progress if we had a federal government that was engaged was is having like cheap antigen testing. They cost five bucks and you get a ten minute result. OK, so imagine at every comedy club there was you have to get tested. You have to show up 15 minutes before the show and there’s a five dollar extra charge of getting the test. And just you throw that onto the ticket price or the place eats it or whatever, it doesn’t matter. You can imagine that you can. And then everybody who walks in has had a negative antigen test and you’ve already had tests. You’ve already had people getting vaccinated that would make it. And then if you really want to be safe, just ask people to wear a mask. But that be hard if they’re having drinks. I don’t know. Like but the point is, like we’re not going to get to zero risk, but we can get it pretty low risk if we do those things and I’m not talking about like those antigen tests that cost five bucks, we’ve had them around for five months. This is not some new technology breakthrough. They have existed for months. Why can’t you get them today? Because the companies take a while to produce them. And like the federal government would have been amazing if they had put in billions of dollars and said, let’s make hundreds of millions of these tests. You go out to restaurants, you can get on an airplane. They just haven’t done it. 

Adam [00:39:14] But despite that, you still have a pretty optimistic tone of voice generally. You’re not too far off from where you were in March where you seem to have a we can do it attitude. 

Dr. Jha [00:39:24] You know, I always believe, like, it doesn’t sound totally cheesy, right? But I’m like, we’re Americans. We can do stuff like we used to send people to the moon like that was cool.  You get to the moon, but like, here’s a five dollar test. Oh, and then literally the guy who’s running the testing for the country, he’s like, oh, we’ve done everything we can. America can’t possibly do any more than what we’ve already done. I’m like, what? This is not America at its best. We can do so much more. But yeah, it’ll take some work. And people just like the federal government just has not been willing to put in the work to do this. And by the way, it will cost a few billion dollars, some billion dollars, but we’re like losing trillions of dollars in economic activity because we don’t have these things. If you think about it from that nightclub point of view, if a nightclub isn’t open at all, if they were told there’s a five dollar extra fee for every guest who comes in to get a test, I bet most nightclub owners would be like, yeah. That’s a no brainer. 

Adam [00:40:32] Yeah. Every comedy club has those bags they make you put your phones in. Those are an extra cost. You put your you put your phone in the bag and you take your test and then you’re on your way in. Incredible. Well, do you have any parting words for the for the audience as they you know, they’re sitting at home with with this anxiety or they’re sitting at home saying, when can I go back and do all the things that I love? What is your what is your message to the anxious people on the street? 

Dr. Jha [00:40:57] Yeah. So I basically I’m telling folks, look, the next two months are going to be hard. You’ve got to hunker down a bit here because the virus is really spreading out of control. And we’re not going to have a federal government that’s going to be deeply involved and engaged. I do hope that if we end up with a Biden presidency and right now we don’t know who’s going to be president because in the middle of the election, what I’m hearing from the Biden team is an absolute like plan to get super aggressive on controlling the virus. So the next couple of months are going to be hard. Early next year, we’re going start to see the vaccine get out and it’ll start slowing the spread of the virus. I’m hoping there’ll be more testing available. That’ll help. And by springtime, things will start looking different. And by summer of 2021, life won’t be totally normal. But boy, it’ll be a lot closer to the summer of 2019 than the summer of 2020. We’ll be, we’ll be on our way back and then there’ll be some things we’re going to be dealing with for like a couple of years, some things that will be different and harder. 

Adam [00:42:00] Like what? 

Dr. Jha [00:42:00] Well so like well so like the, the, the indoor concerts are going to be where you got super those are just going to be hard but maybe OK, if we can have really great testing, like, I don’t know, we’re going to have to sort of play some of that stuff out. But, but, but short of those very high risk things, much of our life starts coming back by next summer. Spring will be better than than what it is right now. I just don’t want people to totally lose hope and just say, forget it, I’m going to go back to normal because there’s a lot of people are going to get sick in the next couple of months. I don’t want any of your listeners to be one of them. We’ve got to get through this period. But if we do, it’s like the light at the end of the tunnel is there. I can see the light. Trust me, it’s there. But but we saw a little bit of ways to go, not not six months, but the next two or three months. 

Adam [00:42:50] Well, I can’t thank you enough for coming on to talk to us about it Ashish. It makes me comforted and also awakened to the stark reality we live in, which is my favorite emotion to feel, frankly, my favorite mixture and basically what I’ve built my career on. So I really thank you for coming on and taking the time. And I know you’re a very busy guy, so we’ll let you go. 

Dr. Jha [00:43:12] Adam thank you so much for having me on. Always fun chatting with you. 

Adam [00:43:20] Well, thank you once again to Ashish Jha for coming on the show, I hope you enjoyed that interview as much as I did. If you did, please leave us a rating or a review wherever you subscribe. It really does help us out. I want to thank our producers, Kimmie Lucas and Sam Roadman, our engineer Ryan Conner, Andrew W.K. for our theme song. Got to thank the greatest PC company on Earth, Phalcon Northwest for building me the beautiful gaming PC I am recording this very interview for you on and that I use to stream on Twitch.tv every Monday, Tuesday and Thursday. Let me tell you a little bit about what I’m doing on Twitch every Monday and Tuesday I do learning streams where I live research a topic that I’m interested in and that you’re interested in live on the stream for you. And every Thursday at five p.m. Pacific, we do a live stand up comedy show. I bring in some of the best comics from around the country who are currently stuck in their apartments, can’t do comedy, live on stage. We bring them to you. So check that out at Twitch.tv/AdamConover. If you have a topic you’d like to see on the show, you can email me about it at Factually@AdamConover.net and go to AdamConover.net for all my different mailing lists and whatnot. And @AdamConover, wherever you get your social media, including Tik Tok. Yes, I am now on Tik Tok. All right. I think that’s all my plugs. Thanks so much for listening. And remember, stay curious.