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- [00:00]
Jonathan Cohn
Hey everybody, it's Jonathan Cohn here at the Bulwark. Very exciting show today. We are going to be talking about medicine, public health, vaccines, the Trump administration, the Biden administration, what it's like to be the sexiest doctor alive, which is actually not something I know about, but my guest does because he was once named that. We are here with Mikhail Varshavsky. If you don't know who that is, ask one of the 14 million people who follow him on YouTube and know him as Dr. Mike. We, he has got a huge audience and makes a lot of sense talking about healthcare and medicine. So really glad to have him here. Before we start, if you are new to the Bulwark, please check us out online, check out our YouTube channel, check out our newsletters, subscribe like us. We really appreciate it. Dr. Mike, excited to have you here visiting at the Bulwark.
- [00:55]
Mikhail Varshavsky
Thank you so much, Jonathan. I'm excited to talk about all the subjects you just brought up because I feel like, like there's a lot of inaccuracies, controversies, misinformation, tidbits swirling around and hopefully we can put them to bed today.
- [01:08]
Jonathan Cohn
Yeah, no, there's a lot. And, and you do have an audience. I will say full disclosure, you know, I, I work, I'm a journalist, I work in health policy. I do a lot of, I, I, I spend a decent amount of time writing about public health. So I was familiar with you, but only a little bit. And I mentioned to my kids I was interviewing Dr. Mike and they were like, whoa, that's so cool that I, I, I never get that. So thank you for that.
- [01:30]
Mikhail Varshavsky
But that's awesome that your kids are for all the variety that's out there. The fact that they're focusing on health is exciting to me.
- [01:37]
Jonathan Cohn
Yeah, well, and I mean, I think that's, that's part we're going to talk about today. Right. Because this is how people are getting so much information right now. And I feel like as someone, again, I'm kind of an old guy but you know, as someone I, you know, I pay attention, a lot of attention to sort of well known, a lot of the well known spokespeople from medicine who go on TV and I am used to being influential, but they're just not reaching a lot of people and younger people especially are getting information for you too, are getting it through social media and we need smart, well informed voices. They're getting a message out. So that brings me to you. First of all, just how did you do a little origin story here? I mean, how did you. How did you even get to be a doctor?
- [02:19]
Mikhail Varshavsky
Well, my origin story starts probably when I was six years old, I immigrated to the United States with my family from Russia under refugee status, being Jews, and my father was a physician back in Russia. Had to go through medical school residency for the second time. Difficult in a new language, especially in your 40s, while raising me and my sister. So I got to witness the entire medical school journey as a 9, 10 year old, which is fairly unusual. Most kids are younger when their parents are in that level of education. And I fell in love with the field. I said, this is exactly what I want to do. Not only am I passionate about it, but it fit my skill set. I got the best grades in my science classes. And I said, that's where, that's where I want to put my focus. In fact, right out of high school, I was fortunate enough to be accepted into a seven year combined program where you get your bachelor's and your doctorate in seven years. So you shortened by a year, one year less tuition, one year earlier to become a doctor. Actually, in a funny way, my first year of actual medical school, I couldn't attend a welcome party because it was at a bar and I wasn't yet 21 years old. I was the sole student not allowed to attend the party, but I graduated at age 24. I was young, I was excited. Started my family medicine residency at Atlantic Health and I said, I'm going to be the best family medicine doctor I could be. But I didn't know life was about to change in a year. My social media platforms went viral where I was just sharing my day to day of being a med student and then a medical resident. I had to make a choice. There was a crossroads. Do I lean into this superficial, sexy doctor thing that folks were writing about, or do I completely ignore it and go on with my training? I realized there was actually a third path. And the third path was to lean in, go on all these media shows, the talk shows, daytime, and allow them to bring up the sexy doctor title, but then pivot the conversation to something about primary care, about the importance of making lifestyle changes, highlighting the misinformations that my patients were falling victim to. And it worked for a short period of time, but then the reality of 15 minutes of fame set in. All the gatekeepers of these talk shows, news programs, got bored and no longer booked me for the program. So I said, perfect, let's take all this information and bring it to YouTube, where there are no gatekeepers. We can be in charge of the information, we could tell the truth. And I thought that would be the game changer. Everyone would fall in love with the transparency, the truth. And they didn't. For the first year, there was a big challenge. Our partner who helped us launch the channel actually fired us and said we were a failure. But we pushed on. We said we're going to continue to do better. We're going to study the analytics, we're going to learn what people enjoy watching, but never give up the medical ethics of the program. And a few short months after we were fired, the channel exploded. And over the last seven, eight years has been continually growing to now, as you said, 14 million subscribers, about 100 million views per month on the channel with educational topics at the forefront, beating up misinformation, no matter what side of the political spectrum it comes from. And I think people have really bought into the fact that they're going to get unbiased, accurate information as best as I can deliver it.
- [05:36]
Jonathan Cohn
Yeah, yeah. Well, first of all, I bet producers and sponsors who decided to cut you off, they're probably regretting that. And I want to pause that. Obviously we're here to talk healthcare, not immigration. But I should say that story you told about your dad, first of all rings true. My memory, my grandfather came here from Germany in the 19th, the German Jew came in 1930s, got out just in time, same story, was a physician, had to start all over again. I still remember now I was not alive then, but hearing stories that he was an orderly. Actually here's a board certified urologist working as an orderly in Illinois, taking his medical boards and just amazing. And then, you know, went on to a career being a family practitioner in Brooklyn, not too far from where you are. And such a parable though, about how many immigrants come here and the hard work they do and you know, American success story.
- [06:24]
Mikhail Varshavsky
Well, that's the fear of what's going on now. Are we having an unwinding of that and actually the cycle rotating in the opposite direction where folks are leaving the United States for fear of loss of grants, NIH cuts, et cetera. But I'm sure we're going to get into that.
- [06:40]
Jonathan Cohn
Yeah, well, I mean, let's, let's pause that for one second because I mean, you're in the New York area, you're in the healthcare sector and we'll, we'll go back to the other topics in a minute. But I mean, the immigrant workforce in healthcare, I mean, it's like a backbone. I mean, can you imagine, I mean, imagine, you tell me, because you're there every day. But I mean, it seems to me, at least where I'm not in New York, I'm based in Michigan. But you go in the healthcare sector and especially when you get down to sort of long term care workers, we like depend on that immigrant workforce to staff and we have staffing shortage as it is. I mean, I assume that's the case where you are.
- [07:09]
Mikhail Varshavsky
Yeah, we have staffing shortages across the board in health care. We have lack of residency training spots in health care. We have issues in creating incentives for young people to get excited about certain industries and fields. For me as a family medicine doctor, that's kind of on the lower part of the health care totem pole in terms of student interest. They want to go into the higher paying, fancier specialties. And as a result, the backbone of our health care system, which is primary care, is not getting the attention it deserves. And there's a lot of issues of why that needs to be fixed. But the first part of it is we don't have the spots to train the necessary primary care physicians. And I feel like that's the unnoticed section of all of this.
- [07:55]
Jonathan Cohn
When you kind of took off, I mean, and I remember this first time you sort of popped on my radar screen. It was during COVID I mean, that's when you started. You know, you kind of were getting some exposure as sort of as a truth teller during COVID First of all, you were, were you out of medical school then already or were you.
- [08:09]
Mikhail Varshavsky
Yeah, I was out of medical school. I was probably three years or so into being an attending at that point.
- [08:15]
Jonathan Cohn
And you were in New Jersey at that time, correct?
- [08:18]
Mikhail Varshavsky
Yep.
- [08:18]
Jonathan Cohn
So, I mean, you were. I mean, people forget. I mean, I thought the whole covet experience has been memory hold in some ways, but I mean, New Jersey and New York got slammed. I, I just sort of curious, what do you remember about those first early weeks and months? I mean, what was it like?
- [08:31]
Mikhail Varshavsky
There was a lot of fear. Ironically, when the pandemic first started, we, or at least the conversations of what the pandemic would become first started. We reluctantly waited to make content about COVID 19. I remember there were some case reports coming out in late December, early January, where people were requesting that we would cover the, the, this new illness. At which point it was called something different. But we said, we're gonna wait, let's see what happens. Let's get more information so that we're not just making a speculative video. And I think our first video on the topic came out in late January at Which point we were still figuring things out. And there was a mantra that was born about at that time from our channel called stay alert, not anxious. Because I saw, even for myself, how easy it is to become anxious, given the fact that we have this new virus. It's spreading so rapid. There's information that's spreading rapidly that could be true or untrue. Everyone was confused. Hospital systems were confused. Where should budgets go? How should we manage these patients? There was a lot of criticism about how we handled COVID 19 when it came to ventilator use. But that's now looking back with all the information we have now. Back then, we saw patients with low oxygen rates. And what we did prior to our knowledge that we have now of COVID 19, was to put them on a ventilator. Then we realized perhaps we're being too aggressive and we had to taper that back. But we could only learn that as time went on. So we saw our emergency rooms get overwhelmed, our inpatient rooms get overwhelmed. Elective care, that was quite important. Cancer screenings, surgeries needed to be rescheduled. It was difficult to get care for certain individuals who were having heart attacks because there was so much pressure on the emergency 911 dispatch system. Even within my hospital, we had to dedicate a new ward specifically for patients with lung issues, mostly related to COVID 19. And that was a brutal first wave for us. There was so much we didn't know. There was so much worry about decimation of our healthcare system. The fact that we couldn't even deliver basic medical care and we had to triage care. Who should we see, who should we not see? Who can we actually help as opposed to hurt with our medical care? And it was a very, very scary time that we've forgotten about a bit and now only look at what we've done wrong in the years afterwards. But we need to remember how scary the condition was early on in the days of 2020.
- [11:10]
Jonathan Cohn
Yeah, I'm glad you mentioned that. You know, again, I'm based in Michigan, so Detroit got hit just a little bit. We were like the kind of second wave of cities. And it was, it was, it was, it was brutal. I mean, I mean, every day there were stories in the news about prominent people who were dying. And of course, they were just one, you know, piece of much larger waves and the hospitals were completely overwhelmed. But it was also, I mean, there is. I do feel like that was like this inflection point in the relationship between the sort of public and the medical establishment and the public health Establishment, we sort of see this trust gap opening up. And I'm sort of curious because, I mean, this is, this is what you do. Now, looking back, the public health officials, when they get a lot of, they get a lot of, you know, a lot of people. I mean, you know, you have to, you have the haters, right? And you have people want to like string up Dr. Fauci or lock them away or whatever it is they want to do to him. But a lot of people just don't trust. They've lost a lot of faith. And I'm curious, what is your. If you had to go back and grade the public health response and the communications response during COVID you know, assess it, how well did they do? What did they do wrong? What could get better next time?
- [12:15]
Mikhail Varshavsky
I think they did a great job given the circumstances and given the fact that they were coming into the pandemic underprepared. Not from a pandemic preparedness standpoint, not from a scientific standpoint, but from a communication standpoint. Even three years prior to the pandemic, I wrote an article for the American Academy of Family Physicians website where I explained that the lack of evidence based, accurate communicators on social media was creating a gray zone. And in the gray zone is where grifters flourish. I actually did a TED talk at the time and I called them IKA experts. I know all experts. They do a phenomenal job. Whenever there is a gray zone where modern science doesn't yet have all the data or all the knowledge, they throw in theories with a massive amount of confidence and therefore they're able to sway public opinion, confuse individuals, and therefore lead to bad health outcomes. So I saw that gap was forming. And as basically was predicted by that article, three years later, we weren't ready from a CDC standpoint, from a government standpoint, from a Dr. Fauci standpoint, to be able to communicate on a mass scale. There were posts going out from the CDC with three likes on them, but yet my videos were getting millions of views. That was a problem. It's a problem because it creates a discrepancy in trust value and perceived trust value. So when someone who's spreading misinformation because they put on a white coat and they say some extreme, scary fear mongering type content, it would get a lot of views, views in the algorithm. So when people would look at a piece of content, they would say, wow, this has a million views. Fear mongering, and the CDC has 100 views with 3 likes on it. I'm going to trust the thing with a million views because that's social proof. And I think because of that, we were at a significant disadvantage as a healthcare community as a whole. Now, that being said, what the CDC didn't point out enough is all of the misinformation that was being shared, they weren't quick to fact check it, and they also weren't quick to point out the strategies that grifters and people who were spreading misinformation were using. One of the main strategies was because the pandemic went on for such a long period of time and they were different developments that happened throughout the pandemic. These people who were spreading misinformation were taking statements that were said at specific moments of time and using them as weapons against the CDC or health care providers like myself to act like we were doing doublespeak or we were the ones spreading misinformation or contradicting ourselves, when in reality we needed to lean into the fact that science evolves. If we learn new data, we have to evolve with that data, otherwise we're not doing a good job by the patients, by the viewers, by the people who trust the cdc. And I think because the leaders of the cdc, those who were in front of the cameras every day, were not trained in this type of communication, they were at a disadvantage. They frequently made missteps and it became political, it became us versus them mentality, it became left verse, right, which then ended up flipping, interestingly enough, because when the pandemic first started and the vaccine was being developed, this was Operation Warp Speed headed by President Trump. Then we saw a few years later, as mandates were being forced, perhaps where they didn't need to be, where recommendations were being made about boosters that weren't 100% accurate. We started seeing a flipping of the left and right parties. We started seeing more vaccine hesitancy on the right and less vaccine hesitancy on the left, which is interesting because the anti vaccine movement started on the west coast with liberals, and yet now it's completely flipped sides. And I think partially that happened as a result of what transpired with the parties, but also with the fact that there was a libertarian buy in. In that moment, the libertarians who didn't like the overreach from the government with mandates surrounding masking and vaccines, mask mandates that didn't make sense for very young children, they started seeing that as an encroachment on their rights. So they ended up joining the people who were on the liberal side of things, just like we're seeing it play out right now with RFK junior Secretary Kennedy ran for president as a Democrat. He then didn't see success, swapped to independent, didn't see success there, ended up joining President Donald Trump on the right. So none of it really makes sense. And it seems like people are going to wherever they can succeed for personal benefit as opposed to what they truly stand for. And that's the most disappointing part of it all. Yeah.
- [17:13]
Jonathan Cohn
Yeah. Well, we'll talk about Secretary Kennedy in a second.
- [17:15]
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- [18:37]
Jonathan Cohn
One part of this because I mean, I've talked to a lot of physicians, public health officials about COVID and what went wrong. And I think a lot of us feel like one of the errors was there were statements made with more confidence than, you know, being stated as absolutes. When it was, we think, you know, or we were 95% sure this is, this is what we think based on the best information possible. Like you were saying, the science changes. I mean, you know, two months into the pandemic, you know, you think one thing, six months, oh, okay, data came in. It's different. When I have asked people about that, I often get the response again from physicians. Whatever they'll say, that's all well and good. But here's the thing. If we don't speak with total confidence, if we don't express that we know what we're talking about, not only are people not going to listen, but if I, if I give that caveat, if I say, you know, I'm 95% sure of X, one of those, you know, what did you, what was the acronym you used?
- [19:33]
Mikhail Varshavsky
The IKA experts.
- [19:35]
Jonathan Cohn
I, aka experts, you know, is going to jump on that 5% and exploit it, and then that's what's going to go viral. So, so I actually think that's, that's a, I get that. That's a reasonable point. So what do you say to that?
- [19:46]
Mikhail Varshavsky
I think it's a reasonable point short term. But long term, it actually yields much worse outcomes. In fact, I had Dr. Paul Offit on my podcast several times for people.
- [19:57]
Jonathan Cohn
Who don't know who he is. He's, he's. Well, you tell people who he is.
- [20:00]
Mikhail Varshavsky
He works at Children's Hospital Philadelphia as head of their vaccine education program. Creator of the rotavirus vaccine that we routinely administer to children. Fantastic physician that has been at the forefront of battling vaccine information, not just from a press side, but also from a literary side. Numerous bestsellers. Fantastic individual who understands how to speak en masse about vaccines, I guess is a short way to put it. And he pointed out how there was inaccuracy in the messaging from the cdc, the fda, when it came to boosters, especially as time went on and when he brought his concerns to Dr. Fauci. Dr. Fauci said, look, if we send out a mixed message saying, oh, this vaccine is good for certain groups, but not all, we'll have less uptake. And we're worried about the impact that will have on the public. I think when you take that approach, you will have perhaps short term, better buy in, but long term, you're hurting the trust that is necessary for a good doctor patient relationship, for a good researcher patient relationship. And what I've seen as time has gone on is for every time we did one of those strategies of let's just, let's just exaggerate a little bit in order to get better buy it. The IK experts pounced on that. And from an emotional standpoint, that's a much more powerful message. They lied to you versus they're not as confident as I am. I think when folks use their BS detectors, they're very good at it. They understand when someone's not telling them the truth. And when you come in as saying, we don't know all the answers, but we're trying to get you the best data. Here's what we can tell you, here's what the recommendation is. It's mixed, it's not super clear, but we want you to have the truth. I think that's much more powerful. And I'm not saying that from just an opinion standpoint of how I feel. It's where I've had the greatest success with my patients and, and in media. I just recently did a series called Jubilee Surrounded, where you sit in the middle surrounded by individuals who disagree with you. For my episode, it was those who are either vaccine skeptical or full on anti vaccine. I approached it with I don't have all the answers. I know what I've experienced, I know what research shows us. Here's how I make my decisions. And it allows people to go on the journey with you. They can then back channel your logic in order to get to where you are. And when you try and do this paternalistic practice of medicine or paternalistic practice of recommendations, I feel like that only sets you up for failure. Much in the same way how we said, oh, if there's someone spreading misinformation, we should de platform them. Again, short term might be a good strategy, but that deep platforming will only swap when an opposite political party comes into power. And then we're just silencing individuals without any knowledge and no one knows where that really that balance should live. Because in healthcare you need to have debate, you need to be able to have discourse. That's how we push our ideas forward. If we actually look at the history of how medical science evolved, the person who first recommended that we wash our hands from the morgue to delivering babies was viewed as someone who wasn't mentally healthy, who was put into an insane asylum. So we need to be able to have this flexibility of being comfortable with debate and discourse, but at the same time being able to correct if someone is full on spreading misinformation, usually for their own benefit. And I think when we do this paternalistic thing of I know what's best for you, we only get worse outcomes. I mean, I see that with my patients. If I tell a patient, here's what you need to do as opposed to saying, hey, here's what I think is best, here's the reasons why I think it's best, but we could also go in this direction or in this direction, how do you feel? That's when I get the best buy in. That's when patients feel the most empowered and that's when we get the best outcomes.
- [24:05]
Jonathan Cohn
I'm curious, I mean, nowadays patients come in, right? A lot of your paid, not all of them obviously, but I bet a lot of them come in. I've, you know, oh, I checked on Google, it tells me this. Or you know, WebMD or one of your Ikea influencers. I'm curious. Imbalance. Do you feel like it's a plus or a minus that people have access to so much information?
- [24:26]
Mikhail Varshavsky
I honestly don't think it matters. It's gonna be there whether we like it or not. And I think that we've done perhaps too good of a job at villainizing social media. It's easy to point out its flaws, it's easy to point out how complicated it is, but the reality is there are potential benefits and there are potential harms. What we do in medicine is with any medication, with any treatment, with any therapy, we always try and evaluate both sides and figure out what are the ways we can maximize benefits and limit harms. So I feel like we need to do the same thing that we do in healthcare with social media. We need to figure out what age groups, what content creates harm, figure out what we can use social media for in a beneficial way and adapt to it like we've done with any other technology in the past. But if we constantly just fear monger and point out its negatives and encourage the younger generations to stay off of it in a specific industry, we're going to create more problems. Just like when I was starting on social media, the feedback that I gotten from senior physicians was, don't do that. That's unprofessional. Sharing your private life is not something that a good doctor would do. That could not be further from the truth. Are there issues with sharing your personal life? Absolutely. Is there a loss of privacy? Absolutely. Can you potentially overstep and create a mistake? You absolutely can. But at the same time, there's been tremendous benefit. We've educated millions across social media. We've decreased fear about going to see the doctor. I did a live tour where I went to multiple cities doing this silly live show that was healthcare, educational, focused and constantly parents came up to me and said, my child was afraid to go to a doctor. I was afraid to go to a doctor. But seeing how you described what should happen during a visit, not only was I not scared, but I wasn't scared to speak up for myself when something went wrong. Or perhaps I wasn't scared to seek a second opinion when I felt like this doctor wasn't treating me fairly. Because you taught me what a proper visit should go like. And I think that if we just villainize social media, we create tremendous harm unintentionally. It's like a great book. When Jonathan Haidt had the subtitle to his book, When Good Intentions Carry Bad Outcomes, I believe that was coddling of the American Mind. That was his subtitle. And I think that's a good premise there, where we have good intentions by saying social media is this harmful thing could spread misinformation. But I think if we try and remove it or fully silence it or even silence those individuals who are spread misinformation, we'll get into a worse position than we are in even now.
- [27:08]
Jonathan Cohn
So let's talk about Secretary Kennedy and. And, you know, now, couple months into his tenure, you know, as someone who writes about immorality, I always have to pause when I do this sort of sentence on Secretary, you know, Secretary Robert F. Kennedy, comma, who. And I had to describe who he is. And I always pause because my instinct to say he's anti vaccination. But he would say, I mean, he doesn't describe himself as anti vaccinate. He's like, I'm not anti vaccinated vaccination. I'm just asking questions. I just want to make sure they're safe. I just want to get the data out there. Because it's not out there yet. We don't really know what we're doing. We haven't studied these things well enough. I'll just give you a second here. I mean, you're trained in this field. Is that true?
- [27:46]
Mikhail Varshavsky
It's not true. I don't know why he's saying the things that he's saying. I can't attribute to his intentions, but I can say that it's just not true. He is anti vaccine. He's crossed that line numerous times. If you look at some of his earlier interviews, and I have a full video on this on YouTube where I take his own sound bites from over a decade ago. He would say things like, I don't know anything about vaccines. I know about mercury, so I'm gonna just talk about mercury. Great. He would then say a few years later, I support vaccines. All my children have been vaccinated. The Lancet recently came out and said, X number of million of lives were saved with vaccines. And he was pro vaccine at that point. And then as time went on, he changed the name of his organization from World Mercury Project to Children's Health Defense. I think largely because in the year 2000, we removed almost all thimerosal from routine children's vaccinations with the exception of multi dose flu vials. And we saw no drop in autism rates like he thought would happen. So he changed the mercury focus to Now Children's Health Defense Fund, which had numerous claims being made about vaccinations and other exposures that children have. And he then started making statements like on one of the talk shows, he said, if I had the choice, I wouldn't vaccinate my children again. Or if I see a healthy parent with a child walking and hiking, I would tell them, better not vaccinate that child. He's literally telling the public not to vaccinate. That is what an anti vaccine individual does. And these are from his words. I'm not giving my opinion of what his thoughts are. These are his words. And then there's statements of him saying that if you look at a child paraphrasing a bit, if you look at a child who's received even one or two vaccines, they're not the same as a bright, unvaccinated child. His own children have vaccines. That's him saying that about his own children. So I don't know how you get in front of Congress and say, I am not anti vaccine, but you're making these terrible claims about children who have been vaccinated. You're saying you wish your children weren't vaccinated and you wouldn't do it again. You're outwardly telling people on hiking trails to not vaccinate your children. You're going on podcasts and saying there's no such thing as a safe vaccine. That is how I define someone who is anti vaccine. So whether or not he wants better data or he doesn't understand the data I can attribute to why he's finding these issues. But it's misinformation driven. He's clearly taking an anti vaccine stance. And at the same time, I will say he flip flops quite often. How can you, as Secretary of Health and Human Services, go out and say you wouldn't vaccinate your own children, but then a few days later or a few days before, go out and say the best way to protect against these conditions is with a vaccination? Who's gonna trust you when you say a message like that? Can you imagine if one of my patients came into my office and said, what's the best way to prevent measles, mumps? And I say, vaccines? And they go, do you? Would you vaccinate your kids again? I say, no. What do you think the success rate or the chance that that parent will want to vaccinate their children? It's, it's absolutely an anti vaccine stance. The news agencies that are afraid to say it, or they're putting it mildly by saying he's vaccine hesitant, that is not true. The vaccine hesitant label belongs to parents who are afraid of making the wrong decision because they've heard misinformation, they've heard a scary story, they've heard of a child who was hurt by vaccines. Guess what? It does happen. Every medical intervention has a potential harm to it. But that is our job as physicians and researchers to figure out where that line is and figure out what that safe recommendation would be for our patients. And we've done that. The world has done that. Dozens of studies have confirmed it. Whether we're talking about dimerosol, aluminum, whatever ingredient you want to talk about, it's been studied across millions of children just the past month. In July, 1.2 million children were tested by Danish researchers found that aluminum exposure from vaccines had no impact on children. 50 conditions were studied. I mean, to say that there's not enough research means you don't know what research actually is. So it's not just he's anti vaccine, he's actively spreading misinformation at the same time.
- [32:26]
Jonathan Cohn
I'm glad you sort of drew that distinction between the vaccine hesitant parents, you know, and Secretary Kennedy or people like him.
- [32:34]
Mikhail Varshavsky
Wait, can I make one analogy on that? Because I think it's valid to hit the message home. Someone who is anti vaccine and anti vaccine, Anti vaccine activist is the equivalent of someone who yells fire in a crowded movie theater. A vaccine hesitant parent or an individual is someone who sees smoke in the theater and yells fire. They might not know if there is a fire. They don't see a fire, but they do see smoke. So they're afraid and they want to do the right thing. And I don't think it's fair to put those same people in the same category.
- [33:06]
Jonathan Cohn
Yeah, I mean, I have interviewed tons of people over the years who are, you know, vaccine hesitant. And, you know, they're parents, right? I mean, they're concerned about their kids. You know, they're getting bombarded with this information, you know, and they don't know who to trust and who not to trust. Let me actually ask you to address one of the concerns I hear in these interviews. I'm sure you hear this in your, in your practice sometimes, because I think it's, it's just, it's both typical, but also one probably on people's minds, which is there's a lot of fear of the COVID vaccine because it's this new technology. Right. It's this MRNA vaccine and it's, it's new and they. People feel like there's no way we could know about it. Right. Because it's so brand new. This is scary. We need to be careful about it. Pretend I'm, I'm a patient. I just came into your office, I got a kid, I'm like, I don't know, I'm scared of this vaccine. What would you say to me?
- [33:52]
Mikhail Varshavsky
I think the timing of the situation of when this encounter is happening is really important in deciding how I would have this conversation. Because let's say this conversation was happening early in the pandemic, in early 2021. Let's say in that moment. I would say, look at how devastating things have been. Yes, perhaps we don't have the level of data that we've had with other vaccines, although we've studied in tens of thousands of individuals. Here's why I think it's beneficial for you. Here's why we need to get out of this. Because if we just keep the status quo, here's what would happen. And I would lay out the pros and cons, but currently this is a very different conversation to be had. It's. Have you had your initial set of your primary series of vaccines? Have you had at least one booster? Have you been ill with the condition? All of those things would change my recommendation as to how that individual should proceed. But when it comes to the Technology now, these COVID 19 MRNA vaccines have been given at such scale, it's unprecedented the scale that they've been given on, in terms of how many millions of people, if not billions at this point have received a vaccine that we have a really good understanding of where the pros are, where the cons are, and that's what I would discuss with the individual. Yes, There are certain subgroups where we experience conditions like myocarditis in young males that perhaps don't need a booster because they're otherwise healthy. They've had their primary series, they've already been ill with COVID 19, and perhaps the risk benefit isn't in their interest, but that needs to be individualized for the person you're speaking to, not minimized and said all vaccines are perfectly safe and there's no potential risk. There are, but we need to discuss those individually with patients and we need to also not fear monger when they do happen to try and catastrophize the situation in order to make it seem like everyone is lying to you. They're not. Because we went into medical school, we went into residency in order to do best by our patients, not to somehow exploit that trust for our own benefit. If we wanted to do that, we'd be in the financial sector, not in the healthcare sector.
- [36:00]
Jonathan Cohn
I wanna take for a second and look at the other part of the sort of Kennedy agenda, which is food healthy living, right? I mean, if that's the slogan, right, make America healthy again, unlike what he says on vaccines, at least at the high. At the sort of high level of a slogan, as a theory. I think everybody in medicine, public health, thinks, yeah, we, we should. There's lots we could do to make America healthy, right? And things involving diet activity and that's. And that sort. Watching Secretary Kenny, watching what they're doing to sort of advance health healthy. Let's. Let's look at food, maybe particularly in nutrition. Do you. What do you see? Do you think, like, this could be really helpful? This is, this is going in the right direction? Do you have mis. What are you saying?
- [36:41]
Mikhail Varshavsky
I think that I disagree with you. I think that his messaging surrounding food is not much different than his messaging surrounding vaccines. He states he wants safe vaccines. He says he wants a healthier food supply. He wants to make America healthy. He doesn't have a trademark on that. Scientists, doctors want safe vaccines, and guess what? We have them. Doctors have been talking with patients, myself included, about lifestyle changes for well over a decade. He is not bringing anything new to the conversation. He's just trying to create an us versus them war. As if we don't care about our patients, as if we don't want safety, as if we don't care about the foods that our patients consume. We absolutely do. But here's what we need in order to make good nutrition recommendations. We need an NIH that funds nutrition research. Guess what RFK junior Secretary Kennedy is doing to that research? Cutting funding. So, yeah, you could talk all day long about improving the food supply, but if you're cutting the research to understand how to have a healthy food supply and are scoring political points by talking about different sugar substitutions within soda, which changes nothing from what the actual harm is of overconsumption of soda, you're distracting people from the real problem and are not actually solving that problem. I just had on my show Kevin hall, who's one of our premier metabolic researchers. Like, if I had to pick the Michael Jordan of someone who's doing metabolic research or was doing Metabolic research. It would be Kevin Hall. He was studying how metabolism changes during weight loss, weight gain, about what following a low carb diet versus a low fat diet would have on our health. He was doing the research that Secretary Kennedy would want the answers to. And the second that Secretary Kennedy took over, not only was Kevin Hall's lab silenced from a censorship standpoint, they were trying to manipulate what the studies were showing from his lab. If they didn't agree with what, whatever Secretary Kennedy's personal notions were, which is not how science is practiced, a scientist gets excited when research disagrees with them because that means they're getting a better understanding of how something works. They, they can better fine tune their understanding of the subject they're studying. But the Secretary of Health and Human Services, when, when he sees research that disagrees with his personal notions, silences, it changes what is said from a press standpoint about that research. So Kevin hall went to them and said, if you're going to keep censoring my work, you're not going to be investing in nutrition work. I'm going to take early retirement. And he did. We shut down his lab. He's no longer working for the nih. He's raised these flags to leaders at the nih. No one cares. So if you're going to tell me you want to make America healthy again, you care about the food supply, those are all things that the medical community cares about as well. But you're not doing anything to actually solve that problem. You're not actually making America healthy again. You just have a really neat slogan and I think that's what I hope more Americans realize.
- [40:03]
Jonathan Cohn
One last question. I think there's a lot of physicians out there who feel like you do. They're very frustrated, they're angry, they don't like the vaccine misinformation. They feel like the emphasis on health is at best misfortune misplaced in terms of the way it's being executed. And they don't know what to do. You know, and you know, he's in charge of hhs, you know, he's setting policy, he's changing, you know, he or the people who run the Trump administration, who knows who's really doing what. But you know, they're changing who, who's in charge of these agencies, they're defunding them, they're cutting off research and is, it's hard to see how that changes, at least in the next few years, because it probably takes a change in management in Washington. So what's your advice to be. And everyone you know, not everyone has 14 million followers on YouTube. What's your advice to physicians in practice or anybody working in healthcare or anyone who just cares about this? What's your advice?
- [40:57]
Mikhail Varshavsky
I think that this is a wake up call to all the major medical organizations, the major medical groups of each subspecialty, the American Academy of Family Physicians, the ama, the aoa, all these groups have been quite comfortable functioning without the benefit of social media. And what they've come to realize is now that they are facing such a challenge, they don't have a megaphone in order to reach millions of people, to have the impact that they did 30 years ago when they would go on primetime news and have the audience's attention in order to make meaningful change within their subspecialties or organization. So they need to drastically, drastically change funding to start implementing social media programs, working, collaborating with individuals who are doing a great job, and most importantly, unifying together. I don't see enough unifying statements calling for Secretary Kennedy to resign. I've publicly called on him to resign. I've written a Fox News op ed calling on him to resign. A lot of the medical institutions are quiet. They're slowly starting to roll out messaging, but it's slow, it's ineffective. There's a lot of fear behind it. Even industry leaders. Dr. Sanjay Gupta, industry giant, one of the most trusted voices in healthcare on CNN over the last decade, someone I look up to throughout my years of communicating on Healthcare before November 2024, quite vocal about the fear that Secretary Kennedy at that time, RFK Jr. Could become head of HHS. Since then, pretty silent. I want all the medical voices, whether you're a community physician, whether you're Dr. Sanjay Gupta, whether you're the AMA way to come together and not just say what he's doing is wrong and nitpicking specific statements. Realize that he doesn't care when you nitpick. He is winning. And when he's winning to the degree that he is, we need to do something drastic. We all need to unify together. Get all of the deans of medical schools to come together and call on Secretary Kennedy to resign in order to have the best potential chance that the public listens. There's no way the public ignores the message of every med school dean, of every physician, of every medical organization unifying and coming together to say this person should not be in charge. Not just for the fact that he's under equipped and doesn't understand the research, but he's actively spreading harm. When I was making my YouTube video on his Twitter profile, he has misinformation, scaring people away from the Gardasil vaccine, saying that not only is it ineffective, he says that it claims more lives than it saves countries across the globe. Millions of people across the globe disagree. Science disagrees. But just because one guy believes it to be the way he wants it to be, we're suddenly making changes to our healthcare organization. The most powerful country in the world. It's so disappointing and not something I would ever expect to have seen.
- [44:07]
Jonathan Cohn
I'm imagining the conversation with those medical school deans and I know at least what some of them are going to say is they're going to say, well, that's all well and good, but he controls our funds. If we come out against, and this administration has shown is absolutely willing to be vindictive, that you go after them, they go after you. And you know, that's my residency funding, that's my research funding, that's my clinical funding. You name it, we couldn't survive that. What would you say to a medical school dean sitting across from you who says, I'd love to, I'd love to be more vocal. I can't.
- [44:39]
Mikhail Varshavsky
The stamina of vindictiveness runs out and it runs out quick. You could be vindictive in episodes. You can't be vindictive against every medical school dean, United States, every major medical organization in the U.S. there's too many people against you. And again, this isn't a left, right or center issue. This is apolitical. It's clinical. He's saying inaccurate things over and over again. This isn't about, oh, I just don't like what he stands for. I love that we talk about vaccine safety. I love that we have food supply in our conversation. That's all well and good, but what has been done is tremendous cuts to nutrition research, instilling fear surrounding vaccines. The worst measles outbreak that we've had in over 30 years. We're getting cuts to organizations like UNICEF. Gavi. Gavi vaccinates more than half the world's children. And if Secretary Kennedy doesn't realize that by vaccinating the world those who can't afford vaccines, we are actually being selfish by protecting ourselves and doing that. That just means he's shortsighted and we don't need a person who's short sighted in charge of such a valuable office.
- [45:51]
Jonathan Cohn
Well, on that note, Dr. Mike, thanks for joining us, really appreciate all your time. Everybody follow Dr. Mike, follow the bulwark and we'll see you next time.
- [46:01]
Mikhail Varshavsky
Thank you so much, Jonathan.