Paul Offit (4:27)

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Mike (4:37)

No judgments.

Paul Offit (4:38)

But that's weird.

Mike (4:39)

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Paul Offit (6:50)

Right. So we've seen a handful of these children in our hospital, Children's Hospital Philadelphia. And it's a post infectious phenomenon. In other words, these children often have no signs or symptoms of COVID 19 none. And then sort of weeks later, after they've been exposed presumably to the virus, they develop this sort of multi system disease characterized by rash and so called vasculitis, meaning inflammation of the vessels. And because all organs have blood vessels, therefore all organs are affected, the organ that is most severely affected is the heart. The two arteries that supply the heart can become inflamed and with that you can suffer essentially heart attack and death, which is has happened now to about four or five children in the United States. Again, as a general rule, the COVID 19 or SARS CoV 2, the virus spares children. As a general rule. I mean, I think there's fewer than 15 children in the United States who've died as compared to say 160 children who died of influenza this year. So it tends to generally spare children. But there is this unusual Syndrome. This is a weird virus. I mean, it's a bat coronavirus that just recently made its debut in the United States, and we are learning as we go.

Mike (8:00)

Yeah. If there wasn't the entire pandemic we're dealing with, but if, say, this was only showing up in the rare cases in children that you've been seeing, would that even be. I mean, we're insane about the health of our children, so maybe the answer is yes. But would that even be a national conversation? Would it be concerning parents as much as it is now? Because I think in the beginning with coronavirus, people who are at least informed said, well, at least it isn't affecting children, though they could spread it to others. Now I'm hearing from parents, ooh, this is. This is a new wrinkle. Now we've got to be really worried about the effects of coronavirus.

Paul Offit (8:36)

It's still very rare. I mean, you're still Talking about maybe 100 children total in the United States who've been affected by this, and I think fewer than five who've died from it. But so it's still extremely rare. You're still more likely to die from influenza in this country than from. From this virus as a child to someone less than 18. But. Yeah, but it is worrisome. I mean, it's a new wrinkle to this weird, weird virus.

Mike (8:58)

Yeah. Now, I wanted to ask you about how your thoughts on the virus have changed, because I randomly was driving in my car in early March, and I heard you on the Serious show, which was dedicated to medical professionals that's run by NYU Langone. And in that show, and we do have the clip, you were, I don't want to say dismissive, but the context you put it in is against the flu, which a lot of people were saying, and you found the flu to be much more dangerous. And you also said you don't understand what the. Why we're quarantining. So how did you. I mean, I assume you've changed your mind about that, but you tell me.

Paul Offit (9:36)

Yeah, in two ways. I think, first of all, the. I still thought at the time that there could be a more sort of surgical way of doing this, which is to say, protect nursing homes. You know, older people should stay home. Anyone who's even mildly ill should stay home. Anyone who, you know, who's exposed to someone who's mildly ill in their house should all stay home. Because, again, I thought this was going to be such a huge hit to our economy. I mean, I thought early on I predicted as many as a 20% loss of our workforce. It could be as high as 30% now, and it could be even higher than that. So, you know, it's just we're going to be digging out from this. For years I thought there was a target away, but I think in the end, I think you couldn't trust that people were going to do that. And I think Dr. Fauci was right. Just scare the hell out of people and make us all stay home. The other thing I think I was wrong about, you know, because flu causes typically about, you know, can cause 60,000, 65,000 deaths a year. I never thought we'd be that high because wrongly, I assumed that we would be similar to other countries. Means it turns out we're 4% of the world's population and 30% of its deaths. I mean, we've done much worse in our country than most other countries. I think of the 240 countries in this world, we're 231st in terms of deaths per million. I never imagined we would be that bad. So I was wrong on both those counts.

Mike (10:51)

Now I wanna play a clip and I swear this isn't a gotcha. I loved your book. I've loved our conversation so far. But I wanna ask you an implication, but I have to play this so the audience hears. Daniel, do you have that?

Paul Offit (11:00)

You know, we have by CDC estimates between 18,000 and 45,000 deaths from influenza this year. We have 14 deaths from this virus. And people are treating this like it's a viral apocalypse. And. And I don't see it. I don't understand the quarantining, which I think is probably going to do very little to stop spread, given that there's a tremendous base of infection that is asymptomatic or mildly symptomatic that you're not going to identify that's going to cause spread. I mean, this is in the community. It's going to spread. If somebody comes into our hospital and has COVID 19 as compared to influenza, we treat the COVID 19 differently. And I just don't see. I honestly don't understand why. I think we've done a bad job of how we've educated the public about this because we've scared them to death.

Mike (11:41)

And so absolutely, I mean this sincerely, not in the spirit of a gotcha, but as a scientist, when you hear that and you do an assessment, what occurs to you? What thoughts run through your head?

Paul Offit (11:52)

Yeah, what occurs to me is I probably shouldn't talk for things where you get to record it. Because then you can see how you're wrong. I mean, I was wrong. I think initially when this virus came into the country, the thinking was that it was that its reproducibility index, meaning the number of people you would infect during a day, was similar to flu, which is to say two. You would infect roughly two people a day. And I didn't understand why we were treating this virus differently given that it was spread by small droplets like flu was spread. And given that it had a reproducibility index similar to flu, why were we treating it so differently than flu? And the answer was I was wrong. And we were all wrong. I mean, it doesn't have a reproducibility index of 2, it has a reproducibility index somewhere closer to 6. Because unlike flu, it's not just spread by small droplets. It's also spread by so called really small droplets, meaning micro aerosolization. So those droplets can hang in the air for 14 to 18 minutes, meaning people don't have to have direct contact with you, they just have to be in your airspace within 10 or 15 minutes of your being there. That's a little more like measles than it is like flu. And I think that's just something we found out. Also there is a so called fecal oral component to spread. So it's like norovirus, you know. And I think there were some early indications of that with seeing the virus on cruise ships, nursing homes, that's very neurovirus like. And so I think, you know, again, we learned as we went. I didn't and I do. I mean, I'm listening to myself say that, and I get how I said that then based on what we knew then. But I think we're learning. We've learned more as we've gone. So therefore what I said was dead wrong.

Mike (13:20)

But also I do think that the lesson that we had learned again and again and again with bird flu, H1N1, even Ebola, is that there's often an element of absolute panic and the panic can do more harm than good. And so it, it seemed like that was the important point to emphasize. Governor Cuomo said the same thing. I think the fear could do more harm than good. But the problem is when you're wrong about the fear or the panic being worse than the disease, it makes it look like you underplayed it. And I don't know if you have any thoughts as someone who communicates about public health. What's the best way to strike that balance?

Paul Offit (13:59)

Well, again, I do think that we are going to. There's two parts of this public health disaster. I mean, the first is the suffering and the hospitalization and death caused by the virus. I do think that by doing what we did, completely shutting down without sort of, I do think we could have done this in a more surgical way. I mean, in the Northeast, half the deaths are in nursing homes. So, you know, that could have been a more targeted strategy, meaning make sure that, you know, that you, if you're going to do testing, and we were terrible at doing testing in this country, you know, make sure you do the testing there. No one can walk into that home until that nursing home, until they're tested. I mean, really try and isolate those and you would have prevented as many as half the deaths in the Northeast, where about half the deaths in the country occurred. So I do think that the targeting strategy was not a ridiculous idea. Because the second part of this public health disaster is what you're about to see, which is massive joblessness associated with no doubt massive homelessness and all the public health disasters that come with massive homelessness like food insecurity and domestic violence and child abuse and depression and suicide, etc. That's round two. And I do think if we'd done a little better in round two, especially with testing, we wouldn't be in as bad of a position we're at. We're like one of the worst countries in the world in terms of death per million. We're terrible about the way we handled this.

Mike (15:17)

Do you think there's something that affects others in your field such that they can't do what you just did, listen to what you said and said. I got it wrong. Now let's try to be right because I do see a lot of, and hear a lot of people, medical professionals, just digging their heels in and not being able to do that.

Paul Offit (15:32)

No, I think you have to learn as you go. I mean, it's, you know, science, medicine, nature is humbling. And I think, you know, you have to be open minded the fact that you might be wrong. So I think I was certainly not right about those things that I said early. But, you know, I'm willing to learn as I go, which in some ways is the theme of this book. I think, you know, we as doctors do learn as we go. I mean, there were things I learned as a pediatrician when I was training in the late 1970s, early 80s that were sort of taught as gospel that were wrong. And so we have to change. And I think that's sort of part of this book you're trying to say, look, here are the data showing that a lot of the things that we're doing, we shouldn't be doing. I think the most surprising thing to me was heart stents. I mean, heart stents don't work. And you think this makes perfect sense, right? Someone just had a heart attack, for example, or they had angina or meaning chest pain, because one of the two arteries that supply their heart is blocked, say more than 70%. And the area where there was damage beyond that was exactly the area that was being supplied by the artery. So wouldn't it make sense to put a stent in there that opens up that clogged area? Wouldn't that make sense? And there was a study done where they actually did sham stenting, meaning they pretended to put a stent in half the patient or they put a stent in the other half. And then they made sure that they did as good as they could in terms of medical treatment, meaning lower the bad cholesterol levels, made sure you kept the blood pressure normal, meaning for people who had high blood pressure. And there was no difference between the two groups. So why would that be true? And now we know that that big heart artery also supplies smaller and smaller arteries which were also blocked and you weren't opening that up. So I think that if there's anything I do in this book that probably threatens an industry, it's, it's that.

Mike (17:14)

And finally, did you ever think that we would get to this point in this country where we would be having a debate, a relatively uninformed debate, about the potential efficacy of hydroxychloroquine?

Paul Offit (17:28)

I know. So I think, I think what Donald Trump initially said was that hydroxychloroquine was going to be the greatest breakthrough in the history of medicine. Didn't work out that way. I mean, it turns out that there's been now three prospective placebo controlled studies showing that it doesn't in any sense lessen your risk of going to the ICU or lessen your risk of going to the morgue. What it does do though, 10% of people had to drop out because it causes heart toxicities, arrhythmias. So no, it's not the wonder drug it was claimed to be. It was an example of kind of the executive branch co opting science.

Mike (18:01)

Uh huh. So you're saying the discovery of antibiotics and then maybe germ theory are still 1 and 2 and haven't been displaced, right?

Paul Offit (18:08)

Not yet.

Mike (18:09)

Not yet. The name of the book is Overkill. The author who I've enjoyed talking to is Paul Offit, When Modern Medicine Goes Too Far. He's the director of Vaccine Education center at the Children's Hospital Philadelphia. Thanks so much.

Paul Offit (18:23)

Thank you.

Mike (18:33)

Are you still quoting 30 year old movies? Have you said cool beans in the past 90 days? Do you think Discover isn't widely accepted? If this sounds like you, you're stuck in the past. Discover is accepted at 99% of places that take credit cards nationwide. And every time you make a purchase with your card, you automatically earn cash back. Welcome to the now it pays to Discover. Learn more@discover.com credit card Based on the February 2024 Nielsen report, the missing child.

Paul Offit (19:05)

Is Lucia Blix, 9 years old.

Mike (19:07)

Please let her come back home Thursdays the kidnappers plumbed it meticulously. If money is what it takes to get her back, we're gonna pay it. The secrets they hide.

Paul Offit (19:20)

You can't talk about this.

Mike (19:21)

You can't write about it. Are the clues. The mother's hiding something. I know it. To find her, tell me where she is. The stolen girl New episodes Thursdays stream on Hulu. And now the spiel. So as we discussed up top on Sunday, Maryland Senator Chris Van Holland appeared on every, well, I mean not every show. Not the NBA post game shows, but all the what they call the Sunday shows. The topic was the detention of Kilmar Abrego Garcia. It's a serious topic and one hesitates to use the somewhat flippant phrase applied to whenever a guest hits every single Sunday show. But that phrase is the full Ginsburg. Ginsburg was William Ginsburg, Monica Lewinsky's lawyer in the first year and a half of that scandal. And they say he was the first to do the full complement of Sunday shows. But really, are we sure? Did anyone ever go back to check to see if Dean Rusk was one time on Face the Nation, Meet the Press and ABC's predecessor to this Week. Remember this one from Wherever thoughtful people search for answers to the issues of.

Paul Offit (20:30)

The day, ABC News presents the award winning interview program Issues and Answers.

Mike (20:37)

Putting issues right there in the title. Very solid, very proper, very post war. So I was researching the Full Ginsburg and there is a website that tracks it. It's on Wikipedia. Didn't take me much to find it. But since Ginsburg first executed the full Ginsburg, here are some full Ginsburg fun facts. There have been 38 full Ginsburgs since the first Ginsburg. The second full Ginsburg. The Buzz Aldrin of full Ginsburgs was Rick La. Remember him ran for Senate against Hillary Clinton. Want to guess who has the most full Ginsburgs? This is going to be a trivia segment, by the way, so I'll present it as trivia. Trivia. Who has the most full ginsburgs? Well, on February 14, 2016 and February 21, 2016, this current member of the cabinet who is a three time full Ginsburg did back to back full Ginsburg's his first and second full Ginsburg. I'll give you the topic. Who would have done that In February of 2016, his second place comeback in South Carolina in the primary there. All right, let's go to the tape.

Paul Offit (21:47)

Senator Marco Rubio of Florida. Senator Rubio, welcome back to Meet the Press, sir.

Mike (21:52)

Thank you. Thanks for having me on.

Paul Offit (21:53)

You got it. Okay.

Mike (21:54)

Sorry about that.

Paul Offit (21:55)

Let me start with how you feel about this win this second place finish last night you had every major endorsement that you could have had and yet you still finished a distant second in South Carolina. How do you look at this as a positive and not a negative?

Mike (22:10)

And Marco Rubio answered, I don't know, maybe in nine years I'll get a gig working for the guy. Couple more full Ginsburg trivia questions. So since Hillary Clinton talked about her presidential run in a full Ginsburg in 2007, which by the way, that didn't take. But, but there have been only four female full Ginsburgs. Cabinet secretaries Kathleen Sebelius and Janet Napolitano were part of a government panel doing the full Ginsburg on the same day, May 9, 2009. To talk about what do you remember what might have been the very, very pressing topic to get not one but two cabinet secretaries. Maybe a hint is one's Department of Homeland Security, the other is Health and Human Services. What would they been talking about? May of 2009 is George Stephanopoulos with the answer the swine flu.

Paul Offit (23:02)

It continues to spread, but there are.

Mike (23:04)

Signs that the outbreak is smaller and.

Paul Offit (23:06)

Less severe than first feared.

Mike (23:08)

Now here is my final full Ginsburg Final Jeopardy. So Since Hillary Clinton 2007, Sibelius and Napolitano talking about swine flu in 2009, there have been 26 full Ginsburgs. The breakdown is 24 men, two women. Name the two women. Here are your hints. One was talking about her presidential bid in 2011. The primary would be in 2012. She was getting ahead of it. The other was to Discuss Benghazi in 2012. All right. That one I think you could get. You know the person who talked about Benghazi and that film Innocence of Muslims and this became a point of dispute. She blamed what we've come to call Benghazi, mostly on the film. Here she is on Face the Nation doing that. What our assessment is as of the present is in fact, fact what it began spontaneously in Benghazi as a reaction to what had transpired some hours earlier in Cairo, where of course, as you know, there was a violent protest outside of our embassy sparked by this hateful video. And that is Susan Rice, the other female post swine flu full Ginsburg gal. And what a gal. She ran for President in 2012 race. Here she was on Meet the Press host David Gregory hosting, then confronting her with her own words. During a speech that you gave in.

Paul Offit (24:34)

2004 at an education conference, you spoke openly and in detail about gays and lesbians. And I want to play just a.

Mike (24:40)

Portion of that speech and have you react to it. It's a very sad life. It's part of Satan, I think, to.

Paul Offit (24:48)

Say that this is gay. It's anything but gay.

Mike (24:50)

It leads to the personal enslavement of individuals because if you're involved in the.

Paul Offit (24:56)

Gay and lesbian lifestyle, it's bondage.

Mike (24:59)

I mean, it could be a life spent flogging or spanking or just cuddling in cups of chamomile tea because you know nothing of gay people. Michele Bachmann despite your many Ginsburg, you are talking out of your hat. But I hope you just listener today more than yesterday, know a lot more about the full Ginsburg and possibly a lot more than you ever hope to know. The Gist is produced by Cory Wara, Michelle Peska, CBSO of Peach Fish Production. Ingrid Green does our Instagram and so many of our social media improve? And thanks for listening. The Gist is brought to you by Progressive Insurance. Fiscally responsible financial geniuses, Monetary magicians. These are things people say about drivers who switch their car insurance to Progressive and save hundreds. Visit progressive.com to see if you could save Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states or situations.