 The Son of Our Times coronavirus, this is Think Tech. I'm Jay Fidel. It's the one o'clock block with Mike DeWert. And we're talking to our chief scientist here about herd immunity and update on herd immunity and vaccines. It's getting complicated and it needs to be clarified. We saw a very interesting segment by Rachel Maddow on MSNBC last week, which made herd analysis of how things would work in Donald Trump's attempts to do herd. He called it herd mentality. He really meant herd immunity. I'm not sure he knows what he's talking about. I am sure he doesn't know what he's talking about. But let's examine herd immunity, Mike, and see what you have found in your scientific analysis of it. I'm so excited about this show because it clarifies, perhaps, confusion that we have seen. Yeah, so we talked about herd immunity before, months ago when we talked about what it would take to achieve herd immunity in Hawaii. The consensus is that you need 60% to 80% of the population to have infection and get over it to achieve herd immunity by infection. In Hawaii, that of a 1.4 million population is about a million people who got to get the disease. And that's a lot of sick people. In the current state, as of today, about 1% of the people in Hawaii that catch the disease die. So that's 10,000 dead people, almost years worth of casualties from all other causes put together that we're talking about. So herd immunity is, I don't know, the first slide shows what I think of this in terms of it just shows a cartoon of Greenberg says, back in 1776, we were willing to fight the common enemy of the British. Now a lot of people are collaborating with the common enemy of COVID. I don't really understand all of the sociology which is much harder than physics, but that's where we are. There's people who don't want to fight the common enemy who want us to let the reaper take his toll and have 10,000 more fellow citizens in Hawaii die. And the United States as a whole has 300 million people. So about 200 million people about to get the disease. And 1% of 200 million is 2 million, which is dying. There'll be more than that, wouldn't it? I mean, what Rachel Maddow said was that 2.97 is the average death rate. And that would be, gee, at 200, that would be 6 million people die. Yeah, yeah, I'm hoping that Hawaii got our death rate down to about where it is in New Zealand, about 1%. I'm hoping that the United States as a whole could do as well. The problem is that we will overwhelm the healthcare system if we try to achieve herd immunity too quickly due to infection. And then there's the question of whether your immunity lasts. Like we showed in August 24th with a simulation of a COVID, of a pandemic spread, that if the herd immunity, if your immunity to the disease only lasts a few months, then we'll be subject to repeated waves of infection every couple of years. And every wave will get worse because people will be weakened from the previous wave. So we can look at the reaper taken as 1% to 3% toll over two years and if our immunity from infection is not permanent. So no matter what, we really need a vaccine and we need to be patient and go for it. Let's see what some next slides say. So the next slide, I, well, I just talked about this dangerous solution of herd immunity. So I talked about as many people could die from the healthcare system collapsing as from the disease itself. And we'll go into what healthcare collapse in Hawaii would take. And my guess is that most of the people who are advocating for herd immunity by infection have a delusion of insulated privilege. They think they're not gonna get it because they're too rich, they got too many doctors around them because they're young and not sick, like tennis player Novak Djokovic who tried to organize a tournament in Serbia and then ended up getting COVID-19 himself passing it on to some of his family members. So, and we're finding lately that even young people who get the disease can have a weakened cardiovascular system putting them at risk when they engage in sports of dying or being extremely sick. They can show no symptoms, no classical symptoms of the COVID, they can be over them and yet still not have their heart and cardiovascular system healed enough to deal with stress, strength, strength of sports. So, non-fatal cases, you still gotta watch people and make them stay off the fields, stay out of the games until you're really sure that they're over it. So, and I just find this whole discussion of herd immunity offensive because human beings are not cattle, we're not plungeable herd animals. The person that you so widely throw away could have been the professor of medicine that would have taught the surgeon that would have saved your life. And now you're gonna die because that surgeon didn't learn the critical thing or they could have been the wily fire captain who knows exactly where the place is gonna go next who would have saved your home. But now he's not there to use his experience or she's not there to use her experience to help you. So, this is just a concept we really should not even allow into our medical. I find it really remarkable and ironic that Trump would support herd immunity or even suggest it when at the same time he would strike Roe v. Wade. So, we have all these people dying but all these fetuses living in families that may be dysfunctional because they're impoverished. We could have another Ruth Bader Ginsburg succumb to COVID in a herd immunity analysis. Yeah, I mean, these are of course separate issues. The issue of Roe v. Wade versus herd and how we treat this pandemic. Although it does look like the respect for wife is very strong until that life is actually in the world then it's on its own. So. Yeah, yeah, yeah. But, you know, one thing that you said I'd like to just dwell on for a minute that is when you have, when you want and get herd immunity by not doing anything then the healthcare system is likely to collapse. And I think you touched this point that if the healthcare system collapses people die not only from COVID they die from a lot of other things that the healthcare system cannot help them with. So, you know, all kinds of fatalities from non-COVID causes. And that's worse than a million or two or six million, whatever you calculate out because the healthcare system can't save people. Yeah, yeah. So on the next page we're going through some updated numbers for just to likey. So like I say, we'd need about a million people to get sick and that's a pretty conservative number that's 60% instead of 80% of our 1.4 million Hawaii residents with a 1% fatality rate, which is what it was as of this morning. That would be 10,000 people dead, hospitalized about 6.5% of COVID cases in Hawaii that haven't been hospitalized. And on average you're in for 11 days. So that's 720,000 beds, 712,000 bed days. We've got about maybe 800 beds we could put towards COVID patients. So that means we could, we have to spread this million cases over about 900 days. You could tolerate 11, and even then we still talk about 1100 cases a day, which is like three times anything we've had before in Hawaii. So even if we get inpatient for a vaccine, we still are gonna deal with this for at least three years unless we're willing to completely collapse the healthcare system. And we filled the hospital with COVID patients and there's like other patients that aren't gonna get help. Transplant patients might wait in this to get longer. Doctors will start getting sick. Nurses are already getting sick. Nurses, doctors, hospital staff, anybody that comes in contact with the patients is at risk and is putting other people at risk. So this, if you're inpatient for a vaccine, well, your impatience isn't going to be rewarded. Yeah. Well, one thing, just a footnote to all of this is that while you have these millions of people and in the state of Hawaii, an extraordinary number of people dying from a herd immunity initiative, the economy is really bad. The economy goes to zero effectively because it's A, people can't function and B, they're scared. So I think, to the extent we worry about the economy now, in Trump's world of herd immunity, it would be much worse. Yeah, if we were having 1,100 cases in the day of the COVID-19 in Hawaii, which is kind of the number you're talking about to achieve herd immunity by infection, you'll see people way scared to go out and even go to the grocery store. You'll see people reluctant to take jobs to the grocery delivery. I mean, you might not be able to get your Uber Eats for the carry out from the border. We need to really pull together, wear our masks, wash our hands, do our social distancing, do everything we can to slow the spread of this disease so we don't get the infection rates up to 1,100 a day. And if we need to keep avoiding dangerous activities like going to bars, having big sporting events in stadiums, we need to do that. Now, the Great Depression was a horrible four years for the United States of America, but we got through it. And if fewer people died in the Great Depression, then we died during the boom afterwards per year. Well, what about the, can some kind of herd immunity initiative coexist logically with rolling out a vaccine? With what? With having a vaccine? With, yeah, having a vaccine. Sure. I mean, well, the vaccine is the best way to achieve herd immunity. If you achieve herd immunity by vaccinating 60% to 80% of the population, then you've achieved herd immunity without killing people. If, so, and in the meantime, you still have to manage the infection there's a vaccine, isn't it? Even if tomorrow they announced our phase three clinical trials of success, this is 100% effective vaccine. Now we got to roll it out. Well, you got to roll out doses for 300 million people. And even at the flu, where that's the kind of numbers we're talking about, the flu vaccine, that takes the whole year to ramp up to make those doses with the current technology. So we're still talking about having to do your social distancing for a year. One's even once the vaccine is out because we're not going to have it right away. Yeah, and you said 300 million people would have to get the vaccine, but that's only in this country. And that assumes that we have, we're in sort of international lockdown because if we open the, if we think that that's going to enable us to open the borders wrong again, because you have, then you have to deal on a global basis and you need a lot more than 300 million vaccine inoculations. Yeah, and some of these vaccines that are in development take two doses spread some months apart to be fully effective. So if you have 300 million vaccines become 600 million for the world, it becomes goes from 7 billion to 14 billion doses to be produced. And some of the vaccines, they need to be refrigerated, they need to be frozen. They may not be suitable for the third, even for rural America. They're going to some of the more remote places, it might be hard to get the proper refrigeration or cooling to get those doses out there. And people who are poor may not be able to travel twice to get a vaccine to a big city. And so we do have a problem, even if we had the vaccine right away, like tomorrow, we'd still have years before we could vaccinate them. And as you pointed out, if everybody in the world isn't safe, nobody in the world is safe. Yeah. Especially if immunity lasts. Well, the other thing that strikes me is that, I don't feel that the public knows exactly what this state of vaccine development is. Okay, we know you have to get through a phase three trial, although the Chinese seem to have skipped that in their efforts at a vaccine, which may be more successful than we think. I mean, I don't know if there's not much news about the Chinese efforts at vaccine. We know they're working on one or they actually are using it. But what strikes me is you got Moderna, you got, what's the other one? Well, you have Novartis, you have Johnson, Johnson. AstraZeneca. I mean, so three at least to come to mind, and I'm sure there's more out there if you started Googling this. So are they all the same, Mike? No, they're not all the same. I mean, like the Spudyk V has got a vector based upon a common cold virus, common adenovirus to deliver immunity to coronavirus, to your system, but it takes two doses of Spudyk V to actually achieve what they claim they're achieving. And it's not even clear that the Russian Spudyk V is actually working as well. Preliminary data they provided are 76 patients in this preliminary trial. Some of the, apparently according to some of the reviewers, some of the patients today are suspiciously similar. They just copied one column of spreadsheet to another column of spreadsheet. So they're asking for more data from the Russians, but the Russians now claim to be in a phase three trial of about 40,000 people. I hope it works, you know. I mean, we don't want people being harmed by a bad vaccine or people thinking they're been immunized to have it and going on cannibals and catching it as easy as. But in the United States, there's three vaccines that are in phase three trials now. There's, of course, the Moderna one. AstraZeneca, they had to pause their trial as a couple of patients developed neurological symptoms. I haven't read enough to know whether those symptoms were related to the vaccine or not. They've resumed their trial. So apparently they're satisfied that the risk is low enough that they can safely continue the trial. Moderna, then there's Pfizer and BioNTech. They have a vaccine. That vaccine takes two doses. The AstraZeneca vaccine takes two doses. Let's see if there's what's Moderna's. Moderna's takes two doses. So we've got it. The three vaccines that are leading contenders to be out soon is because they're based through trial all require two doses. And AstraZeneca, of course, is based in Britain. So they're gonna be under pressure not to provide justice to the United States first. They're gonna have to ramp up production from Britain and Europe, as well as the United States. And ethically, you should make it available to everyone in the world. Russia partnered with Reddy's Lab in India to make hundreds of millions of doses for, you know, in a generic facility, Dr. Reddy's Labs. So there's at least some people trying to make an effort to be ethical about how this vaccine was distributed. Anything from Germany? I remember Trump was trying to buy the German technology, German research on this, and they said, no. But they seem to be advanced enough to, you know, attract his interest. Yeah, is this what you're talking about, the Sanofi vaccine? I can't remember Sanofi, is it? Could be. This is where he tried to buy the research, buy the scientists, buy the company. And he was offering a billion dollars. I don't know if that was your money or mine, but it failed because they said, no, you can't buy us. Yeah, yeah, there's been a whole bunch of these claims of medications or vaccines that could be effective. I don't know what the general... You know, one of the other things that's popped up here is an article I saw about espionage, that there's a fair amount of espionage going on in the world where each country is nice to know we're all into isolationist mode, and the collaboration you would have hoped in the case of a global pandemic is not complete. And in fact, some countries are doing active espionage to find out the progress of other countries and companies. This article suggested that Russia was doing that because that's what Russia does. It does espionage. And China, for that matter, was also doing it. And for that matter, the US was doing it. How does that enter into the process of trying to find at least a few workable vaccine solutions? Yeah, I think the doctors and scientists generally want to genuinely want to solve the problem and help as many people as possible. The nationalism does get in the way because it makes it hard for you to learn from people in other countries who may have stumbled upon something important and useful. I mean, this would be like hiding space aliens and if the Russians say, yeah, we've got the weapon that will kill the space aliens or anybody else have it, or the Americans have that or the Europeans have that. Big aliens would invade and take over the rest of the world and be surrounded. Ha, ha, ha. You know, there's also a question of skepticism. And I think that comes from a number of places. Well, I mean, for me, I'm skeptical of anything that Trump says. I don't believe anything he says. And I'm usually validated in my skepticism because what he says isn't true, such as his analysis overheard mentality. But you know, that feeds through the community. And then of course, there are people who are anti-vaxxers anyway, and they're skeptical of any drug and certainly any vaccine, especially with the role experimental and nobody can really point to a long time successful experience. So what you have is you have a distrust of him, distrust of administration. And we know that the CDC has lost the trust of the public. NIH has lost the trust of the public. The FDA has lost the trust of the public. HHS has lost the trust of the public. That affects people's willingness to get on board and take a vaccine, especially when it's gonna be brand new and rolled out in large numbers, ideally into large numbers of people. So the expectation is that some 50% of people will say no. But that affects the, what do you call it, the pandemic effect of the vaccine, doesn't it? That does. And I guess it's thank goodness for Dr. Fauci, at least he seems to maintain some trust and integrity through this mess. If people don't take it, Mike, it's not, if people don't take it, it's not gonna be effective on an epidemiological level, right? I gotta say, given the rush that Trump is putting on, and I don't wanna bash Trump. I mean, the scientists are gonna do everything they can to make sure that the trials adhere to scientific integrity and are well-run. And we have seen the CDC give advice and then retract advice that was inconvenient for administration, like the recent retraction of their guidance that aerosols could spread the COVID so you really didn't ask up. Now they say, no, no, no, you gotta be a subject for extended period. Well, the science is kind of leading towards, yeah, aerosols might be a problem. We take precautions as if it was aerosolized. And the same thing with the vaccine. I'm going to read the reports, the peer-reviewed reports on the vaccine before I take it. That's, having said that, it's most people won't be able to do that evaluation. And so it's something we need to bring back the trust in expertise. And we've got administrations done everything in candor, road trust and science, unfortunately. Perhaps the only thing that we'll bring back the trust is if people start getting vaccinated and the vaccinated people stop dying and the unvaccinated people keep dying, I hate to say it that way, but then maybe they'll wake up and say, yes, we need to get vaccinated. Yeah, yeah, they're going to wait to see what happens. And I think I would wait to see what happens. It's like buying a new piece of electronic gear. You don't want to be the first online. You want to make sure it works, give it a little experience. No need to make yourself a kitty pig. I mean, that would be the analysis. But one, you know, we had a show earlier today, Mike. A kitty pig. Well, I mean, if I don't know if it works, you know, I'm going to be less enthusiastic about taking it. And if I keep hearing all this stuff about warp speed, I'm going to be less enthusiastic about taking it. And I do believe that Trump does have an extraordinary effect on the honesty of people around him, including government agencies and for that matter, companies. So I'm just skeptical. But, you know, we had one show earlier today where, you know, these guys were talking about air cleaners, air purifiers, purifiers. Where with or without a ultraviolet, you know, component, they were able to screen out objects, you know, microscopic objects of .03 microns, which is pretty small. And that means they could probably screen out viral particles. A viral particle with the lipid oil shell is bigger than a viral particle without the shell, of course. And .3 microns would cover a lot of these COVID particles. So theoretically, an air purifier would be able to screen this out. And if theoretically, if we have, you know, aerosol spread and you put an adequate air cleaner, yeah. In the room, you can screen out particles. Maybe you can't get them all, but could certainly reduce the number of particles that may be reducing the number of particles reduces the risk for people in the room. That's one layer. See, his theory was layering. You have that. You have masks, you have social distancing, and so on and so forth. Even without a vaccine, you reduce the risk to each individual by having all these layers. Do you agree? Oh, yeah. I'm not sure about the efficacy of air purifiers. They could hurt. You just have to make sure about the maintenance and cleanliness of it. But yeah, you want to be proactive. Wash your hands, wear your mask. Every time in the grocery store, I wear not just a mask, but a face shield. It's an extra layer of protection for me. Face shield doesn't do anything to protect other people. And outdoors is way safer than indoors. I mean, if you want to take a walk with a friend, it's better to do it in the park than to do it in the mall, for example. Yeah, yeah. Well, one thing that came up a few days ago, I'd like to post to you and see if you have a reaction. There's a doctor, and this is not a scientific study, but there was a doctor that did a study of something in the order of 200,000 people on their level of vitamin D, which is the sunshine vitamin. And he found it was associated with some medical school in Massachusetts. And he found that if you had a sub-recommended, below standard level of vitamin D in your body, you were more likely to get COVID. If you had an adequate amount of vitamin D in your body, you were less likely. And he had some data on that. I doubt it would meet scientific rigor, but it did suggest that, and this is consistent with going out for a walk, although that's a ventilation question also. But it did suggest that if you had plenty of vitamin D, you'd be better off. You have any thoughts? Well, a lot of claims have made for vitamin D. I even saw one doctor who claimed that if you got enough sunshine, you'd never get cancer because of the vitamin D. So that's overblown. So a lot of claims have been overblown claims for vitamin D. I think it can't hurt you to take your vitamin D, make sure you don't have an actual deficiency, a modest amount of sunlight. Vitamin D has been shown to reduce respiratory infections. You know, if you can get up to a normal amount instead of having a deficiency. So it can't hurt. I'd have to read more of the science to know whether it really, really helps. Yeah. Well, taking all those things into consideration, I mean, the national efforts or lack of the fact, the work on the vaccine, you know, I don't know, I don't think herd immunity is worth a damn, but that's just me. Maybe you too. And Sweden, all of Sweden would have to go along with us on that. But all these, all these factors we've been talking about, how does that inform policy in a state where we really can't control, you know, we can't control our commerce, so to speak, with other places that there's always going to be comings and goings, even if it's minimal, there's still comings and goings. How does that inform our policy? You know, is there anything that we could do, should do as a state, you know, given these factors to minimize the loss of life? As soon as contact tracing you need to be able to track down the people that exposed to you, test people have been exposed to Garcheshaw and symptoms. And now we can control the spread and we open a few things. But if we really want to achieve herd immunity by infection, we do have a thousand cases a day. Like a fire storm. If we had a thousand cases a day of COVID-19, 10 deaths every day. Yeah, and we need a better way to, we need some better analytics and better modeling to predict which business is the most, which business is the most less risky to actually open. Because we do want to open the economy, we just want to do it in a smart way based on science. Well, there are many people who come up with things, not necessarily a vaccine because that's certainly the expensive route, but ways to minimize the risk to layer the protections and so forth. And as you say, testing, you know, we have, Oceanit was in the paper, which we had a show with Oceanit several weeks ago about this, but there's been a cup test, which is cheap and immediate to find out if you have it. And although, you know, the comparative accuracy of that test may not be the same as the nostril test, if you take it every day, this is what the analysis was, then you can achieve accuracy because even if it's off on one day over a period of days, it's likely to be just as accurate or more than, you know, the traditional nostril test. But I think all these things we have to pay attention to, and I guess if I were to answer that question myself, I would say yes, but we have to do what we say is right. We have to find ways to do what is right. And, you know, there was a piece also about the 44,000, now 55,000 tickets that HPD has given out to people, which demonstrates that people are not following the rules. I mean, what is on their minds? Do they not take this seriously? I have to put at least some of that on Trump's door. But the reality is that if we wanted to know these things and inform our own policy, the very first thing we would do is follow the same rules that we all know are the rules from six months ago. Yeah, and turn it off, Twitter and Facebook. Don't get your information from there. Thank you, Mike. It's always great to talk to you. I would like to continue this discussion because there will be so many things that cross our bow in the next few weeks, and we should evaluate them in light of what we know and what science tells us. Thank you, Mike, to work.