COVID19 and More

A week in review

Welcome to my first (real) substack post

This installment is just a summary of things I’ve worked on, or I’ve enjoyed this week.

1.     Podcast with Bari Weiss

Bari Weiss is one of my favorite journalists, and her substack and podcast consistently offer thoughtful views.  We talked for 90 minutes about COVID19, vaccination, errors in messaging, ivermectin and more.  Check it out here:

Bari Weiss @bariweiss

There is so much noise in the public conversation about Covid. But @VPrasadMDMPH has emerged as a voice of calm, nuance and reason. Give him a follow and listen to his deeply informed perspective vaccines, mandates, masks, institutional distrust and more.

podcasts.apple.com‎Honestly with Bari Weiss: Vaccine Hesitant? A Doctor Responds on Apple PodcastsSo much of the conversation about Covid-19 is angry and full of finger-pointing. Dr. Vinay Prasad has consistently been able to cut through the noise, the confusion, and the endless bickering. He does this by consistently avoiding the blame game and following the data wherever it leads. Dr. Prasad…

https://www.honestlypod.com/podcast/episode/223f05ce/vaccine-hesitant-a-doctor-responds

or here:

https://podcasts.apple.com/us/podcast/vaccine-hesitant-a-doctor-responds/id1570872415?i=1000536259516

2.     Also on Bari’s substack, I contributed a few hundred words with my thoughts on Biden’s push (via employers) to get people vaccinated.  I am skeptical of just how many people this will motivate—my argument is purely empirical.

Vaccine Mandates: The End of Covid? Or the Beginning of Tyranny?

3.     In my weekly column on MedPage Today, I argue that it is time to start accepting it: sars-cov-2 is an endemic virus. This means that all of us will eventually (in next decade or so) get exposed to the virus. All you can do is optimize your chances when you get exposed—that means for adults, getting vaccinated.  And beyond that, there is not much one can do.   Asking vaccinated college kids to abide by strict restrictions is a policy that makes no sense, when one truly understands the virus is endemic. Read the full take here:

Marty Makary MD, MPH @MartyMakary

"When we truly come to accept that avoiding the virus for decades is impossible, many things change." @VPrasadMDMPH @medpagetoday

medpagetoday.comAccept It: COVID Will Be an Endemic VirusEveryone will meet with the virus eventually, but doing so safely (while vaccinated) is key

https://www.medpagetoday.com/opinion/vinay-prasad/94646   

4.     I have been busy on my youtube channel. And put out 8 videos in the last week.  Here they are.

a.     My thoughts on the FDA booster vote – clearly this was under massive political pressure and clearly it makes no sense at all. There is no credible evidence that a 20 year health care worker needs a 3 dose of Pfizer vax.  Why not run a trial?

b.     John Ioannidis has a new paper on what considerations apply to vaccinating adolescents and kids.  Check it out

c.     Sars-cov-2 is endemic: Denial, Anger, Bargaining, Depression and Acceptance

d.     Pfizer announced top line results of vaccinating kids 5 to 11.  The press release literally said nothing other than geometric mean titers are non-inferior, but you would not know that from reading twitter.  So much unknown.  We have to move cautiously.

e.     J&J finally announces some booster data.  What gives? Who wants a J&J booster?  Has the CDC delayed guidance on J&J boosters just to give Johnson & Johnson first crack at keeping their market share?  My thoughts

f.      COVID19 has destroyed Science.  It won’t survive.  It is slowly dying infront of our eyes

g.     Testing vaccinated college kids with asymptomatic weekly or biweekly testing – is entirely unproven.  Assertions it has to “work” are false.  It also boggles the mind.

h.     Follow the science is an empty broken slogan. Science can never guide policy alone. It requires values.  The slogan practically means follow the values of wealthy professors who can live their normal life via zoom. 

5.     My plenary session podcast episode with Dr. Dan Morgan, ID Doctor

6.     Dhruv Khullar has a lot of guts to point out that long covid has many open scientific questions.  There is so much we do not know.  I was glad to be quoted in the piece https://www.newyorker.com/magazine/2021/09/27/the-struggle-to-define-long-covid

7.     Nice video by a doctor I admire: Kwadwo Kyeremanteng

Kwadwo Kyeremanteng @kwadwo777

My thoughts on the lack of extracurricular activities in schools. Our kids stepped up and got vaccinated. There are plenty of activities that are low-risk(track&field). Many families can't afford activities outside of school. Lets do the right thing.Kids have gone through enough

8.     Great interview with Anders Tegnel on why Sweden’s policy choices were the right idea, and ZeroCovid is a delusion https://unherd.com/thepost/anders-tegnell-sweden-won-the-argument-on-covid/

9.     My colleague Monica Gandhi makes an argument in Washington Post on the end of the pandemic. https://www.washingtonpost.com/outlook/2021/09/21/covid-pandemic-end/?tid=ss_tw

10.  A new article in the Atlantic on Follow the Science, reminds me of what I wrote last fall.  We are in perfect agreement.  New Atlantic article: https://www.theatlantic.com/ideas/archive/2021/09/following-the-science-democracy-experts-covid-19/620138/  My two cents from last year:  https://www.medpagetoday.com/opinion/vinay-prasad/89856

11.  A great slide by Adam Cifu on why surrogate endpoints are often unreliable

Adam Cifu @adamcifu

A. Everyone should get vaccinated. B. With every vaccine maker releasing data that a booster raises antibody levels, let's pause and consider surrogate endpoints. Remember, a surrogate endpoint is an endpoint that a patient only knows is important because a doctor has said it is.

12.  An op ed pointing out that ZeroCovid is a dangerous fantasy https://www.wsj.com/articles/zero-covid-coronavirus-pandemic-lockdowns-china-australia-new-zealand-11628101945

13.  An interesting tweet by Ryan Horath pointing out that people who believe in outdoor cloth masking suffer from many problems in reasoning that are also present amongst those with other irrational beliefs

Ryan Horath @therealrthorat

This is as dumb as anything anti-vaxxers believe, and yet we are just supposed to nod our heads and pretend it makes sense. Scientific illiteracy is indeed very high, but it goes far beyond anti-vaxxers and includes much of the media and many scientists.

San Francisco Chronicle @sfchronicle

“I think in California, there is a social norm around masking,” said Arnab Mukherjea, chair of Cal State East Bay’s public health department. “If you go outside, 75% of people are wearing masks.” https://t.co/258kDSrZ02 https://t.co/QvqSnpuIdQ

14.   An article in Reason Magazine on why student quarantines are destroying education and unlikely to serve any purpose. https://reason.com/2021/09/21/quarantined-l-a-schoolkids-have-lower-covid-rates-than-vaccinated-teachers/

15.  COVID19 may be impacting kids mental health https://www.tennessean.com/story/news/politics/2021/09/22/vanderbilt-doctor-covid-19-driving-mental-health-crises-kids/5811071001/

16.  A great article on why college campuses are the craziest places on earth.  https://reason.com/2021/09/21/college-campuses-have-the-craziest-covid-19-restrictions-of-all/

17. Bapu does a podcast on a paper we did together

    Freakonomics, M.D. @DrBapuPod

    .@AnupamBJena’s team found that cardiology conference attendees “were more likely to have attended a top medical school, received funding from the @NIH, or led a clinical trial.” So why do their patients have better outcomes when they’re out of town?

    

    freak.wsWhat Happens to Patients When Thousands of Cardiologists Leave Town? (Freakonomics, M.D. Ep. 7) - FreakonomicsThis week, Bapu Jena presents some hot-off-the-presses research exploring the relationship between how many patients a doctor sees, and how well those patients do. Plus, the surprising impact of annual cardiology conferences that prompted Bapu’s first conversation with Stephen Dubner on Freakonomics…

18. Ending with a kind plug

    Harrison Souchereau @HSouch

    Society would be just a little less insane if people listened to @VPrasadMDMPH at least once a week. Fantastic video

    

    youtube.comWill Science Survive COVID19? | A Scientist ReflectsVinay Prasad, MD MPHHematologist/ Oncologist Associate Professor of Epidemiology & Biostatisticswww.vinayakkprasad.comHost of Plenary Session Podcastwww.plen...