Jay Bhattacharya: The Case Against Lockdowns
政治与社会音乐与艺术哲学与宗教技术与编程生物与进化
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covidvaccinedonpolicysciencestudiesratefearpublichealthdiseasesaiddeathtalkpandemicdatadidnriskprotectionvulnerable
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🎙️ 完整对话（3042 条）
Lex Fridman (00:00.000)
The following is a conversation with Jay Bhattacharya,
以下是与杰伊·巴塔查亚 (Jay Bhattacharya) 的对话，
Lex Fridman (00:02.900)
Professor of Medicine, Health Policy and Economics
医学、卫生政策和经济学教授
Lex Fridman (00:06.100)
at Stanford University.
在斯坦福大学。
Lex Fridman (00:08.180)
Please allow me to say a few words about lockdowns
请允许我就封锁说几句话
Lex Fridman (00:11.400)
and the blinding, destructive effects of arrogance
以及傲慢带来的令人眼花缭乱的破坏性影响
Jay Bhattacharya (00:14.380)
on leadership, especially in the space of policy and politics.
关于领导力，特别是在政策和政治领域。
Lex Fridman (00:19.820)
Jay Bhattacharya is the coauthor
杰伊·巴塔查亚 (Jay Bhattacharya) 是合著者
Jay Bhattacharya (00:21.780)
of the now famous Great Barrington Declaration,
现在著名的大巴灵顿宣言，
Lex Fridman (00:24.460)
a one page document that in October 2020
2020 年 10 月的一页文件
Jay Bhattacharya (00:27.860)
made a case against the effectiveness of lockdowns.
提出了反对封锁有效性的理由。
Lex Fridman (00:32.000)
Most of this podcast conversation
此播客对话的大部分内容
Jay Bhattacharya (00:33.600)
is about the ideas related to this document.
是关于与本文档相关的想法。
Lex Fridman (00:36.360)
And so let me say a few things here about what troubles me.
因此，让我在这里说一些困扰我的事情。
Jay Bhattacharya (00:41.580)
Those who advocate for lockdowns as a policy
那些主张将封锁作为一项政策的人
Lex Fridman (00:44.480)
often ignore the quiet suffering of millions
常常忽视数百万人的默默痛苦
Jay Bhattacharya (00:47.340)
that it results in, which includes economic pain,
它导致的，包括经济痛苦，
Lex Fridman (00:50.180)
loss of jobs that give meaning and pride
失去意义和自豪感的工作
Jay Bhattacharya (00:52.580)
in the face of uncertainty, the increase in suicide
面对不确定性，自杀人数增加
Lex Fridman (00:55.760)
and suicidal ideation, and in general,
和自杀意念，一般而言，
Jay Bhattacharya (00:58.560)
the fear and anger that arises from the powerlessness
由于无能为力而产生的恐惧和愤怒
Lex Fridman (01:02.360)
forced onto the populace
Jay Bhattacharya (01:04.200)
by the self proclaimed elites and experts.
Lex Fridman (01:08.140)
Many folks whose job is unaffected by the lockdowns
Jay Bhattacharya (01:11.600)
talk down to the masses about which path forward
Lex Fridman (01:14.040)
is right and which is wrong.
Lex Fridman (01:16.600)
What troubles me most is this very lack of empathy
Lex Fridman (01:20.040)
among the policymakers for the common man
Lex Fridman (01:22.880)
and in general for people unlike themselves.
Lex Fridman (01:26.280)
The landscape of suffering is vast
Lex Fridman (01:28.580)
and must be fully considered
Lex Fridman (01:30.220)
in calculating the response to the pandemic
Jay Bhattacharya (01:33.220)
with humility and with rigorous,
Lex Fridman (01:36.300)
open minded scientific debate.
Jay Bhattacharya (01:39.300)
Jay and I talk about the email from Francis Collins
Lex Fridman (01:42.100)
to Anthony Fauci that called Jay and his two coauthors
Jay Bhattacharya (01:46.440)
fringe epidemiologists and also called
Lex Fridman (01:49.640)
for a devastating published take down of their ideas.
Jay Bhattacharya (01:53.240)
These words from Francis broke my heart.
Lex Fridman (01:57.140)
I understand them, I can even steel man them,
Lex Fridman (02:00.760)
but nevertheless, on balance,
Lex Fridman (02:02.960)
they show to me a failure of leadership.
Jay Bhattacharya (02:06.720)
Leadership in a pandemic is hard,
Lex Fridman (02:09.100)
which is why great leaders are remembered by history.
Jay Bhattacharya (02:12.660)
They are rare, they stand out and they give me hope.
Lex Fridman (02:17.660)
Also, this whole mess inspires me
Jay Bhattacharya (02:21.620)
on my small individual level to do the right thing
Lex Fridman (02:24.700)
in the face of conformity, despite the long odds.
Jay Bhattacharya (02:29.500)
I talked to Francis Collins,
Lex Fridman (02:31.460)
I talked to Albert Burla, Pfizer CEO.
Jay Bhattacharya (02:34.200)
I also talked and will continue to talk
Lex Fridman (02:36.580)
with people like Jay and other dissenting voices
Jay Bhattacharya (02:39.840)
that challenge the mainstream narratives
Lex Fridman (02:42.040)
and those in the seats of power.
Jay Bhattacharya (02:43.820)
I hope to highlight both the strengths and weaknesses
Lex Fridman (02:46.900)
in their ideas with respect and empathy,
Lex Fridman (02:49.660)
but also with guts and skill.
Lex Fridman (02:53.200)
The skill part, I hope to improve on over time.
Lex Fridman (02:56.840)
And I do believe that conversation
Lex Fridman (02:59.780)
and an open mind is the way out of this.
Lex Fridman (03:03.480)
And finally, as I've said in the past,
Lex Fridman (03:06.020)
I value love and integrity far, far above money,
Jay Bhattacharya (03:10.420)
fame and power.
Lex Fridman (03:12.020)
Those latter three are all ephemeral.
Jay Bhattacharya (03:15.120)
They slip through the fingers of anyone
Lex Fridman (03:17.000)
who tries to hold on and leave behind
Jay Bhattacharya (03:19.960)
an empty shell of a human being.
Lex Fridman (03:23.460)
I prefer to die a man who lived by principles
Jay Bhattacharya (03:26.240)
that nobody could shake and a man
Lex Fridman (03:28.700)
who added a bit of love to the world.
Jay Bhattacharya (03:31.880)
This is the Lex Friedman podcast.
Lex Fridman (03:33.980)
To support it, please check out our sponsors
Jay Bhattacharya (03:36.440)
in the description.
Lex Fridman (03:37.640)
And now, here's my conversation with Jay Bhattacharya.
Lex Fridman (03:43.860)
To our best understanding today, how deadly is COVID?
Lex Fridman (03:48.460)
Do we have a good measure for this very question?
Lex Fridman (03:52.660)
So the best evidence for COVID, the deadliness of COVID,
Lex Fridman (03:56.100)
comes from a whole series of seroprevalence studies.
Jay Bhattacharya (04:00.040)
Seroprevalence studies are these studies
Lex Fridman (04:01.540)
of antibody prevalence in the population at large.
Jay Bhattacharya (04:04.800)
I was part of the very first set of seroprevalence studies,
Lex Fridman (04:08.940)
one in Santa Clara County, one in L.A. County,
Lex Fridman (04:10.940)
and one with Major League Baseball around the U.S.
Lex Fridman (04:14.240)
If I may just pause you for a second.
Jay Bhattacharya (04:17.180)
If people don't know what serology is and seroprevalence,
Lex Fridman (04:20.720)
it does sound like you say zero prevalence.
Jay Bhattacharya (04:23.080)
It's not, it's sero and serology is antibodies.
Lex Fridman (04:26.020)
So it's a survey that counts the number of antibodies.
Jay Bhattacharya (04:29.920)
Specific to COVID, yes.
Lex Fridman (04:31.220)
People that have antibodies specific to COVID,
Jay Bhattacharya (04:34.900)
which perhaps shows an indication
Lex Fridman (04:37.060)
that they likely have had COVID,
Lex Fridman (04:39.160)
and therefore this is a way to study
Lex Fridman (04:41.700)
how many people in the population
Jay Bhattacharya (04:43.160)
have been exposed to or have had COVID.
Lex Fridman (04:45.440)
Exactly, yeah, exactly.
Lex Fridman (04:46.840)
So the idea is that we don't know
Lex Fridman (04:51.840)
exactly the number of people with COVID
Jay Bhattacharya (04:53.520)
just by counting the people
Lex Fridman (04:54.920)
that present themselves with symptoms of COVID.
Jay Bhattacharya (04:57.780)
COVID has, it turns out, a very wide range of symptoms,
Lex Fridman (05:01.760)
ranging from no symptoms at all
Jay Bhattacharya (05:04.160)
to this deadly viral pneumonia
Lex Fridman (05:05.920)
that has killed so many people.
Lex Fridman (05:07.500)
And the problem is, if you just count the number of cases,
Lex Fridman (05:10.460)
the people who have very few symptoms
Jay Bhattacharya (05:12.340)
often don't show up for testing.
Lex Fridman (05:15.040)
They're outside of the can of public health.
Lex Fridman (05:18.200)
And so it's really hard to know the answer to your question
Lex Fridman (05:21.980)
without understanding how many people are infected,
Jay Bhattacharya (05:24.240)
because you can probably tell the number of deaths,
Lex Fridman (05:26.380)
even though there's some controversy over that.
Lex Fridman (05:28.320)
But that, so the numerator is possible,
Lex Fridman (05:31.320)
but the denominator is much harder.
Lex Fridman (05:33.060)
How much controversy is there about the death?
Lex Fridman (05:35.060)
We're gonna go on a million tangents.
Jay Bhattacharya (05:36.900)
Is that, okay, we're gonna, I have a million questions.
Lex Fridman (05:40.100)
So one, I love data so much,
Lex Fridman (05:43.500)
but I'm like almost tuned out
Lex Fridman (05:45.460)
paying attention to COVID data,
Jay Bhattacharya (05:47.400)
because I feel like I'm walking on shaky ground.
Lex Fridman (05:49.900)
I don't know who to trust.
Jay Bhattacharya (05:52.140)
Maybe you can comment on different sources of data,
Lex Fridman (05:54.400)
different kinds of data.
Jay Bhattacharya (05:55.980)
The death one, that seems like a really important one.
Lex Fridman (05:59.140)
Can we trust the reported deaths associated with COVID,
Lex Fridman (06:03.220)
or is it just a giant, messy thing that mixed up?
Lex Fridman (06:06.020)
And then there's this kind of stories about hospitals
Jay Bhattacharya (06:09.600)
being incentivized to report a death as COVID death.
Lex Fridman (06:14.300)
So there's some truth in some of that.
Jay Bhattacharya (06:16.440)
Let me just talk about the incentives.
Lex Fridman (06:19.060)
So in the United States, we passed this CARES Act
Jay Bhattacharya (06:23.200)
that was aimed at making sure hospital systems
Lex Fridman (06:26.400)
didn't go bankrupt in the early days of the pandemic.
Jay Bhattacharya (06:29.480)
The couple of things they did,
Lex Fridman (06:30.420)
one was they provided incentives to treat COVID patients,
Jay Bhattacharya (06:34.620)
tens of thousands of dollars extra per COVID patient.
Lex Fridman (06:38.780)
And the other thing they did is they gave a 20% bump
Jay Bhattacharya (06:41.780)
to Medicare payments for elderly patients
Lex Fridman (06:43.560)
who are treated with COVID.
Jay Bhattacharya (06:44.420)
The idea is that there's more expensive to treat them
Lex Fridman (06:46.360)
at the early days.
Lex Fridman (06:48.320)
So that did provide an incentive
Lex Fridman (06:49.500)
to sort of have a lot of COVID patients in the hospital,
Jay Bhattacharya (06:52.540)
because your financial success of the hospital,
Lex Fridman (06:55.900)
or at least not lack of financial ruin
Jay Bhattacharya (06:57.900)
depended on having many COVID patients.
Lex Fridman (07:00.620)
The other thing on the death certificates
Jay Bhattacharya (07:02.140)
is that reporting of deaths is a separate issue.
Lex Fridman (07:04.100)
I don't know that there's a financial incentive there,
Lex Fridman (07:06.540)
but there is this sort of like complicated,
Lex Fridman (07:08.900)
you know, when you fill out a death certificate
Jay Bhattacharya (07:11.240)
for a patient with a lot of conditions,
Lex Fridman (07:13.940)
like let's say a patient has diabetes,
Jay Bhattacharya (07:15.380)
a patient that, well, that diabetes could lead
Lex Fridman (07:17.620)
to heart failure.
Jay Bhattacharya (07:20.020)
You know, you have a heart attack, heart failure,
Lex Fridman (07:22.080)
your lungs fill up, then you get COVID and you die.
Lex Fridman (07:26.420)
So what do you write on the death certificate?
Lex Fridman (07:28.200)
Was it COVID that killed you?
Lex Fridman (07:29.540)
Was it the lungs filling up?
Lex Fridman (07:31.220)
Was it the heart failure?
Lex Fridman (07:32.860)
Was it the diabetes?
Lex Fridman (07:34.060)
It's really difficult to like disentangle.
Lex Fridman (07:37.660)
And I think a lot of times what's happened
Lex Fridman (07:40.160)
is that people have like erred
Jay Bhattacharya (07:42.020)
on the side of signing it as COVID.
Lex Fridman (07:44.860)
Now, what's the evidence of this?
Jay Bhattacharya (07:46.140)
There's been a couple of audits of death certificates
Lex Fridman (07:49.640)
in places like Santa Clara County,
Jay Bhattacharya (07:51.060)
where I live, in Alameda County, California,
Lex Fridman (07:54.260)
where they carefully went through the death certificate
Lex Fridman (07:56.540)
and said, okay, is this reasonable to say
Lex Fridman (07:57.940)
this was actually COVID or it was COVID incidental?
Lex Fridman (08:00.860)
And they found that about 25%, 20, 25% of the deaths
Lex Fridman (08:03.780)
were more likely incidental than directly due to COVID.
Jay Bhattacharya (08:08.380)
I personally don't get too excited about this.
Lex Fridman (08:10.440)
I mean, it's a philosophical question, right?
Lex Fridman (08:12.260)
Like ultimately, what kills you?
Lex Fridman (08:16.180)
Which is an odd thing to say if you're not in medicine,
Lex Fridman (08:19.380)
but like really, it's almost always multifactorial.
Lex Fridman (08:23.340)
It's not always just the bus hits you.
Jay Bhattacharya (08:25.140)
The bus hits you, you get a brain bleed.
Lex Fridman (08:27.180)
Was it the brain bleed that killed you?
Lex Fridman (08:28.700)
Would it have burst anyway?
Lex Fridman (08:29.620)
I mean, you know, the bus hits you, killed you, right?
Jay Bhattacharya (08:32.440)
The way you die is a philosophical question,
Lex Fridman (08:34.120)
but it's also a sociological and psychological question
Jay Bhattacharya (08:36.820)
because it seems like every single person
Lex Fridman (08:40.360)
who has passed away over the past couple of years,
Jay Bhattacharya (08:43.140)
kind of the first question that comes to mind.
Lex Fridman (08:44.980)
Was it COVID?
Lex Fridman (08:45.820)
Was it COVID?
Lex Fridman (08:46.640)
Not just because you're trying to be political,
Lex Fridman (08:48.380)
but just in your mind.
Lex Fridman (08:49.380)
No, I think there's a psychological reason for this, right?
Jay Bhattacharya (08:51.900)
So, you know, we spent the better part
Lex Fridman (08:55.520)
of at least a half century in the United States
Jay Bhattacharya (08:57.700)
not worried too much about infectious diseases.
Lex Fridman (09:01.700)
The notion was we essentially conquered them.
Jay Bhattacharya (09:03.820)
It was something that happens
Lex Fridman (09:04.780)
in far away places to other people.
Lex Fridman (09:07.820)
And that's true for much of the developed world.
Lex Fridman (09:10.000)
Life expectancy were going up for decades and decades.
Lex Fridman (09:13.940)
And for the first time in living memory,
Lex Fridman (09:16.080)
we have a disease that can kill us.
Jay Bhattacharya (09:18.340)
I mean, I think we're effectively evolved to fear that,
Lex Fridman (09:21.300)
like the panic centers of our brain,
Jay Bhattacharya (09:23.380)
the lizard part of our brain takes over.
Lex Fridman (09:26.020)
And our central focus has been avoiding this one risk.
Lex Fridman (09:29.940)
And so it's not surprising that people,
Lex Fridman (09:32.400)
when they're filling out death certificates
Jay Bhattacharya (09:33.900)
or thinking about what led to the death,
Lex Fridman (09:36.580)
this most salient thing that's in the front
Jay Bhattacharya (09:38.980)
of everyone's brain would jump to the top.
Lex Fridman (09:41.200)
And we can't ignore this very deep psychological thing
Jay Bhattacharya (09:46.840)
when we consider what people say on the internet,
Lex Fridman (09:51.000)
what people say to each other,
Lex Fridman (09:52.320)
what people write in scientific papers, everything.
Lex Fridman (09:55.720)
It feels like when COVID has been brought onto this world,
Jay Bhattacharya (10:05.160)
everything changed in the way people feel about each other,
Lex Fridman (10:09.320)
just the way they communicate with each other.
Jay Bhattacharya (10:11.760)
I think the level of emotion involved,
Lex Fridman (10:15.820)
I think in many people, it brought out the worst in them.
Jay Bhattacharya (10:20.520)
For sometimes short periods of time
Lex Fridman (10:22.200)
and sometimes it was always therapeutic,
Jay Bhattacharya (10:24.200)
like you were waiting to get out
Lex Fridman (10:25.520)
like the darkest parts of you,
Jay Bhattacharya (10:27.720)
just to say, if you're angry at something in this world,
Lex Fridman (10:30.240)
I'm going to say it now.
Lex Fridman (10:31.740)
And I think that's probably talking
Lex Fridman (10:34.040)
to some deep primal thing that fear we have
Jay Bhattacharya (10:38.600)
for formalities of all different kinds.
Lex Fridman (10:41.800)
And then when that fear is aroused
Jay Bhattacharya (10:43.960)
in all the deepest emotions,
Lex Fridman (10:46.000)
it's like a Freudian psychotherapy session,
Lex Fridman (10:49.880)
but across the world.
Lex Fridman (10:51.200)
It's something that psychologists are going to have
Jay Bhattacharya (10:53.800)
a field day with for a generation trying to understand.
Lex Fridman (10:56.480)
I mean, I think what you say is right,
Lex Fridman (10:59.160)
but piled on top of that is also this sort of,
Lex Fridman (11:04.220)
this impetus to empathy,
Jay Bhattacharya (11:05.960)
the empathized compassion toward others,
Lex Fridman (11:08.640)
essentially militarized, right?
Lex Fridman (11:11.320)
So I'm protecting you by some actions
Lex Fridman (11:16.520)
and those actions, if I don't do them,
Jay Bhattacharya (11:20.280)
if you don't do them,
Lex Fridman (11:21.120)
well, that must mean you hate me.
Jay Bhattacharya (11:24.400)
It's created this like social tension
Lex Fridman (11:26.400)
that I've never seen before.
Lex Fridman (11:27.240)
And we looked at each other
Lex Fridman (11:30.960)
as if we were just simply sources of germs
Jay Bhattacharya (11:35.620)
rather than people to get to know,
Lex Fridman (11:37.840)
people to enjoy, people to get to learn from.
Jay Bhattacharya (11:41.180)
It colored basically almost every human interaction
Lex Fridman (11:44.840)
for every human on the planet.
Jay Bhattacharya (11:47.200)
Yeah, the basic common humanity.
Lex Fridman (11:49.600)
It's like you can wear a mask,
Jay Bhattacharya (11:50.880)
you can stand far away,
Lex Fridman (11:52.680)
but the love you have for each other
Jay Bhattacharya (11:54.700)
when you're looking into each other's eyes,
Lex Fridman (11:56.200)
that was dissipating by region too.
Jay Bhattacharya (11:59.920)
I've experienced having traveled
Lex Fridman (12:01.520)
quite a bit throughout this time.
Jay Bhattacharya (12:03.660)
It was really sad,
Lex Fridman (12:06.320)
even people that are really close together,
Jay Bhattacharya (12:08.360)
just the way they stood,
Lex Fridman (12:09.760)
the way they looked at each other.
Lex Fridman (12:11.560)
And it made me feel for a moment
Lex Fridman (12:15.560)
that the fabric that connects all of us
Jay Bhattacharya (12:17.400)
is more fragile than I thought.
Lex Fridman (12:20.000)
I mean, if you walk down the street,
Jay Bhattacharya (12:21.280)
or if you ever, if you did this during COVID,
Lex Fridman (12:23.200)
I'm sure you had this experience
Jay Bhattacharya (12:24.400)
where you walk down the street,
Lex Fridman (12:25.440)
if you're not wearing a mask,
Jay Bhattacharya (12:26.400)
or even if you are,
Lex Fridman (12:27.700)
people will jump off the sidewalk
Jay Bhattacharya (12:30.240)
that you walked past them,
Lex Fridman (12:31.960)
as if you're poison,
Jay Bhattacharya (12:33.960)
even though the data are that COVID spreads
Lex Fridman (12:37.920)
indifferently outdoors,
Jay Bhattacharya (12:39.040)
or if at all, really, outdoors.
Lex Fridman (12:41.440)
But it's not simply a biological
Jay Bhattacharya (12:43.480)
or infectious disease phenomenon,
Lex Fridman (12:45.440)
or epidemiological phenomenon.
Jay Bhattacharya (12:46.280)
It is a change in the way humans treated each other,
Lex Fridman (12:50.680)
I hope temporary.
Jay Bhattacharya (12:52.840)
I do wanna say on the flip side of that,
Lex Fridman (12:54.840)
so I was mostly in Boston, Massachusetts
Jay Bhattacharya (12:58.240)
when the pandemic broke out.
Lex Fridman (12:59.480)
I think that's where I was, yeah.
Lex Fridman (13:01.440)
And then I came here to Austin, Texas
Lex Fridman (13:04.320)
to visit my now good friend, Joe Rogan,
Lex Fridman (13:07.560)
and he was the first person without pause,
Lex Fridman (13:11.000)
this wasn't a political statement,
Jay Bhattacharya (13:12.360)
this was anything,
Lex Fridman (13:13.400)
just walked toward me and gave me a big hug
Lex Fridman (13:16.560)
and say, it's great to see you.
Lex Fridman (13:18.360)
And I can't tell you how great it felt
Jay Bhattacharya (13:20.360)
because I, in that moment,
Lex Fridman (13:21.640)
realized the absence of that connection back in Boston
Jay Bhattacharya (13:24.240)
over just a couple of months.
Lex Fridman (13:26.840)
And it's, we'll talk about it more,
Lex Fridman (13:30.180)
but it's tragic to think about that distancing,
Lex Fridman (13:34.200)
that dissolution of common humanity at scale,
Lex Fridman (13:36.880)
what kind of impact it has on society.
Lex Fridman (13:39.400)
Just across the board, political division,
Lex Fridman (13:43.200)
and just in the quiet of your own mind,
Lex Fridman (13:45.380)
in the privacy of your own home, the depression,
Jay Bhattacharya (13:47.560)
the sadness, the loneliness that leads to suicide.
Lex Fridman (13:51.180)
And forget suicide, just low key suffering.
Jay Bhattacharya (13:55.800)
Yeah, no, I think that's the suffering,
Lex Fridman (13:58.400)
that isolation, we're not meant to live alone,
Jay Bhattacharya (14:00.940)
we're not meant to live apart from one another.
Lex Fridman (14:02.400)
I mean, that's, of course, the ideology of lockdown
Jay Bhattacharya (14:04.440)
is to make people live apart, alone, isolated,
Lex Fridman (14:07.920)
so that we don't spread diseases to each other, right?
Lex Fridman (14:10.240)
But we're not actually designed as a species
Lex Fridman (14:12.280)
to live that way.
Lex Fridman (14:14.100)
And that, what you're describing, I think,
Lex Fridman (14:16.600)
if everyone's honest with themselves, have felt,
Jay Bhattacharya (14:19.260)
especially in places where lockdowns have been
Lex Fridman (14:22.020)
sort of very militantly enforced,
Jay Bhattacharya (14:23.940)
has felt deep into their core.
Lex Fridman (14:26.420)
Well, if I could just return to the question of deaths.
Jay Bhattacharya (14:30.060)
You said that the data isn't perfect,
Lex Fridman (14:31.580)
because we need these kind of seroprevalence surveys
Jay Bhattacharya (14:35.460)
to understand how many cases there were
Lex Fridman (14:37.940)
to determine the rate of deaths.
Lex Fridman (14:39.940)
And we need to have a strong footing
Lex Fridman (14:42.100)
in the number of deaths.
Lex Fridman (14:42.940)
But if we assume that the number of deaths
Lex Fridman (14:45.800)
is approximately correct, like what's your sense,
Lex Fridman (14:49.260)
what kind of statements can we say about the deadliness
Lex Fridman (14:52.660)
of COVID across different demographics?
Jay Bhattacharya (14:55.920)
Maybe not in a political way or in the current way,
Lex Fridman (14:58.820)
but when history looks back at this moment of time,
Jay Bhattacharya (15:03.380)
50 years from now, 100 years from now,
Lex Fridman (15:05.220)
the way we look at the pandemic 100 years ago,
Lex Fridman (15:09.540)
what will they say about the deadliness of COVID?
Lex Fridman (15:12.500)
I mean, I think the deadliness of COVID depends on
Jay Bhattacharya (15:14.980)
not just the virus itself, but who it infects.
Lex Fridman (15:18.480)
So probably the most important thing about it,
Jay Bhattacharya (15:20.380)
about the deadliness of COVID,
Lex Fridman (15:21.780)
is this steep age gradient in the mortality rate.
Lex Fridman (15:26.260)
So according to these seroprevalence studies
Lex Fridman (15:28.900)
that have been done, now hundreds of them,
Jay Bhattacharya (15:32.720)
mostly from before vaccination,
Lex Fridman (15:34.380)
because vaccination also reduces
Jay Bhattacharya (15:35.580)
the mortality risk of COVID,
Lex Fridman (15:37.780)
the seroprevalence studies suggest that the risk of death,
Jay Bhattacharya (15:42.460)
if you're, say, over the age of 70, is very high.
Lex Fridman (15:47.260)
You know, 5% if you get COVID.
Jay Bhattacharya (15:50.620)
If you're under the age of 70, it's lower, 0.05.
Lex Fridman (15:54.020)
But there's not a single sharp cutoff.
Jay Bhattacharya (15:56.380)
It's more like, I have a rule of thumb that I use.
Lex Fridman (15:59.520)
So if you're 50, say, the infection fatality rate
Jay Bhattacharya (16:03.400)
from COVID is 0.2%, according to the seroprevalence data.
Lex Fridman (16:07.500)
That means 99.8% survival if you're 50.
Lex Fridman (16:11.460)
And for every seven years of age above that, double it.
Lex Fridman (16:14.580)
Every seven years of age below that, halve it.
Lex Fridman (16:17.020)
So a 57 year old would have a 0.4%.
Lex Fridman (16:20.940)
Mortality, a 64 year old would have a 0.8% and so on.
Lex Fridman (16:24.680)
And if you have a severe chronic disease,
Lex Fridman (16:26.860)
like diabetes or if you're morbidly obese,
Jay Bhattacharya (16:29.500)
it's like adding seven years to your life.
Lex Fridman (16:32.420)
And this is for unvaccinated folks?
Jay Bhattacharya (16:35.060)
This is unvaccinated before Delta also.
Lex Fridman (16:38.940)
Are there a lot of people that would be listening to this
Jay Bhattacharya (16:41.700)
with PhDs at the end of their name
Lex Fridman (16:43.940)
that would disagree with the 99.8, would you say?
Lex Fridman (16:47.500)
So I think there's some disagreement over this.
Lex Fridman (16:49.940)
And the disagreement is about the quality
Jay Bhattacharya (16:52.980)
of the seroprevalence studies that were conducted.
Lex Fridman (16:56.260)
So as I said earlier, I was the senior investigator
Jay Bhattacharya (16:58.900)
in three different seroprevalence studies
Lex Fridman (17:00.620)
very early in the epidemic.
Jay Bhattacharya (17:03.060)
I view them as very high quality studies.
Lex Fridman (17:07.100)
In Santa Clara County, what we did is we used a test kit
Jay Bhattacharya (17:10.700)
that we obtained from someone who works
Lex Fridman (17:16.260)
in major league baseball, actually.
Jay Bhattacharya (17:18.020)
He had ordered these test kits very early in March, 2020,
Lex Fridman (17:21.300)
that measures, very accurately measures antibody levels,
Jay Bhattacharya (17:25.980)
antibodies in the bloodstream.
Lex Fridman (17:28.620)
These test kits were eventually were approved by the,
Jay Bhattacharya (17:31.700)
had an EUA by the emergency use authorization by the FDA,
Lex Fridman (17:35.980)
sort of shortly after we did this.
Lex Fridman (17:37.760)
And it had a very low false positive rate,
Lex Fridman (17:40.260)
false positive means if you don't have
Jay Bhattacharya (17:43.500)
these COVID antibodies in your bloodstream,
Lex Fridman (17:46.100)
the kit shows up positive anyways.
Jay Bhattacharya (17:48.340)
That turns out to happen about 0.5% of the time.
Lex Fridman (17:52.580)
And based on studies, a very large number of studies
Jay Bhattacharya (17:56.060)
looking at blood from 2018, you try it against this kit,
Lex Fridman (18:00.540)
and 0.5% of the time, 2018,
Jay Bhattacharya (18:03.340)
there shouldn't be antibodies there to COVID.
Lex Fridman (18:05.620)
So if it turns positive to false positives, 0.5% of the time.
Lex Fridman (18:08.780)
And then like a false negative rate, about 10%, 12%,
Lex Fridman (18:14.380)
something like that, I don't remember the exact number,
Lex Fridman (18:16.740)
but the false positive rate is the important thing there.
Lex Fridman (18:18.980)
So you have a population in March, 2020 or April, 2020,
Jay Bhattacharya (18:22.420)
with very low fraction of patients
Lex Fridman (18:25.300)
having been exposed to COVID,
Jay Bhattacharya (18:26.580)
you don't know how much, but low,
Lex Fridman (18:28.780)
even a small false positive rate
Jay Bhattacharya (18:30.380)
could end up biasing your study quite a bit.
Lex Fridman (18:34.340)
But there's a formula to adjust for that.
Jay Bhattacharya (18:36.020)
You can adjust for the false positive rate,
Lex Fridman (18:37.540)
false negative rate.
Jay Bhattacharya (18:38.380)
We did that adjustment, and those studies found
Lex Fridman (18:42.060)
in a community population,
Lex Fridman (18:43.460)
so leaving aside people in nursing homes
Lex Fridman (18:45.100)
who have a higher death rate from COVID,
Jay Bhattacharya (18:48.660)
the death rate was 0.2% in Santa Clara County
Lex Fridman (18:52.060)
and in LA County.
Jay Bhattacharya (18:53.460)
Across all age groups in a community,
Lex Fridman (18:56.060)
community meaning just like regular folks.
Jay Bhattacharya (18:58.100)
Yeah, so that's actually a real important question too.
Lex Fridman (19:00.180)
So the Santa Clara study,
Jay Bhattacharya (19:02.180)
we did this Facebook sampling scheme,
Lex Fridman (19:05.780)
which is, I mean, not the ideal thing,
Lex Fridman (19:08.060)
but it was very difficult to get a random sample
Lex Fridman (19:11.140)
and during lockdown,
Jay Bhattacharya (19:14.180)
where we put out an ad on Facebook
Lex Fridman (19:17.060)
soliciting people to volunteer for the study,
Jay Bhattacharya (19:19.860)
randomly selected set of people.
Lex Fridman (19:22.260)
We were hoping to get a random selection of people
Jay Bhattacharya (19:24.120)
from Santa Clara County, but it tended to,
Lex Fridman (19:26.340)
the people who tend to volunteer
Jay Bhattacharya (19:27.580)
were from the richer parts of the county.
Lex Fridman (19:28.940)
Like I had Stanford professors writing,
Jay Bhattacharya (19:31.300)
begging to be in the study
Lex Fridman (19:32.260)
because they wanted to know their antibody levels.
Lex Fridman (19:34.180)
So we did some adjustment for that.
Lex Fridman (19:36.220)
In LA County, we hired a firm
Jay Bhattacharya (19:38.340)
that had a preexisting representative sample of LA County.
Lex Fridman (19:44.460)
But it didn't include nursing homes,
Jay Bhattacharya (19:46.020)
it didn't include people in jail, things like that,
Lex Fridman (19:48.200)
didn't include the homeless populations.
Lex Fridman (19:49.760)
So it's representative of a community dwelling population,
Lex Fridman (19:53.860)
both of those.
Lex Fridman (19:54.940)
And there we found that both in LA County
Lex Fridman (19:57.940)
and Santa Clara County in April, 2020,
Jay Bhattacharya (1:00:01.380)
about Francis Collins and like I said,
Lex Fridman (1:00:03.420)
I still believe he's a great man and a great scientist.
Jay Bhattacharya (1:00:09.340)
One of the things when I talked to him off mic
Lex Fridman (1:00:13.420)
about the vaccine,
Jay Bhattacharya (1:00:16.860)
the excitement he had about when we were recollecting
Lex Fridman (1:00:21.260)
when they first gotten an inkling
Jay Bhattacharya (1:00:23.540)
that it's actually going to be possible to get a vaccine,
Lex Fridman (1:00:26.900)
just he wasn't messaging,
Jay Bhattacharya (1:00:28.900)
just in the private or of our own conversation,
Lex Fridman (1:00:31.300)
he was really excited and why was he excited?
Jay Bhattacharya (1:00:34.180)
Because he gets to help a lot of people.
Lex Fridman (1:00:36.500)
This is a man that really wants to help people
Lex Fridman (1:00:40.560)
and there could be some institutional self delusion,
Lex Fridman (1:00:43.660)
the arrogance, all those kinds of things
Jay Bhattacharya (1:00:45.660)
that lead to this kind of email.
Lex Fridman (1:00:47.220)
But ultimately the goal is this,
Jay Bhattacharya (1:00:49.340)
I don't think people quite realize this.
Lex Fridman (1:00:51.780)
The reason he would call you a fringe epidemiologist,
Jay Bhattacharya (1:00:55.060)
the reason there needs to be a devastating published
Lex Fridman (1:00:58.100)
take down, he, I believe really believes
Jay Bhattacharya (1:01:01.860)
that it could be very dangerous
Lex Fridman (1:01:05.380)
and it's a lot of burden to carry on his shoulders
Jay Bhattacharya (1:01:09.360)
because like you said, in his role
Lex Fridman (1:01:11.140)
where he defines some of the public policy,
Jay Bhattacharya (1:01:16.260)
depending on how he thinks about the world,
Lex Fridman (1:01:19.020)
millions of people could die
Jay Bhattacharya (1:01:20.300)
because of one decision he make.
Lex Fridman (1:01:22.820)
And that's a lot of burden to walk with.
Jay Bhattacharya (1:01:24.700)
Yeah, no, I think that's right.
Lex Fridman (1:01:25.940)
I don't think that he has bad intentions.
Jay Bhattacharya (1:01:29.420)
I think that he was basically put,
Lex Fridman (1:01:31.980)
was put or maybe put himself in a position
Jay Bhattacharya (1:01:34.380)
where this kind of conflict of interest
Lex Fridman (1:01:38.060)
was going to create this kind of reaction, right?
Jay Bhattacharya (1:01:42.700)
The kind of humility that you're calling for
Lex Fridman (1:01:44.540)
is almost impossible when you have that dual role
Jay Bhattacharya (1:01:48.100)
that you shouldn't have as funder of science
Lex Fridman (1:01:51.380)
and also setter of scientific policy.
Jay Bhattacharya (1:01:53.460)
I agree with everything you just said,
Lex Fridman (1:01:54.500)
except the last part.
Jay Bhattacharya (1:01:55.700)
The humility is almost impossible.
Lex Fridman (1:02:00.100)
Humility is always difficult.
Jay Bhattacharya (1:02:01.640)
I think there's a huge incentive
Lex Fridman (1:02:04.740)
for humility in that position.
Jay Bhattacharya (1:02:06.700)
Now look at history.
Lex Fridman (1:02:08.520)
Great leaders that have humility are popular as hell.
Lex Fridman (1:02:14.460)
So if you like being popular,
Lex Fridman (1:02:16.760)
if you like having impact, legacy,
Jay Bhattacharya (1:02:19.660)
these descendants of ape seem to care about legacy,
Lex Fridman (1:02:22.220)
especially as they get older in these high positions.
Jay Bhattacharya (1:02:25.980)
I think the incentive for humility is pretty high.
Lex Fridman (1:02:28.380)
Well, the thing is there's a lot
Jay Bhattacharya (1:02:30.340)
that he has to be proud of in his career.
Lex Fridman (1:02:32.300)
I mean, the Human Genome Project
Jay Bhattacharya (1:02:34.540)
wouldn't have happened without him.
Lex Fridman (1:02:36.260)
And he is a great man and a great scientist.
Lex Fridman (1:02:39.460)
So it is tragic to me that his career
Lex Fridman (1:02:41.660)
has ended in this particular way.
Jay Bhattacharya (1:02:44.820)
Can I ask you a question
Lex Fridman (1:02:46.060)
about my podcast conversation with him?
Jay Bhattacharya (1:02:50.700)
By way of advice or maybe criticism,
Lex Fridman (1:02:54.380)
there's a lot of people that wrote to me
Jay Bhattacharya (1:02:56.260)
kind words of support and a lot of people
Lex Fridman (1:03:00.020)
that wrote to me respectful, constructive criticism.
Lex Fridman (1:03:03.340)
How would you suggest to have conversations
Lex Fridman (1:03:06.180)
with folks like that?
Lex Fridman (1:03:07.820)
And maybe, I mean,
Lex Fridman (1:03:11.020)
because I have other conversations like this,
Jay Bhattacharya (1:03:12.900)
including I was debating whether to talk to Anthony Fauci.
Lex Fridman (1:03:17.380)
He wanted to talk.
Lex Fridman (1:03:19.220)
And so what kind of conversation do you have?
Lex Fridman (1:03:22.820)
And sorry to take us on a tangent,
Lex Fridman (1:03:24.620)
but almost from an interview perspective
Lex Fridman (1:03:27.300)
of how to inspire humility and inspire trust in science
Jay Bhattacharya (1:03:31.780)
or maybe give hope that we know what the heck we're doing
Lex Fridman (1:03:34.460)
and we're gonna figure this out?
Jay Bhattacharya (1:03:35.700)
I mean, I think you're,
Lex Fridman (1:03:38.460)
I've had been now interviewed by many people.
Jay Bhattacharya (1:03:41.220)
I think the style you have really works well, Lex.
Lex Fridman (1:03:44.460)
You have to,
Jay Bhattacharya (1:03:45.540)
because I don't think you're gonna be ever an attack dog
Lex Fridman (1:03:48.980)
trying to go after somebody and force them to like,
Jay Bhattacharya (1:03:53.260)
sort of admit that they were wrong or whatever about,
Lex Fridman (1:03:55.780)
I mean, I also actually find that form of journalism
Lex Fridman (1:03:58.740)
and podcasting really off putting.
Lex Fridman (1:04:00.500)
It's hard to watch.
Jay Bhattacharya (1:04:02.180)
Also, it's a whole other tangent.
Lex Fridman (1:04:04.100)
Is that actually effective?
Jay Bhattacharya (1:04:05.380)
I don't think so.
Lex Fridman (1:04:06.220)
Do you wanna ask Hitler,
Lex Fridman (1:04:09.140)
and I think about this a lot, actually interviewing Hitler.
Lex Fridman (1:04:11.020)
I've been studying a lot about the rise and fall
Jay Bhattacharya (1:04:13.620)
of the Third Reich.
Lex Fridman (1:04:15.140)
I think about interviewing Stalin.
Jay Bhattacharya (1:04:16.660)
Like I put myself in that mindset,
Lex Fridman (1:04:18.540)
like how do you have conversations with people
Jay Bhattacharya (1:04:22.700)
to understand who they are so that,
Lex Fridman (1:04:24.900)
not so you can sit there and yell at them,
Lex Fridman (1:04:28.220)
but to understand who they are
Lex Fridman (1:04:29.340)
so that you can inspire a very large number of people
Jay Bhattacharya (1:04:32.420)
to be the best version of themselves
Lex Fridman (1:04:33.940)
and to avoid the mistakes of the past.
Jay Bhattacharya (1:04:36.220)
I believe that everyone that's involved in this debate
Lex Fridman (1:04:39.700)
has good intentions.
Jay Bhattacharya (1:04:41.180)
They're coming at it from their points of view.
Lex Fridman (1:04:44.060)
They have their weaknesses.
Lex Fridman (1:04:48.180)
And if you can paint a picture in your questioning
Lex Fridman (1:04:50.820)
by sympathetic questioning of those strengths and weaknesses
Lex Fridman (1:04:55.180)
and their point of view, you've done a service.
Lex Fridman (1:04:57.340)
That's really all I personally like to see
Jay Bhattacharya (1:05:00.180)
in those kinds of interviews.
Lex Fridman (1:05:02.100)
I don't think a gotcha moment is really the key thing there.
Jay Bhattacharya (1:05:06.700)
The key thing is understanding where they're coming from,
Lex Fridman (1:05:09.340)
understanding their thinking,
Jay Bhattacharya (1:05:10.660)
understanding the constraints they faced
Lex Fridman (1:05:12.340)
and how did they manage them.
Jay Bhattacharya (1:05:14.140)
That's gonna provide a much,
Lex Fridman (1:05:15.700)
I mean, to me, that's what I look for
Jay Bhattacharya (1:05:17.100)
when I listen to podcasts like yours,
Lex Fridman (1:05:19.860)
is an understanding of that person and the moment
Lex Fridman (1:05:24.660)
and how they dealt with it.
Lex Fridman (1:05:26.300)
I mean, I guess the hope is to discover in a sympathetic way
Jay Bhattacharya (1:05:30.580)
a flaw in a person's thinking together.
Lex Fridman (1:05:33.820)
Like as opposed to discovering the positive thing together,
Jay Bhattacharya (1:05:37.140)
you discover the thing, well,
Lex Fridman (1:05:39.620)
I didn't really think about that.
Lex Fridman (1:05:40.860)
Yeah, I mean, that's how science is, right?
Lex Fridman (1:05:42.940)
That's why we find it so attractive is this,
Jay Bhattacharya (1:05:46.160)
I like it when a student shows me I'm thinking incorrectly.
Lex Fridman (1:05:51.540)
Right, I'm really grateful to that student
Jay Bhattacharya (1:05:53.960)
because now I have an opportunity to change my mind about it
Lex Fridman (1:05:57.300)
and then start thinking even more correctly.
Jay Bhattacharya (1:05:58.980)
I mean, and there are moments when,
Lex Fridman (1:06:02.860)
I mean, like this is probably a good time to say
Lex Fridman (1:06:05.020)
like what I think I got wrong during the pandemic, right?
Lex Fridman (1:06:07.920)
So like for instance, you said Francis Collins had a moment
Jay Bhattacharya (1:06:10.660)
when he learned that there was quite possible
Lex Fridman (1:06:14.780)
to get a vaccine going.
Jay Bhattacharya (1:06:16.620)
He must've learned that quite early.
Lex Fridman (1:06:19.060)
And I didn't learn that early.
Jay Bhattacharya (1:06:21.520)
I mean, I didn't know, in March of 2020,
Lex Fridman (1:06:25.940)
in my experience with vaccine development,
Jay Bhattacharya (1:06:28.140)
it would've take, I thought it would take a decade or more
Lex Fridman (1:06:30.740)
to get a vaccine.
Lex Fridman (1:06:33.020)
That was wrong, right?
Lex Fridman (1:06:34.220)
I didn't, and I was so happy
Jay Bhattacharya (1:06:38.020)
when I started to see the preliminary numbers
Lex Fridman (1:06:40.420)
in the Pfizer trial that strongly suggested
Jay Bhattacharya (1:06:43.940)
it was going to work.
Lex Fridman (1:06:46.340)
And I was, I mean, like very few times in my life
Jay Bhattacharya (1:06:49.700)
I'm so happy to be wrong.
Lex Fridman (1:06:50.980)
And it changes kind of, I think I've heard you mention
Jay Bhattacharya (1:06:55.480)
that a lockdown is still a bad idea
Lex Fridman (1:06:58.180)
unless the vaccine comes out in like tomorrow.
Jay Bhattacharya (1:07:01.800)
There's still like suffering and economic pain,
Lex Fridman (1:07:05.300)
all kinds of pain can still happen
Jay Bhattacharya (1:07:07.100)
in even just a scale of weeks versus months.
Lex Fridman (1:07:13.180)
Yeah.
Jay Bhattacharya (1:07:14.100)
Well, let's talk about the vaccine.
Lex Fridman (1:07:16.320)
What are your thoughts on the safety and efficacy
Lex Fridman (1:07:18.940)
of COVID vaccines at the individual and the societal level?
Lex Fridman (1:07:22.900)
So for the vaccine safety data,
Jay Bhattacharya (1:07:26.220)
it's actually challenging to convey to the public
Lex Fridman (1:07:30.100)
how this is normally done.
Jay Bhattacharya (1:07:31.460)
Like normally you would do this in the context of the trial,
Lex Fridman (1:07:34.400)
you'd have a long trial with large numbers,
Jay Bhattacharya (1:07:37.020)
relatively large numbers of people,
Lex Fridman (1:07:38.700)
you'd follow them over a long time
Lex Fridman (1:07:40.100)
and the trial will give you some indication
Lex Fridman (1:07:42.380)
of the safety of the vaccine.
Lex Fridman (1:07:43.740)
And it did, I mean, but the trial,
Lex Fridman (1:07:47.620)
the way it was constructed, when it came out
Jay Bhattacharya (1:07:51.180)
that it was protective against COVID,
Lex Fridman (1:07:52.780)
it was no longer ethical to have a placebo arm.
Lex Fridman (1:07:56.340)
And so that placebo arm was vaccinated, large part of it.
Lex Fridman (1:08:00.140)
And so that meant that from the trial,
Jay Bhattacharya (1:08:02.280)
you were not going to be able to get data
Lex Fridman (1:08:05.180)
on the longterm safety profiles of the vaccine.
Lex Fridman (1:08:09.380)
And also the other thing about trials,
Lex Fridman (1:08:10.900)
although there's tens of thousands of people enrolled,
Jay Bhattacharya (1:08:13.020)
that's still not enough to get
Lex Fridman (1:08:14.460)
when you deploy a vaccine at population scale,
Jay Bhattacharya (1:08:18.940)
you're gonna see things that weren't in the trial,
Lex Fridman (1:08:21.220)
guaranteed, populations of people
Jay Bhattacharya (1:08:23.820)
that weren't represented well in the trial
Lex Fridman (1:08:25.740)
are gonna be given the vaccine
Lex Fridman (1:08:27.860)
and then they're gonna have things that happen to them
Lex Fridman (1:08:29.980)
that you didn't anticipate.
Lex Fridman (1:08:32.260)
So I wasn't surprised when people were a little bit
Lex Fridman (1:08:35.580)
skeptical when the trial was done about the safety profile,
Jay Bhattacharya (1:08:38.580)
just the way the nature of the thing was gonna make it
Lex Fridman (1:08:40.700)
so that it was gonna be hard to get a complete picture
Jay Bhattacharya (1:08:43.660)
from the trials itself.
Lex Fridman (1:08:45.120)
And the trial showed they were pretty safe
Lex Fridman (1:08:47.540)
and quite effective at preventing both you
Lex Fridman (1:08:51.300)
from getting COVID,
Jay Bhattacharya (1:08:52.580)
like I said, I think the main endpoint of the trial itself
Lex Fridman (1:08:54.900)
was a symptomatic COVID, right?
Lex Fridman (1:08:57.840)
So that was like, that was, I mean, it was really to me,
Lex Fridman (1:09:03.660)
like it was about as amazing achievement as anything,
Jay Bhattacharya (1:09:06.620)
organizing a trial of that scale and running it so quickly.
Lex Fridman (1:09:10.740)
And the final results being so surprisingly high.
Lex Fridman (1:09:14.420)
So good, right?
Lex Fridman (1:09:16.060)
And so, but the problem then was,
Jay Bhattacharya (1:09:20.060)
normally it would take a long time,
Lex Fridman (1:09:23.020)
the FDA would tell Pfizer to go back
Lex Fridman (1:09:25.460)
and try it in this subgroup,
Lex Fridman (1:09:27.140)
they'd work more on dosing,
Jay Bhattacharya (1:09:28.660)
they do all these kinds of things
Lex Fridman (1:09:31.060)
that kind of didn't, we really didn't have time for
Lex Fridman (1:09:33.340)
in the middle of the pandemic, right?
Lex Fridman (1:09:34.800)
So you have a basis for approval that it's less full
Jay Bhattacharya (1:09:40.940)
than normally you would have for a population scale vaccine.
Lex Fridman (1:09:44.120)
But the results were good, the results looked really good.
Lex Fridman (1:09:47.520)
And actually, I should say for the most part,
Lex Fridman (1:09:49.960)
that's been born out when we've given the vaccine at scale
Lex Fridman (1:09:53.000)
in terms of protection against severe disease, right?
Lex Fridman (1:09:56.760)
So people who have got the vaccine
Jay Bhattacharya (1:09:59.340)
for a very long time after they've had
Lex Fridman (1:10:01.240)
for the full vaccination have had great protection
Jay Bhattacharya (1:10:04.520)
against being hospitalized and dying if they get COVID.
Lex Fridman (1:10:08.480)
Let's separate, because this seems to be,
Jay Bhattacharya (1:10:11.460)
there's critics of both categories, but different.
Lex Fridman (1:10:16.060)
Kids and kids, not older people,
Jay Bhattacharya (1:10:20.940)
like let's say five years old and above or something,
Lex Fridman (1:10:24.340)
or 13 years old and above.
Lex Fridman (1:10:26.060)
So for those, it seems like the reduction
Lex Fridman (1:10:31.500)
of the rate of fatalities and serious illness
Jay Bhattacharya (1:10:35.940)
seems to be something like 10X.
Lex Fridman (1:10:38.280)
I mean, for older people, it is a godsend, this vaccine.
Jay Bhattacharya (1:10:42.300)
It transforms the problem of focus protection
Lex Fridman (1:10:47.020)
from something that's quite challenging,
Jay Bhattacharya (1:10:49.220)
possible, I believe, but quite challenging
Lex Fridman (1:10:50.820)
to something that's much, much more manageable.
Jay Bhattacharya (1:10:53.180)
Because the vaccine in and of itself when deployed
Lex Fridman (1:10:56.180)
in older populations is a form of focus protection.
Jay Bhattacharya (1:11:00.020)
Yes, by the way, we'll talk about the focus protection
Lex Fridman (1:11:03.340)
in one segment, because it's such a brilliant idea
Jay Bhattacharya (1:11:05.740)
for this pandemic or for future pandemics.
Lex Fridman (1:11:08.500)
I thought the sociological, psychological discussion
Jay Bhattacharya (1:11:11.760)
about the letter from Francis Collins is,
Lex Fridman (1:11:15.300)
because it was so recent, it has been so troubling to me,
Lex Fridman (1:11:17.380)
so I'm glad we talked about that first.
Lex Fridman (1:11:20.220)
But so there seems to be, the vaccines work
Jay Bhattacharya (1:11:24.940)
to reduce deaths, and that has especially
Lex Fridman (1:11:29.340)
the most transformative effects for the older folks.
Jay Bhattacharya (1:11:33.300)
I've told you one thing that I got wrong in the pandemic.
Lex Fridman (1:11:35.100)
Let me tell you the second thing I got wrong,
Jay Bhattacharya (1:11:36.500)
for sure, in the pandemic.
Lex Fridman (1:11:38.220)
In January of this year, 2021,
Jay Bhattacharya (1:11:43.020)
I thought that the vaccines would stop infection.
Lex Fridman (1:11:48.060)
Yes.
Jay Bhattacharya (1:11:48.900)
Right, it would make it so that you were much less likely
Lex Fridman (1:11:51.620)
to be infected at all, because the antibodies
Jay Bhattacharya (1:11:55.260)
that were produced by the vaccines
Lex Fridman (1:11:56.460)
looked like they were neutralizing antibodies
Jay Bhattacharya (1:11:58.220)
that would essentially block you from being infected at all.
Lex Fridman (1:12:01.220)
That turned out to be wrong, right?
Lex Fridman (1:12:06.220)
So I think, and it became clear as data came out
Lex Fridman (1:12:10.660)
from Israel, which vaccinated very early,
Jay Bhattacharya (1:12:12.540)
that they were seeing surges of infection,
Lex Fridman (1:12:14.860)
even in a very highly vaccinated population,
Jay Bhattacharya (1:12:17.820)
that the vaccine does not stop infection.
Lex Fridman (1:12:21.780)
So you're a used car salesman,
Lex Fridman (1:12:24.220)
and you were selling the vaccine,
Lex Fridman (1:12:26.180)
and the features you thought a vaccine would have,
Jay Bhattacharya (1:12:28.460)
I mean, I have a similar kind of sense
Lex Fridman (1:12:30.100)
when the vaccine came out.
Jay Bhattacharya (1:12:31.660)
Vaccine would reduce, if you somehow were able to get it,
Lex Fridman (1:12:37.500)
it would reduce rate of death and all those kinds of things,
Lex Fridman (1:12:40.300)
but it would also reduce the chance of you getting it,
Lex Fridman (1:12:44.260)
and if you do get it, the chance of you transmitting it
Jay Bhattacharya (1:12:47.100)
to somebody else.
Lex Fridman (1:12:48.860)
And it turns out that those latter two things
Jay Bhattacharya (1:12:52.180)
are not as definitive, or in fact,
Lex Fridman (1:12:55.820)
I mean, I don't know to which degree they're not there at all.
Jay Bhattacharya (1:12:57.860)
I think it's a little complicated,
Lex Fridman (1:12:59.260)
because I think the first two or three months
Jay Bhattacharya (1:13:01.580)
after you're fully vaccinated, after the second dose,
Lex Fridman (1:13:04.340)
you have 60, 70% efficacy peak against infection.
Lex Fridman (1:13:10.420)
So that, which is pretty good, I mean, right?
Lex Fridman (1:13:12.740)
But by six, seven, eight months, that drops to 20%.
Jay Bhattacharya (1:13:16.780)
Some places, some studies, like there's a study
Lex Fridman (1:13:19.180)
out of Sweden that suggests it might even drop to zero.
Jay Bhattacharya (1:13:21.540)
But, and then you're also infectious
Lex Fridman (1:13:23.420)
for some period of time, if you do get it,
Jay Bhattacharya (1:13:25.740)
even though you're vaccinated.
Lex Fridman (1:13:27.020)
Correct.
Jay Bhattacharya (1:13:27.860)
It seems to be lucidated that the period of time
Lex Fridman (1:13:30.820)
your infectious is shorter.
Jay Bhattacharya (1:13:31.860)
Is shorter, but the infectivity per day is about as high.
Lex Fridman (1:13:36.500)
So you still, the point is that the vaccine
Jay Bhattacharya (1:13:39.340)
might reduce some risk of infecting others,
Lex Fridman (1:13:41.820)
but it's not a categorical difference.
Jay Bhattacharya (1:13:44.820)
So, it's not safe to be in the presence
Lex Fridman (1:13:49.660)
of just vaccinated people.
Jay Bhattacharya (1:13:51.220)
You can still get infected.
Lex Fridman (1:13:53.860)
Right, so, I mean, there's a million things
Jay Bhattacharya (1:13:56.180)
I wanna ask here, but is there in some sense
Lex Fridman (1:13:59.700)
because the vaccine really helps
Jay Bhattacharya (1:14:04.020)
on the worst part of this pandemic,
Lex Fridman (1:14:06.820)
which is killing people.
Jay Bhattacharya (1:14:08.300)
Yes.
Lex Fridman (1:14:09.940)
Doesn't that mean, where does the vaccine hesitancy
Jay Bhattacharya (1:14:14.340)
come from in terms of, it seems like,
Lex Fridman (1:14:17.640)
obviously a vaccine is a powerful solution
Jay Bhattacharya (1:14:20.560)
to let us open this thing up.
Lex Fridman (1:14:22.540)
Yeah, so I wrote a Wall Street Journal op ed
Jay Bhattacharya (1:14:24.540)
with Sunetra Gupta in December of last year.
Lex Fridman (1:14:26.980)
Yes.
Jay Bhattacharya (1:14:27.820)
A very night with a very naive title,
Lex Fridman (1:14:29.780)
which says we can end the lockdowns in a month.
Lex Fridman (1:14:32.380)
And the idea is very simple.
Lex Fridman (1:14:33.860)
Vaccinate all vulnerable people
Lex Fridman (1:14:39.220)
and then open up.
Lex Fridman (1:14:40.700)
Open up.
Jay Bhattacharya (1:14:41.540)
Right, and the idea was that the lockdown harms,
Lex Fridman (1:14:44.660)
this is directly related to the Great Barrington Declaration.
Jay Bhattacharya (1:14:47.100)
Great Barrington Declaration said the lockdown harms
Lex Fridman (1:14:49.500)
are devastating to the population at large.
Jay Bhattacharya (1:14:53.240)
There's this considerable segment of people
Lex Fridman (1:14:55.980)
that are vulnerable, protect them.
Jay Bhattacharya (1:14:58.340)
Well, with the vaccine, we have a perfect tool
Lex Fridman (1:15:00.300)
to protect the vulnerable, which is, I still believe,
Lex Fridman (1:15:02.740)
I mean, it's true, right?
Lex Fridman (1:15:04.300)
You vaccinate the vulnerable, the older population,
Lex Fridman (1:15:07.180)
and as you said, there's a tenfold decrease
Lex Fridman (1:15:09.380)
in the mortality risk from getting infected,
Jay Bhattacharya (1:15:13.180)
which is, I mean, amazing.
Lex Fridman (1:15:14.980)
So that was the strategy we outlined.
Lex Fridman (1:15:17.240)
What happened is that the vaccine debate got transformed.
Lex Fridman (1:15:20.480)
So first there's, so you're asking about vaccine hesitancy.
Jay Bhattacharya (1:15:22.860)
I think first there's the inherent limitations
Lex Fridman (1:15:27.020)
of how to measure vaccine safety, right?
Lex Fridman (1:15:29.460)
So we talked about a little bit about the trial,
Lex Fridman (1:15:31.620)
but also after the trial, there's a mechanism,
Lex Fridman (1:15:35.140)
and this is the work I've been involved with before COVID,
Lex Fridman (1:15:37.940)
on tracking and identifying and checking
Jay Bhattacharya (1:15:42.460)
whether the vaccines actually are safe.
Lex Fridman (1:15:43.980)
And the central challenge is one of causality.
Lex Fridman (1:15:47.260)
So you no longer have the randomized trial,
Lex Fridman (1:15:50.500)
but you wanna know is the vaccine,
Jay Bhattacharya (1:15:52.780)
when it's deployed at scale, causing adverse events.
Lex Fridman (1:15:57.940)
Well, you can't just look at people who are vaccinated
Lex Fridman (1:16:00.100)
and see what adverse events happen,
Lex Fridman (1:16:02.100)
because you don't know what would have happened
Jay Bhattacharya (1:16:03.980)
if the person had not been vaccinated.
Lex Fridman (1:16:06.980)
So you have to have some control group.
Jay Bhattacharya (1:16:09.820)
Now, what happened is there's several systems
Lex Fridman (1:16:12.080)
to check this that the CDC uses.
Jay Bhattacharya (1:16:14.700)
One very commonly known one now is called VAERS,
Lex Fridman (1:16:18.220)
the Vaccine Adverse Event Reporting System.
Jay Bhattacharya (1:16:20.580)
There, anyone who has an adverse event,
Lex Fridman (1:16:23.420)
either a regular person or a doctor can just go report,
Jay Bhattacharya (1:16:26.820)
look, I had the vaccine and two days later I had a headache
Lex Fridman (1:16:28.940)
or whatever it is, the person died
Lex Fridman (1:16:32.060)
a day after I had the vaccine, right?
Lex Fridman (1:16:34.280)
Now, the vaccine was rolled out to older people first,
Lex Fridman (1:16:38.800)
and older people die sometimes with or without the vaccine.
Lex Fridman (1:16:42.180)
So sometimes you'll see someone's vaccinated
Lex Fridman (1:16:44.740)
and a few days later they die.
Lex Fridman (1:16:46.700)
Did the vaccine cause it or something else cause it?
Jay Bhattacharya (1:16:48.540)
Really difficult to tell.
Lex Fridman (1:16:50.320)
In order to tell, you need a control group.
Jay Bhattacharya (1:16:53.540)
For that, there are other systems the FDA and CDC have,
Lex Fridman (1:16:58.580)
like there's one called VSD, Vaccine Safety Datalink.
Jay Bhattacharya (1:17:02.360)
There's another system called BEST,
Lex Fridman (1:17:05.060)
I forget what the acronym is,
Jay Bhattacharya (1:17:06.880)
to essentially to track cohorts of people,
Lex Fridman (1:17:11.480)
vaccinated versus unvaccinated,
Jay Bhattacharya (1:17:13.940)
with as careful of matching as you can do.
Lex Fridman (1:17:15.700)
It's not randomized,
Lex Fridman (1:17:17.020)
and then see if you have safety signals
Lex Fridman (1:17:21.380)
that pop up in the vaccinated
Jay Bhattacharya (1:17:23.700)
relative to the control group unvaccinated.
Lex Fridman (1:17:27.100)
And so that's, for instance,
Lex Fridman (1:17:28.140)
how the myocarditis risk was picked up
Lex Fridman (1:17:32.000)
in especially young men.
Jay Bhattacharya (1:17:34.260)
It's also how the higher risk of blood clots
Lex Fridman (1:17:38.020)
in middle age and older women
Jay Bhattacharya (1:17:41.060)
with the J&J vaccine was picked up.
Lex Fridman (1:17:43.940)
There, what you have are situations
Jay Bhattacharya (1:17:46.400)
where the baseline risk of these outcomes are so low
Lex Fridman (1:17:50.460)
that if you see them in the vaccinated arm at all,
Jay Bhattacharya (1:17:54.100)
that it's not hard to understand that the vaccine did this.
Lex Fridman (1:17:57.420)
Young men should not be having myocarditis.
Jay Bhattacharya (1:18:00.540)
Middle age women should not be having
Lex Fridman (1:18:02.300)
huge blood clots in the brain.
Lex Fridman (1:18:04.400)
So when you see that, you can say it's linked.
Lex Fridman (1:18:05.900)
Now, the rates are low.
Lex Fridman (1:18:07.380)
So young men, maybe one in 5,000,
Lex Fridman (1:18:09.540)
one in 10,000 of the vaccine,
Jay Bhattacharya (1:18:11.940)
vaccine related myocarditis, pericarditis.
Lex Fridman (1:18:14.180)
Young women, middle age women, I don't know.
Jay Bhattacharya (1:18:17.660)
I'm not sure what the right number might be,
Lex Fridman (1:18:19.700)
but like I'd say, it's like one in hundreds of thousands,
Jay Bhattacharya (1:18:23.700)
something like that.
Lex Fridman (1:18:26.420)
So these are rare outcomes,
Lex Fridman (1:18:27.900)
but they are vaccine linked outcomes.
Lex Fridman (1:18:30.940)
How do you deal with that as a messaging thing?
Jay Bhattacharya (1:18:33.780)
I think you just tell people.
Lex Fridman (1:18:35.380)
You tell people here are the risks.
Jay Bhattacharya (1:18:36.860)
You transparently tell them.
Lex Fridman (1:18:37.860)
And just, you're not,
Lex Fridman (1:18:38.700)
so they're not getting into something that they don't know.
Lex Fridman (1:18:41.200)
And don't treat people like they're children
Lex Fridman (1:18:45.460)
and need to be told lies
Lex Fridman (1:18:47.300)
because they won't understand
Jay Bhattacharya (1:18:48.700)
the full complexity of the truth.
Lex Fridman (1:18:50.980)
People, I think, are pretty good at,
Jay Bhattacharya (1:18:54.220)
or actually, people with time are good at understanding data,
Lex Fridman (1:18:59.660)
but better than anything.
Jay Bhattacharya (1:19:01.460)
They're better at,
Lex Fridman (1:19:04.460)
they're extremely good at detecting arrogance and bullshit.
Lex Fridman (1:19:08.440)
And you give them either one of those.
Lex Fridman (1:19:10.780)
I mean, I'll give you one
Jay Bhattacharya (1:19:11.700)
that's where I think it's greatly undermined vaccine,
Lex Fridman (1:19:14.740)
greatly undermined the demand for the vaccine,
Jay Bhattacharya (1:19:16.620)
is this weird denial that if you recover from COVID,
Lex Fridman (1:19:20.460)
you have extremely good immunity,
Jay Bhattacharya (1:19:24.100)
both against infection and access to disease.
Lex Fridman (1:19:27.100)
And that denial leads to people distrusting the message
Jay Bhattacharya (1:19:31.820)
given by like the CDC director, for instance,
Lex Fridman (1:19:33.860)
in favor of the vaccine, right?
Lex Fridman (1:19:35.940)
Why would you deny a thing that's such an obvious fact?
Lex Fridman (1:19:39.580)
Like you can look at the data and it just,
Jay Bhattacharya (1:19:42.060)
I mean, it just pops out at you
Lex Fridman (1:19:43.700)
that people that are COVID recovered
Jay Bhattacharya (1:19:45.860)
are not getting infected again at very high rates,
Lex Fridman (1:19:48.760)
much lower rates.
Jay Bhattacharya (1:19:50.340)
After these kinds of conversations,
Lex Fridman (1:19:53.020)
I'm sure after this very conversation,
Jay Bhattacharya (1:19:55.560)
I often get a number of messages from Joe, Joe Rogan,
Lex Fridman (1:19:59.420)
and from Sam Harris, who to me are people I admire,
Jay Bhattacharya (1:20:03.600)
I think are really intelligent, thoughtful human beings.
Lex Fridman (1:20:06.560)
They also have a platform.
Lex Fridman (1:20:08.420)
And I believe, at least in my mind,
Lex Fridman (1:20:11.140)
about this COVID set of topics,
Jay Bhattacharya (1:20:14.120)
they represent a group of people.
Lex Fridman (1:20:19.860)
Each group has smart, thoughtful,
Jay Bhattacharya (1:20:25.700)
well intentioned human beings.
Lex Fridman (1:20:27.900)
And I don't know who is right,
Lex Fridman (1:20:30.320)
but I do know that they're kind of tribal a little bit,
Lex Fridman (1:20:36.300)
those groups.
Lex Fridman (1:20:37.200)
And so the question I wanna ask is like,
Lex Fridman (1:20:41.060)
what do you think about these two groups
Lex Fridman (1:20:45.900)
and this kind of tension over the vaccine
Lex Fridman (1:20:49.860)
that sometimes it just keeps finding different topics
Jay Bhattacharya (1:20:54.020)
on which to focus on,
Lex Fridman (1:20:55.380)
like whether kids should get vaccinated or not,
Jay Bhattacharya (1:20:57.820)
whether there should be vaccine mandates or not,
Lex Fridman (1:21:00.380)
which seem to be often very kind of specific policy
Jay Bhattacharya (1:21:03.420)
kinds of questions that miss the bigger picture.
Lex Fridman (1:21:06.180)
I think it's a symptom of the distrust
Jay Bhattacharya (1:21:08.300)
that people have in public health.
Lex Fridman (1:21:10.460)
I think this kind of schism over the vaccine
Jay Bhattacharya (1:21:13.900)
does not happen in places
Lex Fridman (1:21:15.300)
where the public health authorities
Lex Fridman (1:21:16.580)
have been much more trustworthy, right?
Lex Fridman (1:21:18.860)
So you don't see this vaccine
Jay Bhattacharya (1:21:20.060)
hasn't seen Sweden, for instance.
Lex Fridman (1:21:23.620)
What's happened in the United States
Jay Bhattacharya (1:21:25.620)
is that the vaccine has become first because of politics,
Lex Fridman (1:21:30.540)
but then also because of the scientific arrogance,
Jay Bhattacharya (1:21:33.020)
this sort of touchstone issue,
Lex Fridman (1:21:35.100)
and people line up on both sides of it,
Lex Fridman (1:21:37.180)
and the different language you're hearing
Lex Fridman (1:21:39.540)
is structured around that.
Lex Fridman (1:21:40.820)
So before the election, for instance,
Lex Fridman (1:21:42.580)
I did a testimony in the House
Jay Bhattacharya (1:21:46.580)
on measurement of vaccine safety.
Lex Fridman (1:21:49.760)
And I was invited by the Republicans.
Jay Bhattacharya (1:21:52.540)
There were, I think, four other experts
Lex Fridman (1:21:54.420)
invited by the Democrats,
Jay Bhattacharya (1:21:55.260)
or three other experts invited by Democrats,
Lex Fridman (1:21:57.620)
each of whom had a lot of experience
Jay Bhattacharya (1:21:59.220)
in measuring vaccine safety.
Lex Fridman (1:22:00.600)
I was really surprised to hear them each doubt
Jay Bhattacharya (1:22:04.720)
whether the FDA would do a reasonable job
Lex Fridman (1:22:06.860)
in assessing vaccine safety,
Jay Bhattacharya (1:22:08.760)
including by people who have long records
Lex Fridman (1:22:11.140)
of working with the FDA.
Jay Bhattacharya (1:22:12.940)
I mean, these are professionals, great scientists,
Lex Fridman (1:22:17.100)
whose main sort of goal in life
Jay Bhattacharya (1:22:19.420)
is to make sure that unsafe vaccines
Lex Fridman (1:22:22.460)
don't get released into the world.
Lex Fridman (1:22:24.100)
And if they are, they get pulled.
Lex Fridman (1:22:26.420)
And they're casting down on the vaccine
Jay Bhattacharya (1:22:28.500)
the ability to track vaccine safety before the election.
Lex Fridman (1:22:32.100)
And then after the election,
Lex Fridman (1:22:34.860)
the rhetoric switched on a dime, right?
Lex Fridman (1:22:38.380)
All of a sudden, it's Republicans that are cast
Jay Bhattacharya (1:22:40.580)
as if they're vaccine hesitant.
Lex Fridman (1:22:42.780)
That kind of political shift, the public notices.
Jay Bhattacharya (1:22:46.860)
If all it takes is an election to change
Lex Fridman (1:22:49.340)
how people talk about the safety of the vaccine,
Jay Bhattacharya (1:22:51.460)
well, we're not talking science anymore,
Lex Fridman (1:22:53.260)
many people think, right?
Jay Bhattacharya (1:22:54.820)
I think that created its hesitancy.
Lex Fridman (1:22:58.380)
The other thing I think,
Jay Bhattacharya (1:22:59.740)
I think the hesitancy,
Lex Fridman (1:23:04.140)
some politicians viewed it as a political,
Jay Bhattacharya (1:23:07.960)
as sort of like a political opportunity
Lex Fridman (1:23:10.740)
to sort of demonize people who are hesitant.
Lex Fridman (1:23:14.300)
And that itself fueled hesitancy, right?
Lex Fridman (1:23:16.820)
Like if you're telling me I'm a rube
Jay Bhattacharya (1:23:18.620)
that just doesn't want the vaccine
Lex Fridman (1:23:19.920)
because I want everyone to die,
Jay Bhattacharya (1:23:20.880)
well, I'm gonna react really negatively.
Lex Fridman (1:23:25.180)
And if you're talking down to me
Jay Bhattacharya (1:23:27.580)
about my legitimate sort of concerns
Lex Fridman (1:23:32.860)
about whether this vaccine is safe to take,
Jay Bhattacharya (1:23:34.300)
I mean, I've heard from women
Lex Fridman (1:23:36.540)
who were thinking about getting pregnant,
Lex Fridman (1:23:37.740)
should I take the vaccine?
Lex Fridman (1:23:38.780)
I don't know.
Jay Bhattacharya (1:23:39.620)
I mean, there are all kinds of questions,
Lex Fridman (1:23:41.240)
legitimate questions that I think
Jay Bhattacharya (1:23:44.240)
should have good data to answer
Lex Fridman (1:23:45.900)
that we don't necessarily have good data to answer.
Lex Fridman (1:23:47.940)
So what do you do in the face of that?
Lex Fridman (1:23:50.160)
Well, one reaction is to pretend
Jay Bhattacharya (1:23:52.980)
like we know for a fact that it's safe
Lex Fridman (1:23:55.460)
when we don't have the data to know for a fact
Jay Bhattacharya (1:23:57.700)
in that particular group
Lex Fridman (1:23:58.540)
with that particular set of clinical circumstances you know.
Lex Fridman (1:24:01.880)
And that I think breeds hesitancy.
Lex Fridman (1:24:03.780)
People can detect that bullshit.
Jay Bhattacharya (1:24:06.460)
Whereas if you just tell people, you know, I don't know.
Lex Fridman (1:24:09.320)
Yeah, leave with humility.
Jay Bhattacharya (1:24:10.680)
Yeah, you will end up with a better result.
Lex Fridman (1:24:14.620)
Let me ask you about,
Jay Bhattacharya (1:24:15.940)
I've recently had a conversation with the Pfizer CEO.
Lex Fridman (1:24:19.180)
This is part therapy session, part advice,
Jay Bhattacharya (1:24:24.180)
because again, I really want us to get through this together
Lex Fridman (1:24:29.860)
and it feels like the division is a thing
Jay Bhattacharya (1:24:31.640)
that prevents us from getting through this together.
Lex Fridman (1:24:35.260)
And once again, just like with Francis Collins,
Jay Bhattacharya (1:24:38.620)
a lot of people wrote to me words of support
Lex Fridman (1:24:43.660)
and a lot of people wrote to me words of criticism.
Jay Bhattacharya (1:24:48.900)
I'm trying to understand the nature of the criticism.
Lex Fridman (1:24:53.140)
So some of the criticism had to do with against the vaccine
Lex Fridman (1:24:57.540)
and those kinds of things.
Lex Fridman (1:24:58.940)
That I have a better understanding of.
Lex Fridman (1:25:02.080)
But some kind of deep distrust of Pfizer.
Lex Fridman (1:25:07.440)
So actually looking at Big Pharma broadly,
Jay Bhattacharya (1:25:13.840)
I'm trying to understand am I so naive
Lex Fridman (1:25:19.620)
that I just don't see it?
Jay Bhattacharya (1:25:21.540)
Because yes, there's corrupt people and they're greedy,
Lex Fridman (1:25:26.380)
they're flawed in all walks of life.
Lex Fridman (1:25:29.820)
But companies do quite an incredible job
Lex Fridman (1:25:35.740)
of taking a good idea at the scale
Lex Fridman (1:25:37.780)
and making some money with that idea.
Lex Fridman (1:25:39.580)
But they are the ones that achieve scale on a good idea.
Jay Bhattacharya (1:25:43.420)
I don't know, it's not obvious to me.
Lex Fridman (1:25:46.340)
I don't see where the manipulation is.
Lex Fridman (1:25:49.780)
So the fear that people have and I talked to Joe
Lex Fridman (1:25:53.820)
about this quite a bit.
Jay Bhattacharya (1:25:55.020)
I think this is a legitimate fear
Lex Fridman (1:25:57.500)
and a fear you should often have
Jay Bhattacharya (1:26:00.300)
that money has influenced,
Lex Fridman (1:26:01.780)
this proportional influence, especially in politics.
Lex Fridman (1:26:04.940)
So the fear is that the policy of the vaccine
Lex Fridman (1:26:10.560)
was connected to the fact that lots of money
Jay Bhattacharya (1:26:13.500)
could be made by manufacturing the vaccine.
Lex Fridman (1:26:17.540)
And I understand that.
Lex Fridman (1:26:19.340)
And it's actually quite a heck of a difficult task
Lex Fridman (1:26:22.040)
to alleviate that concern.
Jay Bhattacharya (1:26:24.580)
Like you really have to be a great man or woman or a leader
Lex Fridman (1:26:27.900)
to convince people that you're not full of shit,
Jay Bhattacharya (1:26:30.460)
that you're not just playing a game on them.
Lex Fridman (1:26:32.700)
I don't know, it's a difficult task.
Lex Fridman (1:26:35.280)
But at the same time, I really don't like
Lex Fridman (1:26:38.080)
the natural distrust every billionaire,
Jay Bhattacharya (1:26:41.820)
distrust everybody who's trying to make money
Lex Fridman (1:26:44.180)
because it feels like under a capitalistic system at least,
Jay Bhattacharya (1:26:47.860)
the way to do a lot of good,
Lex Fridman (1:26:50.380)
like to do good at scale in the world
Jay Bhattacharya (1:26:53.260)
is by being at least in part motivated by profit.
Lex Fridman (1:26:57.940)
I mean, I share your ambivalence, right?
Lex Fridman (1:26:59.360)
So on the one hand, you have a fantastic achievement.
Lex Fridman (1:27:02.860)
The discovery of the vaccine
Lex Fridman (1:27:06.720)
and then the manufacturing at scale
Lex Fridman (1:27:08.860)
so that billions of people can take the vaccine
Jay Bhattacharya (1:27:12.660)
in a relatively short time.
Lex Fridman (1:27:14.080)
That is a remarkable achievement
Jay Bhattacharya (1:27:15.700)
that could not have happened without companies like Pfizer.
Lex Fridman (1:27:20.340)
And on the other hand,
Jay Bhattacharya (1:27:21.540)
there is this sort of corrupting influence of that money.
Lex Fridman (1:27:25.820)
Just to give you one example,
Jay Bhattacharya (1:27:27.380)
there's an enormous controversy over whether
Lex Fridman (1:27:30.260)
relatively inexpensive repurposed drugs
Jay Bhattacharya (1:27:32.820)
can be used to treat the disease.
Lex Fridman (1:27:38.280)
None of, no company like Pfizer
Jay Bhattacharya (1:27:40.400)
has any interest whatsoever in evaluating it.
Lex Fridman (1:27:43.020)
Even Merck, I think it was Merck,
Jay Bhattacharya (1:27:45.500)
that had the patent on ivermectin now expired,
Lex Fridman (1:27:50.420)
has no interest at all in checking to see if it works.
Jay Bhattacharya (1:27:54.460)
Not only do they not have interest,
Lex Fridman (1:27:57.580)
they have a way of talking about people
Jay Bhattacharya (1:28:01.580)
who might have a little bit of interest
Lex Fridman (1:28:04.540)
that's again.
Jay Bhattacharya (1:28:06.180)
Fringe.
Lex Fridman (1:28:07.980)
Full of arrogance.
Jay Bhattacharya (1:28:09.540)
Yeah.
Lex Fridman (1:28:10.380)
And that is what troubles me.
Jay Bhattacharya (1:28:12.920)
Is there not a, it's back to the play of science.
Lex Fridman (1:28:15.660)
It's not, they're not a bit of curiosity.
Jay Bhattacharya (1:28:17.700)
One, okay, one, the natural curiosity of a human being
Lex Fridman (1:28:20.780)
that should always be there and an open mind is.
Lex Fridman (1:28:23.340)
And second, in the case of ivermectin
Lex Fridman (1:28:25.700)
and other things like that,
Jay Bhattacharya (1:28:27.220)
you have to acknowledge
Lex Fridman (1:28:28.940)
that there's a very large number of people
Jay Bhattacharya (1:28:31.500)
who care about this topic.
Lex Fridman (1:28:33.580)
And this is a way to inspire them
Jay Bhattacharya (1:28:36.540)
to also play in the space of science,
Lex Fridman (1:28:38.860)
to inspire them with science.
Jay Bhattacharya (1:28:39.860)
You can't just like dismiss everybody
Lex Fridman (1:28:42.840)
that you can't just dismiss people, period.
Jay Bhattacharya (1:28:45.860)
Yeah.
Lex Fridman (1:28:46.700)
Well, I mean, I think here, take ivermectin, right?
Jay Bhattacharya (1:28:48.340)
There's actually a study funded by the NIH,
Lex Fridman (1:28:51.700)
by Tony Fauci's NIAID and the NIH
Jay Bhattacharya (1:28:56.020)
called ACTIV6 that's a randomized trial of ivermectin.
Lex Fridman (1:29:02.780)
It's due to be completed in March, 2023.
Lex Fridman (1:29:07.260)
So normally when you have private actors
Lex Fridman (1:29:10.940)
like these big drug companies that have no interest
Jay Bhattacharya (1:29:13.740)
in conducting some kind of scientific experiment
Lex Fridman (1:29:16.660)
that would have some public benefit,
Jay Bhattacharya (1:29:18.740)
it's the job of the government,
Lex Fridman (1:29:20.940)
and in this case, the NIH to fund that kind of work.
Jay Bhattacharya (1:29:24.500)
The NIH has been incredibly slow
Lex Fridman (1:29:29.180)
in its evaluations of these repurposed drugs.
Lex Fridman (1:29:32.940)
And it's been left to lots of other private activities
Lex Fridman (1:29:37.820)
of uneven quality.
Lex Fridman (1:29:39.620)
And hence, that's why you have these big fights.
Lex Fridman (1:29:42.220)
Because the data are not solid,
Jay Bhattacharya (1:29:44.220)
you're gonna have these big fights.
Lex Fridman (1:29:45.940)
Yeah, but also, okay, forget the process of science here,
Jay Bhattacharya (1:29:50.100)
the studies, not enough effort being put into the studies,
Lex Fridman (1:29:53.580)
just the way it's being communicated about.
Jay Bhattacharya (1:29:55.180)
Yeah, no, like to horse paste, I mean, come on.
Lex Fridman (1:29:57.520)
The FDA put a tweet out telling people who are like,
Jay Bhattacharya (1:30:01.780)
they're taking ivermectin
Lex Fridman (1:30:02.740)
because they've heard good things about it
Lex Fridman (1:30:04.140)
and they're sick and they're desperate.
Lex Fridman (1:30:06.180)
And to call it horse paste, that was terrible.
Jay Bhattacharya (1:30:09.740)
That was deeply irresponsible.
Lex Fridman (1:30:10.960)
My hope is grounded in the fact
Jay Bhattacharya (1:30:13.740)
that young people see the bullshit of this,
Lex Fridman (1:30:16.540)
young PhD students, graduate students,
Jay Bhattacharya (1:30:18.700)
young students in college,
Lex Fridman (1:30:20.200)
they see the less than stellar way
Jay Bhattacharya (1:30:25.940)
that our scientific leaders
Lex Fridman (1:30:27.660)
and our political leaders are behaving,
Lex Fridman (1:30:29.380)
and then the new generation
Lex Fridman (1:30:30.580)
will not repeat the mistakes of the past.
Jay Bhattacharya (1:30:33.180)
That is my hope, because that's the cool thing I see
Lex Fridman (1:30:36.680)
about young people is they're good at detecting bullshit
Lex Fridman (1:30:40.260)
and they don't want to be part of that.
Lex Fridman (1:30:43.460)
That's my hope in the space of science.
Jay Bhattacharya (1:30:46.780)
Let me return to this idea
Lex Fridman (1:30:48.460)
of the Great Barrington Declaration,
Jay Bhattacharya (1:30:50.540)
return to the beginning.
Lex Fridman (1:30:52.660)
So what are the basics?
Lex Fridman (1:30:54.760)
Can you describe what the Great Barrington Declaration is?
Lex Fridman (1:30:57.280)
What are some of the ideas in it?
Jay Bhattacharya (1:30:58.660)
You mentioned focused protection.
Lex Fridman (1:31:01.520)
What are your concerns about lockdowns?
Jay Bhattacharya (1:31:04.460)
Just paint the picture of this early proposal.
Lex Fridman (1:31:07.380)
Sure, so the Great Barrington Declaration,
Lex Fridman (1:31:09.260)
first, why is it called Great Barrington Declaration?
Lex Fridman (1:31:11.860)
It's such a great name.
Jay Bhattacharya (1:31:14.580)
I mean, it's such an epic name,
Lex Fridman (1:31:16.820)
but the reason why it's called that is way less than epic.
Jay Bhattacharya (1:31:20.380)
It was because the conference,
Lex Fridman (1:31:23.900)
which is organized by Martin Kulldorff,
Jay Bhattacharya (1:31:25.540)
who was a professor at Harvard University,
Lex Fridman (1:31:27.780)
by a statistician, he actually designed the safety system,
Jay Bhattacharya (1:31:33.040)
the statistical system that the FDA uses
Lex Fridman (1:31:36.340)
for tracking vaccine safety.
Jay Bhattacharya (1:31:38.940)
He and I had met previously just the summer before,
Lex Fridman (1:31:43.100)
that summer, and he invited me
Jay Bhattacharya (1:31:45.940)
to come to this small conference
Lex Fridman (1:31:47.740)
where he was inviting me and Sunetra Gupta,
Jay Bhattacharya (1:31:50.220)
who is a professor of theoretical epidemiology at Harvard,
Lex Fridman (1:31:53.380)
sorry, at Oxford University.
Lex Fridman (1:31:54.900)
And I mean, I jumped at the chance
Lex Fridman (1:31:57.980)
because I knew that Martin and Sunetra
Jay Bhattacharya (1:32:00.980)
were both smarter than me,
Lex Fridman (1:32:02.160)
and it would be fun to talk about
Lex Fridman (1:32:04.380)
what the right strategy would be.
Lex Fridman (1:32:07.260)
On the drive in, I didn't know what the name of the town was
Lex Fridman (1:32:10.740)
and I asked, they said it was Great Barrington,
Lex Fridman (1:32:13.540)
and I had it in the back of my head.
Jay Bhattacharya (1:32:16.020)
Martin and I arrived a little early
Lex Fridman (1:32:17.620)
and we were writing an op ed about some of the ideas,
Jay Bhattacharya (1:32:20.180)
I hope we'll get to talk about very soon,
Lex Fridman (1:32:22.340)
about focused protection and the right strategy.
Lex Fridman (1:32:25.420)
And when Sunetra arrived,
Lex Fridman (1:32:27.260)
we realized we'd actually come basically to the same place
Jay Bhattacharya (1:32:30.140)
about the right way to deal with the epidemic.
Lex Fridman (1:32:34.340)
And I thought, well, why don't we write something
Jay Bhattacharya (1:32:37.940)
like the Port Huron Statement,
Lex Fridman (1:32:39.260)
is what I had in the back of my head.
Lex Fridman (1:32:41.460)
And I'm like, well, what's the name of this town again?
Lex Fridman (1:32:43.580)
It was Great Barrington.
Jay Bhattacharya (1:32:44.700)
Yeah, so it's not Barrington, it's Great Barrington.
Lex Fridman (1:32:47.940)
Which is fantastic, right?
Jay Bhattacharya (1:32:50.060)
It's so over the top that it's perfect.
Lex Fridman (1:32:53.060)
It's literally like the Big Bang.
Jay Bhattacharya (1:32:55.740)
There's something about these over the top fun titles
Lex Fridman (1:32:58.300)
that just really delivered the power.
Jay Bhattacharya (1:33:01.140)
That's my main contribution was the title,
Lex Fridman (1:33:03.740)
the name Great Barrington Decorate.
Lex Fridman (1:33:05.820)
But yeah, so it was kind of a,
Lex Fridman (1:33:07.340)
so the idea is actually, well, the title is great.
Lex Fridman (1:33:12.060)
And I think that it was written in a very stylish way.
Lex Fridman (1:33:14.820)
It's less than a page, you can go look online and read it.
Jay Bhattacharya (1:33:18.740)
It's written for, not for scientists,
Lex Fridman (1:33:21.820)
but for the general public
Lex Fridman (1:33:23.180)
so that people can understand the ideas really simply.
Lex Fridman (1:33:26.900)
But it is not actually a radical set of ideas.
Jay Bhattacharya (1:33:29.500)
It actually represents the old pandemic plans
Lex Fridman (1:33:32.820)
that we've used for a century
Jay Bhattacharya (1:33:35.180)
dealing with other similar pandemics.
Lex Fridman (1:33:38.740)
And it's twofold.
Jay Bhattacharya (1:33:41.420)
First, let me talk about the science it rests on,
Lex Fridman (1:33:43.420)
and then I'll talk about the plan.
Jay Bhattacharya (1:33:45.100)
The science actually, some of it we already talked about.
Lex Fridman (1:33:47.700)
There's this massive age gradient
Jay Bhattacharya (1:33:49.620)
in the risk of COVID infection.
Lex Fridman (1:33:51.980)
Older people face much higher risk than younger people.
Jay Bhattacharya (1:33:55.740)
The second bit of science is all,
Lex Fridman (1:33:57.380)
that's not controversial, right?
Jay Bhattacharya (1:33:58.780)
Even if you think the IFR is 0.7 or 0.2,
Lex Fridman (1:34:01.980)
no matter what, everyone thinks,
Jay Bhattacharya (1:34:03.460)
everyone agrees on this age gradient.
Lex Fridman (1:34:06.700)
The second bit of science is also not controversial.
Jay Bhattacharya (1:34:09.860)
The lockdown focused policies that we've followed
Lex Fridman (1:34:13.380)
have absolutely devastating consequences
Jay Bhattacharya (1:34:16.340)
on the health of the population.
Lex Fridman (1:34:20.100)
Let me just give you some examples.
Lex Fridman (1:34:21.940)
And this was known in October of 2020 when we wrote it.
Lex Fridman (1:34:24.660)
So the UN was sounding alarms
Jay Bhattacharya (1:34:28.060)
that there would be tens of millions of people
Lex Fridman (1:34:31.780)
who would starve as a consequence
Jay Bhattacharya (1:34:34.100)
of the economic dislocation caused by the lockdowns.
Lex Fridman (1:34:37.420)
And that's come to pass.
Jay Bhattacharya (1:34:38.700)
Hundreds of thousands of children
Lex Fridman (1:34:40.780)
in places like South Asia dead from starvation
Jay Bhattacharya (1:34:43.380)
as a consequence of lockdowns.
Lex Fridman (1:34:47.740)
The priorities like the treatment of patients
Jay Bhattacharya (1:34:53.620)
with tuberculosis in poor countries stopped
Lex Fridman (1:34:57.580)
because of lockdowns.
Jay Bhattacharya (1:35:00.540)
Childhood vaccinations of measles, mumps, rubella,
Lex Fridman (1:35:04.340)
DPT, diphtheria, so on, pertussis, tetanus,
Jay Bhattacharya (1:35:07.940)
all those standard vaccination campaigns stopped.
Lex Fridman (1:35:11.940)
Tens of millions of children skipping these doses
Jay Bhattacharya (1:35:15.940)
for diseases that are actually deadly for them.
Lex Fridman (1:35:19.820)
Is there, just on a small tangent,
Jay Bhattacharya (1:35:22.820)
is it well understood to you what are the mechanisms
Lex Fridman (1:35:26.100)
that stop all those things because of lockdowns?
Lex Fridman (1:35:28.540)
Is it some aspect of supply chain?
Lex Fridman (1:35:30.460)
Is it just literally because hospital doors are closed?
Jay Bhattacharya (1:35:34.420)
Is it because there's a disincentive to go outside
Lex Fridman (1:35:37.900)
by people even when they deeply need help?
Jay Bhattacharya (1:35:40.380)
It's all of the above.
Lex Fridman (1:35:42.180)
But a lot of those efforts,
Jay Bhattacharya (1:35:43.860)
especially those vaccination efforts are funded
Lex Fridman (1:35:46.340)
and run by Western efforts.
Jay Bhattacharya (1:35:49.540)
Like Gavi is a, I think it's a Gates funded thing actually
Lex Fridman (1:35:53.020)
that provides vaccines for millions of kids worldwide.
Lex Fridman (1:35:57.820)
And those efforts were scaled back.
Lex Fridman (1:36:00.860)
Malaria prevention efforts.
Lex Fridman (1:36:02.500)
So in the developing world,
Lex Fridman (1:36:04.380)
it was a devastating effect, these lockdowns.
Jay Bhattacharya (1:36:07.820)
There was also direct effects.
Lex Fridman (1:36:08.900)
Like in India, the lockdowns, when they first instituted,
Jay Bhattacharya (1:36:13.060)
there was an order that 10 million migrant workers
Lex Fridman (1:36:16.940)
who live in big cities and they live hand to mouth,
Jay Bhattacharya (1:36:19.660)
they buy coconuts, they sell the coconuts with the money,
Lex Fridman (1:36:23.420)
they buy food for themselves and coconuts
Jay Bhattacharya (1:36:25.100)
for the next day to sell,
Lex Fridman (1:36:27.700)
walk back to their villages
Jay Bhattacharya (1:36:29.180)
or go back to their villages overnight.
Lex Fridman (1:36:33.180)
So 10 million people walking back to their villages
Jay Bhattacharya (1:36:35.500)
or taking a train back, 1,000 died on route.
Lex Fridman (1:36:39.100)
Overcrowded trains dying essentially on the side of the road.
Jay Bhattacharya (1:36:42.180)
I mean, it was absolutely inhumane policy.
Lex Fridman (1:36:46.500)
And the lockdowns there,
Jay Bhattacharya (1:36:50.500)
it's kind of like what's happened in the West as well,
Lex Fridman (1:36:53.140)
but it was so severe.
Jay Bhattacharya (1:36:55.340)
There was a seroprevalence study done in Mumbai
Lex Fridman (1:36:58.540)
by a friend of mine at the University of Chicago.
Lex Fridman (1:37:00.180)
What he found was that in the slums of Mumbai,
Lex Fridman (1:37:03.500)
there were 70% seroprevalence in July or August of 2020,
Lex Fridman (1:37:08.700)
whereas in the rest of Mumbai, it was 20%, right?
Lex Fridman (1:37:12.300)
So it was incredibly unequal.
Jay Bhattacharya (1:37:14.180)
The lockdowns protected the relatively well off
Lex Fridman (1:37:17.660)
and spread the disease among the poor.
Lex Fridman (1:37:22.260)
So that's in the developing world.
Lex Fridman (1:37:25.500)
In the developed world, the health effects of lockdowns
Lex Fridman (1:37:27.900)
were also quite bad, right?
Lex Fridman (1:37:31.060)
So we've talked already about isolation and depression.
Jay Bhattacharya (1:37:34.140)
There was a study done in July of 2020
Lex Fridman (1:37:37.660)
that found that one in four young adults
Jay Bhattacharya (1:37:41.180)
seriously considered suicide.
Lex Fridman (1:37:43.420)
Now, suicide rates haven't spiked up so much,
Lex Fridman (1:37:47.940)
but the depths of despair that would lead somebody
Lex Fridman (1:37:51.420)
to seriously consider suicide itself
Jay Bhattacharya (1:37:53.420)
should be a source of great concern in public health.
Lex Fridman (1:37:57.820)
Yeah, this is one of the troubling things about measuring
Jay Bhattacharya (1:38:01.460)
well being is we're okay at measuring death and suicide.
Lex Fridman (1:38:06.220)
We're not so good at measuring suffering.
Jay Bhattacharya (1:38:08.980)
It's like people talk about maybe even Holodomor
Lex Fridman (1:38:14.940)
under Stalin or the concentration camps with Hitler.
Jay Bhattacharya (1:38:19.500)
We talk about deaths, but we don't talk about the suffering
Lex Fridman (1:38:23.940)
over periods of years by people living in fear,
Jay Bhattacharya (1:38:27.740)
by people starving, psychological trauma
Lex Fridman (1:38:30.980)
that lasts a lifetime, all of those things.
Jay Bhattacharya (1:38:33.900)
I mean, and just to get back to that point,
Lex Fridman (1:38:36.460)
we closed schools, especially in blue states,
Jay Bhattacharya (1:38:38.540)
we closed schools.
Lex Fridman (1:38:40.120)
Now, richer parents could send their kids
Jay Bhattacharya (1:38:42.300)
to private schools, many of which stayed open
Lex Fridman (1:38:44.100)
even in the blue states.
Jay Bhattacharya (1:38:45.060)
They could get pods, they could get tutors,
Lex Fridman (1:38:47.060)
but that's not true for poor and middle class parents.
Lex Fridman (1:38:51.780)
And as a result, what we did is we took away
Lex Fridman (1:38:54.540)
life opportunities for kids.
Jay Bhattacharya (1:38:56.060)
We tried to teach five year olds to read via Zoom
Lex Fridman (1:38:59.420)
in kindergarten, right?
Lex Fridman (1:39:02.780)
And the consequence actually, you think, okay,
Lex Fridman (1:39:05.240)
we can just make it up, but it's really difficult
Jay Bhattacharya (1:39:07.260)
to make that up.
Lex Fridman (1:39:08.980)
There's a literature in health economics that shows
Jay Bhattacharya (1:39:12.420)
that even relatively small disruptions in schooling
Lex Fridman (1:39:18.620)
can have lifelong consequences, negative consequences
Lex Fridman (1:39:21.140)
for kids, right?
Lex Fridman (1:39:22.500)
So they end up growing up poorer, they lead shorter lives
Lex Fridman (1:39:27.340)
and less healthy lives as a consequence.
Lex Fridman (1:39:30.180)
And that's what the literature now shows is likely to happen
Jay Bhattacharya (1:39:32.740)
with the interruptions of schooling that we had
Lex Fridman (1:39:35.740)
in the United States.
Jay Bhattacharya (1:39:36.700)
Many European countries actually managed to avoid this.
Lex Fridman (1:39:39.180)
There were in the early days of the epidemic
Jay Bhattacharya (1:39:40.860)
great indications that children first were not
Lex Fridman (1:39:43.660)
very severely at risk from COVID itself,
Jay Bhattacharya (1:39:46.660)
nor are they super spreaders.
Lex Fridman (1:39:49.100)
Schools were not the source of community spread,
Jay Bhattacharya (1:39:51.620)
communities spread the disease to schools,
Lex Fridman (1:39:54.860)
not the other way around.
Lex Fridman (1:39:57.460)
And we can talk about the scientific base of that
Lex Fridman (1:39:59.300)
if you'd like, but that was pretty well known
Jay Bhattacharya (1:40:01.720)
even in October.
Lex Fridman (1:40:04.580)
We closed hospitals in order to keep them
Jay Bhattacharya (1:40:07.820)
available to COVID patients, but as a result,
Lex Fridman (1:40:10.980)
women skipped breast cancer screening.
Jay Bhattacharya (1:40:14.140)
As a result, they are showing up with late stage
Lex Fridman (1:40:16.980)
breast cancer that should have been picked up last year.
Jay Bhattacharya (1:40:19.660)
Men and women skipped colon cancer screening,
Lex Fridman (1:40:21.860)
again, with later stage disease that should have been
Jay Bhattacharya (1:40:24.160)
picked up last year with earlier stage.
Lex Fridman (1:40:26.180)
For patients with diabetes, it's very important
Jay Bhattacharya (1:40:29.820)
to have regular screening for blood sugar levels
Lex Fridman (1:40:33.180)
and sort of counseling for lifestyle improvement.
Lex Fridman (1:40:36.740)
And we skipped that.
Lex Fridman (1:40:38.140)
People stayed home with heart attacks
Lex Fridman (1:40:39.700)
and died at home with heart attacks.
Lex Fridman (1:40:43.460)
So you had this like sort of wide range of medical
Lex Fridman (1:40:47.380)
and psychological harms that were being utterly ignored
Lex Fridman (1:40:51.900)
as a result of the lockdowns.
Jay Bhattacharya (1:40:53.980)
Plus there's the economic pain.
Lex Fridman (1:40:57.240)
So like you said, whatever is a good term
Jay Bhattacharya (1:41:00.420)
for the non laptop class, people would lose their jobs.
Lex Fridman (1:41:05.040)
Yes, there might be in the Western world support
Jay Bhattacharya (1:41:07.700)
for them financially, but the big loss there
Lex Fridman (1:41:11.440)
that is perhaps correlated with depression and suicide
Jay Bhattacharya (1:41:14.960)
is loss of meaning, loss of hope for the future,
Lex Fridman (1:41:19.980)
loss of kind of a sense of stability,
Jay Bhattacharya (1:41:23.020)
all the pride you have in being able to make money
Lex Fridman (1:41:30.060)
that allows you to pave your own way in the world.
Lex Fridman (1:41:32.820)
And yes, just having less money than you're used to
Lex Fridman (1:41:35.660)
so your family, your kids are suffering,
Jay Bhattacharya (1:41:37.560)
all those kinds of things.
Lex Fridman (1:41:38.400)
And there's, again, an economics literature on this,
Jay Bhattacharya (1:41:41.340)
on deaths of despair it was called.
Lex Fridman (1:41:43.660)
2009, there was the great recession.
Jay Bhattacharya (1:41:45.900)
It led to an enormous uptake in overdose from drugs,
Lex Fridman (1:41:50.820)
suicidality, depression, as a result of the job losses
Jay Bhattacharya (1:41:55.100)
that happened during the great recession.
Lex Fridman (1:41:57.580)
Well, that's happening again,
Jay Bhattacharya (1:41:59.140)
like an enormous increase in drug overdoses.
Lex Fridman (1:42:03.980)
That's not an accident, that's a lockdown harm, right?
Jay Bhattacharya (1:42:07.900)
Same thing with the job losses.
Lex Fridman (1:42:10.460)
The job losses, by the way, are like, it's so interesting
Jay Bhattacharya (1:42:12.940)
because the states that stayed open
Lex Fridman (1:42:15.620)
have had much, much lower unemployment
Jay Bhattacharya (1:42:18.420)
than the states that stayed closed.
Lex Fridman (1:42:20.740)
The labor force participation rates declined by 3%.
Jay Bhattacharya (1:42:23.500)
It's women that separated
Lex Fridman (1:42:25.440)
because they stayed home with their kids.
Jay Bhattacharya (1:42:28.540)
We've reversed a generation of women,
Lex Fridman (1:42:33.380)
improving women's participation in the labor force.
Lex Fridman (1:42:37.140)
Do you think it has to do with the institutions
Lex Fridman (1:42:41.140)
that we mentioned that there was so much priority given
Jay Bhattacharya (1:42:44.500)
or so much power given to maybe NIH
Lex Fridman (1:42:48.260)
versus other civilian leaders?
Lex Fridman (1:42:51.700)
Or do people just not care about the economic pain?
Lex Fridman (1:42:54.420)
The leaders, I mean, because to me it was obvious.
Jay Bhattacharya (1:42:59.380)
I mean, probably it's just studying history.
Lex Fridman (1:43:03.540)
Whenever I listen to people on Twitter
Jay Bhattacharya (1:43:06.540)
or on mainstream news or just anything,
Lex Fridman (1:43:09.820)
I realize that's the very kind of top.
Jay Bhattacharya (1:43:14.380)
The people that have a voice
Lex Fridman (1:43:17.220)
represent a tiny selection of people.
Lex Fridman (1:43:19.620)
And so whenever there's hard times,
Lex Fridman (1:43:21.740)
I always kind of think about the quiet, the voiceless,
Jay Bhattacharya (1:43:27.280)
the quiet suffering of the tens of millions,
Lex Fridman (1:43:30.000)
of the hundreds of millions.
Lex Fridman (1:43:33.860)
Do the political leaders not just give a damn?
Lex Fridman (1:43:36.380)
I mean, I think it was actually a very odd ethical thing
Jay Bhattacharya (1:43:39.540)
at the beginning of the pandemic
Lex Fridman (1:43:41.260)
where if you brought up economic harms at all,
Jay Bhattacharya (1:43:44.300)
you were seen as callous.
Lex Fridman (1:43:47.620)
So I had a reporter call me up
Jay Bhattacharya (1:43:50.040)
almost at the very beginning of the epidemic
Lex Fridman (1:43:51.580)
asking me about a very particular phenomenon.
Lex Fridman (1:43:56.900)
So he was anticipating a rise in child abuse
Lex Fridman (1:44:00.640)
because children were gonna be staying at home.
Jay Bhattacharya (1:44:02.300)
Child abuse is generally picked up at school.
Lex Fridman (1:44:04.980)
And that actually happened.
Lex Fridman (1:44:06.020)
So the reported child abuse dropped,
Lex Fridman (1:44:08.500)
but actual child abuse increased
Jay Bhattacharya (1:44:11.900)
because normally you pick up the child abuse at school
Lex Fridman (1:44:14.100)
and that you have the intervention, right?
Lex Fridman (1:44:16.080)
So yeah, so I was talking about like,
Lex Fridman (1:44:17.920)
well, there's gonna be some economic harms
Lex Fridman (1:44:19.100)
and they're gonna have health consequences,
Lex Fridman (1:44:20.180)
but the economic harms matter.
Lex Fridman (1:44:21.740)
But he counseled me.
Lex Fridman (1:44:24.540)
And I think he had my best interest at heart.
Jay Bhattacharya (1:44:27.460)
Like if you were to put that in the story,
Lex Fridman (1:44:29.500)
I would be, I'd essentially be canceled.
Jay Bhattacharya (1:44:31.700)
Because what the narrative that arose in March of 2020
Lex Fridman (1:44:36.340)
is if you care about money at all,
Jay Bhattacharya (1:44:39.700)
you're evil and crass, you must only care about lives.
Lex Fridman (1:44:43.700)
The problem with that narrative is that that money,
Jay Bhattacharya (1:44:46.340)
which we're talking about,
Lex Fridman (1:44:47.340)
is actually lives of poor people, right?
Jay Bhattacharya (1:44:51.540)
When you throw 100 million people around the world
Lex Fridman (1:44:54.660)
into poverty, you're going to see enormous harm
Jay Bhattacharya (1:44:58.060)
to their health, enormous increases in their mortality.
Lex Fridman (1:45:01.260)
It is not immoral to think about that and worry about that
Jay Bhattacharya (1:45:04.860)
in the context of this pandemic response.
Lex Fridman (1:45:07.300)
Our mind focused so much on COVID that it forgot
Jay Bhattacharya (1:45:11.020)
that there are so many other public health priorities as well
Lex Fridman (1:45:13.540)
that need our attention desperately.
Lex Fridman (1:45:16.420)
And this is the thing I sensed about San Francisco
Lex Fridman (1:45:21.220)
when I visited, I was thinking of moving there for a startup.
Jay Bhattacharya (1:45:24.620)
This is the thing I'm really afraid of,
Lex Fridman (1:45:26.580)
especially if I have any effect on the world
Jay Bhattacharya (1:45:30.420)
through a startup, is losing touch in this kind of way.
Lex Fridman (1:45:34.300)
That you mentioned the laptop class,
Jay Bhattacharya (1:45:38.060)
living in this world where you're only concerned
Lex Fridman (1:45:40.260)
about this particular class of people.
Lex Fridman (1:45:44.380)
And also, perhaps early on in the pandemic,
Lex Fridman (1:45:48.900)
amongst the laptop class,
Jay Bhattacharya (1:45:50.060)
there was a legitimate concern for health,
Lex Fridman (1:45:51.920)
like you're not sure how deadly this virus is.
Jay Bhattacharya (1:45:55.940)
You're not sure who to listen to, so there's a real concern.
Lex Fridman (1:45:58.900)
And then at a certain point when the data starts coming in,
Jay Bhattacharya (1:46:02.060)
you start becoming more and more detached from the data.
Lex Fridman (1:46:05.140)
You don't start caring less and less,
Lex Fridman (1:46:07.300)
and you start just swimming in the space of narratives,
Lex Fridman (1:46:10.740)
like existing in the space of narratives,
Lex Fridman (1:46:12.420)
and you have this narrative in San Francisco
Lex Fridman (1:46:15.420)
in the laptop class that you just are very proud
Jay Bhattacharya (1:46:19.660)
that you know the truth,
Lex Fridman (1:46:21.180)
you're the sole possessors of the truth,
Jay Bhattacharya (1:46:22.940)
you congratulate yourself on it,
Lex Fridman (1:46:25.140)
and you don't care what actually gigantic detrimental effect
Jay Bhattacharya (1:46:28.940)
that has on society, because you're mostly fine.
Lex Fridman (1:46:34.460)
I'm so terrified of that.
Jay Bhattacharya (1:46:36.840)
Well, actually, I think the antidote to that
Lex Fridman (1:46:38.500)
is just to remember.
Jay Bhattacharya (1:46:39.760)
You remember.
Lex Fridman (1:46:40.600)
Yeah. Yeah.
Jay Bhattacharya (1:46:41.920)
I don't think, you know, remember where you came from
Lex Fridman (1:46:44.020)
and remember who you're doing this for.
Jay Bhattacharya (1:46:46.380)
At the back of your head should always be,
Lex Fridman (1:46:48.000)
what's the purpose?
Lex Fridman (1:46:49.520)
Like, why am I here?
Lex Fridman (1:46:50.780)
What's the purpose of this?
Lex Fridman (1:46:51.740)
And if the purpose is simply self aggrandizement,
Lex Fridman (1:46:56.540)
then you should rethink,
Jay Bhattacharya (1:46:57.660)
because it'll just end up being a hollow life.
Lex Fridman (1:47:01.180)
All of us will be forgotten in the end.
Jay Bhattacharya (1:47:04.860)
Focused protection, the idea, the policy,
Lex Fridman (1:47:08.580)
what is focused protection?
Jay Bhattacharya (1:47:09.980)
Right, so I was saying that there's two scientific bases,
Lex Fridman (1:47:12.900)
right, so one is this steep age gradient,
Lex Fridman (1:47:15.140)
and the second is the existence of locked arms.
Lex Fridman (1:47:17.100)
Again, I think there's very little disagreement
Jay Bhattacharya (1:47:19.260)
in the scientific community on both of those facts.
Lex Fridman (1:47:22.360)
If you put those facts together,
Jay Bhattacharya (1:47:24.540)
the obvious policy is to protect the people
Lex Fridman (1:47:27.780)
who are at the most severe risk from the disease itself.
Lex Fridman (1:47:31.620)
And that's the idea of focused protection.
Lex Fridman (1:47:33.100)
That's the general principle of it.
Jay Bhattacharya (1:47:35.180)
The actual implementation of it
Lex Fridman (1:47:37.420)
depends on the living circumstances
Jay Bhattacharya (1:47:39.800)
of the people that are at risk,
Lex Fridman (1:47:41.700)
the resources that are available in the community,
Jay Bhattacharya (1:47:44.100)
the technology that's available to do this.
Lex Fridman (1:47:49.380)
And so it's almost always going to be,
Jay Bhattacharya (1:47:51.900)
in fact, it'll always be a local thing,
Lex Fridman (1:47:54.900)
because it'll depend on all of those things
Jay Bhattacharya (1:47:58.340)
which are all local in nature.
Lex Fridman (1:48:00.340)
Right, so one very, very obvious thing,
Jay Bhattacharya (1:48:02.900)
in a country like ours,
Lex Fridman (1:48:04.820)
where so many older people live in institutionalized settings
Lex Fridman (1:48:08.140)
and nursing home settings,
Lex Fridman (1:48:10.540)
and that's where older, really vulnerable,
Jay Bhattacharya (1:48:13.100)
chronically ill patients often live,
Lex Fridman (1:48:16.340)
and you know this disease affects that group,
Jay Bhattacharya (1:48:18.340)
most commonly, it is absolutely vital
Lex Fridman (1:48:21.260)
to protect that group.
Jay Bhattacharya (1:48:23.620)
We should have known that in February 2020,
Lex Fridman (1:48:26.780)
just from the Chinese data.
Lex Fridman (1:48:30.240)
And we should have thought about that group
Lex Fridman (1:48:33.220)
as the key constraint in our policymaking.
Jay Bhattacharya (1:48:38.940)
Instead, we thought about, in February and March 2020,
Lex Fridman (1:48:41.780)
as hospital beds as the key constraint.
Jay Bhattacharya (1:48:44.900)
Hospital beds and ventilator shortages,
Lex Fridman (1:48:46.940)
and so we ran around trying to address
Jay Bhattacharya (1:48:49.900)
that constraint, like a linear programming problem,
Lex Fridman (1:48:53.500)
you figure out which constraint's binding
Lex Fridman (1:48:55.340)
and you address that one thing
Lex Fridman (1:48:56.500)
and then you go on to the next one, right?
Jay Bhattacharya (1:48:58.800)
If that one constraint,
Lex Fridman (1:49:00.700)
we said, okay, the constraint is hospital beds.
Jay Bhattacharya (1:49:04.260)
That led to the decision in many of the Northeast states
Lex Fridman (1:49:08.300)
to send COVID infected patients who were on the verge
Jay Bhattacharya (1:49:12.420)
or looked like they were about to recover
Lex Fridman (1:49:14.420)
back to nursing homes,
Jay Bhattacharya (1:49:17.300)
who then spread the disease all through there,
Lex Fridman (1:49:19.260)
because they wanted to preserve the hospital beds.
Jay Bhattacharya (1:49:21.820)
Well, for somebody who loves numerical optimization,
Lex Fridman (1:49:25.260)
I love the way you frame this.
Lex Fridman (1:49:27.980)
But those are kind of connected, right?
Lex Fridman (1:49:30.380)
If you actually focus on protecting the vulnerable,
Jay Bhattacharya (1:49:33.780)
you will also have the effect
Lex Fridman (1:49:36.500)
of not hitting the ceiling of the available hospital beds.
Jay Bhattacharya (1:49:40.820)
That's the irony.
Lex Fridman (1:49:41.660)
If we protected the vulnerable,
Jay Bhattacharya (1:49:44.180)
the vulnerable are the most likely to be hospitalized,
Lex Fridman (1:49:47.140)
and so by protecting the hospital,
Jay Bhattacharya (1:49:48.700)
by protecting the vulnerable,
Lex Fridman (1:49:49.900)
we will also have addressed the shortage of hospital beds
Jay Bhattacharya (1:49:53.080)
more effectively.
Lex Fridman (1:49:53.920)
So that little shift in priority
Jay Bhattacharya (1:49:55.620)
would have had a big impact.
Lex Fridman (1:49:57.740)
Okay, but specifically, the idea is to,
Lex Fridman (1:50:01.740)
and we could talk about different ideas
Lex Fridman (1:50:03.700)
of how to actually do this,
Lex Fridman (1:50:04.660)
but you basically do a lockdown or something like that
Lex Fridman (1:50:10.100)
on a very small set of people.
Jay Bhattacharya (1:50:12.260)
You may have to do that
Lex Fridman (1:50:13.300)
if community spread is very high,
Lex Fridman (1:50:14.900)
but generally, I think it would depend on, again,
Lex Fridman (1:50:18.540)
the living circumstances and the,
Lex Fridman (1:50:20.460)
so for instance, if you are in a,
Lex Fridman (1:50:23.340)
if you have a, here's a very simple idea
Jay Bhattacharya (1:50:25.440)
that doesn't require a lockdown forced on them.
Lex Fridman (1:50:28.260)
I don't actually generally,
Jay Bhattacharya (1:50:29.340)
I'm not in favor of that kind of forced lockdown
Lex Fridman (1:50:31.100)
because you just won't get cooperation.
Lex Fridman (1:50:33.980)
But what you could do is provide resources
Lex Fridman (1:50:36.300)
to that group of people.
Lex Fridman (1:50:38.040)
So imagine you live next door to somebody, an older couple,
Lex Fridman (1:50:43.740)
and there's high community spread.
Jay Bhattacharya (1:50:46.300)
Well, they have to go grocery shopping.
Lex Fridman (1:50:48.940)
We did like, some communities did these
Lex Fridman (1:50:50.940)
like senior only grocery hour, right?
Lex Fridman (1:50:53.780)
But they have to still have to go out
Lex Fridman (1:50:55.100)
and they might get exposed
Lex Fridman (1:50:56.780)
when they're shopping amongst other seniors.
Lex Fridman (1:50:59.640)
Well, why not organized home delivery of groceries to them?
Lex Fridman (1:51:03.400)
We did that for the laptop class, right?
Jay Bhattacharya (1:51:06.380)
Or you can even just use a volunteer effort.
Lex Fridman (1:51:09.060)
The older people living next door,
Jay Bhattacharya (1:51:10.220)
just call them up and say,
Lex Fridman (1:51:11.060)
can I help you go out and go shopping for you?
Lex Fridman (1:51:13.580)
And so you would have potentially federal support
Lex Fridman (1:51:16.500)
of that kind of thing.
Lex Fridman (1:51:17.340)
So these kinds of efforts.
Lex Fridman (1:51:19.500)
Identify where the vulnerable people live.
Jay Bhattacharya (1:51:22.100)
It's really challenging in multigenerational homes.
Lex Fridman (1:51:24.580)
In LA County, for instance,
Jay Bhattacharya (1:51:25.580)
there's a lot of older people living together
Lex Fridman (1:51:28.780)
with younger people in relatively crowded,
Jay Bhattacharya (1:51:31.460)
there it's really quite a challenge.
Lex Fridman (1:51:34.120)
But there again, you can use resources.
Lex Fridman (1:51:35.780)
So if grandma is worried that grandson has come home,
Lex Fridman (1:51:40.780)
but is potentially been exposed,
Jay Bhattacharya (1:51:42.000)
grandson calls grandma says, I mean,
Lex Fridman (1:51:43.660)
I might've been at a party where COVID was.
Jay Bhattacharya (1:51:47.140)
Grandma calls public health, public health,
Lex Fridman (1:51:49.140)
and says, okay, you can have this hotel room
Jay Bhattacharya (1:51:50.700)
for a couple of days until you check to turn negative.
Lex Fridman (1:51:54.340)
In case it wasn't clear,
Jay Bhattacharya (1:51:56.060)
the idea of focused protection
Lex Fridman (1:51:58.620)
is the people that are vulnerable, protect them.
Lex Fridman (1:52:03.100)
And everybody else goes on with their lives,
Lex Fridman (1:52:06.180)
open up the economy, just do as it was before.
Jay Bhattacharya (1:52:09.780)
There was still fear abroad.
Lex Fridman (1:52:10.960)
So there still would be some restrictions
Jay Bhattacharya (1:52:12.900)
that people would pose on themselves.
Lex Fridman (1:52:14.100)
They probably would go to parties less.
Lex Fridman (1:52:15.760)
The grandsons probably wouldn't go so many parties, right?
Lex Fridman (1:52:19.360)
There would be less participation in big gatherings.
Lex Fridman (1:52:23.500)
And you may even say like big gatherings
Lex Fridman (1:52:25.140)
in order to restrict community spread again.
Jay Bhattacharya (1:52:27.500)
I'm not against any of that,
Lex Fridman (1:52:29.380)
but you shouldn't be closing businesses.
Jay Bhattacharya (1:52:31.820)
You shouldn't be closing churches and synagogues.
Lex Fridman (1:52:34.020)
You shouldn't be forcing people to not go to school.
Jay Bhattacharya (1:52:38.560)
You should not be shuttering businesses.
Lex Fridman (1:52:41.340)
You should just allow society to go on.
Jay Bhattacharya (1:52:44.060)
Some disease will spread, but as we've seen,
Lex Fridman (1:52:46.900)
the lockdown didn't stop the disease from spreading anyways.
Jay Bhattacharya (1:52:50.100)
Right.
Lex Fridman (1:52:50.940)
So what do you make of the criticism that this idea,
Jay Bhattacharya (1:52:54.100)
like all good ideas cannot actually be implemented
Lex Fridman (1:52:59.740)
in a heterogeneous society
Lex Fridman (1:53:01.300)
where there's a lot of people intermixing?
Lex Fridman (1:53:03.660)
And once you open it up,
Jay Bhattacharya (1:53:06.400)
people like the younger people will just forget
Lex Fridman (1:53:09.380)
that this is even existing.
Lex Fridman (1:53:11.140)
And they'll stop caring about the older people
Lex Fridman (1:53:13.060)
and mess up the whole thing.
Lex Fridman (1:53:14.300)
And the government will not want to fund
Lex Fridman (1:53:16.820)
any kind of the great efforts you're talking about
Jay Bhattacharya (1:53:18.900)
about food delivery and then the food delivery services
Lex Fridman (1:53:21.980)
be like, why the heck am I helping out on this anyway?
Jay Bhattacharya (1:53:24.460)
Because like, it's not making me much money.
Lex Fridman (1:53:26.740)
And so therefore like all good ideas, it will collapse.
Jay Bhattacharya (1:53:30.560)
That might be true.
Lex Fridman (1:53:31.400)
I mean, I think it's always a risk with policy thing,
Lex Fridman (1:53:34.000)
but I think if you think back to the moment,
Lex Fridman (1:53:37.180)
but we actually felt like we were in this together
Jay Bhattacharya (1:53:39.060)
to some extent.
Lex Fridman (1:53:39.900)
Yes.
Jay Bhattacharya (1:53:40.800)
Right, I think that that empathy that we had
Lex Fridman (1:53:44.460)
that was used to like tell people to stay in
Lex Fridman (1:53:48.820)
and like happily, not go in happily,
Lex Fridman (1:53:51.260)
but like stay in to like wear a mask
Jay Bhattacharya (1:53:55.000)
or to do all these things that we thought
Lex Fridman (1:53:57.100)
would help other people could have been redirected
Jay Bhattacharya (1:53:59.820)
to actually helping the people who most needed to be helped.
Lex Fridman (1:54:02.860)
Especially, I do remember March.
Lex Fridman (1:54:08.120)
So this is even way before Barrington,
Lex Fridman (1:54:10.460)
all that kind of stuff.
Jay Bhattacharya (1:54:12.580)
March, April, May, there was a feeling like
Lex Fridman (1:54:16.100)
if we all just work together, we'll solve this.
Lex Fridman (1:54:20.860)
And that maybe started to, when did that start breaking down?
Lex Fridman (1:54:24.380)
I mean, unfortunately the election is mixed into this.
Jay Bhattacharya (1:54:28.740)
That it became politicized.
Lex Fridman (1:54:30.900)
But I think it lasted quite a long time.
Jay Bhattacharya (1:54:32.860)
I think into the summer,
Lex Fridman (1:54:33.880)
I think there was some of that sense.
Jay Bhattacharya (1:54:36.740)
I don't know, it obviously varied among different people.
Lex Fridman (1:54:39.820)
But I think that it's true it would have been challenging.
Jay Bhattacharya (1:54:42.380)
It's also true that it's heterogeneous,
Lex Fridman (1:54:44.860)
exactly the way you said.
Lex Fridman (1:54:46.820)
But what that means is you need a local response,
Lex Fridman (1:54:49.860)
a response, so like my vision of a public health officer
Jay Bhattacharya (1:54:53.460)
is someone that understands their community,
Lex Fridman (1:54:56.460)
not necessarily the nation at large, but their community,
Lex Fridman (1:54:59.200)
and then works within their community
Lex Fridman (1:55:01.420)
to figure out how to deploy the resources
Jay Bhattacharya (1:55:03.300)
that they have available
Lex Fridman (1:55:05.580)
to do the kind of protection policies we're talking about.
Jay Bhattacharya (1:55:08.140)
That's what should have happened.
Lex Fridman (1:55:10.020)
Instead, they spent a huge amount of efforts
Jay Bhattacharya (1:55:12.740)
closing, making sure businesses stayed closed.
Lex Fridman (1:55:15.540)
Businesses that, I mean,
Jay Bhattacharya (1:55:17.220)
they're like hardware stores that closed.
Lex Fridman (1:55:20.680)
What good did closing a hardware store do
Lex Fridman (1:55:23.780)
for the spread of COVID?
Lex Fridman (1:55:24.980)
If it had an effect on COVID spread,
Jay Bhattacharya (1:55:26.900)
I mean, it's gonna be March.
Lex Fridman (1:55:28.020)
Checking to make sure that plexiglass
Jay Bhattacharya (1:55:30.020)
was put up everywhere,
Lex Fridman (1:55:31.100)
which now in retrospect turns out
Jay Bhattacharya (1:55:32.460)
to have probably made the disease worse.
Lex Fridman (1:55:37.240)
Masking enforcement, so shaming around masks,
Jay Bhattacharya (1:55:40.340)
I mean, a huge amount of effort on things
Lex Fridman (1:55:42.500)
that were only tangentially related to focus protection.
Lex Fridman (1:55:47.000)
What if we turned our energy,
Lex Fridman (1:55:49.140)
that enormous energy put into that,
Lex Fridman (1:55:52.260)
instead into focus protection of the vulnerable?
Lex Fridman (1:55:54.460)
That's essentially the conversation I was calling for.
Lex Fridman (1:55:57.100)
And it wasn't, I mean, I didn't think of it
Lex Fridman (1:55:59.380)
as we had every single idea.
Jay Bhattacharya (1:56:01.020)
I mean, we gave some concrete proposals,
Lex Fridman (1:56:03.580)
but the criticism we got was that
Jay Bhattacharya (1:56:05.140)
those concrete proposals weren't enough.
Lex Fridman (1:56:08.180)
And the answer to that is that's true.
Jay Bhattacharya (1:56:10.220)
They weren't enough.
Lex Fridman (1:56:11.060)
I wasn't thinking of them as enough.
Jay Bhattacharya (1:56:12.660)
I was thinking that I wanted to involve
Lex Fridman (1:56:15.300)
an enormous number of people in local public health
Jay Bhattacharya (1:56:17.980)
to help think about how to do focus protection
Lex Fridman (1:56:20.900)
in their communities.
Jay Bhattacharya (1:56:22.180)
The question that's interesting here is about the future too.
Lex Fridman (1:56:29.260)
So COVID has very specific characteristics,
Jay Bhattacharya (1:56:32.740)
like you mentioned, about the curve of the death rate
Lex Fridman (1:56:36.180)
based on the, like it seems like with COVID,
Jay Bhattacharya (1:56:39.580)
it's a little bit easier to actually identify
Lex Fridman (1:56:42.140)
a group of people that you need to protect.
Lex Fridman (1:56:45.660)
So other viruses may not be this way.
Lex Fridman (1:56:47.940)
So might lockdown be a good idea, like hardcore lockdown
Jay Bhattacharya (1:56:53.420)
for a future virus that's 10 times deadlier,
Lex Fridman (1:56:57.660)
but spreads at the same rate as COVID?
Jay Bhattacharya (1:56:59.780)
Or maybe another way to ask that is imagine a virus
Lex Fridman (1:57:02.860)
that's 10 times deadlier, what's the right response?
Jay Bhattacharya (1:57:06.260)
I mean, I think it's always gonna be focus protection,
Lex Fridman (1:57:08.780)
but the group that needs the focus protection may change
Lex Fridman (1:57:12.140)
depending on the biology of the virus, right?
Lex Fridman (1:57:14.380)
So the polio epidemic in the 40s and 50s in the US,
Jay Bhattacharya (1:57:18.580)
the great, the people at most risk were children.
Lex Fridman (1:57:23.220)
We didn't know really at the beginning
Jay Bhattacharya (1:57:24.980)
there was this fecal oral spread.
Lex Fridman (1:57:27.020)
And so we did all kinds of crazy things,
Jay Bhattacharya (1:57:30.340)
including like spraying DDT in communities,
Lex Fridman (1:57:33.580)
which somehow was supposed to get rid of polio.
Lex Fridman (1:57:37.020)
But the focus was on whenever there was an outbreak,
Lex Fridman (1:57:40.020)
they would close the school down.
Lex Fridman (1:57:42.060)
And that was the right thing to do
Lex Fridman (1:57:43.700)
because that group that needed protection was children.
Lex Fridman (1:57:48.720)
And the disease was spread, we thought in schools.
Lex Fridman (1:57:53.620)
I don't think there's a single formula that works,
Lex Fridman (1:57:56.660)
but there's a single principle that works, right?
Lex Fridman (1:57:59.380)
No matter, it's hard to imagine a disease
Jay Bhattacharya (1:58:02.260)
that's uniformly deadly across every group
Lex Fridman (1:58:05.420)
in every single person.
Jay Bhattacharya (1:58:07.220)
There's always gonna be some group
Lex Fridman (1:58:09.700)
that's differentially harmed.
Jay Bhattacharya (1:58:13.700)
There's always gonna be some group
Lex Fridman (1:58:14.840)
that's differentially protected.
Lex Fridman (1:58:16.260)
And that may change over time, right?
Lex Fridman (1:58:17.980)
So like in this disease, in this epidemic,
Jay Bhattacharya (1:58:23.420)
as people got infected and recovered,
Lex Fridman (1:58:25.840)
we now had a class of people
Jay Bhattacharya (1:58:27.180)
that were pretty well protected against the disease.
Lex Fridman (1:58:30.900)
They should be, like instead of ostracizing them
Jay Bhattacharya (1:58:34.360)
because they don't want a vaccine,
Lex Fridman (1:58:36.020)
we should be allowing them to work.
Jay Bhattacharya (1:58:37.780)
I mean, we're having staffing shortages in hospitals now
Lex Fridman (1:58:41.300)
because we forgot that principle.
Lex Fridman (1:58:43.320)
Is quite a bit of this a technology problem?
Lex Fridman (1:58:46.580)
So being able to,
Lex Fridman (1:58:49.700)
how much of it is a sociological problem?
Lex Fridman (1:58:53.940)
How much of it is a technology problem?
Jay Bhattacharya (1:58:56.380)
Like where do you put the blame
Lex Fridman (1:58:59.100)
sort of on why this didn't go so great
Lex Fridman (1:59:01.420)
and how it can go great in the beginning?
Lex Fridman (1:59:04.160)
I mean, think about lockdowns.
Jay Bhattacharya (1:59:05.420)
Like if we didn't have Zoom,
Lex Fridman (1:59:06.980)
we wouldn't have lockdowns.
Jay Bhattacharya (1:59:08.620)
There's a reason in 2009 we didn't lock down.
Lex Fridman (1:59:11.580)
I mean, we didn't have the technology to replace work
Jay Bhattacharya (1:59:13.740)
with this remote technology.
Lex Fridman (1:59:17.900)
So we had good lockdown technology in Zoom.
Jay Bhattacharya (1:59:21.340)
We didn't have good focus protection technology.
Lex Fridman (1:59:25.320)
Yeah, I mean, focus protection
Jay Bhattacharya (1:59:26.260)
is always gonna be complicated,
Lex Fridman (1:59:27.340)
especially for something like this that spreads so easily,
Jay Bhattacharya (1:59:29.500)
it's gonna be complicated.
Lex Fridman (1:59:30.980)
And I'm the last person to say it would have been perfect.
Jay Bhattacharya (1:59:34.980)
There would have been people that would have gotten sick,
Lex Fridman (1:59:37.740)
but they got sick anyways.
Jay Bhattacharya (1:59:39.040)
The hope was that if we suppress community spread
Lex Fridman (1:59:41.500)
low enough, we can protect the vulnerable.
Jay Bhattacharya (1:59:44.540)
That was the hope by lockdown.
Lex Fridman (1:59:47.180)
The reality was that only a certain class of people
Jay Bhattacharya (1:59:50.380)
were able to benefit from lockdown.
Lex Fridman (1:59:51.820)
The rest of society, we call them essential workers,
Jay Bhattacharya (1:59:53.820)
had to keep working and they got sick.
Lex Fridman (1:59:56.660)
And the disease kept spreading.
Jay Bhattacharya (1:59:58.180)
It didn't actually have a substantial effect
Lex Fridman (20:00.360)
something like 40 to 50 times more infections
Jay Bhattacharya (20:04.260)
than cases in both places.
Lex Fridman (20:06.780)
So for every case that had been reported
Jay Bhattacharya (20:09.220)
to the public health authorities,
Lex Fridman (20:10.940)
we found 40 or 50 other infections,
Jay Bhattacharya (20:15.340)
people with antibodies in their blood
Lex Fridman (20:17.940)
that suggested that they'd had COVID and recovered.
Lex Fridman (20:20.220)
So people were not reporting,
Lex Fridman (20:21.580)
or severe, at least in those days, underreporting.
Jay Bhattacharya (20:25.020)
Yeah, I mean, there was testing problem.
Lex Fridman (20:26.900)
I mean, there weren't so many tests available.
Jay Bhattacharya (20:29.020)
People didn't know.
Lex Fridman (20:30.180)
A lot of them, we asked a set of questions
Jay Bhattacharya (20:32.720)
about the symptoms they'd faced,
Lex Fridman (20:34.860)
and most of them said they'd faced no symptoms,
Jay Bhattacharya (20:36.340)
or at the most, 30, 40% of them said
Lex Fridman (20:38.300)
they'd faced no symptoms.
Lex Fridman (20:40.780)
And I mean, even these days,
Lex Fridman (20:42.200)
how many people report that they get COVID
Lex Fridman (20:44.260)
when they get COVID?
Lex Fridman (20:45.100)
Okay, have those numbers, that 0.2%,
Lex Fridman (20:49.140)
has that approximately held up over time?
Lex Fridman (20:51.420)
That is, so Professor John Ioannidis,
Jay Bhattacharya (20:53.420)
who's a colleague of mine at Stanford,
Lex Fridman (20:55.260)
is a world expert in meta now,
Lex Fridman (20:56.800)
so probably the most cited scientist on Earth, I think,
Lex Fridman (21:00.140)
at least living.
Jay Bhattacharya (21:01.220)
He did a meta analysis of now 100 or more
Lex Fridman (21:04.780)
of these seroprevalence studies.
Lex Fridman (21:08.020)
And what he found was that that 0.2%
Lex Fridman (21:11.540)
is roughly the worldwide number.
Jay Bhattacharya (21:13.820)
In fact, I think he cites this lower number, 0.15%,
Lex Fridman (21:17.380)
as the median infection fatality rate worldwide.
Lex Fridman (21:20.620)
So we did these studies,
Lex Fridman (21:21.900)
and it generated an enormous amount of blowback
Jay Bhattacharya (21:25.220)
by people who thought that the infection fatality rate
Lex Fridman (21:27.060)
is much higher.
Lex Fridman (21:28.460)
And there's some controversy over the quality
Lex Fridman (21:30.420)
of some of the other studies that are done.
Lex Fridman (21:32.380)
And so there are some people who look at this
Lex Fridman (21:34.700)
same literature and say, well,
Jay Bhattacharya (21:36.380)
the lower quality studies tend to have lower IFRs.
Lex Fridman (21:39.780)
The higher quality studies.
Lex Fridman (21:40.620)
IFR?
Lex Fridman (21:41.460)
Oh, infection fatality rate, I apologize.
Jay Bhattacharya (21:43.380)
I do this in lectures, too, I apologize.
Lex Fridman (21:45.740)
And I'm going to rudely interrupt you
Lex Fridman (21:48.620)
and ask for the basics sometimes, if it's okay.
Lex Fridman (21:51.660)
No, of course.
Lex Fridman (21:52.580)
So these higher quality studies, they say,
Lex Fridman (21:55.500)
tend to produce higher IFR.
Lex Fridman (21:56.620)
But the problem is that if you want
Lex Fridman (21:58.820)
a global infection fatality rate,
Jay Bhattacharya (22:00.860)
you need to get seroprevalence studies from everywhere,
Lex Fridman (22:04.420)
even in places that don't necessarily
Jay Bhattacharya (22:05.940)
have the infrastructure set up
Lex Fridman (22:07.060)
to produce very, very high quality studies.
Lex Fridman (22:09.620)
And in poor places in the world,
Lex Fridman (22:14.740)
places like Africa,
Jay Bhattacharya (22:15.900)
the infection fatality rate is incredibly low.
Lex Fridman (22:20.020)
And in some richer places, like New York City,
Jay Bhattacharya (22:23.500)
the infection fatality rate is much higher.
Lex Fridman (22:25.780)
There's a range of IFRs, not a single number.
Jay Bhattacharya (22:30.780)
This sometimes surprises people,
Lex Fridman (22:32.620)
because they think, well, it's a virus,
Jay Bhattacharya (22:34.140)
it should have the same properties no matter where it goes.
Lex Fridman (22:36.780)
But the virus kills or infects or hurts
Jay Bhattacharya (22:42.140)
in interaction with the host.
Lex Fridman (22:44.740)
And the properties of both the host and the virus
Jay Bhattacharya (22:47.780)
combine to produce the outcome.
Lex Fridman (22:50.140)
But you also mentioned the environment, too?
Jay Bhattacharya (22:53.020)
Well, I'm thinking mainly just about the person.
Lex Fridman (22:55.580)
Like if I'm gonna think about it,
Jay Bhattacharya (22:56.900)
the most simplest way to think about it is age.
Lex Fridman (22:58.820)
Age is the single most important risk factor.
Lex Fridman (23:01.220)
So older places are going to have a higher IFR
Lex Fridman (23:05.980)
than younger places.
Jay Bhattacharya (23:07.020)
Africa, 3% of Africa is over 65.
Lex Fridman (23:10.140)
So in some sense, it's not surprising
Jay Bhattacharya (23:12.660)
that they have a low infection fatality rate.
Lex Fridman (23:15.380)
So that's one way you would explain
Jay Bhattacharya (23:16.900)
the difference between Africa and New York City
Lex Fridman (23:18.980)
in terms of the fatality rate, is the age, the average age?
Jay Bhattacharya (23:22.020)
Yeah, and especially in the early days of the epidemic
Lex Fridman (23:24.820)
in New York City, the older populations
Jay Bhattacharya (23:29.740)
living in nursing homes were differentially infected
Lex Fridman (23:33.380)
based on, because of policies that were adopted,
Jay Bhattacharya (23:35.900)
to send COVID infected patients back to nursing homes
Lex Fridman (23:39.100)
to keep hospitals empty.
Lex Fridman (23:40.340)
What do you mean by differentially infected?
Lex Fridman (23:42.900)
The policy that you adopt determines who is most exposed.
Jay Bhattacharya (23:47.380)
Right, okay.
Lex Fridman (23:48.500)
So that's what I mean by different.
Jay Bhattacharya (23:49.340)
The policy, it's the person that matters.
Lex Fridman (23:52.820)
I mean, it's not like the virus just kind of doesn't care.
Jay Bhattacharya (23:56.140)
I mean, the policy determines the nature of the interaction.
Lex Fridman (23:59.340)
And there's also, I mean, there is some contribution
Jay Bhattacharya (24:01.660)
from the environment, different regions
Lex Fridman (24:04.900)
have different proximity maybe of people interacting
Jay Bhattacharya (24:08.300)
or the dynamics of the way they interact.
Lex Fridman (24:10.100)
Yeah, like if you have situations
Jay Bhattacharya (24:12.740)
where there's lots of intergenerational interactions,
Lex Fridman (24:17.260)
then you have a very different risk profile
Jay Bhattacharya (24:19.500)
than if you have societies
Lex Fridman (24:21.500)
that are where generations are more separate
Jay Bhattacharya (24:23.540)
from one another.
Lex Fridman (24:25.860)
Okay, so let me just finish real fast about this.
Lex Fridman (24:27.620)
So you have in New York, you have a population
Lex Fridman (24:32.820)
that was infected in the early days
Jay Bhattacharya (24:34.180)
that was very likely going to die,
Lex Fridman (24:36.980)
had a much higher likelihood of dying if infected.
Lex Fridman (24:40.140)
And so New York City had a higher IFR,
Lex Fridman (24:43.220)
especially in the early days than like Africa has had.
Lex Fridman (24:49.260)
The other thing is treatment, right?
Lex Fridman (24:50.900)
So the treatments that we adopted
Jay Bhattacharya (24:52.940)
in the early days of the epidemic,
Lex Fridman (24:54.020)
I think actually may have exacerbated the risk of death.
Lex Fridman (24:58.220)
Which treatments?
Lex Fridman (25:00.100)
Using ventilators, like the over reliance on ventilators
Jay Bhattacharya (25:03.180)
is what I'm primarily thinking of,
Lex Fridman (25:04.580)
but I can think of other things.
Lex Fridman (25:06.520)
But that also we've learned over time
Lex Fridman (25:09.620)
how better to manage patients with the disease.
Lex Fridman (25:12.700)
So you have all those things combined.
Lex Fridman (25:14.700)
So that's where the controversy over this number is.
Jay Bhattacharya (25:18.100)
I mean, New York City also is a central hub
Lex Fridman (25:23.660)
for those who tweet and those who write powerful stories
Lex Fridman (25:29.220)
and narratives in article form.
Lex Fridman (25:31.740)
And I remember those quite dramatic stories
Jay Bhattacharya (25:34.700)
about sort of doctors in the hospitals
Lex Fridman (25:36.500)
and these kinds of things.
Jay Bhattacharya (25:37.380)
I mean, there's very serious, very dramatic,
Lex Fridman (25:40.500)
very tragic deaths going on always in hospitals.
Jay Bhattacharya (25:44.840)
Those stories, loved ones losing each other on a deathbed,
Lex Fridman (25:50.860)
that's always tragic.
Lex Fridman (25:52.340)
And you can always write a hell of a good story about that.
Lex Fridman (25:55.220)
And you should, about the loss of loved ones.
Lex Fridman (25:58.220)
But they were doing it pretty well, I would say,
Lex Fridman (26:01.820)
over this kind of dramatic deaths.
Lex Fridman (26:04.060)
And so in response to that, it's very unpleasant to hear,
Lex Fridman (26:09.240)
even to consider the possibility
Jay Bhattacharya (26:11.140)
that the death rate is not as high as you might feel.
Lex Fridman (26:17.500)
Yeah, I was surprised by the reaction,
Jay Bhattacharya (26:20.580)
both by regular people and also the scientific community
Lex Fridman (26:23.860)
in response to those studies,
Jay Bhattacharya (26:25.660)
those early studies in April of 2020.
Lex Fridman (26:29.100)
To me, they were studies.
Jay Bhattacharya (26:31.620)
I mean, they're the kinds of,
Lex Fridman (26:33.640)
not exactly the kinds of work I've worked on all my life,
Lex Fridman (26:35.620)
but kind of like the kind of, you write a paper
Lex Fridman (26:39.700)
and you get responses from your fellow scientists
Lex Fridman (26:42.860)
and you change the paper to improve it,
Lex Fridman (26:45.340)
you hopefully learn something from it.
Jay Bhattacharya (26:47.260)
Well, but to push back, it's just a study.
Lex Fridman (26:50.480)
But there's some studies, and this is kind of interesting,
Jay Bhattacharya (26:53.260)
because I've received similar pushback on other topics.
Lex Fridman (26:59.380)
There's some studies that, if wrong,
Jay Bhattacharya (27:04.380)
might have wide ranging detrimental effects on society.
Lex Fridman (27:09.740)
So that's the way they would perceive the studies.
Jay Bhattacharya (27:12.000)
If you say the death rate is lower,
Lex Fridman (27:13.900)
and you end up, as you often do in science,
Jay Bhattacharya (27:16.500)
realizing that, nope, that was a flaw
Lex Fridman (27:19.940)
in the way the study was conducted,
Jay Bhattacharya (27:21.140)
or we're just not representative of a broader population,
Lex Fridman (27:23.900)
and then you realize the death rate is much higher,
Jay Bhattacharya (27:26.020)
that might be very damaging in people's view.
Lex Fridman (27:29.620)
So that's probably where the scientific community
Jay Bhattacharya (27:33.500)
sort of just steel man the kind of response,
Lex Fridman (27:36.660)
is that's where they felt like,
Jay Bhattacharya (27:40.020)
there's some findings where you better be damn sure
Lex Fridman (27:43.420)
before you kind of report them.
Jay Bhattacharya (27:45.880)
Yeah, I mean, we were pretty sure we were right,
Lex Fridman (27:47.400)
and it turns out we were right.
Lex Fridman (27:48.500)
So we released the Santa Clara study
Lex Fridman (27:54.120)
via this open science process
Lex Fridman (27:56.780)
and this server called MedArchive.
Lex Fridman (27:59.860)
It's designed for releasing studies
Jay Bhattacharya (28:02.220)
that have not yet been peer reviewed
Lex Fridman (28:03.900)
in order to garner comment from the scientists
Jay Bhattacharya (28:06.540)
before peer review.
Lex Fridman (28:08.540)
The LA County study,
Jay Bhattacharya (28:09.880)
we went through this traditional peer review process
Lex Fridman (28:12.400)
and got it published in the Journal
Jay Bhattacharya (28:13.660)
of American Medical Association sometime in like July,
Lex Fridman (28:16.580)
I think, I forget the date, of 2020.
Jay Bhattacharya (28:19.040)
The Santa Clara study released in April of 2020
Lex Fridman (28:22.000)
in this sort of working paper archive.
Jay Bhattacharya (28:25.100)
The reason was that we felt we had an obligation,
Lex Fridman (28:28.180)
we had a result that we thought was quite important,
Lex Fridman (28:31.960)
and we wanted to tell the scientific community about it
Lex Fridman (28:35.020)
and also tell the world about it.
Lex Fridman (28:36.700)
And we wanted to get feedback.
Lex Fridman (28:38.100)
I mean, that's part of the purpose
Jay Bhattacharya (28:39.840)
of sending it to these kinds of places.
Lex Fridman (28:42.280)
I think a lot of the problem is that
Jay Bhattacharya (28:45.500)
when people think about published science,
Lex Fridman (28:47.860)
they think of it as automatically true.
Lex Fridman (28:50.380)
And if it goes through peer review,
Lex Fridman (28:51.460)
it's automatically true.
Jay Bhattacharya (28:52.300)
If it hasn't gone through peer review,
Lex Fridman (28:53.300)
it's not automatically true.
Lex Fridman (28:54.940)
And especially in medicine,
Lex Fridman (28:56.540)
when we're not used to having this access
Jay Bhattacharya (28:59.860)
to pre peer reviewed work.
Lex Fridman (29:03.420)
I mean, in economics, actually, that's quite normal.
Jay Bhattacharya (29:05.860)
You takes years to get something published.
Lex Fridman (29:07.940)
So there's a very active debate over
Jay Bhattacharya (29:10.660)
or discussion about papers before they're peer reviewed
Lex Fridman (29:13.460)
in this sort of working paper way,
Jay Bhattacharya (29:16.260)
much less normal or much newer in medicine.
Lex Fridman (29:20.460)
And so I think part of that,
Jay Bhattacharya (29:21.520)
the perception about what process happens in open science
Lex Fridman (29:26.100)
when you release a study, that got people confused.
Lex Fridman (29:29.380)
And you're right, it was a very important result
Lex Fridman (29:31.500)
because we had just locked the world down
Jay Bhattacharya (29:33.780)
in middle of March with, I think, catastrophic results.
Lex Fridman (29:38.740)
And if that study was right, if our study was right,
Jay Bhattacharya (29:41.940)
that meant we'd made a mistake.
Lex Fridman (29:44.020)
And not because the death rate was low,
Jay Bhattacharya (29:45.820)
that's actually not the key thing there.
Lex Fridman (29:47.800)
The key thing is that we had adopted these policies,
Jay Bhattacharya (29:51.620)
these test and trace policies,
Lex Fridman (29:53.340)
these policies, these lockdown policies
Jay Bhattacharya (29:55.420)
aimed at suppressing the virus level to close to zero.
Lex Fridman (2:00:00.280)
on community spread in non laptop class populations.
Lex Fridman (2:00:05.980)
And also we should probably expand the class of people
Lex Fridman (2:00:08.380)
we call vulnerable to those who would suffer,
Jay Bhattacharya (2:00:12.220)
who have the capacity to suffer,
Lex Fridman (2:00:15.700)
given the policies you're weighing.
Jay Bhattacharya (2:00:19.060)
It's very disingenuous to call the vulnerable
Lex Fridman (2:00:22.700)
just the people, obviously we had the very specific meaning,
Lex Fridman (2:00:26.180)
but broadly speaking, vulnerable should include anybody
Lex Fridman (2:00:31.740)
who can suffer based on the policies you take
Jay Bhattacharya (2:00:34.780)
in response to a virus.
Lex Fridman (2:00:36.980)
That principle you just said is completely agree with
Jay Bhattacharya (2:00:39.100)
is something I think has been lost.
Lex Fridman (2:00:42.820)
And unfortunately lost, right?
Lex Fridman (2:00:44.260)
So the policies themselves, if they have harm,
Lex Fridman (2:00:49.380)
those are real and we shouldn't pretend like they're not.
Lex Fridman (2:00:53.460)
And essentially demonize the people that suffer them.
Lex Fridman (2:00:58.180)
Or pretend, I mean like a lot of times like the depression
Jay Bhattacharya (2:01:01.500)
that we've been talking about,
Lex Fridman (2:01:02.720)
that's thought of as like not so important,
Lex Fridman (2:01:06.020)
but it is important.
Lex Fridman (2:01:08.380)
And especially the harm to the people in poor countries,
Jay Bhattacharya (2:01:12.460)
it's like been out of sight, out of mind
Lex Fridman (2:01:14.820)
in much of the rich parts of the world.
Jay Bhattacharya (2:01:16.900)
Once again, I've hoped that we seeing this,
Lex Fridman (2:01:20.140)
learning lessons of history with the communication tools
Jay Bhattacharya (2:01:22.980)
who have now will learn this.
Lex Fridman (2:01:24.260)
It's like going to another country
Lex Fridman (2:01:26.180)
and bombing targeted terrorist locations,
Lex Fridman (2:01:29.380)
and there's going to be some civilians who die,
Jay Bhattacharya (2:01:32.100)
pretending that the child who watches their dad die
Lex Fridman (2:01:37.740)
is not going to grow up, first of all, traumatized,
Lex Fridman (2:01:40.620)
but second of all, potentially bring more hate to the world
Lex Fridman (2:01:43.700)
than the hate that you were allegedly fighting
Jay Bhattacharya (2:01:46.860)
in the first place.
Lex Fridman (2:01:47.700)
That's another sort of considering only one kind of harm
Lex Fridman (2:01:52.580)
and not the full range of harms
Lex Fridman (2:01:54.100)
that are being caused by your policies.
Jay Bhattacharya (2:01:55.780)
You know, like the good return to focus protection,
Lex Fridman (2:01:59.180)
we still should be following the policy now for COVID
Lex Fridman (2:02:01.700)
and we're not, right?
Lex Fridman (2:02:03.060)
So the vaccines, there's a great shortage of vaccines.
Jay Bhattacharya (2:02:06.860)
You wouldn't know it in the United States
Lex Fridman (2:02:08.480)
and the rich parts of the world,
Lex Fridman (2:02:09.820)
but there's a great shortage of vaccines.
Lex Fridman (2:02:11.660)
We're not going to be able to vaccinate the most of the,
Jay Bhattacharya (2:02:15.280)
like the entire set of elderly at least,
Lex Fridman (2:02:17.140)
and or larger groups until late 2022.
Jay Bhattacharya (2:02:20.980)
Huge numbers of older people around the world
Lex Fridman (2:02:24.140)
in poor countries that have not COVID recovered yet,
Lex Fridman (2:02:27.480)
so they're still quite vulnerable, have not had the vaccine.
Lex Fridman (2:02:30.940)
And yet we're talking about vaccinating five year olds
Jay Bhattacharya (2:02:34.500)
who benefit, if at all, from the vaccines
Lex Fridman (2:02:37.620)
of just a very little bit
Jay Bhattacharya (2:02:38.600)
because they face such a low risk of harm from COVID.
Lex Fridman (2:02:43.080)
Well, something that's a little bit near and dear
Jay Bhattacharya (2:02:45.940)
to our specific, the two of our hearts.
Lex Fridman (2:02:49.280)
So you're at Stanford.
Lex Fridman (2:02:51.300)
So Stanford recently announced
Lex Fridman (2:02:53.700)
that they're going back to virtual,
Jay Bhattacharya (2:02:55.660)
at least for some period of time in response to the,
Lex Fridman (2:02:59.300)
maybe you can clarify, but I think it's in response
Lex Fridman (2:03:01.340)
to the escalated, how would they phrase it?
Lex Fridman (2:03:05.380)
It's related to Omicron.
Lex Fridman (2:03:07.860)
And a few other universities are kind of like
Lex Fridman (2:03:12.140)
considering back and forth.
Jay Bhattacharya (2:03:13.660)
In my perspective, as somebody who loves
Lex Fridman (2:03:16.580)
in person lectures, who sees the value of that
Jay Bhattacharya (2:03:23.140)
to students, to young minds, also looking at the data,
Lex Fridman (2:03:28.460)
seems the risk aversion in university policies
Jay Bhattacharya (2:03:36.140)
around this, given how healthy the student population is,
Lex Fridman (2:03:40.900)
seems not well calibrated.
Jay Bhattacharya (2:03:44.020)
Let's put it this way.
Lex Fridman (2:03:44.860)
Also, pathological is one way to put it.
Jay Bhattacharya (2:03:48.100)
Given that, I believe, depending on the university,
Lex Fridman (2:03:50.660)
but I think many universities require
Jay Bhattacharya (2:03:53.140)
that the student body is vaccinated at this point.
Lex Fridman (2:03:57.020)
So I think it's a big mistake by Stanford to do this.
Lex Fridman (2:04:01.060)
And I'd like to say that because I just hope MIT doesn't.
Lex Fridman (2:04:07.380)
But what are your thoughts about Stanford?
Lex Fridman (2:04:09.020)
Is there a student?
Lex Fridman (2:04:10.140)
I completely agree with you.
Jay Bhattacharya (2:04:11.340)
I think we have failed in our mission
Lex Fridman (2:04:14.980)
to educate our students by this decision.
Lex Fridman (2:04:18.860)
And I think, frankly, just more broadly,
Lex Fridman (2:04:20.900)
I think we failed generally over the course
Jay Bhattacharya (2:04:22.980)
of the last year and a half in living up
Lex Fridman (2:04:24.880)
to our educational mission.
Jay Bhattacharya (2:04:27.620)
In person teaching is vital.
Lex Fridman (2:04:31.980)
Now, I can understand, if you have older faculty,
Jay Bhattacharya (2:04:35.300)
the principle of focus protection says,
Lex Fridman (2:04:37.180)
provide some alternative teaching arrangements for them.
Jay Bhattacharya (2:04:40.260)
That makes sense to me.
Lex Fridman (2:04:42.580)
From the kid's point of view,
Jay Bhattacharya (2:04:44.300)
they're more harmed by not getting the education
Lex Fridman (2:04:46.940)
we promised them than by COVID.
Lex Fridman (2:04:51.420)
So applying this principle of this focus protection,
Lex Fridman (2:04:54.740)
let young professors teach in person.
Jay Bhattacharya (2:04:58.020)
This is before the vaccine.
Lex Fridman (2:04:59.140)
After the vaccine, let everyone teach in person.
Jay Bhattacharya (2:05:01.260)
Yeah, this is the part,
Lex Fridman (2:05:02.220)
I don't understand the discussion we're even having
Jay Bhattacharya (2:05:04.580)
because, okay, let's leave focus protection aside here
Lex Fridman (2:05:09.580)
because that's a brilliant policy for,
Jay Bhattacharya (2:05:12.480)
perhaps for the future when there's no vaccine.
Lex Fridman (2:05:15.800)
Now with the vaccine, I'm misunderstanding something here
Jay Bhattacharya (2:05:20.160)
because we're now in a space that's psychological.
Lex Fridman (2:05:24.940)
It's no longer about biology
Jay Bhattacharya (2:05:27.700)
because with the booster shots,
Lex Fridman (2:05:30.560)
which I believe MIT is now requiring before January,
Jay Bhattacharya (2:05:34.880)
with the booster shots, the data shows,
Lex Fridman (2:05:37.180)
no matter how old you are, the risks are very low
Jay Bhattacharya (2:05:41.760)
for ending up in a hospital
Lex Fridman (2:05:44.760)
relative to all the other risks you face when you're older.
Jay Bhattacharya (2:05:49.500)
I don't understand.
Lex Fridman (2:05:51.480)
Can you explain the policy around closing a university
Lex Fridman (2:05:57.120)
but also just a policy about just being so scared still
Lex Fridman (2:06:04.680)
in the university setting?
Jay Bhattacharya (2:06:06.160)
I think the great universities have done great harm
Lex Fridman (2:06:09.840)
by modeling this kind of behavior.
Jay Bhattacharya (2:06:12.360)
Yes, to me, sorry to keep interrupting,
Lex Fridman (2:06:15.260)
but to me, the university should be the beacon
Jay Bhattacharya (2:06:17.840)
of great behavior, not the beacon of scared, conservative,
Lex Fridman (2:06:24.600)
let's not mess up.
Jay Bhattacharya (2:06:26.160)
Pathological.
Lex Fridman (2:06:27.000)
Let's not make it pathological.
Jay Bhattacharya (2:06:27.840)
Let's not make anybody angry.
Lex Fridman (2:06:31.040)
It should be a place to play in the space of ideas.
Jay Bhattacharya (2:06:33.880)
Yes, so I think the central problem is,
Lex Fridman (2:06:37.680)
actually related to the central problem
Jay Bhattacharya (2:06:39.080)
of COVID policy more generally,
Lex Fridman (2:06:41.360)
the goal seems to be to stop the disease from spreading
Jay Bhattacharya (2:06:46.240)
rather than to reduce the harm from the disease.
Lex Fridman (2:06:51.600)
If the goal is to stop the disease from spreading,
Jay Bhattacharya (2:06:54.040)
the sad fact is we have no technology to accomplish that.
Lex Fridman (2:06:59.160)
At this point.
Jay Bhattacharya (2:07:00.240)
Yes.
Lex Fridman (2:07:01.080)
Like it's already deeply integrated into human civilization.
Lex Fridman (2:07:05.160)
Well, I mean, it's here forever, right?
Lex Fridman (2:07:07.040)
There's a zero survey of white tail deer in the US.
Jay Bhattacharya (2:07:11.120)
It turns out 80% of white tail deer in the US
Lex Fridman (2:07:13.440)
have COVID antibodies.
Jay Bhattacharya (2:07:15.760)
Dogs get it, cats get it.
Lex Fridman (2:07:18.040)
There's almost certainly human animal transmission of it.
Jay Bhattacharya (2:07:22.480)
I mean, presumably, I mean, I've heard bats get it,
Lex Fridman (2:07:24.280)
apparently, so you have a situation
Jay Bhattacharya (2:07:28.320)
where you have this disease that's here to stay.
Lex Fridman (2:07:30.640)
Yeah.
Lex Fridman (2:07:31.480)
And the vaccines don't stop the spread of it,
Lex Fridman (2:07:33.320)
the lockdowns don't stop the spread of it.
Jay Bhattacharya (2:07:34.600)
We have no technology to stop the spread of it.
Lex Fridman (2:07:38.400)
And so we're burning the earth trying to stop,
Jay Bhattacharya (2:07:41.000)
do something that's impossible
Lex Fridman (2:07:42.980)
rather than working on what's possible.
Lex Fridman (2:07:47.760)
And so like letting regular college happen,
Lex Fridman (2:07:51.880)
that's a great good.
Jay Bhattacharya (2:07:53.160)
Universities are a wonderful invention
Lex Fridman (2:07:56.440)
and it's contributed so much to society.
Jay Bhattacharya (2:07:58.820)
Just decide to shut it down.
Lex Fridman (2:08:00.720)
The universities should be fighting tooth and nail
Jay Bhattacharya (2:08:03.360)
to not be shut down, not the other way around.
Lex Fridman (2:08:07.200)
Whatever the mechanisms that results
Jay Bhattacharya (2:08:09.380)
in the universities doing that,
Lex Fridman (2:08:10.480)
that's probably, this is me talking,
Jay Bhattacharya (2:08:12.600)
it probably has to do with certain incentives
Lex Fridman (2:08:14.480)
for the administration, probably has to do with lawyers
Lex Fridman (2:08:16.800)
and legal kinds of things to avoid legal trouble.
Lex Fridman (2:08:21.180)
But once again, it's when the administration
Jay Bhattacharya (2:08:24.640)
has too much power and too much definition
Lex Fridman (2:08:27.300)
of what the policy is for the university,
Jay Bhattacharya (2:08:29.200)
that's when you get into trouble.
Lex Fridman (2:08:30.760)
The beauty, the power of the university
Jay Bhattacharya (2:08:33.300)
should be about the faculty and the students.
Lex Fridman (2:08:36.320)
Administration just gets in the way, get out of the way.
Jay Bhattacharya (2:08:41.400)
I mean, they can help organize things.
Lex Fridman (2:08:43.160)
They play some important role, but they certainly do.
Lex Fridman (2:08:45.880)
But they need to remember what the mission is.
Lex Fridman (2:08:47.560)
The mission is not safety.
Jay Bhattacharya (2:08:50.160)
The mission, actually, universities should be
Lex Fridman (2:08:52.420)
dangerous places for ideas and whatnot.
Lex Fridman (2:08:55.980)
What is the role of fear in a pandemic?
Lex Fridman (2:08:59.220)
We've been dancing around it.
Lex Fridman (2:09:00.740)
Is it useful?
Lex Fridman (2:09:01.740)
Is it destructive?
Lex Fridman (2:09:03.220)
Or is there sort of a complicated story here?
Lex Fridman (2:09:05.860)
Because they're taking us back into January 2020.
Jay Bhattacharya (2:09:10.060)
There was so much uncertainty.
Lex Fridman (2:09:11.460)
This could have been a pandemic that is Black Death,
Jay Bhattacharya (2:09:16.700)
the bubonic plague.
Lex Fridman (2:09:17.820)
It could have killed hundreds of millions of people.
Jay Bhattacharya (2:09:21.140)
We don't know that.
Lex Fridman (2:09:22.660)
We're very new to this.
Jay Bhattacharya (2:09:24.100)
It's been a while.
Lex Fridman (2:09:25.180)
We're rusty.
Lex Fridman (2:09:26.540)
So there is some value to fear
Lex Fridman (2:09:29.460)
so that you don't do the stupid thing.
Jay Bhattacharya (2:09:31.340)
You don't just go on living.
Lex Fridman (2:09:33.120)
I guess where I come from,
Jay Bhattacharya (2:09:34.180)
I think it's almost entirely counterproductive.
Lex Fridman (2:09:36.740)
I think fear should never be used as a tactic
Jay Bhattacharya (2:09:39.960)
to manipulate human behavior by public health.
Lex Fridman (2:09:44.100)
So the fear on the individual level,
Jay Bhattacharya (2:09:47.100)
that feeling of fear,
Lex Fridman (2:09:48.740)
you should be very hesitant about that feeling
Jay Bhattacharya (2:09:51.140)
because it could be easily manipulated by the powerful.
Lex Fridman (2:09:53.940)
Exactly.
Jay Bhattacharya (2:09:54.780)
I think that fear is natural.
Lex Fridman (2:09:57.940)
And it's not something that you have to stoke to get
Lex Fridman (2:10:03.580)
when the facts on the ground suggest it, right?
Lex Fridman (2:10:07.060)
In fact, the tendency for humans
Jay Bhattacharya (2:10:09.220)
in the face of threats from infectious disease
Lex Fridman (2:10:12.780)
is to exaggerate the fear in their own minds
Jay Bhattacharya (2:10:16.420)
of being contaminated by the environment and by others.
Lex Fridman (2:10:19.960)
That's just natural to humans.
Lex Fridman (2:10:21.780)
And the role of public health
Lex Fridman (2:10:24.460)
is not necessarily to eradicate the fear,
Lex Fridman (2:10:27.180)
but obviously technological advances
Lex Fridman (2:10:28.700)
can help eradicate the fear,
Lex Fridman (2:10:29.820)
but it's really to help manage that fear
Lex Fridman (2:10:32.700)
and help people put the sort of incentives
Jay Bhattacharya (2:10:38.580)
that come out of that to useful things
Lex Fridman (2:10:40.420)
as opposed to harmful things.
Jay Bhattacharya (2:10:43.700)
What's happened in this pandemic
Lex Fridman (2:10:45.380)
is that there's been a deliberate policy to stoke the fear,
Jay Bhattacharya (2:10:49.100)
to help make people think that the disease
Lex Fridman (2:10:51.420)
is worse than it actually is.
Jay Bhattacharya (2:10:53.580)
In survey after survey, you see this.
Lex Fridman (2:10:56.060)
And that's been incredibly damaging.
Lex Fridman (2:10:58.300)
So young people have readily given away
Lex Fridman (2:11:02.380)
their willingness to participate in regular life
Jay Bhattacharya (2:11:04.940)
because A, they fear COVID more than they ought,
Lex Fridman (2:11:09.260)
and B, they fear that they're gonna harm the vulnerable
Jay Bhattacharya (2:11:13.060)
in their lives.
Lex Fridman (2:11:14.700)
You put those two together
Lex Fridman (2:11:15.820)
and you get this powerful demand for lockdowns.
Lex Fridman (2:11:18.340)
You see this all over the world.
Jay Bhattacharya (2:11:20.580)
Broadly speaking, you have a powerful demand
Lex Fridman (2:11:23.460)
for irrational policies, irrational policies,
Jay Bhattacharya (2:11:26.540)
because I would like to mention the flip side of that.
Lex Fridman (2:11:29.180)
I've been saddened to see how much money
Jay Bhattacharya (2:11:32.780)
there is to be made by the martyrs,
Lex Fridman (2:11:37.540)
the people, the conspiracy theorists
Jay Bhattacharya (2:11:40.660)
that tell you you should be afraid of the government.
Lex Fridman (2:11:46.140)
You should be afraid of the man.
Jay Bhattacharya (2:11:49.180)
It feels like fear is the problem.
Lex Fridman (2:11:51.700)
I think there's some guy that once said something
Jay Bhattacharya (2:11:53.740)
about we should fear fear itself.
Lex Fridman (2:11:58.900)
He was a president or something.
Jay Bhattacharya (2:11:59.940)
I vaguely remember that.
Lex Fridman (2:12:01.740)
So I'm worried about both sides here, that.
Jay Bhattacharya (2:12:06.100)
Well, I think the general principle
Lex Fridman (2:12:07.740)
is that should not be a tool of public policy, right?
Jay Bhattacharya (2:12:11.380)
The public policy should attempt,
Lex Fridman (2:12:13.780)
and public health policy in particular,
Jay Bhattacharya (2:12:15.100)
should attempt to address that fear.
Lex Fridman (2:12:16.860)
It's not that you should tell people lies, of course not.
Jay Bhattacharya (2:12:22.740)
Tell people accurately what the risk is.
Lex Fridman (2:12:26.460)
Give people tools that have evidence
Jay Bhattacharya (2:12:29.020)
that they can address their risk with
Lex Fridman (2:12:32.540)
and level with people when we don't know.
Jay Bhattacharya (2:12:36.180)
I think that is the right adult way
Lex Fridman (2:12:38.780)
to deal with this pandemic from a public health point of view.
Lex Fridman (2:12:41.620)
And that is not the policy we have followed.
Lex Fridman (2:12:44.660)
Instead, public health is intentionally stoked the fear
Jay Bhattacharya (2:12:47.500)
in order to gain compliance with its edicts.
Lex Fridman (2:12:50.500)
And I think the consequence of that
Jay Bhattacharya (2:12:53.300)
is people distrust public health.
Lex Fridman (2:12:56.620)
What you're talking about, the distrust of government,
Jay Bhattacharya (2:12:58.620)
I think is partly a consequence of that.
Lex Fridman (2:13:00.780)
That movement, which is much smaller once upon a time,
Jay Bhattacharya (2:13:03.340)
is much larger now because of essentially
Lex Fridman (2:13:06.940)
people look at what public health has done
Lex Fridman (2:13:09.100)
and said they've lied to me a whole bunch of times
Lex Fridman (2:13:12.220)
and a whole bunch of things is the general sense.
Lex Fridman (2:13:15.340)
And there are consequences to that.
Lex Fridman (2:13:17.260)
We're gonna have to work in public health for a long time
Jay Bhattacharya (2:13:20.100)
to try to regain the trust of the public.
Lex Fridman (2:13:22.900)
Throughout all of this, you've been inspiring to me,
Jay Bhattacharya (2:13:26.180)
to a lot of people.
Lex Fridman (2:13:27.740)
So you've been fearless, bold,
Jay Bhattacharya (2:13:32.660)
in these kind of challenging the policies
Lex Fridman (2:13:35.940)
and not in a martyr kind of way
Jay Bhattacharya (2:13:38.980)
because you're walking the line gracefully
Lex Fridman (2:13:42.260)
and beautifully, I would say.
Lex Fridman (2:13:44.460)
And looking at that, I think you're an inspiration
Lex Fridman (2:13:49.340)
to a lot of young people.
Lex Fridman (2:13:50.300)
So I have to ask, what advice would you give them
Lex Fridman (2:13:53.940)
if they're thinking of going into science,
Jay Bhattacharya (2:13:56.500)
if they're thinking of having an impact in the world,
Lex Fridman (2:13:59.540)
what advice would you give them about their career
Lex Fridman (2:14:03.820)
and maybe about their life?
Lex Fridman (2:14:05.900)
Thinking about somebody in high school,
Jay Bhattacharya (2:14:07.620)
maybe in undergraduate college.
Lex Fridman (2:14:09.740)
I'd say a few things.
Jay Bhattacharya (2:14:10.620)
One is, this is a wonderful profession.
Lex Fridman (2:14:13.180)
You have an opportunity to improve the lives of so many
Lex Fridman (2:14:17.340)
and do it by having fun,
Lex Fridman (2:14:19.180)
the kind of play we're talking about.
Jay Bhattacharya (2:14:20.900)
It's an absolute privilege to be able to work
Lex Fridman (2:14:24.060)
in this kind of area.
Lex Fridman (2:14:27.260)
And to young people looking to say,
Lex Fridman (2:14:28.580)
that have some gifts or desire for this area,
Jay Bhattacharya (2:14:32.740)
I say, please, go for it.
Lex Fridman (2:14:35.780)
So this area of science broadly.
Jay Bhattacharya (2:14:37.620)
Yeah, I mean, it could be,
Lex Fridman (2:14:39.580)
I mean, I don't have any gifts in AI,
Lex Fridman (2:14:41.260)
but like, it could be your buddy,
Lex Fridman (2:14:43.180)
or in health or in medicine or whatever,
Jay Bhattacharya (2:14:46.260)
whatever your gifts lie, develop them,
Lex Fridman (2:14:48.340)
work hard and develop them,
Jay Bhattacharya (2:14:49.300)
because it's worth it.
Lex Fridman (2:14:50.140)
It's worth it, not just because you get some status,
Lex Fridman (2:14:54.420)
but because the journey is fun.
Lex Fridman (2:14:56.900)
And the result is improvements in the lives of so many.
Lex Fridman (2:15:00.540)
So I think that is the encouragement I give.
Lex Fridman (2:15:03.220)
I'd also say, if you're looking at this ugliness
Jay Bhattacharya (2:15:06.020)
of this debate that's happened over the pandemic,
Lex Fridman (2:15:09.260)
I'd say to young people,
Jay Bhattacharya (2:15:10.580)
we need you to come in and help transform it.
Lex Fridman (2:15:13.780)
Many of the people you see in this debate
Jay Bhattacharya (2:15:15.100)
that behave poorly, I ask you forgive them.
Lex Fridman (2:15:18.460)
I've done my best to try,
Jay Bhattacharya (2:15:21.740)
because many of them are acting out of their own sense
Lex Fridman (2:15:25.980)
that they need to do good,
Lex Fridman (2:15:27.380)
but the mistake they've made is in this arrogance
Lex Fridman (2:15:31.580)
and this power.
Lex Fridman (2:15:32.420)
So when you come in, remember that example
Lex Fridman (2:15:34.300)
as a negative example.
Lex Fridman (2:15:35.780)
And so that when you join the debate,
Lex Fridman (2:15:38.220)
you'll join it in a spirit of humility
Lex Fridman (2:15:40.460)
and a spirit of trying to learn
Lex Fridman (2:15:42.460)
while keeping that love that led you
Jay Bhattacharya (2:15:45.860)
to enter the field in the first place.
Lex Fridman (2:15:48.260)
And yeah, choose forgiveness versus like derision.
Jay Bhattacharya (2:15:54.460)
Like the people that you know have messed up,
Lex Fridman (2:15:57.500)
like give them a pass,
Jay Bhattacharya (2:15:59.460)
because it feels like that's how improvement starts.
Lex Fridman (2:16:03.380)
Funny, I've been thinking this is like,
Lex Fridman (2:16:05.700)
I told you I'm Christian, right?
Lex Fridman (2:16:06.900)
So like God has given me many opportunities
Jay Bhattacharya (2:16:10.140)
to forgive people, learned to practice how to do that.
Lex Fridman (2:16:12.700)
Gave you a gift.
Jay Bhattacharya (2:16:13.740)
It's a very humbling thing, I guess.
Lex Fridman (2:16:15.500)
Is there a memory from when you were young
Lex Fridman (2:16:19.940)
that was very formative to you?
Lex Fridman (2:16:22.340)
So you just gave advice to some young people.
Jay Bhattacharya (2:16:24.580)
Is there something that stands out to you
Lex Fridman (2:16:26.460)
that a decision you made, an event that happened
Lex Fridman (2:16:32.220)
that made you the man you are today?
Lex Fridman (2:16:35.540)
I actually grew up in a relatively poor environment.
Jay Bhattacharya (2:16:38.340)
Like I was born in India and we moved when I was four.
Lex Fridman (2:16:42.700)
My dad had eight brothers and sisters
Lex Fridman (2:16:46.340)
and my mom had four brothers and sisters.
Lex Fridman (2:16:48.380)
She grew up in the slum in Calcutta.
Jay Bhattacharya (2:16:52.380)
My dad, his dad died when he was young
Lex Fridman (2:16:54.820)
and he supported his family, his brothers and sisters
Jay Bhattacharya (2:16:57.260)
with university scholarship money.
Lex Fridman (2:16:59.180)
Came to the US and my dad worked in a McDonald's,
Jay Bhattacharya (2:17:02.540)
even though he's an electrical engineer,
Lex Fridman (2:17:04.100)
couldn't find a job in 1971.
Lex Fridman (2:17:06.580)
And so he worked at McDonald's.
Lex Fridman (2:17:09.220)
We lived in a, like this, basically the housing port
Jay Bhattacharya (2:17:14.340)
like development in Cambridge,
Lex Fridman (2:17:16.940)
this like this middle building on the 17th floor,
Jay Bhattacharya (2:17:19.020)
this like housing development.
Lex Fridman (2:17:20.580)
I mean, I think that was transformative for me.
Jay Bhattacharya (2:17:25.060)
Like I didn't realize so much at the time
Lex Fridman (2:17:27.300)
how that experience of being essentially like poor,
Jay Bhattacharya (2:17:32.220)
lower middle class, what effect it had on my outlook.
Lex Fridman (2:17:36.300)
You mentioned to me offline
Jay Bhattacharya (2:17:37.460)
that you listened to the conversation
Lex Fridman (2:17:38.820)
that I had with my dad.
Lex Fridman (2:17:40.620)
What impact did your dad have on your life?
Lex Fridman (2:17:42.660)
What memories do you have about him?
Jay Bhattacharya (2:17:44.980)
He was a rocket scientist actually.
Lex Fridman (2:17:46.740)
He helped design rocket guidance systems.
Jay Bhattacharya (2:17:51.060)
He died when I was 20 and I still miss him to this day.
Lex Fridman (2:17:55.340)
And I think that experience of seeing him
Jay Bhattacharya (2:17:58.660)
sacrifice himself for his family, brilliant man,
Lex Fridman (2:18:05.180)
but in many ways frustrated with like his opportunities
Jay Bhattacharya (2:18:08.580)
in the world, which is probably what led him
Lex Fridman (2:18:10.060)
to come to the US in the first place.
Jay Bhattacharya (2:18:12.820)
That's transformed, that's had a transformative effect on me
Lex Fridman (2:18:16.660)
and I wish I could tell him that looking back.
Lex Fridman (2:18:21.660)
Do you think about your own mortality?
Lex Fridman (2:18:25.300)
Do you think about your death?
Jay Bhattacharya (2:18:26.900)
Your dad is no longer with us.
Lex Fridman (2:18:29.380)
You're the old wise sage that represents.
Jay Bhattacharya (2:18:35.780)
I've only worried about death once in this pandemic.
Lex Fridman (2:18:39.820)
Although I've had two, my cousin was 73
Lex Fridman (2:18:43.100)
and my uncle who's 74 died in India during the pandemic.
Lex Fridman (2:18:47.860)
And I grieve them both from COVID.
Jay Bhattacharya (2:18:52.700)
Like the fear of COVID really has only hit me
Lex Fridman (2:18:55.500)
only really once during this and it wasn't for me.
Lex Fridman (2:18:58.940)
And I recognize it's irrational.
Lex Fridman (2:19:01.020)
So on the eve of the Santa Clara County seroprevalence study,
Jay Bhattacharya (2:19:06.140)
it was a really interesting thing
Lex Fridman (2:19:07.940)
because so many people volunteered to help.
Lex Fridman (2:19:10.700)
And my daughter who's 20, I guess she was 19 at the time
Lex Fridman (2:19:16.660)
and my wife also volunteered to help
Jay Bhattacharya (2:19:18.420)
with like various aspects of the study.
Lex Fridman (2:19:21.020)
And so the eve of the study,
Jay Bhattacharya (2:19:22.020)
they were going to go out in public
Lex Fridman (2:19:24.100)
and I didn't know what the death rate was
Jay Bhattacharya (2:19:25.780)
because we hadn't done the study.
Lex Fridman (2:19:27.820)
And I suspected it was lower than people were saying
Lex Fridman (2:19:30.300)
but I didn't know.
Lex Fridman (2:19:31.660)
I knew about the age gradient
Jay Bhattacharya (2:19:33.820)
because I'd seen the Chinese data and my daughter's young
Lex Fridman (2:19:37.140)
but my wife is my age and I didn't know the death rate.
Lex Fridman (2:19:40.900)
And I couldn't sleep the night before.
Lex Fridman (2:19:43.620)
Like what if I'm putting my family,
Jay Bhattacharya (2:19:45.860)
my daughter and my wife at risk
Lex Fridman (2:19:48.700)
because of some activity that I'm doing.
Jay Bhattacharya (2:19:52.220)
It was kind of, I don't know.
Lex Fridman (2:19:53.420)
I mean, it was.
Lex Fridman (2:19:54.260)
So it's worried about the wellbeing of others.
Lex Fridman (2:19:58.700)
Yeah.
Jay Bhattacharya (2:19:59.540)
When you look in the mirror.
Lex Fridman (2:20:00.420)
If I die, I die.
Jay Bhattacharya (2:20:01.420)
I mean, like I just, it's not, again, I'm Christian.
Lex Fridman (2:20:04.180)
So I don't, death is not the end for me, I believe.
Lex Fridman (2:20:07.940)
And so I don't particularly worried about my own death
Lex Fridman (2:20:10.580)
but I do, I mean, I just, I think we can't help
Lex Fridman (2:20:14.420)
but we worry about the wellbeing of our loved ones.
Lex Fridman (2:20:17.540)
So from the perspective of God, then let me ask you,
Lex Fridman (2:20:23.340)
what do you think is the meaning
Lex Fridman (2:20:24.420)
of this whole journey we're on?
Lex Fridman (2:20:25.900)
What do you think is the meaning of life?
Lex Fridman (2:20:28.060)
You know, it's very simple.
Jay Bhattacharya (2:20:29.140)
Love one another.
Lex Fridman (2:20:30.740)
Treat your neighbor as yourself.
Jay Bhattacharya (2:20:32.660)
It's love, as simple as that.
Lex Fridman (2:20:35.780)
Well, I'd love to see a little bit more of that
Jay Bhattacharya (2:20:38.220)
in this pandemic.
Lex Fridman (2:20:39.940)
It's an opportunity for the best of our nature to shine.
Jay Bhattacharya (2:20:44.260)
It's, I've seen some of the worst
Lex Fridman (2:20:47.700)
but I think some of that is just good therapy.
Lex Fridman (2:20:49.780)
And I'm hoping in the end, what we have here is love.
Lex Fridman (2:20:54.900)
At the very least, make your dad proud
Jay Bhattacharya (2:20:57.580)
with some incredible rockets that we're launching.
Lex Fridman (2:21:01.660)
I think you'd get along well with my dad, Lex.
Jay Bhattacharya (2:21:04.540)
I definitely would.
Lex Fridman (2:21:05.900)
Thank you so much.
Jay Bhattacharya (2:21:06.740)
This is an incredible honor to talk to you, Jay.
Lex Fridman (2:21:08.860)
You've been an inspiration to so many people
Lex Fridman (2:21:11.500)
and keep fighting the good fight.
Lex Fridman (2:21:13.340)
Thank you so much for spending your valuable time
Jay Bhattacharya (2:21:15.740)
with me today.
Lex Fridman (2:21:16.580)
Thank you for having me here, appreciate it.
Jay Bhattacharya (2:21:18.460)
Thanks for listening to this conversation
Lex Fridman (2:21:20.100)
with Jay Bhattacharya.
Jay Bhattacharya (2:21:21.460)
To support this podcast,
Lex Fridman (2:21:22.860)
please check out our sponsors in the description.
Lex Fridman (2:21:26.060)
And now let me leave you some words from Alice Walker.
Lex Fridman (2:21:29.520)
The most common way people give up their power
Jay Bhattacharya (2:21:33.200)
is by thinking they don't have any.
Lex Fridman (2:21:35.480)
Thank you for listening and hope to see you next time.
Jay Bhattacharya (30:00.060)
That was essentially the idea.
Lex Fridman (30:01.900)
If we can just get the virus to go away,
Jay Bhattacharya (30:04.820)
we won't have to ever worry about it again.
Lex Fridman (30:07.420)
The main problem with our result
Jay Bhattacharya (30:09.360)
as far as that strategy was concerned wasn't the death rate,
Lex Fridman (30:11.580)
it was the 40 to 50 times more infections than cases.
Jay Bhattacharya (30:14.820)
It was the 2.5% or 3% or 4% prevalence rate
Lex Fridman (30:19.580)
that we identified of the antibodies in the population.
Jay Bhattacharya (30:23.060)
If that number is right, it's too late.
Lex Fridman (30:25.820)
The virus is not going to go to zero.
Lex Fridman (30:28.140)
And no matter how much we test and trace and isolate,
Lex Fridman (30:30.260)
we're not going to get the viral level down to zero.
Lex Fridman (30:34.020)
So we're gonna have to let the virus
Lex Fridman (30:36.460)
go through the entire population in some way or some other?
Jay Bhattacharya (30:39.820)
We can talk about that in a bit.
Lex Fridman (30:41.160)
That's the Great Barrington Declaration.
Jay Bhattacharya (30:42.460)
You don't have to let the virus go through the population.
Lex Fridman (30:44.240)
You can shield preferentially.
Jay Bhattacharya (30:46.900)
The policy we chose was to shield preferentially
Lex Fridman (30:50.060)
the laptop class,
Jay Bhattacharya (30:52.180)
the set of people who could work from home
Lex Fridman (30:54.660)
without losing their job.
Lex Fridman (30:56.700)
And we did a very good job at protecting them.
Lex Fridman (30:59.420)
Well, let me take a small tangent.
Jay Bhattacharya (31:04.080)
We're gonna jump around in time,
Lex Fridman (31:06.620)
which I think will be the best way to tell the story.
Lex Fridman (31:09.260)
So that was the beginning.
Lex Fridman (31:10.580)
Yeah, okay, actually, can I go back one more thing for that?
Jay Bhattacharya (31:13.940)
Because that's really important
Lex Fridman (31:14.780)
and I should have started with this.
Lex Fridman (31:17.540)
What led me to do those studies was a paper
Lex Fridman (31:22.000)
that I had remembered seeing
Jay Bhattacharya (31:23.740)
from the H1N1 flu epidemic in 2009.
Lex Fridman (31:26.420)
This is where I've been much less active
Jay Bhattacharya (31:28.340)
in writing about that.
Lex Fridman (31:29.180)
I had written like a paper or two about that in 2009.
Jay Bhattacharya (31:34.020)
There was actually the same debate over the mortality rate,
Lex Fridman (31:38.780)
except it unfolded over the course of three years,
Jay Bhattacharya (31:41.660)
two or three years.
Lex Fridman (31:43.240)
The early studies of the mortality rate in H1N1
Jay Bhattacharya (31:47.980)
counted the number of cases in the denominator,
Lex Fridman (31:52.220)
counted the number of deaths in the numerator,
Jay Bhattacharya (31:53.680)
cases meaning people identified as having H1N1,
Lex Fridman (31:56.620)
showing up the doctor, tested to have it.
Lex Fridman (32:00.500)
And the earliest estimates of the H1N1 mortality
Lex Fridman (32:04.040)
were like 4%, 3%, really, really high.
Jay Bhattacharya (32:08.980)
Over the course of a couple of more years,
Lex Fridman (32:11.300)
a whole bunch of seroprevalence studies,
Jay Bhattacharya (32:12.940)
seroprevalence studies of H1N1 flu came out.
Lex Fridman (32:15.820)
And it turned out that there were 100 or more times
Jay Bhattacharya (32:20.620)
people infected per case.
Lex Fridman (32:23.260)
And so the mortality rate was actually something like 0.02%
Jay Bhattacharya (32:27.540)
for H1N1, not the three, like 100 fold difference.
Lex Fridman (32:32.060)
So this made you think, okay,
Jay Bhattacharya (32:34.260)
it took us a couple of two or three years
Lex Fridman (32:36.180)
to discover the truth behind the actual infections
Jay Bhattacharya (32:40.420)
for H1N1, and then what's the truth here
Lex Fridman (32:43.940)
and can we get there faster?
Jay Bhattacharya (32:45.060)
Yeah, and it spreads in a similar way as the H1N1 flu did.
Lex Fridman (32:49.180)
I mean, it spreads via solization,
Jay Bhattacharya (32:51.640)
via person to person breathing, kind of contact up.
Lex Fridman (32:55.480)
It may be some by fomites, but it seems less likely now.
Jay Bhattacharya (32:59.220)
In any case, it seemed really important to me
Lex Fridman (33:01.740)
to speed up the process
Jay Bhattacharya (33:03.540)
of having those seroprevalence studies
Lex Fridman (33:05.900)
so that we can better understand who was at risk
Lex Fridman (33:09.060)
and what the right strategy ought to be.
Lex Fridman (33:12.260)
This might be a good place to kind of compare influenza,
Jay Bhattacharya (33:17.320)
the flu, and COVID in the context of the discussion
Lex Fridman (33:20.980)
we just had, which is how deadly is COVID?
Lex Fridman (33:24.420)
So you mentioned COVID is a very particular
Lex Fridman (33:26.620)
kind of steepness, where the X axis is age.
Lex Fridman (33:32.180)
So in that context, could you maybe compare influenza
Lex Fridman (33:36.260)
and COVID, because a lot of people outside the folks
Jay Bhattacharya (33:41.260)
who suggest that the lizards who run the world
Lex Fridman (33:45.140)
have completely fabricated and invented COVID,
Jay Bhattacharya (33:48.460)
outside of those folks, kind of the natural process
Lex Fridman (33:51.900)
by which you dismiss the threat of COVID is, say,
Jay Bhattacharya (33:54.660)
well, it's just like the flu.
Lex Fridman (33:55.900)
The flu is a very serious thing, actually.
Lex Fridman (33:58.780)
So in that comparison, where does COVID stand?
Lex Fridman (34:03.660)
Yeah, the flu is a very serious thing.
Jay Bhattacharya (34:04.980)
It kills 50, 60,000 people a year,
Lex Fridman (34:07.980)
something I found out,
Jay Bhattacharya (34:08.820)
depending on the particular strain that goes around,
Lex Fridman (34:11.340)
that's in the United States.
Jay Bhattacharya (34:12.760)
The primary difference to me,
Lex Fridman (34:15.060)
there's lots of differences,
Lex Fridman (34:15.900)
but one of the most salient differences
Lex Fridman (34:17.340)
is the age gradient and mortality risk for the flu.
Lex Fridman (34:21.420)
So the flu is more deadly to children than COVID is.
Lex Fridman (34:26.660)
There's no controversy about that.
Jay Bhattacharya (34:29.340)
Children, thank God, have much less severe reactions
Lex Fridman (34:34.340)
to COVID infection than they do to flu infections.
Lex Fridman (34:39.980)
And rate of fatalities and stuff like that.
Lex Fridman (34:41.900)
Rate of fatality, all of that.
Jay Bhattacharya (34:42.860)
I think you mentioned,
Lex Fridman (34:44.840)
I mean, it's interesting to maybe also comment on,
Jay Bhattacharya (34:47.060)
I think in another conversation you mentioned
Lex Fridman (34:48.800)
there's a U shape to the flu curve,
Lex Fridman (34:54.500)
so meaning there's actually quite a large number of kids
Lex Fridman (34:57.540)
that die from flu.
Jay Bhattacharya (34:59.220)
Yeah, I mean, the 1918 flu, the H1N1 flu,
Lex Fridman (35:03.000)
the Spanish flu in the US killed millions of younger people.
Lex Fridman (35:09.500)
And that is not the case with COVID.
Lex Fridman (35:13.460)
More than, I'm gonna get the number wrong,
Lex Fridman (35:16.820)
but something like 70, 80% of the deaths
Lex Fridman (35:19.280)
are people over the age of 60.
Jay Bhattacharya (35:21.420)
Well, we've talked about the fear the whole time, really.
Lex Fridman (35:24.940)
But my interaction with folks,
Jay Bhattacharya (35:27.960)
now I wanna have a family, I wanna have kids,
Lex Fridman (35:30.260)
but I don't have that real firsthand experience,
Lex Fridman (35:32.820)
but my interaction with folks is at the core of fear
Lex Fridman (35:35.860)
that folks had is for their children.
Jay Bhattacharya (35:39.900)
Like that somehow I don't wanna get infected
Lex Fridman (35:46.060)
because of the kids.
Jay Bhattacharya (35:47.900)
Because God forbid something happens to the kids.
Lex Fridman (35:50.780)
And I think that obviously that makes a lot of sense
Jay Bhattacharya (35:54.520)
this kind of the kids come first no matter what,
Lex Fridman (35:57.480)
that's number one priority.
Lex Fridman (35:58.660)
But for this particular virus,
Lex Fridman (36:02.000)
that reasoning was not grounded in data, it seems like,
Jay Bhattacharya (36:05.860)
or that emotion and feeling was not grounded in data.
Lex Fridman (36:09.460)
But at the same time, this is way more deadly than the flu
Jay Bhattacharya (36:12.260)
just overall, and especially to older people.
Lex Fridman (36:15.540)
Yes.
Jay Bhattacharya (36:16.500)
Right, so.
Lex Fridman (36:17.340)
The numbers, when the story is all said and done,
Jay Bhattacharya (36:21.220)
COVID would take many more lives.
Lex Fridman (36:24.060)
Yeah, so, I mean, 0.2 sounds like a small number,
Lex Fridman (36:27.380)
but it's not a small number worldwide.
Lex Fridman (36:29.620)
What do you think that number will be
Jay Bhattacharya (36:31.520)
by the, you know, that's not like me,
Lex Fridman (36:34.160)
but would we cross, I think it's in the United States,
Jay Bhattacharya (36:37.220)
it's the way the deaths are currently reported,
Lex Fridman (36:40.700)
it's like 800,000, something like that.
Lex Fridman (36:42.700)
Do you think we'll cross a million?
Lex Fridman (36:44.420)
Seems likely, yeah.
Lex Fridman (36:46.660)
Do you think it's something that might continue
Lex Fridman (36:49.060)
with different variants, what?
Jay Bhattacharya (36:50.820)
Well, I think, so we can talk about the end state of COVID.
Lex Fridman (36:53.460)
The end state of COVID is it's here forever.
Jay Bhattacharya (36:56.020)
I think that there is good evidence of immunity
Lex Fridman (37:01.020)
after infection, such that you're protected
Jay Bhattacharya (37:05.660)
both against reinfection and also against
Lex Fridman (37:08.540)
severe disease upon reinfection.
Lex Fridman (37:11.340)
So the second time you get it, it's not true for everyone,
Lex Fridman (37:13.940)
but for many people, the second time you get it
Jay Bhattacharya (37:15.660)
will be milder, much milder than the first time you get it.
Lex Fridman (37:18.620)
With the long tail, like that lasts for a long time.
Jay Bhattacharya (37:22.720)
Yeah, so just, there are studies that follow, of course,
Lex Fridman (37:26.100)
people who are infected for a year,
Lex Fridman (37:28.340)
and the reinfection rate is something like
Lex Fridman (37:30.420)
somewhere between 0.3 and 1%.
Lex Fridman (37:33.820)
And like a pretty fantastic study out in Italy
Lex Fridman (37:36.260)
has found that, there's one in Sweden, I think,
Jay Bhattacharya (37:38.780)
there's a few studies that have found similar things.
Lex Fridman (37:41.820)
And the reinfections tend to produce much milder disease,
Jay Bhattacharya (37:46.940)
much less likely to end up in the hospital,
Lex Fridman (37:48.420)
much less likely to die.
Lex Fridman (37:50.100)
So what the end state of COVID is,
Lex Fridman (37:52.540)
it's circulating the population forever
Lex Fridman (37:54.580)
and you get it multiple times.
Lex Fridman (37:56.500)
Yeah, and then there's, I think, studies and discussions
Jay Bhattacharya (38:00.980)
like the best protection would be to get it
Lex Fridman (38:04.300)
and then also to get vaccinated.
Lex Fridman (38:06.220)
And then a lot of people push back against that
Lex Fridman (38:08.740)
for the obvious reasons from both sides,
Jay Bhattacharya (38:10.700)
because somehow the discourse has become
Lex Fridman (38:13.060)
less scientific and more political.
Jay Bhattacharya (38:14.820)
Well, I think you wanna, the first time you meet it
Lex Fridman (38:18.100)
is gonna be the most deadly for you.
Lex Fridman (38:20.300)
And so the first time you meet it,
Lex Fridman (38:21.540)
it's just wise to be vaccinated.
Jay Bhattacharya (38:22.780)
The vaccine reduces severe disease.
Lex Fridman (38:25.420)
Yeah, we'll talk about the vaccine,
Jay Bhattacharya (38:27.700)
because I wanna make sure I address it carefully
Lex Fridman (38:30.100)
and properly and in full context.
Lex Fridman (38:35.020)
But yes, sort of to add to the context,
Lex Fridman (38:38.060)
a lot of the fascinating discussions we're having
Jay Bhattacharya (38:40.380)
is in the early days of COVID
Lex Fridman (38:43.060)
and now for people who are unvaccinated.
Jay Bhattacharya (38:46.460)
That's where the interesting story is.
Lex Fridman (38:49.060)
The policy story, the sociological story and so on.
Lex Fridman (38:52.740)
But let me go to something really fascinating
Lex Fridman (38:55.940)
just because of the people involved,
Jay Bhattacharya (38:57.940)
the human beings involved,
Lex Fridman (38:59.260)
and because of how deeply I care about science
Lex Fridman (39:03.020)
and also kindness, respect and love and human things.
Lex Fridman (39:07.740)
Francis Collins wrote a letter in October 2020
Jay Bhattacharya (39:12.380)
to Anthony Fauci and I think somebody else.
Lex Fridman (39:15.940)
I have the letter, oh, it's not a letter, email, I apologize.
Jay Bhattacharya (39:20.940)
Hi, Tony and Cliff, cgbdeclaration.org.
Lex Fridman (39:29.500)
This proposal, this is the Great Barrington Declaration
Jay Bhattacharya (39:32.940)
that you're a coauthor on.
Lex Fridman (39:34.940)
This proposal from the three fringe epidemiologists
Jay Bhattacharya (39:38.620)
who met with the secretary
Lex Fridman (39:40.120)
seem to be getting a lot of attention
Lex Fridman (39:42.180)
and even a co signature from Nobel Prize winner,
Lex Fridman (39:45.940)
Mike Levitt at Stanford.
Jay Bhattacharya (39:48.700)
There needs to be a quick and devastating
Lex Fridman (39:51.180)
published take down of its premises.
Jay Bhattacharya (39:54.820)
I don't see anything like that online yet.
Lex Fridman (39:57.980)
Is it underway, question mark, Francis.
Jay Bhattacharya (40:00.460)
Francis Collins, director of the NIH,
Lex Fridman (40:03.340)
somebody I talked to on this podcast recently.
Jay Bhattacharya (40:06.140)
Okay, a million questions I wanna ask.
Lex Fridman (40:09.660)
But first, how did that make you feel
Jay Bhattacharya (40:12.620)
when you first saw this email come to light,
Lex Fridman (40:17.620)
when did it come to light?
Jay Bhattacharya (40:20.940)
This week, actually, I think, or last week.
Lex Fridman (40:22.860)
Okay, so this is because of freedom of information.
Jay Bhattacharya (40:25.620)
Yeah.
Lex Fridman (40:26.460)
Which, by the way, sort of maybe,
Jay Bhattacharya (40:30.180)
because I do wanna add positive stuff
Lex Fridman (40:32.140)
on the side of Francis here.
Jay Bhattacharya (40:36.220)
Boy, when I see stuff like that,
Lex Fridman (40:37.860)
I wonder if all my emails leaked, how much embarrassing stuff.
Jay Bhattacharya (40:43.020)
Like, I think I'm a good person,
Lex Fridman (40:45.140)
but I haven't read my old emails.
Jay Bhattacharya (40:49.300)
Maybe, I'm pretty sure sometimes I could be an asshole.
Lex Fridman (40:53.260)
Well, I mean, look, he's a Christian,
Lex Fridman (40:54.980)
and I'm a Christian, I'm supposed to forgive, right?
Lex Fridman (40:57.060)
I mean, I think he was looking at this
Jay Bhattacharya (41:01.500)
Great Barrington Declaration as a political problem
Lex Fridman (41:03.780)
to be solved, as opposed to a serious
Jay Bhattacharya (41:07.340)
alternative approach to the epidemic.
Lex Fridman (41:09.980)
So maybe we'll talk about it in more detail,
Lex Fridman (41:12.280)
but just in case people are not familiar,
Lex Fridman (41:15.020)
Great Barrington Declaration was a document
Jay Bhattacharya (41:18.900)
that you coauthored that basically argues
Lex Fridman (41:22.300)
against this idea of lockdown as a solution to COVID,
Lex Fridman (41:26.220)
and you propose another solution that we'll talk about.
Lex Fridman (41:29.420)
But the point is, it's not that dramatic of a document,
Jay Bhattacharya (41:34.860)
it is just a document that criticizes
Lex Fridman (41:36.920)
one policy solution that was proposed.
Lex Fridman (41:38.940)
But it was the policy solution that had been put forward
Lex Fridman (41:41.180)
by Dr. Collins and by Tony Fauci,
Lex Fridman (41:44.900)
and a few other science, I mean, I think a relatively
Lex Fridman (41:48.060)
small number of scientists and epidemiologists
Jay Bhattacharya (41:50.760)
in charge of the advice given to governments worldwide.
Lex Fridman (41:56.700)
And it was a challenge to that policy
Jay Bhattacharya (42:00.060)
that said that, look, there is an alternate path,
Lex Fridman (42:02.940)
that the path we've chosen, this path of lockdown
Jay Bhattacharya (42:06.080)
with the aim to suppress the virus to zero effectively,
Lex Fridman (42:09.020)
I mean, that was unstated.
Jay Bhattacharya (42:11.060)
Cannot work and is causing catastrophic harm
Lex Fridman (42:14.620)
to large numbers of poor and vulnerable people worldwide.
Jay Bhattacharya (42:19.300)
We put this out in October 4th, I think, of 2020,
Lex Fridman (42:23.500)
and it went viral.
Jay Bhattacharya (42:25.700)
I mean, I've never actually been involved
Lex Fridman (42:27.140)
with anything like this,
Jay Bhattacharya (42:28.940)
where I just put the document on the web,
Lex Fridman (42:31.580)
and tens of thousands of doctors signed on,
Jay Bhattacharya (42:34.260)
hundreds of thousands of regular people signed on.
Lex Fridman (42:37.200)
It really struck a chord of people,
Jay Bhattacharya (42:40.220)
because I think even by October of 2020,
Lex Fridman (42:41.940)
people had this sense that there was something really wrong
Jay Bhattacharya (42:45.160)
with the COVID policy that we've been following.
Lex Fridman (42:48.180)
And they were looking for reasonable people
Jay Bhattacharya (42:52.140)
to give an alternative.
Lex Fridman (42:52.980)
I mean, we're not arguing that COVID isn't a serious thing.
Jay Bhattacharya (42:56.100)
I mean, it is a very serious thing.
Lex Fridman (42:57.620)
This is why we had a policy that aimed at addressing it.
Lex Fridman (43:03.260)
But we were saying that the policy we're following
Lex Fridman (43:05.740)
is not the right one.
Lex Fridman (43:06.960)
So how does a democratic government deal with that challenge?
Lex Fridman (43:12.960)
So to me, that, you asked me how I felt.
Jay Bhattacharya (43:14.880)
I was actually, frankly, just,
Lex Fridman (43:16.720)
I suspected there'd been some email exchanges like that,
Jay Bhattacharya (43:19.760)
not necessarily from Francis Collins,
Lex Fridman (43:21.920)
around the government around this time.
Jay Bhattacharya (43:24.960)
I mean, I felt the full brunt of a propaganda campaign
Lex Fridman (43:29.280)
almost immediately after we published it,
Jay Bhattacharya (43:31.280)
where newspapers mischaracterized it
Lex Fridman (43:34.080)
in the same way over and over and over again,
Lex Fridman (43:39.280)
and sought to characterize me
Lex Fridman (43:41.560)
as sort of a marginal fringe figure or whatnot.
Jay Bhattacharya (43:45.920)
Sunetra Gupta, Martin Kulldorff,
Lex Fridman (43:47.640)
or the tens of thousands of other people that signed it.
Jay Bhattacharya (43:50.360)
I felt the brunt of that all year long.
Lex Fridman (43:53.560)
So to see this in black and white,
Jay Bhattacharya (43:56.240)
in the handwriting, essentially,
Lex Fridman (43:58.680)
I mean, the metaphorical handwriting of Francis Collins
Jay Bhattacharya (44:01.040)
was actually, frankly, a disappointment,
Lex Fridman (44:02.320)
because I've looked up to him for years.
Jay Bhattacharya (44:05.320)
Yeah, I've looked up to him as well.
Lex Fridman (44:07.640)
I mean, I look for the best in people,
Lex Fridman (44:12.160)
and I still look up to him.
Lex Fridman (44:15.320)
What troubles me is several things.
Jay Bhattacharya (44:19.560)
The reason I said about the asshole emails
Lex Fridman (44:23.200)
I send late at night is I can understand this email.
Jay Bhattacharya (44:28.200)
It's fear, it's panic, not being sure.
Lex Fridman (44:34.120)
The fringe, three fringe epidemiologists.
Jay Bhattacharya (44:37.440)
Plus Mike Leavitt, who won a Nobel Prize, I mean.
Lex Fridman (44:40.520)
But using fringe, maybe in my private thoughts,
Jay Bhattacharya (44:45.440)
I have said things like that about others,
Lex Fridman (44:47.920)
like a little bit too unkind.
Jay Bhattacharya (44:50.360)
Like, you don't really mean it.
Lex Fridman (44:52.320)
Now, add to that, he recently, this week,
Jay Bhattacharya (44:56.120)
whatever, doubled down on the fringe.
Lex Fridman (45:00.280)
This is really troubling to me,
Jay Bhattacharya (45:02.520)
that I can excuse this email,
Lex Fridman (45:04.960)
but the arrogance there, Francis, honestly,
Jay Bhattacharya (45:10.000)
I mean, broke my heart a little bit there.
Lex Fridman (45:12.720)
This was an opportunity to, especially at this stage,
Jay Bhattacharya (45:16.120)
to say, just like I told him,
Lex Fridman (45:20.400)
to say I was wrong to use those words in that email.
Jay Bhattacharya (45:23.720)
I was wrong to not be open to ideas.
Lex Fridman (45:27.360)
I still believe that this is not,
Jay Bhattacharya (45:29.640)
like, say, like, actually argue with the proposal,
Lex Fridman (45:33.720)
with the policy, the proposed solution.
Jay Bhattacharya (45:36.240)
Also, the devastating published,
Lex Fridman (45:41.160)
devastating takedown, devastating takedown.
Jay Bhattacharya (45:45.840)
As you say, somebody who's sitting on billions of dollars
Lex Fridman (45:50.840)
that they're giving to scientists,
Jay Bhattacharya (45:54.640)
some of whom are often not their best human beings
Lex Fridman (45:58.080)
because they're fighting with each other over money,
Jay Bhattacharya (46:00.640)
not being cognizant of the fact
Lex Fridman (46:02.440)
that you're challenging the integrity,
Jay Bhattacharya (46:06.600)
you're corrupting the integrity of scientists
Lex Fridman (46:08.800)
by allocating them money,
Jay Bhattacharya (46:10.800)
you're now playing with that
Lex Fridman (46:13.440)
by saying devastating takedown.
Lex Fridman (46:15.960)
Where do you think the published takedown will come from?
Lex Fridman (46:19.600)
It will come from those scientists
Jay Bhattacharya (46:21.560)
to whom you're giving money.
Lex Fridman (46:23.320)
What kind of example would they give
Lex Fridman (46:25.400)
to the academic community that thrives on freedom?
Lex Fridman (46:28.760)
Like, this is, I believe Francis Collins is a great man.
Jay Bhattacharya (46:34.560)
One of the things I was troubled by
Lex Fridman (46:36.680)
is the negative response to him
Jay Bhattacharya (46:38.920)
from people that don't understand
Lex Fridman (46:40.800)
the positive impact that NIH has had on society,
Lex Fridman (46:44.040)
how many people it's helped.
Lex Fridman (46:45.880)
But this is exactly the, so he's not just a scientist.
Jay Bhattacharya (46:50.000)
He's not just a bureaucrat who distributes money.
Lex Fridman (46:53.440)
He's also a scientific leader
Jay Bhattacharya (46:55.720)
that in difficult times we live in,
Lex Fridman (46:58.800)
is supposed to inspire us with trust,
Jay Bhattacharya (47:01.360)
with love, with the freedom of thought.
Lex Fridman (47:04.880)
He's supposed to, you know those fringe epidemiologists?
Jay Bhattacharya (47:08.680)
Those are the heroes of science.
Lex Fridman (47:10.880)
When you look at the long arc of history,
Jay Bhattacharya (47:13.400)
we love those people.
Lex Fridman (47:15.560)
We love ideas, even when they get proven wrong.
Jay Bhattacharya (47:18.400)
That's what always attracted me to science.
Lex Fridman (47:20.240)
Like somebody, the lone voice saying,
Jay Bhattacharya (47:23.720)
oh no, the moon of Jupiter does move.
Lex Fridman (47:29.320)
But the funny thing is,
Jay Bhattacharya (47:30.720)
Galileo was saying something truly revolutionary.
Lex Fridman (47:32.760)
We were saying that what we proposed
Jay Bhattacharya (47:34.920)
in the Great Barbarian Declaration
Lex Fridman (47:35.840)
was actually just the old pandemic plan.
Jay Bhattacharya (47:38.880)
It wasn't anything really fundamentally novel.
Lex Fridman (47:42.120)
In fact, there were plans like this
Jay Bhattacharya (47:46.320)
that lockdown scientists had written
Lex Fridman (47:49.680)
in late February, early March of 2020.
Lex Fridman (47:52.680)
So we were not saying anything radical.
Lex Fridman (47:54.400)
We were just calling for a debate effectively
Jay Bhattacharya (47:57.120)
over the existing lockdown policy.
Lex Fridman (48:00.880)
And this is a disappointment,
Jay Bhattacharya (48:02.600)
a really, truly a big disappointment
Lex Fridman (48:04.720)
because by doing this, you were absolutely right, Lex.
Jay Bhattacharya (48:08.400)
He sent a signal to so many other scientists
Lex Fridman (48:12.280)
to just stay silent, even if you had reservations.
Jay Bhattacharya (48:15.160)
Yeah, devastating take down that people,
Lex Fridman (48:18.360)
you know how many people wrote to me privately,
Jay Bhattacharya (48:21.280)
like Stanford, MIT,
Lex Fridman (48:23.760)
how amazing the conversation with Francis Collins was?
Jay Bhattacharya (48:28.080)
There's a kind of admiration because,
Lex Fridman (48:31.840)
okay, how do I put it?
Jay Bhattacharya (48:33.440)
A lot of people get into science
Lex Fridman (48:38.440)
because they wanna help the world.
Jay Bhattacharya (48:40.480)
They get excited by the ideas
Lex Fridman (48:42.320)
and they really are working hard to help
Jay Bhattacharya (48:46.240)
in whatever the discipline is.
Lex Fridman (48:47.840)
And then there is sources of funding
Jay Bhattacharya (48:50.720)
which help you do help at a larger scale.
Lex Fridman (48:53.360)
So you admire the people that are distributing the money
Jay Bhattacharya (48:58.280)
because they're often, at least on the surface,
Lex Fridman (49:01.320)
are really also good people.
Jay Bhattacharya (49:02.800)
Oftentimes they're great scientists.
Lex Fridman (49:04.760)
So like, it's amazing.
Jay Bhattacharya (49:06.800)
That's why I'm sort of,
Lex Fridman (49:10.640)
like sometimes people from outside
Jay Bhattacharya (49:12.200)
think academia is broken some kind of way.
Lex Fridman (49:14.520)
No, it's a beautiful thing.
Jay Bhattacharya (49:16.320)
It really is a beautiful thing.
Lex Fridman (49:17.960)
And that's why it's so deeply heartbreaking
Jay Bhattacharya (49:19.840)
where this person is,
Lex Fridman (49:23.760)
I don't think this is malevolence.
Jay Bhattacharya (49:26.440)
I think he's just incompetence of communication twice.
Lex Fridman (49:31.160)
I think there's also arrogance at the bottom of it too.
Lex Fridman (49:34.080)
But all of us have arrogance at the bottom.
Lex Fridman (49:36.400)
There's a particular kind of arrogance.
Lex Fridman (49:38.000)
So here it's of the same kind of arrogance
Lex Fridman (49:40.800)
that you see when Tony Fauci gets on TV
Lex Fridman (49:43.280)
and says that if you criticize me,
Lex Fridman (49:46.560)
you're not simply criticizing a man,
Jay Bhattacharya (49:48.440)
you're criticizing science itself.
Lex Fridman (49:51.080)
That is at the heart also of this email.
Jay Bhattacharya (49:55.000)
The certainty that the policies that they were recommending,
Lex Fridman (49:59.480)
Collins and Fauci were recommending
Jay Bhattacharya (50:01.080)
to the president of the United States were right.
Lex Fridman (50:03.480)
Not just right, but right so far right
Jay Bhattacharya (50:06.480)
that any challenge whatsoever to it is dangerous.
Lex Fridman (50:11.000)
And I think that is really the heart of that email.
Jay Bhattacharya (50:13.680)
It's this idea that my position is unchallengeable.
Lex Fridman (50:19.840)
Now to be completely, to be as charitable as I can be
Jay Bhattacharya (50:22.800)
to this, I believe they thought that.
Lex Fridman (50:25.720)
I believe some of them still think that,
Jay Bhattacharya (50:27.760)
that there was only one true policy possible
Lex Fridman (50:31.840)
in response to COVID.
Jay Bhattacharya (50:32.680)
Every other policy was immoral.
Lex Fridman (50:36.240)
And if you come from that position,
Jay Bhattacharya (50:37.840)
then you write an email like that.
Lex Fridman (50:39.160)
You go on TV, you say effectively la science est moi, right?
Jay Bhattacharya (50:42.600)
I mean, that is what happens
Lex Fridman (50:44.560)
when you have this sort of unchallengeable arrogance
Jay Bhattacharya (50:47.720)
that the policy you're following is correct.
Lex Fridman (50:50.040)
I mean, when we wrote the Great Bank Declaration,
Lex Fridman (50:52.240)
what I was hoping for was a discussion
Lex Fridman (50:55.720)
about how to protect the vulnerable.
Jay Bhattacharya (50:57.760)
I mean, that was the key idea to me in the whole thing
Lex Fridman (51:00.000)
was better protection of the older population
Jay Bhattacharya (51:02.960)
who were really at really serious risk
Lex Fridman (51:04.920)
if infected with COVID.
Lex Fridman (51:06.280)
And we had been doing a very poor job, I thought,
Lex Fridman (51:08.640)
to date in many places in protecting the vulnerable.
Lex Fridman (51:12.320)
And what I wanted was a discussion by local public health
Lex Fridman (51:16.600)
about better methods, better policies
Jay Bhattacharya (51:18.800)
to protect the vulnerable.
Lex Fridman (51:20.080)
So when we were met with instead a series
Jay Bhattacharya (51:25.080)
of essentially propagandist lies about it.
Lex Fridman (51:27.320)
So for instance, I kept hearing from reporters in those days,
Lex Fridman (51:31.680)
why do you want to let the virus rip?
Lex Fridman (51:33.480)
Let it rip, let it rip.
Jay Bhattacharya (51:34.560)
The words let it rip does not appear
Lex Fridman (51:37.960)
in the Great Bank Declaration.
Jay Bhattacharya (51:40.360)
The goal isn't to let the virus rip.
Lex Fridman (51:42.760)
The goal is to protect the vulnerable,
Jay Bhattacharya (51:45.000)
to let society go open schools and do other things
Lex Fridman (51:49.520)
that function as best it can
Jay Bhattacharya (51:51.120)
in the midst of a terrible pandemic, yes,
Lex Fridman (51:54.000)
but not let the virus rip
Jay Bhattacharya (51:56.200)
where the most vulnerable aren't protected.
Lex Fridman (51:58.680)
The goal was to protect the vulnerable.
Lex Fridman (52:00.360)
So why let it rip?
Lex Fridman (52:01.600)
Because it was a propaganda term
Jay Bhattacharya (52:03.680)
to hit the fear centers of people's brains.
Lex Fridman (52:06.680)
Oh, these people are immoral.
Jay Bhattacharya (52:08.200)
They just want to let the virus go through society
Lex Fridman (52:09.800)
and hurt everybody.
Jay Bhattacharya (52:11.080)
That was the idea.
Lex Fridman (52:12.920)
It was a way to preclude a discussion
Lex Fridman (52:15.400)
and preclude a debate about the existing policy.
Lex Fridman (52:19.640)
So this is an app called Clubhouse.
Jay Bhattacharya (52:23.360)
I've gone back on it recently to practice Russian,
Lex Fridman (52:28.600)
unrelated for a few big Russian conversations coming up.
Jay Bhattacharya (52:32.560)
Anyway, it's a great way
Lex Fridman (52:33.600)
to talk to regular people in Russian.
Lex Fridman (52:35.520)
But I also, I was nervous.
Lex Fridman (52:37.920)
I was preparing for a Pfizer CEO conversation
Lex Fridman (52:40.280)
and there was a vaccine room and so I joined it.
Lex Fridman (52:43.080)
And it was a pro science room.
Jay Bhattacharya (52:49.000)
These are like scientists
Lex Fridman (52:50.080)
that were calling each other pro science.
Jay Bhattacharya (52:52.720)
The whole thing was like theater to me.
Lex Fridman (52:55.400)
I mean, I haven't thoroughly researched,
Lex Fridman (52:57.200)
but looking at the resume,
Lex Fridman (52:58.240)
they were like pretty solid researchers and doctors.
Lex Fridman (53:04.080)
And they were mocking everybody who was at all,
Lex Fridman (53:10.120)
I mean, it doesn't matter what they stood for,
Lex Fridman (53:11.840)
but they were just mocking people
Lex Fridman (53:13.240)
and the arrogance was overwhelming.
Jay Bhattacharya (53:15.880)
I had to shut off because I couldn't handle
Lex Fridman (53:18.920)
that human beings can be like this to each other.
Lex Fridman (53:21.440)
And then I went back just to double check,
Lex Fridman (53:24.480)
is this really happening?
Lex Fridman (53:25.480)
How many people are here?
Lex Fridman (53:26.920)
Is this theater?
Lex Fridman (53:28.440)
And then I asked to come on stage on Clubhouse
Lex Fridman (53:31.520)
to make a couple of comments.
Lex Fridman (53:32.720)
And then as I opened my mouth, I said, thank you so much.
Lex Fridman (53:36.200)
This is a great room, sort of the usual civil politeness,
Jay Bhattacharya (53:39.920)
all that kind of stuff.
Lex Fridman (53:41.720)
And I said, I'm worried that the kind of arrogance
Jay Bhattacharya (53:47.780)
with which things are being discussed here
Lex Fridman (53:51.560)
will further divide us, not unite us.
Lex Fridman (53:55.440)
And before I said even the unite us, further divide us,
Lex Fridman (54:00.460)
I was thrown off stage.
Jay Bhattacharya (54:02.300)
Now, this isn't why I mentioned platform,
Lex Fridman (54:04.340)
but like I am like Lex Friedman, MIT,
Jay Bhattacharya (54:08.880)
also, which is something those people seem
Lex Fridman (54:11.960)
to sometimes care about, followers and stuff like that.
Lex Fridman (54:15.760)
Like, did you just do that?
Lex Fridman (54:18.200)
And then they said, enough of that nonsense.
Jay Bhattacharya (54:21.100)
Enough of that nonsense.
Lex Fridman (54:22.760)
They said to me, enough of that nonsense.
Jay Bhattacharya (54:27.420)
Somebody who is obviously interviewed, Francis Collins,
Lex Fridman (54:31.540)
is the Pfizer CEO.
Jay Bhattacharya (54:35.040)
To bring you on, French epidemiologist also, so just.
Lex Fridman (54:37.780)
Yeah, exactly.
Lex Fridman (54:38.780)
But this broke my heart, the arrogance.
Lex Fridman (54:40.760)
And this is, echoes of that arrogance
Jay Bhattacharya (54:43.160)
is something you see in this email.
Lex Fridman (54:44.520)
And I really would love to have a million things
Jay Bhattacharya (54:47.000)
to talk about to try to figure out
Lex Fridman (54:48.600)
how can we find a path forward?
Jay Bhattacharya (54:50.420)
I think a lot of the problems we've seen
Lex Fridman (54:54.240)
in the discussion over COVID,
Lex Fridman (54:57.000)
and especially in the scientific community,
Lex Fridman (54:59.600)
there's two ways to look at science, I think,
Jay Bhattacharya (55:02.400)
that have been competing with each other for a while now.
Lex Fridman (55:05.240)
One way, and this is the way that I view science
Lex Fridman (55:08.800)
and why I've always found it so attractive,
Lex Fridman (55:10.920)
is an invitation to a structured discussion
Jay Bhattacharya (55:14.200)
where the discussion is tempered by evidence,
Lex Fridman (55:18.080)
by data, by reasoning and logic, right?
Lex Fridman (55:22.040)
So it's a dialectical process where if I believe A
Lex Fridman (55:25.240)
and you believe B, well, we talk about it.
Jay Bhattacharya (55:29.560)
We come up with an experiment
Lex Fridman (55:30.760)
that distinguishes between the two.
Lex Fridman (55:32.640)
And while B turns out to be right,
Lex Fridman (55:34.920)
I'm all frustrated, but I buy you dinner
Lex Fridman (55:37.100)
and I say, no, no, no, no, C.
Lex Fridman (55:38.480)
And then we go on from there, right?
Jay Bhattacharya (55:40.880)
That's what science is at its best.
Lex Fridman (55:43.320)
It's this process of using data in discussion.
Lex Fridman (55:46.400)
It's a human activity, right?
Lex Fridman (55:48.680)
To learn, to have the truth unfold itself before us.
Jay Bhattacharya (55:54.200)
On the other hand, there's another way
Lex Fridman (55:57.380)
that people have used science or thought about science
Lex Fridman (55:59.800)
as truth in and of itself, right?
Lex Fridman (56:03.360)
Like if it's science, therefore it's true automatically.
Lex Fridman (56:07.080)
And what does the science say to do?
Lex Fridman (56:10.320)
Well, the science never says to do anything.
Jay Bhattacharya (56:12.280)
The science says, here's what's true.
Lex Fridman (56:13.760)
And then we have to apply our human values to say,
Jay Bhattacharya (56:17.840)
okay, well, if we do this, then this is likely to happen.
Lex Fridman (56:21.880)
That's what the science says.
Jay Bhattacharya (56:23.100)
If we do that, then that is likely to happen.
Lex Fridman (56:25.080)
Well, we'd rather have this than that, right?
Lex Fridman (56:27.520)
But science doesn't tell us
Lex Fridman (56:29.420)
that we'd rather have this than that.
Jay Bhattacharya (56:30.440)
It's our human values that tell us
Lex Fridman (56:31.700)
that we'd rather have this than that.
Jay Bhattacharya (56:32.560)
Science plays a role, but it's not the only thing.
Lex Fridman (56:36.040)
It's not the only role.
Jay Bhattacharya (56:36.920)
It's like, it helps understand the constraints we face,
Lex Fridman (56:40.120)
but it doesn't tell us what to do
Jay Bhattacharya (56:41.600)
in face of those constraints.
Lex Fridman (56:43.260)
But underneath it, at the individual level,
Jay Bhattacharya (56:45.640)
at the institutional level,
Lex Fridman (56:46.840)
it seems like arrogance is really destructive.
Lex Fridman (56:52.640)
So the flip side of that, the productive thing is humility.
Lex Fridman (56:55.800)
So sort of always not being sure that you're right.
Jay Bhattacharya (57:03.060)
This is actually kind of,
Lex Fridman (57:05.120)
Stuart Russell talks about this for AI research.
Lex Fridman (57:07.720)
How do you make sure that AI,
Lex Fridman (57:09.480)
super intelligent AI doesn't destroy us?
Jay Bhattacharya (57:11.360)
You built in a sort of module within it
Lex Fridman (57:15.400)
that it always doubts its actions.
Jay Bhattacharya (57:18.560)
Like, it's not sure.
Lex Fridman (57:20.160)
Like, I know it says I'm supposed to destroy all humans,
Lex Fridman (57:23.200)
but maybe I'm wrong.
Lex Fridman (57:24.800)
And that maybe I'm wrong is essential for progress,
Jay Bhattacharya (57:27.860)
for actually doing in the long arc of history better,
Lex Fridman (57:30.840)
not the perfect thing,
Lex Fridman (57:31.760)
but better and better and better and better.
Lex Fridman (57:33.480)
I mean, the question I have here for you is this,
Jay Bhattacharya (57:37.840)
this email so clearly captures some maybe echo,
Lex Fridman (57:41.920)
but maybe a core to the problem.
Lex Fridman (57:44.240)
Do you put responsibility of this email,
Lex Fridman (57:47.040)
of the shortcomings and failures
Lex Fridman (57:49.920)
on individuals or institutions?
Lex Fridman (57:52.060)
Is this Francis Collins, Anthony?
Lex Fridman (57:53.680)
No, this is an institutional failure, right?
Lex Fridman (57:55.320)
So the NIH, so I've had two decades of NIH funding.
Jay Bhattacharya (57:59.180)
I've sat on NIH review panels.
Lex Fridman (58:01.200)
The purpose of the NIH is what you said earlier, Lex.
Jay Bhattacharya (58:03.800)
The purpose of the NIH is to support the work of scientists.
Lex Fridman (58:08.080)
To some extent, it's also to help scientists,
Jay Bhattacharya (58:10.640)
to direct scientists to work on things
Lex Fridman (58:12.760)
that are very important for public health
Jay Bhattacharya (58:14.520)
or for the health of the public.
Lex Fridman (58:17.160)
So, and the way you do that is you say,
Jay Bhattacharya (58:18.740)
okay, we're gonna put $50 million
Lex Fridman (58:21.600)
on the research in Alzheimer's disease this year
Lex Fridman (58:24.480)
or $70 million on HIV or whatever it is, right?
Lex Fridman (58:27.240)
And that pot of money then scientists compete
Jay Bhattacharya (58:30.920)
with each other for the best ideas to use it
Lex Fridman (58:33.440)
to address that problem.
Lex Fridman (58:36.140)
So it's essentially an endeavor
Lex Fridman (58:38.400)
to support the work of scientists.
Jay Bhattacharya (58:40.320)
It is not in and of itself a policy organ.
Lex Fridman (58:45.060)
It doesn't say what public health policy should be.
Jay Bhattacharya (58:48.240)
For that, you have the CDC and what happened
Lex Fridman (58:53.940)
during the pandemic is that people in the NIH
Jay Bhattacharya (58:58.660)
were called upon to contribute
Lex Fridman (59:01.620)
to public health policymaking.
Lex Fridman (59:04.860)
And that created the conflict of interest
Lex Fridman (59:06.860)
you see in that email, right?
Lex Fridman (59:09.020)
So now you have the head of the NIH in effect saying
Lex Fridman (59:13.780)
to all scientists, you must agree with me
Jay Bhattacharya (59:17.020)
in the policy that I've recommended
Lex Fridman (59:20.900)
or else you're a fringe.
Jay Bhattacharya (59:23.580)
That is a deep conflict of interest.
Lex Fridman (59:25.300)
It's deep because first he's conflicted.
Jay Bhattacharya (59:27.420)
He has this dual role as the head of the NIH,
Lex Fridman (59:31.580)
supporter of scientific funding
Lex Fridman (59:33.060)
and then also inappropriately called
Lex Fridman (59:35.900)
to set or help set pandemic policy.
Jay Bhattacharya (59:39.420)
That should never have happened.
Lex Fridman (59:40.860)
There should be a bright line between those two roles.
Jay Bhattacharya (59:44.340)
Let me ask you about just Francis Collins.
Lex Fridman (59:47.180)
I had a chance to talk to him on a podcast.
Jay Bhattacharya (59:49.820)
I don't know if you maybe by chance
Lex Fridman (59:51.140)
gotten a chance to hear a few words.
Jay Bhattacharya (59:52.780)
I heard some of it, yeah.
Lex Fridman (59:54.400)
Well, I have kind of a question to that
Jay Bhattacharya (59:56.760)
because a lot of people wrote to me quite negative things
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