CRISPR is one of those bio-scientific breakthroughs that doesn’t just change science, it has the potential to change society. Abdul talks about what makes CRISPR so important and speaks with Carl Zimmer, science journalist at the New York Times, about how this discovery is already changing society and about his new book “Life’s Edge: The Search for What it Means to Be Alive.”

Transcript

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Dr. Abdul El-Sayed: The FDA approves both Moderna and J&J’s booster, as new research shows that among people who first received a J&J vaccine, boosting with a different vaccine may yield better protection. The FDA has officially set new sell guidelines for restaurants and food manufacturers. The FDA also approved its first e-cigarette product, claiming that the benefit of offering cigarette smokers and alternative outweighs the risk of new nicotine addiction. This is America Dissected. I’m your host, Dr. Abdul El-Sayed. A few years back in India, I had the chance to ride an elephant, and they’re really big. Today, though, an elephant isn’t much bigger than a lot of things that move a lot faster that human ingenuity have created like, say, a truck or a ship or an airplane. But imagine what our ancestors, used to walking or running, or maybe taking a donkey, camel or horse, would have thought as they came upon these huge beasts. What’s saddening is how much the things we’ve created have destroyed in their wake, whether it’s the collective exhaust of our combustion engines or factory farms all over the world, climate change is decimating global biodiversity from the smallest creatures to the biggest. But what if we could change that?

[news clip] Wooly mammoths could roam the Earth by 2027. Geoscientist George Church and his company Colossal, trying to revive the extinct creature.

Dr. Abdul El-Sayed: A new company, appropriately called Colossal, is trying to bring back the wooly mammoth. They say they’re doing it because repopulating the tundra with mammoths could stop the release of greenhouse gases from the ground. But I actually think they’re doing it for simpler reasons. It’d be really cool to see a wooly mammoth. But haven’t we all seen this movie before?

[clip from Jurassic Park] Our scientists have done things which nobody’s ever done before.

[clip from Jurassic Park] Yeah. Yeah. But your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.

Dr. Abdul El-Sayed: This new company’s ’90s film endeavor is all possible because of new biotechnology called CRISPR, or Clustered Regularly Interspaced Short Palindromic Repeats. The irony is that this new technology was actually discovered to be the immune system of the world’s most ancient beings: bacteria and archaea. Here’s how it works. As much as COVID-19 has made us think so, we’re not the only beings that get infected with viruses. It turns out that even one-celled bacteria have classes of viruses that infact them. They’re called phages. But they can’t have elaborate, highly-evolved immune systems like we do because, well, they only are one cell. So instead they evolved the means of holding onto bits and pieces of the virus’s DNA that they pass on to their progeny. Once a virus with the matching DNA attacks, the CRISPR mechanism would allow the virus to cut it up and destroy the virus. But because the mechanism essentially includes a cut and paste mechanism for DNA, scientists have been able to harness it for all kinds of purposes, like trying to bring back wooly mammoths. So far, CRISPR has shown a lot of promise to help treat genetic diseases that involve one or a few faulty genes. For example, a treatment for sickle cell anemia, a terrible genetic blood disorder that leaves the molecule that carries oxygen misshapen, like a sickle, involves cutting and pasting out the faulty DNA in the stem cells the body uses to make blood in the bone marrow. There’s no doubt that some of the therapeutic breakthroughs CRISPR could afford are a game changer. But then there’s another side of it. Just like bringing wooly mammoths back, copy-paste in the human genome can have all sorts of uses, not all of the ethical. As the technology continues to improve, we’re going to have to start asking broader ethical questions about when and how CRISPR can or should be used. Curing a genetic disease is one thing, but what about altering genes for long term chronic diseases like diabetes or heart disease? Or what about other features that offer an advantage in society like height? And then there are purely cosmetic features like eye color. To help us dig through it, I wanted to invite someone who’s been thinking about these issues for some time. Carl Zimmer is a columnist at The New York Times who writes on science and society. He’s just written a book called “Life’s Edge: The Search for What It Means to Be Alive.” He joins me to talk about CRISPR after the break.

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Dr. Abdul El-Sayed: Is that a little bit better?

Carl Zimmer: That sounds better to me.

Dr. Abdul El-Sayed: All right. Can you introduce yourself for the tape?

Carl Zimmer: My name is Carl Zimmer, I’m a columnist for The New York Times.

Dr. Abdul El-Sayed, narrating: What are the implications of bringing back a long extinct species? How do we deal with the ethics of at-home CRISPR kits? How do we define life in the biological sense? These are some of the topics Carl Zimmer is thought through over the last few decades as a journalist and science writer. I wanted to invite him to help us to understand the implications of CRISPR.

Dr. Abdul El-Sayed: I wanted to just jump right in, because CRISPR is one of these technologies that I remember hearing the first inklings of when I was in graduate school, that has, you know, in the way that almost all promising technologies do, has exploded onto the scene since then. What is CRISPR for folks who don’t, who don’t know, haven’t kept up with the science on this front?

Carl Zimmer: So there are kind of two answers to that question. One is CRISPR in terms of where it is in nature is actually an immune system for bacteria. So when they get infected with viruses, they make molecules that can zero in on specific pieces of virus genes and chop them up. So they’re basically, you’re killing the virus before it can kill you. Now, what scientists recognized about a decade ago was that this natural system could be harnessed and transformed into a way of making an edit to any sort of DNA, not just in bacteria, but in our own cells as well. So that basically, if you, if you see a piece of DNA you want to rewrite, you can use these molecules to write a new sequence.

Dr. Abdul El-Sayed: And just to illustrate that, right, and what sparked our interest in having you on was a piece that you wrote about the way that one of the pioneers of CRISPR research, Professor George Church at Harvard, was thinking about trying to repopulate the tundra with wooly mammoths using CRISPR. How does that project sort of show us the capacity for CRISPR to fundamentally change the world that we live in? And also what are some of the issues that that raises? I mean, all of us have seen Jurassic Park, right?

Carl Zimmer: We have seen Jurassic Park. Jurassic Park features big, nasty dinosaurs and not wooly mammoths. So, you know, I mean, I think we have to sort of bear that in mind when we’re thinking about what to bring back from extinction. But this is a project based on the fact that, you know, living elephants have DNA that’s fairly similar to the DNA of wooly mammoths. We actually know what the DNA of wooly mammoth looks like because scientists have pulled up fossils from before they went extinct a few thousand years ago, and they’ve actually sequenced the whole wooly mammoth genome. And so you can line them up and you compare them and say, aha, so here is a gene in living elephants that’s involved in, say, producing hair because elephants produce tiny amounts of hair. And then you can see, while there are some differences in the wooly mammoths corresponding gene, the probably have something to do with there being wooly, you know, making a lot of hair and different shapes of hair and so on. So, George Church of Harvard has this pretty wild idea that you could use tools like CRISPR to rewrite the DNA of an elephant cell so that it would produce the traits of a wooly mammoth. And if you could then turn that cell into a, into an embryo—a big if—and if you can then grow that embryo until it’s ready to be born—another big if—you would, in theory, have something that looks a lot like a wooly mammoth. And so he’s actually got a company now called Colossal with $50 million in initial funding that they’re going to try to do this. There’s an ecological justification for this that they put forward, which is the fact that, you know, wooly mammoths were probably important ecosystem engineers in their day. In other words, by grazing and knocking over trees and so on, they were maintaining vast grasslands across Siberia, across North America, which turn out to be a really good way to store carbon. And so you could conceivably, they argue, use the wooly mammoth in the fight against climate change. We shall see. But you know, the fact is that that’s a fascinating and but pretty speculative use of CRISPR. And the fact is that CRISPR, meanwhile, has become incredibly commonplace throughout the life sciences.

Dr. Abdul El-Sayed: Mmm. I want to, I want to dig into two pieces of the colossal experiment that they’re doing here. The first is on the biological side, which is to say that rather than taking wooly mammoth DNA and then embedding that into the machinery of an embryo, what we’re actually doing is taking an elephant DNA and copy pasting the pieces that are different from a wooly mammoth. So it’s not exactly the same as sort of bringing back a wooly mammoth. They were actually, actually what they would be doing is creating a new thing that was very similar to the template of wooly mammoth. It’s like rather than sort of taking a copy of the wooly mammoth DNA, it’s almost like you have an artist sort of rendering, like this is what a wooly mammoth DNA looks like here. We’re going to start with an elephant and sort of copy-paste what we think matters and then go from there. What does that sort of mechanic tell us about just how easy it’s gotten to copy-paste DNA because of CRISPR technology?

Carl Zimmer: Well, George Church is nothing, if not ambitious. You know, he has been a pioneer at the cutting edge of genome sciences for a very long time. A number of years ago, he wrote a book about biotechnology and then encoded the whole book in a DNA molecule. So that’s the kind of stuff he likes to do. He will be using CRISPR, pushing it to its limits and using other genetic editing tools as well in order to make enough genetic changes to elephant DNA to make it meaningfully like a wooly mammoth. You know, it’s pretty easy now to make a change at one site in some, in a cell’s DNA. That’s that’s pretty straightforward. Doing two at once, that’s trickier because you need molecules for each of those sites. You know, Church wants to do dozens, if not hundreds, maybe even thousands of changes all at once. And that’s ambitious stuff because, you know, you actually, in some cases, have to cut the DNA open in order to change it and that’s potentially damaging. So, you know, it’s by no means a foregone conclusion that he’s going to be able to do all the changes he wants to do. But I think that’s what appeals to him. This is something that would never have been done before.

Dr. Abdul El-Sayed: And then there’s the broader ecological question that this raises. It brings up a book that I recently read Under A White Sky about all of the folly of human attempts to fix the folly of human attempts. And you know, I wonder about this new technology and the power it unleashes and the notion that we might apply it into ecosystems without having thought through all of the unintended consequences of doing just that. How have scientists, ethicists, philosophers thought through some of the implications of this project, or frankly, many of the projects that you could foresee around applying CRISPR technology?

Carl Zimmer: There are a whole bunch of different issues that CRISPR brings up in terms of ethics, and ethicists have been starting to explore them in recent years. You know, I don’t think that we yet have a really strong governmental framework for engaging with these issues yet, but I suspect that will be coming. And, you know, it combines a few different issues. So one is that we have to ask about the ethics of just, you know, manipulating DNA of organisms, you know, is it right for us to do so? What sort of justification should we have to do this? You know, wooly mammoths, like elephants were likely sentient, very sentient creatures in the sense that they had a very complex social life, they bonded together for decades, they have sophisticated kinds of communication that we’re just starting to understand—I’m referring to elephants. Wooly mammoths, probably the same thing. So do we have the right to produce something that might experience a lot of suffering just, you know, for our own goals, you know? I think that’s something worth debating. And then there’s the issue of, OK, when you in effect, you know, modify something and then set it loose in the wild, what are the ecological impacts going to be? And that’s a really important question. But, you know, in a way, it’s not that new of a question because, you know, we have been introducing species all over the world for thousands of years, and sometimes we’re doing that just because we’re bringing, you know, sheep or goats with us, other times we’re doing things for no good reason. So like with starlings, you know, starlings in the United States are, you know, they’re just everywhere. And they were brought to Central Park because somebody thought that the United States should have every bird that was mentioned in Shakespeare. So introducing new species or modification of species is a serious issue as well.

Dr. Abdul El-Sayed: Mm-Hmm. It’s important context to recognize that, even if it doesn’t require this kind of technology were editing at the genome level, we are constantly editing at the ecological level for better or worse, and we’ve seen the consequences of that. I want to switch over now, you know, of course, this is a show about human health and society, and there are a number of both very exciting, but also, you know, very ethically questionable applications that one could imagine with respect to CRISPR. You think about eradicating noxious diseases like Tay-Sachs or cystic fibrosis that are what we call Mendelian, meaning that the genetics are somewhat simple. Versus, you know, selecting infants for the eye color that you want or, you know, a gene that can make them all seven feet tall or, you know a set of genes that may influence their cognitive capacities. And you can start to see some of the ethical quandaries around that. Can you give us a sense of where the science is right now about some of the human medicine applications of of CRISPR?

Carl Zimmer: Yeah. So just to give you one example that’s pretty far along, there are scientists and doctors who are testing out CRISPR as a way to cure sickle cell anemia. So this is a really very serious problem, affects millions of people. And due to a mutation in one of the genes involved with producing hemoglobin in the blood, people with sickle cell anemia produce blood cells that, red blood cells that are defective. They get trapped in narrow passageways and so on. And so it’s it’s a really devastating disease, as any doctor would know. I mean, I don’t need to tell you about it, but but just for people who are not familiar with it, yeah, sickle cell is a terrible disease that, you know, people these days may be able to live typically into their maybe their 40s, but they have a shortened lifespan and they’re in a lot of pain during their life. And the fact is that it’s just one mutation at one site in this gene that is responsible. And if you get two copies of that, of the gene with that mutation, sickle cell anemia. So what scientists are trying to do is they’re trying to use, they are taking cells from people with sickle cell anemia, they’re taking certain forms of stem cells and they’re taking them out of the body and they’re using CRISPR to rewrite their genes so that they can actually produce a normal, healthy form of hemoglobin. And then they take those cells and they graft them back into people with the hope that they are going to be able to make enough healthy red blood cells after that, that they’re going to avoid all these terrible symptoms. And so, you know, we’re in clinical trials for that. And you know, we will we will see how well that works. But that’s just one example of how you could use CRISPR to treat diseases that people have. Another example is HIV. You know, we have drugs that are good at sort of, you know, beating HIV back. So like if a person has an HIV infection, they can take a cocktail of drugs and the virus will be reduced to a level where it’s not going to cause disease. Where it’s just not going to cause AIDS. But, you know, if you ever go off those drugs, it’s going to bounce back. And one reason is that the HIV genes can get inserted into our own cells and they can kind of hide out there. So they’re just the DNA for HIV is just hanging out there just being very quiet, and then under certain circumstances, that cell can start making HIV viruses again. So there are people who are designing CRISPR molecules that would be able to go into our cells and basically hunt down this hidden HIV, cut it out, repair the DNA so that it’s no longer there. And so that the hope is that this would actually be a real cure for HIV rather than turning HIV into a manageable disease where you’re taking drugs for the rest of your life.

Dr. Abdul El-Sayed: And those are two really, really promising therapeutics for very, very serious diseases. You know, of course, HIV, thankfully for folks who have access to antiretrovirals, has become a chronic illness that’s relatively well managed. But but sickle cell anemia is an extremely painful disease that that both shortens a life and causes tremendous levels of suffering in folks who have it. The other side of this, right, is sort of thinking about the non-therapeutic uses of CRISPR in ways that do raise a few more ethical hackles. You know, you can imagine trying to to create a designer baby. Where is a, the technology, but then b, where is the regulatory framework in thinking around these potential uses?

Carl Zimmer: So I mean, certainly, you know, all the leading figures in CRISPR and scientific organizations have, you know, been very emphatic about how just doing, using CRISPR on embryos for enhancement is totally not acceptable. There have been some discussions about, however, about whether it might be acceptable to use CRISPR on embryos that are going to be used in in-vitro fertilization to take out, you know, the mutations for these diseases like sickle cell anemia or Huntington’s disease/ you know, so Huntington’s disease is a brain disease which where people develop it in their forties and it’s inevitably fatal and is a terrible—

Dr. Abdul El-Sayed: Devastating.

Carl Zimmer: Devastating way to die. Yeah. So you know, and you can see in a cell, you know, a fertilized egg, I mean, if you can look at the DNA, you can see if they have that mutation or not, it’s very clear cut. So and you know, these days, people with Huntington’s disease have used IVF and basically picked out the embryos that don’t have the mutation to use, making that choice so that their children don’t have Huntington’s disease. So, you know, is that enhancement? Is that disease prevention, you know, things do start to get kind of blurry. And you know, I think that we will, there will be certain cases in which this challenge will continue. You know, what if I said, OK, we’re going to take care of that Huntington’s disease mutation in that IVF embryo, and by the way, you know, it looks like this child would be eventually at risk for Alzheimer’s, but we’ve identified a mutation in, you know, there’s a mutation in some people in Iceland, for example, that appears to drastically lower the risk of Alzheimer’s. So how about while we’re in there, we fix that as well? You know, what are you going to say? Do you want your child to have a lowered risk for Alzheimer’s or not, you know? And is that enhancement or not? I mean, these aren’t easy questions. And I mean, they’re serious questions and there are ones that we really need to address. I think that, you know, that it’s, that we should well, we should not do is caricature the issues with, or science fiction extremes. OK? So people will often say to me like, Oh, you could just make a baby whatever you wanted, you could make it a, you know, a great seven foot tall basketball player who is like an amazing genius. And you know, like the fact is that these are actually complex traits. Even height is a complex trait. And we don’t understand them very well, and, not only, so there isn’t like one gene you turn on and off to get these different traits, but not only that but the effects of those mutations also depend on the environment in which a child is being grown up in. Do all you want for, you know, to brain associated genes in a child but you know, if you are, if that child is then exposed to lead in their youth, I mean, that’s going to be devastating either way. And so I worry that we sort of look at CRISPR both as a science fiction danger and a quick fix, and then forget about all the serious issues like all the lead pollution in our environment, which really deserves our attention.

Dr. Abdul El-Sayed: I really appreciated two points you made there. The first is that a lot of these decisions tend to get made based on case studies, right? Case studies where you end up having a series of important questions to answer about one particular case that then set precedent about how we ought to be thinking about the uses of these technologies and the technology is just so young that we just don’t have enough cases of that sort. And the second is that, you know, and we talk about this all the time on this podcast is that we focus a lot on what happens beneath the skin and tend to forget about all of the things that happen above the skin. You can genetically manipulate somebody’s risk for cardiovascular disease, but if you still raise them in an environment where there’s low access to walkability and a food environment where those folks only have access to high fat, high carbohydrate foods, the probability that they’re going to get cardiovascular disease may still be substantially high because of the circumstances in the environment. And so much of that has to do with the decisions about how we allocate scarce resources, not just this particular tech. I want to ask about one more sort of test case here, which is that increasingly with these technologies, the simple versions tend to be commodified quickly and you could imagine a scenario where you open up to a pretty serious risk of bioterrorism around being able to, you know, manipulate the genetics of, you know, a particular strain of bacteria. How have the national security implications of this technology been thought through and engaged with?

Carl Zimmer: Well, I mean, there’s certainly been a lot of frameworks that have already been set up for bioterror-type risks. You know, in a way, CRISPR is—I don’t want to say, superfluous if you want to make something dangerous—but the fact is that there’s a lot of nasty bugs already out there in nature that you can just, you know, harvest as it were. And, you know, if you’ve got anthrax, you know, what do you need to go in to the lab and try to make something from scratch, basically? So, you know, and then there are lots of measures that have been taken to try to control that threat and to be able to respond to it. You know, in the CRISPR community, there have been some efforts to say like, OK, well, you know, you know, if somebody like, for a lot of CRISPR research and DNA modification, you actually, you actually order the molecules that you want to change something, you know? So you say, like, I want, I want some CRISPR molecules that will zero in on this gene in, say, a mouse cell. And then I, here’s a little piece of DNA I want you to make from scratch so that I can insert it in that piece where that piece is going to be deleted, that kind of cut and paste you’re talking about. So you gotta send, you send that away to a company. And so, you know, companies are on the lookout. You know, someone says, like, hey, I really want to, I really would really like to have some CRISPR molecules and so on to, for this deadly virus and here’s some DNA I want, oh, yeah, that’ll make it deadlier. Like you can kind of, you can kind of, if you know how to read these, these molecules and just in the sequence of them, you can recognize orders that are not good. So that’s one example of how to potentially be able to reduce that, that threat. And you know, it’s something that has to be taken seriously. And I think what’s even more important is to have, like, really good, you know, ongoing systems in place for how do you respond to some new, you know, pathogen. Like we would really benefit from taking what we’ve learned about COVID-19 and how to make vaccines quickly, for example, and have that ready for anything. And that would help us, not just for some, you know, bioterror created through CRISPR, but you know what, you know, the next bat might have in store for us. That’s just good preparation in general. And ironically, CRISPR will help us with that as well.

Dr. Abdul El-Sayed: Yeah, public health emergency preparedness again, gets back to this idea that, you know, a lot of this has to do with the environment that we choose to build and whether or not it’s secure to these kinds of threats. Finally, you’ve just written a new book which explores a lot of these themes, “Life’s Edge: the Search for What It Means to Be Alive.” Can you tell us a little bit about the book what, you know you’ve been writing on these issues for some time now, and what inspired you to write this book? And, you know, the writing process has always sort of a revelation to the author as well. What did it teach you?

Carl Zimmer: Yeah. So, you know, I have been writing for a number of years about things like CRISPR, about evolution, about disease, basically, like all sorts of things having to do with life in one way or the other. And it’s been really wonderful to spend time with biologists, you know, who are studying all these different amazing creatures and so on. You know, but every now and then you stop and wonder like, OK, well, what is all this stuff? Like, we think of all of this as life, but what do we mean by that? And the funny thing is is like, if you ask one scientist, you might get a definition, you ask the next scientist, you might get a different one. In fact, there are hundreds of definitions of life that are circulating and nobody agrees on them. And in fact, a lot of scientists will say like, Oh, you know, I just study snakes, I don’t really want to get into that stuff. And it’s fascinating to me because, you know, if we’re going to like, if we’re going to go to other planets and moons and look for life and we don’t even know how to put into words what we’re looking for, that seems kind of strange. And you know, what would we do if we encounter life as we don’t know it? And so that led me into spending time with scientists and philosophers who have been really thinking deeply about this and doing research in some cases, trying to get at what the nature of life is. And you know, some of them say, like, maybe life is actually impossible to define. I mean, we, maybe in a way we don’t even understand life well enough yet to do that. And so they’re trying to understand it at a deeper level. For example, taking various molecules and trying to make life again from scratch. So, you know, it’s a work in progress. It’s not, this is not a story looking back at some great big scientific success. There might be one in 100 years, but we’re definitely not there yet. But it’s fascinating to sort of see science grapple with, you know, perhaps the biggest question of all and for now, still really come up short.

Dr. Abdul El-Sayed: Well, we appreciate you working on that because I think, I do think that, you know as someone who’s been a scientist, the bigger picture question sometimes we ask when we’re so focused on, you know, the details that we’re working out every day, get missed. And I do think that it’s really important for folks who have been thinking about these different areas of science to do that sort of meta analysis around the bigger picture questions. And for folks who haven’t picked it up, I do hope that you will. And we are thankful to you, Carl, for being our guest today. That was Carl Zimmer. He is a columnist at the New York Times and author of the new book “Life’s Edge: The Search for What It Means to Be Alive. We really thank you for joining us today to talk a little bit about CRISPR.

Carl Zimmer: Thanks so much for having me.

Dr. Abdul El-Sayed: As usual, here’s what I’m watching right now. The FDA just approved both the Johnson & Johnson and Moderna boosters. That comes just after a new study assessed the differences in the increase in antibodies among people whose first vaccination was with the Johnson & Johnson vaccine if they were boosted with another dose of J&J or with another vaccine. They found that while boosting with J&J yielded an average of a fourfold increase in antibodies, boosting with Moderna yielded a 76-fold increase, and boosting with Pfizer yielded a 35 fold increase. The findings suggest that for the 15 million people who received a first dose of J&J, boosting may be a bit more complex. In other news, 4 in 10 Americans have high blood pressure, and in an effort to take that on, the FDA issued new salt guidelines for 163 categories of foods made by manufacturers and served at restaurants. The voluntary guidelines aim to reduce salt intake by 12% over the next two and a half years. While this is a step in the right direction, it’s a really, really small step. We eat too much salt, and much of that is mindless. Don’t get me wrong, I love the salty burger and some fries, but so much of the food we eat is over salted unnecessarily, and it’s done by design to get us to eat just a bit more. Breads, cereals, crackers, condiments—these account for a large proportion of the salt we eat. But if we take the salt out, won’t our food taste worse? Not necessarily. We get used to less salt if we don’t eat it. Try eating less salt for a week and then going back. Everything just tastes salty. On average, we should probably be eating 40% less salt, which evidence suggests could save up to 500,000 lives over a decade. So these guidelines are weak. They should both have gone further and also imposed some requirements on food manufacturers who contribute to that mindless salt consumption that drives up our overall intake. Why didn’t they? Well, money. Food producers are some of the biggest lobbyists in the entire country. And you better believe they’ll fight tooth and nail to make sure that they’re feeding us more salt. And in our final piece of FDA news, the FDA approved its first e-cigarette product, claiming that the benefit of offering cigarette smokers an alternative outweighs the risk of new nicotine addictions. Here, I’ve got some opinions. We’ll be talking to an expert on e-cigarettes in a few weeks, so stay tuned for that conversation.

That’s it for today. Don’t forget, we’re doing a live taping at the American Public Health Association annual meeting in Denver on October 24th. That’s next weekend. So if you’re going to APHA, make sure you plan to join us at six o’clock on Sunday. On our way out, do me a favor and make sure to rate and review our show. Five stars, please. It goes a long way to getting it to other folks. And if you really like us and want some drip, go on over to the Crooked Media store, pick up some merch. We’ve got a new logo tees and mugs, our Safe and Effective shirts, and our Science Always Win shirts and dad caps.

Dr. Abdul El-Sayed: America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producer is Olivia Martinez. Veronica Simonetti mixed and masters the show. Production support from Tara Terpstra, Lyra Smith, and Ari Schwartz. The theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Sarah Geismer, Sandy Girard and me, Dr. Abdul El-Sayed, your host. Thanks for listening.