Abdul sets expectations on how our current pandemic will end. He then poses the question to John Barry, author of the definitive book about the last great pandemic, The Great Influenza, to see what we can learn from history.

Transcript

Dr. Abdul El-Sayed: America Dissected is brought to you by Marguerite Casey Foundation, which launched the Freedom Scholars Award in partnership with Group Health Foundation last fall. The award is a three million dollar investment, recognizing scholarships critical role in nurturing movements toward our freedom. I asked one of the Freedom Scholars, Dr. Ananya Roy, a professor of Urban Planning, Social Welfare and Geography at the University of California, Los Angeles, why her work is critical to shaping the pursuit of a more just equitable post-pandemic America.

Dr. Ananya Roy: It is not enough for us to survive the pandemic. A post-pandemic society has to be a transformed one. And at the heart of that transformation is the dismantling of police logics, by which I mean the use of policing to manage life and society in America. My own work is focused on the ways in which so many institutions, including universities, are collaborators in this police logic, and how the work of abolition means ending such collaboration and beginning processes of repair and justice.

Dr. Abdul El-Sayed: To learn more about the Freedom Scholars Award and Marguerite Casey Foundation, visit Caseygrants.org. You can also follow them on Twitter at Casey Grants.

Dr. Abdul El-Sayed: New data shows that American life expectancy dropped a whole year in the first half of 2020, but among black and brown Americans, it dropped two to three times more. At least seven new variants are spreading across the US, reminding us that viral evolution poses a real threat. But cases continue to plummet for the sixth straight week, reaching mid-October levels. And nearly one in seven Americans have received at least one dose of vaccine.

Dr. Abdul El-Sayed: This is America Dissected. I’m your host, Dr. Abdul El-Sayed, and it’s way too early to declare victory. Let me level with you for a minute. I am so tired of this pandemic and I say this knowing that I’m one of the lucky ones—nobody in my immediate family has gotten sick, we haven’t lost our jobs or our livelihoods, Sarah and I have had consistent child care. We are so grateful. But I miss so many of the things this pandemic has robbed so many of us of. I miss getting to see my loved ones, particularly the ones who live in other parts of the country. I miss traveling. Before COVID, my work had me traveling often and I haven’t been inside an airport in over a year. I miss making small talk with people without having to worry about if one of us would inadvertently give the other an illness. I miss seeing people smile at the random moments of joy life doles out to us without having to read it through a mask—honestly, I think that’s one of the things I miss most. So I’m going to ask the question that’s on a lot of our minds: how the hell does this pandemic end?

Dr. Abdul El-Sayed: Cases, hospitalizations and deaths are falling precipitously right now, and that’s fantastic news.  But as we discussed with Dr. Angie Rasmussen last week, new variants and the evolution that this virus can do, threaten a scenario where the virus comes roaring back if we’re not diligent about keeping our guard up. But I do want to set expectations a bit here. We’re not just going to wake up one morning to headlines telling us the pandemic is over. We’re not all just going to run outside of our homes and hug the next mask-less person we see. We’re not going to pop back in to work and exchange knowing glances like: that was weird. No, if we’re lucky, it’s probably going to happen like this: cases and hospitalizations and deaths are going to continue to drop. They’ll be bumps and more declines. In the number of cases we’ll find some low, steady state and bump along that way over time. They’ll probably be small outbreaks in some communities, probably of one of the variants. And hopefully our public health agencies will be able to contact-trace them and eliminate them. Vaccine coverage will be high enough so most folks won’t be affected by these outbreaks, because even if they do get infected, the vaccine will have given their immune systems a head start to beat the virus before it has a chance to make them really sick. And as cases continue to abate, institutions will slowly start to open back up: more schools, more workplaces, more restaurants and cafes will open. Restrictions will continue to ease. But risk of transmission won’t be totally gone. And not everyone will have the same tolerance for risk, particularly for people who can’t get vaccinated, like small children for whom risk of illness is low, but not zero. And that’s going to force a lot of hard decisions for families and institutions. Do we go back to a pre-pandemic, “normal” and risk marginalizing people who aren’t comfortable with the risks? Or do we change normal entirely to accommodate that? And what does normal even mean after a year and a half of remote work, school and play? Masks will probably be with us for a while—they’re the best single way to mitigate risk. But then how will this constant reminder of the small but real risks inherent in being together inform how much we want to do that? The other thing that will be with us is, shots, probably every year. This virus mutates fast, just like the flu from 1918 did, which is why we still get a flu shot every year and it’ll probably be the same for coronavirus.

Dr. Abdul El-Sayed: My sense is that many of the habits that we’ve picked up during the pandemic are here to stay. I think that particularly among young people who are forming their understanding of what a work culture even is in this moment, and for whom remote work has been increasingly normal even before the pandemic, their preferences about how and where they want to work will be baked in. For older folks who knew a time when work meant 9:00 to 5:00 in an office, this pandemic will probably also have changed their preferences. It’s nice to be able to bake a cake during lunch or use your own bathroom between meetings. At the same time, as we’ve discussed many times throughout this pod, for most people, work from home is impossible. You can’t drive a city bus or wait tables or manufacture auto parts from home. Though many of these institutions have changed their practices to be COVID-safe, I think the changes will likely fall away. I worry about this because it has the potential to even further exacerbate the glaring inequalities this pandemic has shown us and made worse already. Those at the upper earning strata get more flexibility and less risk. Those at the bottom, get the exact opposite. And that’s for the folks at the lower strata who’ve kept their jobs. For millions who’ve lost their jobs because the small businesses they worked for shut down, having a stable income itself isn’t certain. These big structural questions about how the pandemic is fully cleaved our economy in two—one for high-income knowledge based workers and one for low income people—is something we’re going to have to stay focused on for the next two decades. But first, we’ve got to end this pandemic. Today, we speak with John Barry. He’s got a really interesting perspective on this pandemic because it was informed by the last one. He’s a historian and author of The New York Times best-selling book, The Great Influenza, which has been credited with alerting President George W. Bush to the threat of a major pandemic and to build the pandemic prevention system we had until, of course, Trump decided we didn’t need it. We ask him what history teaches us about how this all ends, after this break.

[ad break]

Dr. Abdul El-Sayed: Our guest today is The New York Times best-selling author of the definitive book about the last great pandemic we faced, called The Great Influenza, written back in 2004, which for obvious reasons, has become a bestseller again. And that’s author John Barry. John, thank you so much for taking the time to join us today.

John Barry: Thank you and Happy Mardi Gras from New Orleans. Canceled Mardi Gras. Every bar in the city has actually been closed by the mayor, which I think is a good thing.

Dr. Abdul El-Sayed: It’s probably a good decision. So it’s going to be Mardi Not-so-Gras.

John Barry: Yeah. OK.

Dr. Abdul El-Sayed: So John, tell us a little bit about what actually inspired you to write the last book back in 2004, and did you ever think that that book was going to become relevant again in just 15 years after you wrote it?

John Barry: Well, it’s probably a longer story than you want to hear as to how I got into writing the book. I will say when I was a kid, there were only two things I wanted to do: one was to be a writer and the other was do medical research. And I had written a book with Steve Rosenberg who is Chief of Surgery at the National Cancer Institute, and he’s really an immunologist who pioneered immunotherapy for cancer. That gave me a very, very solid background on immunology and understanding the scientific process. Without that, there would have been a very, very different book. And no doubt nowhere near as—assuming it is considered good—you know, wouldn’t have been as good. I think anyone who understand—regarding the second part of your question—anyone who understands infectious diseases, realizes, and particularly influenza, expects another pandemic and another one after that and another one after that and another one after that. So I won’t say it surprised me intellectually. Certainly it didn’t. Emotionally is entirely different. I mean, the reality is when the 2009 swine flu thing appeared, the first reports of that out of Mexico were actually about a 10% case mortality, which made it very, very scary. And I remember feeling then a tremendous sense of dread knowing what might happen. As it turned out, of course, that was not accurate information and that turned out to be less lethal than ordinary seasonal influenza. It continues to circulate, that virus. But as I said a minute ago, emotionally, this thing now, hit me the way it’s hit everybody else.

Dr. Abdul El-Sayed: In your book, you take great pains to situate the story of the pandemic in the story of where the science was when it hit, which I really appreciate as someone who, you know, came up in an American medical school and was trained as an epidemiologist. Can you speak to the way that, where we are with science, you feel like in this pandemic both informs what we’ve been able to do, good and bad?

John Barry: Well, I think it’s pretty obvious. Number one, back then, there were great scientists and the advances that came out of their work on the pandemic were extraordinary, including, you might argue, the whole birth of molecular biology, the discovery that DNA carried the genetic code. But the time frame was such and the technology was such that none of those benefits accrued to anyone during the pandemic. Today we are so much more advanced, largely because of some funding that started to flow about 2005, not too long after the book came out, people took the pandemic, influenza pandemics very, very seriously. They started to—H5N1 surfaced, so-called bird flu, which, which had like a 60% mortality rate, and politically, frankly, my book played a small role. You know, Bush read it and so forth, and it got his attention. So they started pouring money into biodefense and influenza research and one of the major areas of research was vaccine technologies, which has served us in very good stead. That, and the planning process and things like that. You know molecular biology allows us to do things that were unimaginable even 20 years ago and the speed with which things happen, obviously—mRNA vaccine, Hummel manipulating another virus to insert, chain the Adenoviruses that JMJ uses, the Russian vaccine is at AstraZeneca, you know, insect cells that Novavax is doing. These things are just extraordinarily rapid and could not have been done even a few years ago.

Dr. Abdul El-Sayed: And I think it’s important to tell that story in full, you know the fact that it was your book that President George W. Bush read and realized that we would be woefully underprepared and really started to really invest in pandemic preparedness in a big way. The Obama administration picked that up and continued it forward. Obviously, the last administration was quite, quite more haphazard. And at the same time, you know, I think the public, because of how far we’ve gotten in science and because of the nature of pathology these days, wasn’t quite ready that an infectious disease could hit us. I mean, the notion that a pandemic was a thing that was not relegated to the past, I think for most folks it wasn’t something that was on the horizon.

John Barry: Right.

Dr. Abdul El-Sayed: Can you speak to maybe how in the past, thinking about 1918 being a time when people regularly died of infectious diseases and you know 2020 being a time when we don’t, thankfully, how that might have shaped the way that the public thought about or engaged with this pandemic early on?

John Barry: I don’t think people took infectious disease seriously. They know about HIV. You know, they’re scared about a Ebola or a Zika headline now and then, but certainly not in their daily lives. People rarely die, at least compared to historical numbers, rarely die of infectious disease anymore. Period. And back in the golden age of antibiotics before resistance began to develop, you know, in the late 50s, a surgeon general of the United States is reported to have said— although actually he never said anything like it, but nonetheless, it’s an urban myth—that said: we have conquered infectious disease. Something to that effect. He’d said something considerably less than that but that reflected the fact that that urban myth is out there, it kind of reflected the attitude of a lot of people in, certainly the public and even some of the medical community. Though I don’t think, at least not in the last 15, 20 years, not the public health community.

Dr. Abdul El-Sayed: How did the 1918 pandemic end?

John Barry: Well, I think two things happened and I’m speculating on both . . . or one’s I guess pretty clear epidemiological: herd immunity did develop. And at the same time, the influenza virus, like all viruses and particularly RNA viruses, mutates. The influenza virus is one of the fastest mutating viruses of all. I think it changed, I think the virus mutated in the direction of what we live with every season. So this combination of the immune system recognizing it and being a little bit less hyper. Because a lot of the deaths in 1918 were probably from an overactive immune response—cytokine storm and so forth—and that stopped happening when the immune system had a more specific targeted response. And again, if the virus mutated in a direction of mildness, like most influenza viruses, it’s very clear that the 1918 virus could bind to cells deep in the lung. Which is pretty uncommon for an influenza virus in that you’re starting out with a fairly serious viral pneumonia when that happens. It’s not a good place to start. And apparently it lost that ability. Now, it may retain it in some technical hypothetical sense, but it was fairly common in 1918 and stopped being common.

Dr. Abdul El-Sayed: Mm hmm.

John Barry: So those two things: mutation, herd immunity. The 1920 influenza season: some people consider that part of the 1918 pandemic—1918, 1919, 1920—and don’t—that was fairly severe, but actually within the realm of a normal, bad influenza season. There was a resurgence in 1928, which actually led to the establishment of the National Institutes of Health. You would have thought Congress might have acted right after the pandemic, but it didn’t. It took a reminder, sort of like an immune booster shot, in 1928 and they established NIH.

Dr. Abdul El-Sayed: We’ll be back with more of my conversation with John, after this break.

[ad break]

Dr. Abdul El-Sayed: And we’re back with more from John Barry. We’re in this really odd moment of the pandemic now where we’re seeing cases fall, and fall substantially and pretty consistently across the board, and yet we have these variants that threaten to be able to bring cases, and potentially mortality, roaring back. And really the question is: how much residual immunity do we actually retain to these variants? And meanwhile, we have a vaccine that we’re rolling out, that wasn’t even in the picture in 1918. How do you see this pandemic ending? You wrote a really convincing piece in The Washington Post a couple of weeks ago saying we’re never really going to be done with this. How do you think about this now? Like when, when do we get to a point where the amount of risk associated with COVID-19 allows us to, to continue life as we once knew it? And then what’s the long tail? How does that look? What does that mean for our lives?

John Barry: Well, number one, thanks for asking. I’m kind of flattered, remembering I’m a historian, not a virologist. The thing is, the viruses the boss. Is—you have heard, you know, from many other people, we are in a race. The more opportunity the virus has to mutate, the more it will mutate and it could mutate in a bad direction, you know. So the more people infected, the worse off we are, not just from their individual—like rolling dice, if you roll them once, the chances of hitting snake eyes are relatively small. If you roll them a thousand times, you are virtually guaranteed to hit snake eyes several times. So the more people infected, the more times a dangerous variant, you know, has much better likelihood of emerging—one that can escape the vaccine or possibly might be more virulent. So we want to cut that off. And I can’t predict and neither can anyone else, what’s going to happen. You know, the vaccines so far are effective even against the South African variant in terms of keeping people out of the hospital. It looks like they are at any rate. And we hope and I haven’t really seen any data on the Brazilian variant, which I think is very concerning because the city in Brazil, Manaus, 76% of the people were infected. That is enough for herd community. It looked like herd immunity and then this new variant is re-infecting people down there. So that’s obviously escaping the natural immune protection that they have. Laboratory data that I have seen does—I think I’ve seen—suggests that we do have some protection against that variant as well. I think that if we can get enough people vaccinated and plus we have natural infection providing some immunity as well, and these variants don’t become dominant in the United States, then I think by late fall we’ll probably be relatively back to normal. But the variants you know are totally unpredictable. I think people have short memories. I think everybody wants to go back to normal, pre-pandemic normal. Some things are going to change forever—we’re talking by Zoom. I think, you know, Zoom is already out there, but I think people are going to be using it a lot more in the future, whether the pandemic completely goes away or not, and other changes in our lives. But in terms of normal social interaction—going to dinner with folks, going to a football game—I think that will come back fairly rapidly if the variants don’t screw everything up. The other thing on the horizon, which has been slower than expected, is therapeutic drugs. When this thing first emerged, people expected therapeutics to be out there before a vaccine. Obviously, that is not happened. I think there was a lot of optimism early that some antivirals that worked against, you know, a couple of other viral diseases would have some effect on COVID-19 and someone looked pretty good in that test tube, but they have not worked real well in people—certainly no magic bullet.

Dr. Abdul El-Sayed: Mm hmm. You raised some really important points here that I want to, I want to pick up, you know, it’s interesting, right? Because a lot of times the way that as humans we think of the virus as this great evil thing because we tend to moralize everything, but really, the virus doesn’t really quite care if it kills you or doesn’t kill you. Its whole goal here is to reproduce. And, you know, what you’ve laid out is a scenario where the flu virus found a way to make its reproduction efficient while also saving a lot of lives. You know, you think about it, one of the more self-defeating things a virus can do is just kill people quickly before it can actually reproduce, in which case that’s really bad news. And so we had, in effect, a chance mutation that made the flu virus less deadly, but allowed it, in effect, to sustain itself up until 100+ years on, it’s just it keeps evolving, keeps coming back seasonally. Whereas these variants sort of represent a different look, right? They are a, a chance mutation that make the virus more transmissible, which is the goal, but also may or may not make the virus more deadly. And if the last great pandemic ended with a chance mutation that enriched a particular strain of the virus that was less deadly, you know, we can’t just assume that that’s going to happen here. In fact, what seems to be happening is, is quite the opposite with the, with the convergent evolution of the variants that we see. And that’s a really important point. I want folks to appreciate that fact that, like, viruses don’t care if they kill you or they don’t kill you. They just care if they can keep reproducing. And our ability to generate an immune response really is the most important thing—whether that’s natural because we got the virus or it’s manmade because we got a vaccine that’s some facsimile of some part of the virus. The other point, which is really interesting that you made, which I really appreciate, is the point that, you know, our lives will have forever changed because of this virus. Right? It’s like the virus creates a social imprint on our behavior and changes the way we do things, which is really quite interesting. You think about major corporations going entirely to work from home and abolishing the whole idea of a major headquarters off the back of this pandemic. Were their experiences from the 1918 pandemic that, that just changed society in ways that for us seem inherent, but didn’t actually necessarily have to have to go that way if it weren’t for that pandemic?

John Barry: Actually, no. That’s one area in which 1918 is not a precedent. And I think one of the big reasons is, and one of the biggest differences between the two viruses is duration. You know, everything in influenza happen faster than with COVID. The incubation period’s 1/3 the time, you shed virus for a shorter period of time, you’re sick for a shorter period of time. And the 1918, there were three waves. The spring of 1918, which was very hit or miss—a lot of places didn’t get hit at all. Los Angeles didn’t record a single influenza death in the spring of 1918, not one. It was also very mild. There were medical journal articles saying this looks like influenza, but it can’t be influenza because it’s not killing enough people. So the virus mutated. Became lethal. But that way, in that second wave in the fall of 1918, where probably 2/3rds of the entire death toll occurred in that period of about 14 or 15 weeks around the world. And in any particular city, it was shorter than that, generally six to 10 weeks. So you have this very intense experience, but it’s a very brief duration. We have already lived through a period long enough to encompass all three waves of the 1918 pandemic, and we’re nowhere near done with it. Part of that is we slowed it down, slowed the transmission down by trying to save lives and non-pharmaceutical intervention, so forth, social distance, et cetera, et cetera. We were right to slow the virus down, but even if we hadn’t done that, it would still take much, much longer to work its way through. So we, the economic impact in 1918 was not nearly as great as what we have gone through in the past year and are continuing to go through. So I think that length of time is significant—that, of course, technology. We can use Zoom. Zoom was already out there. Everybody already—not everybody but a lot of people already—use Zoom and if they didn’t use it, they knew Skype. They had no alternatives in 1918. You know, cities emptied, or people stayed home socially distance in 1918 not because the message was there, but because the fear was so great. It was a much more virulent virus—I mean, maybe I should have said at the beginning rather than assume your audience knows—the death toll in 1918 was 50 – 100 million. If you adjust for population, that’s equal to 225 – 450 million people, today.

Dr. Abdul El-Sayed: Mmm.

John Barry: You know, the worst worst case death projections for COVID are nothing even faintly resembling those kinds of numbers. And again, think of those numbers in an incredibly compressed time frame of, of a matter of weeks. So that impact was incredibly intense. Tragic. But when I was over, it was over.

Dr. Abdul El-Sayed: Mmm.

John Barry: You know, there was a third wave, which was nothing nearly as bad as the second wave, but nobody knew that was coming.

Dr. Abdul El-Sayed: Mm hmm.

John Barry: You know, now we sit around wondering about the next wave and so forth. So, you know, I do think there will be impacts. As you said, you know, companies that don’t use the offices the way they did before. I think those changes probably were out there anyway, they just would have taken much, much longer to develop were it not for the pandemic. But again, nothing like that that I know of happened in 1918. You know, there was a sense of ennui after the pandemic, but it’s hard to separate that from the war itself, which was one of the most disillusioning events in human history.

John Barry: Mm hmm. I want to ask you also about society’s response. You talked about the overwhelming fear and, of course, it was a different kind of of pandemic than the one that we’re experiencing now, as you stated, it just happened a lot faster and was far bigger in scope. There has been marked, in this moment, this, um, this sort of resistance to the notion that there’s actually a pandemic and that there is something that we need to do. And, you know, part of that is just a function of social media. Part of that may be a function of, you know, political culture or the fact that it’s hard for us in our moment to see the impact directly because it’s not happening as quickly. And it’s very much hampered our ability to do basic public health, whether it’s social distancing or any sort of mask engagement at full scale or it’s contact tracing. How do you feel like the way that public trust has existed or not existed in 2020, 2021 shaped the difference in the way that public health could do its work, versus in 1918.

John Barry: Well, I think messaging is everything. In the book, I said the number one lesson from 1918 was that people in authority need to tell the truth.

Dr. Abdul El-Sayed: Mmm.

John Barry: That not doing it kills people, and doing it saves lives. Clearly, some countries around the world have done that very, very well. And other countries have not done so well. You know, I like to compare the United States to Australia because I think Australia and a lot of ways is probably more like the United States than any other country in the world, even including Canada. You know, you’ve got a, sort of racially it’s very similar. It’s probably more Caucasian even than the United States. You know it’s, you know it’s got the space, the frontier. It’s got, it’s individualistic probably as any country in the world, very much like the United States. Australia since October 15th has had four deaths. We’re averaging over 3,000 deaths a day. They’ve had 909 deaths in total. Twenty five million people, that’s 1/13 of the United States. So that’s the equivalent of about 12,000 deaths in the United States. We’re closing in on 500 thousand. So I said it’s, you know, it’s a culture much like American culture. Same virus, they had the same tools. And the difference is leadership. And that, you know, is messaging. A lot of that is messaging. And taking the virus seriously. So messaging is everything, really. When you have no tools that you can work with except public behavior, there’s only one way to get the public—well, there are two ways. One is the use of force, which in this country would probably not be accepted, and the other is convincing people to do the right thing.

Dr. Abdul El-Sayed: So I’ve got to ask you, you have a best-selling book that had new resurgence in 2019, 2020. How has this pandemic been for you? What’s been your experience of the pandemic? It’s a question we ask everyone on our show.

John Barry: Well, for me, there’s been, you know, a lot of concern early, because I certainly understood what was coming. A lot of guilt, you know, it’s I couldn’t, I mean, the book, you know, hit number one on the Times list. And, and, you know, how can you celebrate something like that? You know, it you know, it’s kind of—you know, here in New Orleans, Hurricane Katrina of course, and there was water in the street outside my home, but it didn’t get above the curb. I had friends who lost absolutely everything and I had survivor guilt. And I guess kind of a little bit like that. I have been busy trying to keep track of this. That, you know, I have been part of several efforts that we were talking about messaging earlier. There is an ad hoc group that was originally organized by James Carville and Mary Matalin on messaging to try to convince—you know it was almost like the granular approach of a political campaign. They put it in—or you try to get in not necessarily some national celebrity influencer, but maybe the local high school football coach and a particular community would be the most influential person. We’ve got some very sophisticated people from public health, from, you know, from Ogilvy Public Relations. And we’ve been trying to figure out ways and get messages across to groups that were not necessarily compliant with masks and distancing and stuff like that. So I’ve been busy with that. I did somewhat reluctantly decide that I will write a book on this. So obviously that’s kept me busy. I’ve done a lot better than most people in this. And as I said, makes me feel kind of guilty.

Dr. Abdul El-Sayed: I hear that. Well, we really appreciate your voice, though, and really grateful for your insights and your book. It’s been—you know, if folks haven’t haven’t read it, it really is just an in-depth view of how a pandemic happens, looking at the full scope of history and a real focus on, on the scientific history of this kind of moment as well. I really look forward to reading your book about this pandemic. Obviously, you know, fog of war and living through it, you get some view of it but I think taking a broader sweep of the history of this will be very important and impactful. And we’ll look forward to a discussion about that as well. Really grateful for your time today and your insights and hope that you and your family stay safe, OK?

John Barry: Thanks a lot. Same to you.

Dr. Abdul El-Sayed: As usual, here’s what I’m watching right now. Along with the variants we’ve been tracking out of the UK, South Africa and Brazil, scientists have identified several other new variants in the US. They seem to be converging on a shared set of mutations through a process known as convergent evolution. It tells us a lot about what the virus is trying to do physiologically. Meanwhile, scientists are devising a pan-coronavirus vaccine that shows the immune system how to attack parts of SARS-CoV2 that are critical to any and all variants of the virus. One vaccine once and for all is the idea. Last week, life expectancy calculations showed that overall US life expectancy dropped by an average of one year—that was three years among black Americans in two years among Latin Americans. It reminds us that the consequences of this pandemic have been unequal from the very beginning.

Dr. Abdul El-Sayed: That’s it for this week. Next week, we talk to Jane Oats, President at Working Nation, about the disproportionate toll this virus has taken on women’s livelihoods. If you like the show, I hope you’ll tell others. Rep us by picking up your America Dissected swag today. Our Science Always Wins hats are sold out, but we’ve still got a few more of our sweatshirts and T-shirts. They’re going quick, so make sure to grab one before they’re gone. Crooked.com/store. And I hope I get to see you all at the Incision, my substack newsletter, at Incision.substack.com.

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