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Marginalized communities–including low-income and Black and brown folks, and women and LGBT people–are less likely to have reliable healthcare access in America. But it’s not just that, they’re less likely to have treatments tailored to the health challenges they’re more likely to face. That innovation gap, that’s a function of the way we fund research and the process by which innovations go to market, namely patents. Abdul reflects on the innovation gap and speaks w/ Professor Shobita Parthasarathy, an expert on science and technology policy about how to solve it.

Transcript

Dr. Abdul El-Sayed: Omicron continues to set new COVID case and hospitalization records daily across the United States. The CDC pressed forward on its five-day isolation guidelines, even after blowback from doctors and scientists. This is America Dissected. I’m your host, Dr. Abdul El-Sayed. And wow, we’ve got a lot to catch up on. You remember way back to around this time last year when the first COVID-19 vaccine from Pfizer was being rolled out across the world? One of the primary concerns was this:

[news clip] The Pfizer vaccine needs to be stored at minus 94 degrees Fahrenheit. The Moderna vaccine, minus 36-46 Fahrenheit

Dr. Abdul El-Sayed: mRNA vaccines are a huge leap forward in vaccine technology. They really are a game changer, but because of the touchy physics of mRNA, they require a really complex cold chain to keep them from spoiling, a cold chain that’s really hard to maintain in lower income settings. If you listen to this pod, I don’t need to remind you how much of the global south remains without the same vaccine access that we enjoy here in the United States. Other vaccines like AstraZeneca’s and Johnson & Johnson’s, which don’t require the same cold chain, have been extremely helpful in extending vaccine access. But it stands to question why the technology we need to transport mRNA vaccines while keeping them cold wasn’t available as the new vaccines rolled out. It is an example of what our guest today calls a fundamental innovation gap in health and health care. It’s not just that marginalized people, whether here at home or abroad, often don’t have accessible, affordable health care, it’s that so much of our health care isn’t even designed around the experiences of marginalized communities in the first place. We simply just don’t consider that the process of being marginalized implies a different set of hurdles that exist for people. The innovation gap starts with the problems that get researchers’ attentions in the first place. We spend a lot more money researching the health challenges that affect people in high-income countries—things like heart disease, diabetes and cancer—than on the health challenges that impact low-income people abroad, like river blindness or schistosomiasis, a deadly liver disease. And then it persists in the system that monetized that research, the patent system. You heard a bit about patents recently when I spoke to Professor Jorge Contreras about his book “The Genome Defense” about the Supreme Court battle over gene patenting. But the patent system itself rewards companies with large enough treasure chests to make use of patents and to litigate their enforcement in the courts. It necessarily keeps lower-income folks out. But zoom out even further. All of this has to do with fundamental failures at the intersection between health and capitalism. Whether it’s what we research or what we grant patents, all of it hinges on someone being able to make a buck. And if you don’t have that many bucks to pay because of colonialism, racism or poverty, then the system simply doesn’t spend as much time or energy trying to solve your health care problems. Professor Shobita Parthasarathy has been thinking about the innovation gap for a long time. Because if we’re going to take on health inequities, we need innovations that center the folks who suffer at the wrong end of them. How do we solve the innovation gap and create innovation equity? My conversation with Professor Parthasarathy after this break.

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

Prof. Shobita Parthasarathy: Sure. I’m sure Shobita Parthasarathy. I am a professor and the Director of the Science, Technology, and Public Policy Program at the Ford School of Public Policy at University of Michigan.

Dr. Abdul El-Sayed, narrating: Professor Shobita Parthasarathy is a colleague of mine at the University of Michigan School of Public Policy, where she leads the program on Science, Technology, and Public Policy. She’s been thinking a lot about how our public policy around research funding and patents shape the innovation gap and what we can do to fix it.

Dr. Abdul El-Sayed: Really glad that you could take the time to join us, and we’re, we’ve had an episode earlier about patents, but we really wanted to go deeper. The first episode we did was with Professor Jorge Contreras on his new book on The Genome Defense and we wanted to to sort of zoom out because patents keep coming up in conversations that we have about marginalization and access to health and health care, but then also about pharmaceutical drug policy and drug pricing. And so it was something that we really wanted to do. And obviously, you are an expert when it comes to the intersection between patents and innovation. And so I wanted to just start—how did you get interested in patents and their impact on what gets made, what gets sold, and who gets access to it?

Prof. Shobita Parthasarathy: Yeah. I mean, that’s such an important question, actually, and interesting, right, because how many people spend so much time thinking about patents? I often say when I give talks that, you know, my job has always been to demonstrate to people how important patents are, to make patent sexy, because they’re so consequential and yet they seem so technical. And I think if there’s one thing that I would say to folks it’s that, in fact, that the fact that it gets characterized as a technical space actually makes it really even more important because so many important politics and social decisions happen there and yet we don’t look there because we think it’s objective and technical. But I actually got interested in this kind of related to Jorge Contreras’ book. I got interested in it because I learned about patents on genes. I had a biology background and I had started graduate school in sort of the social studies of science, technology and medicine, and I learned that you could patent a gene, and I thought that was really weird and not in keeping with the science that I had done. And, you know, it didn’t make sense. You know, how could you patent something that was inside of you and seemed to be part of you and natural? And that was the, I guess, the first kernel of a question. And, but it’s related to a much bigger question, right? Which is about the scope of patents, right? What should be patentable? Why do we have a patent system in the first place? And so I actually wrote my first book on the development of genetic testing for breast cancer in the U.S. and Britain. And it turns out that patents were a huge part of that story in terms of shaping access to health care, research into the breast cancer genes and breast cancer susceptibility more generally. And then I wrote a second book called Patent Politics that came out a couple of years ago that looks comparatively at the U.S. and European patent systems and the controversies over patentability and specifically, sort of discussions about patents, equity, morality and the fact that the U.S. and Europe actually deal with these things really differently. And then more recently, I think again, this is not just a scope of patents question, but a strength of patents question, is the issue of what’s called patent, what people call patent evergreening, which is the practice that pharmaceutical companies use to essentially once they get a patent on a drug to kind of extend that patent far beyond the natural life. So the government gives the life of a patent. You get the exclusive rights to commercialize your invention for 20 years. But with patent evergreening, what you essentially do is near the end of the first patent’s life, you apply for another patent and another patent and another patent. And so one analysis actually showed that in practice and some of these, some of our most important drugs are patented for almost 40 years, actually. And so that changes the discussion. Obviously, it’s crucial in terms of equity because it means that these really important drugs are patented and then, and monopolized, which means that they’re less accessible to people, there are fewer generics for a much longer period of time. And so those kinds of questions about, you know, what is the purpose of all of this, and, you know, what are the boundaries of it, and what kinds of questions are we really asking about this, started in graduate school and have kind of continued ever since.

Dr. Abdul El-Sayed: This is a really, really important space, and I think it’s one that, you know, that is kept opaque in a lot of ways, and we’re really grateful to you for shining a light on it. Can you just walk our listeners through the patent system and how an idea becomes a patent, and then, and then how those patents are enforced?

Prof. Shobita Parthasarathy: Yeah, sure. So traditionally, back in the day, long, long ago, let’s say, you know, in the 19th century, somebody would invent something and they would apply for a patent. So a patent is actually a legal document and it is given by the government. So in that patent document, the inventor writes the details of the invention. And actually the originating ideas behind a patent were, first of all, to make that information about the invention publicly available. So the idea was, you write all of the details down and then you file it with the government and then anyone can go and find out about what the state of knowledge is in a particular area and then invent beyond it. But the kind of what the inventor gets out of that, right—they don’t want to just give all of the secrets away—with the inventor gets out of that is that they get exclusivity, and they get exclusivity for a short period of time. Now it’s 20 years, and originally the—I think it was around 14 years—originally the idea was that it would, you know, it sort of gives the inventor a head start in commercializing that invention. That was the basic idea. And then at the aggregate level, the idea was that a robust patent system would lead to more innovation, that would create more markets, it would create economic growth and social benefits because we would have access to more technologies. Now the system has become infinitely more complicated since then. You know, throughout the 19th and into the 20th century is you have companies who are applying for patents and realizing that it gives them an important strategic advantage in the market. And so then doing things like evergreening, that I mentioned before. You have institutions that are actually filing these patents, and so the people who work for Pfizer or Moderna, for example, today are not, they might be named on the patent as individuals, but they’re not the actual ones who own the patent. You have universities who can get federal money. So money from our taxes, that are paying for their research, and there’s, there’s basically a piece of legislation called the Bayh-Dole Act that was passed in 1980 and that Bayh-Dole Act ensures that when you’re a university researcher and you get, you know, you get some federal money, you develop, you know, you discover a gene or you develop an invention, then the university itself actually can apply for a patent. And the university, in an era of shrinking budgets, is really interested in this because they have the potential to get revenue out of it. And so that has sort of led, all of these things have kind of led to weird perversions in the system. And this idea that, you know, patents are good, patents are going to stimulate markets has then led not only everybody to try to apply, you know, many, many, more people trying to apply for patents and to make sure that their patents are super strong and cover as big of a universe as possible. So you might invent a genetically engineered mouse but you cover all genetically engineered animals, for example. But at the same time, the patent office, which is based in the U.S. in Alexandria, Virginia, the patent office has massively increased the number of patents that it gives per year. And so the way that the the process works in that patent office—and I should say that patents are generally speaking, nationally given they’re given by the government so you don’t have an, you have international treaties, but really the systems themselves are national. So it’s a bureaucracy. And so somebody submits a patent application and you have technically-trained experts in the patent office who review that patent application. And now that’s also become much more complicated because there are more patents out there, there’s lots of scientific research. And so those examiners look at the state of the art and say, OK, is this really new? Does it deserve a patent? Are the claims too broad? But they are also under pressure because they get lots and lots of applications. So that process is really quick. And in the U.S. in particular, and this, you know, some of these practices are different in different countries. As I said, I did a pretty deep dive into the U.S.-Europe comparison, but in the U.S. context, the assumption is that, you know, kind of we tend to err, the patent office tends to air on issuing patents and then they assume that any problems will get settled out into, in the court system. You know, it’s our general right and that’s our modus operandi in the U.S. and it certainly fits in the patent system as well. But that’s really important for issues of equity, because who has the money to sue when a patent is problematic, right? It’s going to be companies. And generally speaking, until the breast cancer gene litigation really, most of the litigants in patent cases were companies fighting with one another, and they all have an interest overall in expanding patentability, generally speaking. And so you don’t have anybody raising these kinds of civil society, equity claims. And the structures of these systems are such that it’s very difficult to get those claims into the system at all.

Dr. Abdul El-Sayed: I want to, I want to zoom in on this question of equity in innovation. We know that the number of treatments, for example, that target diseases that are disproportionately suffered in the global south or even among low-income, marginalized groups in the U.S., they’re limited and in some respects, it feels like the patent system has a lot to do with this sort of innovation gap that you’ve talked about in your work. Can you talk a little bit about how this system of patents may squelch the level of innovation that’s focused on lower-income folks and marginalized communities and how that bears out overall in the treatments and the technologies that target the challenges faced in these communities?

Prof. Shobita Parthasarathy: Sure. I would say that there are a couple of ways to think about this, and one is perhaps obvious given this moment that we’re in. Many of your listeners might know about the debates about the TRIPs waiver and the concerns about ensuring that the COVID vaccines are made widely available. And there the problem with the patent system is that it creates monopolies and therefore it makes it really difficult to, you know, to ensure broad access in the system. And you have companies who are essentially trying to innovate in ways that they can get that monopoly power, right? And that leads to the second point, which is that unlike perhaps other areas in innovation, you know—build infrastructure, public policy, public health interventions—there’s a particular orientation towards commodifiable solutions, patentable solutions, because you can get a monopoly and then you can make money, right? And because you can do that, then there’s a disincentive to certain kinds of innovation and an incentive towards particular kinds of commodifiable innovation and an incentive towards innovation in particular areas where you think you’re actually going to get money out of it, right? Whereas of course, for low-income folks, for marginalized folks, they are, the kinds of things that they’re suffering from may not be the most lucrative for companies to invest in, right? They may not be able to pay high prices for patented drugs or other treatments. And I think that this is, this is crucial and this is why I’m interested in thinking about innovation in a broader way is that sometimes the interventions are actually to the built infrastructure, to the environment, to public health—things that can’t be easily commodifiable. But the way that our innovation systems are structured, there’s a strong incentive to focus on those kinds of solutions at the expense of these other kinds of solutions. And what’s interesting to me is that what we’ve seen, and I think we see this in universities, we see this in research funding agencies, is that the patent system is kind of played, as I was suggesting before, a central role, an increasingly primary role, and because of that, all of these other institutions are changing, right? So research funding agencies, the National Institutes of Health, you know, my own institution, the University of Michigan, the incentives that get arrayed in such a way that there’s more attention on making sure that the money that’s given out is focused on commodifiable, patentable solutions, that then create these dual problems that I was suggesting.

Dr. Abdul El-Sayed: One of the things that you write about is that sometimes when we think about the difference between the inaccess to health care versus or—we should say, the inaccessibility of health care—versus the nonexistence of particular treatments, we mistake a health care gap, which is something that I’ve spent a lot of time thinking about, versus an innovation gap. Can you explain maybe the difference here? The fact that, you know, just because you don’t have health care, or even because you do have health care doesn’t necessarily mean that there are the means of care that focus on your issues? Can you speak to that a bit?

Prof. Shobita Parthasarathy: Yeah, sure. So I think that there is a real tendency for us to assume that the problems that we have are really problems of the health care system and that they’re not problems of the innovation system. We tend to think about innovation as being, as I was suggesting before, outside of the scope of political discussion, outside of the scope of society, kind of naturally emerging, based on, you know, what smart people think we should be doing research on, and health care as being the thing that is the problem. And again, this is something that we’ve seen in the context of the COVID vaccine, where—or COVID more generally—that is, you know, access, for example—we’ve been talking about this a lot lately—access to testing, right? We were all complaining, you know, we have this problem with access, access to testing. And we often look abroad and we say, Look at South Korea, they have amazing access to testing. What’s wrong with us, right? And part of the problem there, I would argue, is that we aren’t necessarily innovating for, to address those problems because we tend to think about these kinds of access problems as health care problem. So in the case of COVID testing for, since the beginning of the pandemic, there has been a very serious problem in access to testing in the United States, specifically also for marginalized communities. And one of the things that we could have done from the beginning, or in fact we could have actually done before the pandemic began, was to think about how do we innovate in the area of diagnostics, infectious disease diagnostics, to ensure that we can get reliable, you know, rapid testing available to all? And that kind of question can be an innovation question. Instead, we’ve made it about health care. We think that it’s a health care question. We think that it’s about, OK, can I access my doctor, you know, why is there not a testing center near me? Instead of: how might we have designed the technology itself differently to be more accessible? And there have been some folks who have, for example, been thinking about how do we develop tests for low-resource settings? How do we develop vaccines for low-resource settings? We have to think about the design differently. It isn’t just a distribution question. And I think we tend when we think about equity in general, equity in health care, equity and innovation, we tend to stop at the door of distribution and not go to the question of design. And this is true even with the NIH. I mean, interestingly, the NIH last summer—I don’t know, time has lost all of its meaning in the pandemic, I suppose, but I think it’s 2020, actually—the NIH said, OK, we recognize that there’s a problem with diagnostics, equity and diagnostics. And access for underserved communities. But in practice, what that meant was that they then did a lot of work looking at the question of distribution of the test. Which is fine. Yes, that’s a problem. But if we assume that there’s nothing to be done in terms of the design of the innovation, then we might not actually get to a place that will be equitable. I mean, it’s more obvious in the case of vaccines, we know that with the mRNA vaccines, they have to be kept at a cold temperature for example. There was actually an interesting, I was listening to an interesting new news story that was talking about ensuring vaccination in remote areas of Peru, and they were saying that for some of these vaccines, that the company wants you to use up all six doses, so at once, once you break the vial on the on the vaccine. And so if you don’t have six people available, then you can’t actually do the vaccination. So that’s another example of how it gets interpreted as a distribution question when it’s actually potentially an innovation question. And so that’s just one set of things but I think again, we tend to minimize the flexibility the science has, and when actually, I think a lot of the answers to equity and innovation are early, early on, upstream in the research process.

Dr. Abdul El-Sayed: Yeah, and I really appreciate the point that you made about the assumptions that go into who the user base is, and that part, that’s partly the problem of people tend to solve problems in the ways that they encounter them. And when people who are marginalized are not included in the innovation process, we’re missing the perspective of how a different user may face the problem and the ways that lack of access to resources may shape a problem. And when we miss that in the very process of empowering innovation, then you have to ask, you know, who we’re innovating for and for what we’re innovating. And too often the answer to that has to do with who can make a buck rather than how can we solve a problem? I want to ask, you know, you’ve thought a lot about how we fix this. What are some of the ways of doing that? And you know, what does it mean to put marginalized folks at the center of our innovation process?

Prof. Shobita Parthasarathy: Sure. So I think at a fundamental level, and this might seem perhaps a little bit surprising, but I, but I think it’s actually the way to go, is we need to start by reframing these problems. We need to realize that we’re often talking about social problems or public health problems and not biomedical or technical problems. You know, you mentioned bringing marginalized folks for the table or, you know, this idea that often innovation isn’t happening to address the kinds of concerns that marginalized folks have, and there was this really interesting study done analyzing NIH grants that showed that the least funded grants were grants that basically included topic words relating to reproduction and women. But less funded grants were grants like that included words like socioeconomic, health disparity, risk, etc., right? And so what that tells me, you know, tells me a number of things. It’s a super interesting study that I talk about in depth in the white paper, Health Innovation Policy for the People, but more generally, I think what it suggests to me is that if you reframe these problems really as social or public health problems, it does a couple of things. The first is that it actually recognizes that the technologies have to work in society. It’s an explicit attention to that. And once you realize that, then you must engage as experts, both folks from marginalized communities and social scientists and humanists, right? Again. To go back to the COVID example that looms large, there has been a lot of discussion recently about, you know, who knew that vaccine hesitancy would be such a big problem, especially in communities of color? Who knew that public trust would be such an issue? Again, if you understand the question of vaccines not merely as a technical problem, but actually as a, you know, social issue, that is we want to vaccinate the population, we need to think then about social dimensions, historical legacies of institutionalized mistrust. It opens up a much broader and interdisciplinary set of questions that I think research funding agencies need to think about if they actually want to solve the problems that might on their face seem like they’re just about drugs into bodies but in fact, are much bigger social and public health problems them we need to think about them in a much more interdisciplinary way. And engaging those folks in the process means, as I suggested, putting them on research grants, it means engaging them in peer review processes in terms of how grants are allocated it means bringing them in as advisers at the top levels of priority setting—those are the kinds of things that I’m thinking about. And I think about that both in the research funding side, but also on the patents side. Because like, as I suggested before, too frequently when it comes to the patent system, it’s kind of hermetically sealed. You know, there’s a fiction that everything that’s happening there is highly technical, but in fact, it’s profoundly social, and the decisions that even these technical examiners are making about what should be patented, what the scope of the patent should be, have profound impacts, right, on who gets access to a drug, when they get access to it, how people feel when they’re participating in studies. And you know, there was actually just today an article by someone who was participating in a clinical trial for the vaccines, the Moderna vaccine, who said, You know, I participated as a, as you know, in the trial, and now this company is basically using its intellectual property position to deny access around the world, I don’t want to participate in this kind of thing anymore, and I don’t want anyone else, you know, and I hope others do the same. And I bring that up because I think that engaging folks like that and realizing that people’s contributions are valuable and need to be incorporated into these processes that again, these are social processes, are important for folks in patent offices to think about, to understand, that it is that is essentially a social contract, and they’re in charge of modulating and shaping that social contract, and that people aren’t just, you know, again, bodies or tissues or cells, that they’re, we’re contributors. We’re contributors as taxpayers, we’re contributors, as research subjects. And so, you know, we’re part of this system together. And then finally, I would say we need to really think seriously about innovation in a much broader way. We tend to think about innovation as very much market based. And as I was suggesting before, there is a lot of innovation out there that can be beneficial to societies, but specifically to marginalized communities, that we don’t, we don’t even begin to think about. Our efforts to translate the, you know, technical knowledge into the public sphere, into the policy sphere, is almost exclusively through the marketplace. And I think that there are other options that we need to explore in order to ensure that really everybody gets access to them. And I would add to that just that often marginalized communities themselves are really the experts in their lives and their realities and in the kinds of things that would help them. They are often innovators themselves in trying to make, in order to maximize, you know, sort of what’s available to them. And so we can do a lot, researchers can do a lot if we actually engage them as experts and learn from them. OK, what are the kinds of innovative ideas, how can they be scaled up? Those are the kinds of things we want to be thinking about and not assuming that the market is the only place, for example, to improve public health.

Dr. Abdul El-Sayed: Yeah, I really appreciate that point, and I’m really grateful to you for your work on this issue, elucidating the ways that our patent system and our system of research tend to exacerbate inequities in access to innovation. That was Professor Shobita Parthasarathy, who is a leader in the space between science, technology and public policy. Really grateful to you for joining us today.

Prof. Shobita Parthasarathy: Thank you so much.

Dr. Abdul El-Sayed, narrating: As usual, here’s what I’m watching right now. Buckle up. It’s been a while and we’ve got a lot to catch up on. Back in 2021, just as Omicron was making headlines, we outlined three questions that we needed to answer. Is it more capable of evading our immune response? And is it more severe? Well, last month’s experience has answered those questions. Is it more transmissible? Well:

[news clip] The US has recorded more than one million new COVID-19 infections on Monday. That’s a world record for confirmed daily cases.

Dr. Abdul El-Sayed: Yes, it’s more transmissible. Way, way more transmissible. That’s owing to a couple of things. First, as we discussed with Dr. Angie Rasmussen, its spike protein mutations make it a lot stickier in binding to our cells. The combination of mutations has also rendered it more vaccine evasive. Importantly, boosters work! A recent study out of the U.K. found that people who’d been boosted within two to four weeks were 75% protected from infection. If a booster is 75% effective, how come so many boosted people are getting breakthrough infections? Well, 25% of a massive number of exposures is a lot of breakthrough infections. One thing that we are learning about Omicron is that it may not behave the same way in the body as previous variants. Rather than the lungs, Omicron seems to take up residence in our throats. That means it’s a lot closer to our mouths and noses, which helps explain why it’s so infectious too. But it also helps explain the fact that Omicron is a lot less severe. A recent study of over a million cases in the U.K. found that Omicron was about a third is likely to hospitalize someone as Delta was. That said, because it’s so infectious, it’s still causing more hospitalizations overall. How can that be? Let’s walk through the math. Even if Omicron is a third as likely to cause someone to be hospitalized, if there are four times as many cases overall, then multiply four by one third, meaning 25% more hospitalizations overall. There’s a really important, if terrifying caveat here. Rather than being lower, the rate of hospitalizations among kids with Omicron is about the same as it was with previous variants. But you’ve got to take into account the fact that Omicron is infecting way, way more people, and it’s leading to the highest number of pediatric hospitalizations we’ve ever seen with COVID-19. That, too, may have something to do with the fact that Omicron infects the throat. Kids have smaller airways and throat infection can literally choke them. All of this is complicating perhaps the most important decision we face as a society: whether to send our kids back to school.

[news clip] As fears loom that students will have to go back to remote learning. Some schools already are.

Dr. Abdul El-Sayed: Hundreds of districts have already delayed back to school, opting for virtual learning instead. But the evidence about the impact of keeping kids out of school has had on their learning and development paints a really bleak picture. Kids need one another. And while there’s a consensus that kids ought to be in-person at school, there’s been altogether too much resistance to doing the things that make that easier, like mask or vaccine mandates. But the challenge at schools isn’t just about the kids and their safety, it’s also about staffing. Schools are facing severe staffing shortages as Omicron infects hundreds of thousands of people a day. And it’s not just schools, but literally every facet of our society. To try and address it, the CDC rushed out a new set of isolation guidelines, reducing isolation recommendations from the previous ten days down to five days for boosted individuals. Importantly, the CDC decided against requiring a negative test after five days, prompting severe backlash from scientists and doctors like me. To be generous to the CDC for a minute, there’s clear evidence that Omicron does clear faster than Delta and other previous variants. In fact, between 80 and 95% of patients will not be infectious after five days. That said, that leaves 5 to 20% of people. All that said, there’s no guarantee that people aren’t shedding virus after five days. So you could imagine a scenario where someone isolates for five days, leaves their home the next day, and promptly infects more people. A negative test would at least offer some protection against that very scenario, but they didn’t require a negative test though. Why? It has nothing to do with science. It has a lot more to do with this:

[news clip] Anxious Americans are standing in long lines and staring at empty shelves in the scramble for scarce COVID tests. The rush fueled by Omicron rapid spread.

Dr. Abdul El-Sayed: It is astounding to me. Absurd. Indescribable, that two years into this damn thing, we still don’t have enough tests for the whole population. It is absolutely mind blowing. But it also explains the CDC challenge. If they were to recommend a negative test to release from isolation, it would both exacerbate the testing shortage and defeat the purpose of shortening the isolation window because there are so few tests to go around. It also rub a whole lot more egg on the faces of the administration. But the CDC stands for Centers for Disease Control and Prevention. They have a responsibility for containing COVID-19, not alleviating worker shortages. I’ll be honest with you, to my mind, this just adds to a pile of mistakes in judgment and messaging at the agency. And don’t get me wrong, I believe in the CDC and the work they do. But like my country, I believe in it enough to criticize it when it misses the mark. And it’s missing the mark. That’s it for today. On your way out, if you haven’t already, please rate and review and share our show. Also, if you love the show and want to rep us, I hope you’ll drop by the Crooked store for some America Dissected drip. We’ve got our logo mugs and t-shirts, our Science Always Wins t-shirts, sweatshirts and dad caps, and our Safe and Effective tees.

America Dissected is a product of Crooked Media. Our producer is Austin Fischer. Our associate producer is Olivia Martinez. Veronica Simonetti mixes 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, Michael Martinez, and me, Dr. Abdul El-Sayed, your host. Thanks for listening.