How to Meet Safely Without Masks (with Mike Osterholm)

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Epidemiologist Mike Osterholm has devised a three-part formula for what to do if you want to get together with people in close quarters without a mask. He shares that advice with Andy and answers questions many of us have, including whether people under 50 should get boosted and when to take antivirals. Then, Andy and Mike critique the missteps made as this pandemic unfolded and what lessons we need to learn to better prepare for the next one.

Keep up with Andy on Post and Twitter and Post @ASlavitt.

Follow Mike Osterholm on Twitter @mtosterholm.

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Andy Slavitt, Mike Osterholm

Andy Slavitt  00:18

This is IN THE BUBBLE with Andy Slavitt. Email me at a new email address, Many of you are and I love getting your emails I’ve been reading through them. It’s great to engage with you directly. Look, it is easy to be a little bit confused about what to do with COVID these days. We’re in this sort of bit Twixt in between stage. And we’re also just hearing a lot of confusing things. Many of them not exactly right. We heard about the tripledemic. We’ve had guests on this show talks about the tripledemic. Turns out not so much with the tripledemic. Turns out, we had an early flu season. But that was it. There’s a lot of forcefulness from the anti Vax community, particularly in social media, if you spend time on social media, is that really having a lot lately, but they’re coming very aggressively. There’s this just a baffling number and baffling language of variance in the just frequency which they come which just is hard to pay attention to plenty of predictions that are just going the wrong way. And there’s a lot of controversy over almost everything that comes out, including whether or not people under 50 should get boosters. The gentleman arguments about that. And of course, the FDA recommended this week that boosters be given on an annual basis for COVID, just like the flu. So why is that the case? Why is all this happening? I think there’s three things going on. First of all, there are some people who have become COVID commentators who are striving for continued relevance as the pandemic abs, I think this is particularly true among the anti-vax community. And I think they are also aiming to gain traction to reduce vaccines for MMR and for other types of things. So there’s a bit of a movement born here. The second reason is, there is genuine disagreement about science, this is still a relatively new disease. And we’re still learning about it. And so there’s some genuine disagreement. Third is poor communication. And I think that poor communication is all the way around. It’s the people who are delivering messages. I also think we’re not doing as good a job listening, as we were earlier on I was we were a couple of years ago. So we may not remember the things we’re hearing or may not be paying attention. And so people aren’t using interventions as much as they were in the past. And we’re going to talk about all three of those things today with Mike Osterholm from the University of Minnesota CIDRAP. Mike is the granddaddy of pandemics. He’s fabulous. These are great conversations, we really get into it. And as a special surprise, I think perhaps the most helpful and relevant part of this conversation to many is, Mike has devised a formula for what to do if you want to get together with people in close quarters without a mask. And it’s kind of interesting coming from Mike because he’s one of these people who has very cautious about everything as he studies the virus and how it spreads, and is a strong recommender of high quality masks. And yet, he has devised a formula a three part formula for how you can get together with people safely in his view without wearing a mask. So that’ll be interesting. My kids been very present during this pandemic. He’s often been right and he’s occasionally been wrong like everybody else. But he’s usually the person who is careful. And by that I mean he caveats. What he says, with what he knows and what he doesn’t know. He is often the first to say, I don’t know, or we don’t know when people are hungry for answers. And you know, he takes a strong position. But it’s clear on what the limitations are. Because I’ve known him so well for so long. We can get into a really, I think, revealing conversation here today. Let’s bring him on. This will be a conversation which really allows you to catch up and what you should really know about, think about and understand about what’s going on with COVID right now.

Andy Slavitt  04:57

What was it like to move during the pandemic?

Mike Osterholm  05:00

You know, we had been planning this for several years. So it wasn’t really a challenge in many ways, a lot of the furniture and so forth, we bought new that was delivered. We worked with, you know, a person who coordinated all the deliveries, etc. So it worked out really well. And also just conscious here. This was a situation in this building where the safety officer who was in charge of overall safety died from COVID during the pandemic, people took it very seriously here. It was good that they took it seriously. And so I feel very confident in that. And, and in fact, you know, we’ve established what has now become known kind of as the, unfortunately the ultra-home protocol, it says we can get together without respiratory protection. If you’ve had no in contact with anyone who’s had COVID. In the past three days, you’d have no symptoms on the day out, you had even sniffles, and you test within six hours of coming. And we’ve had a number of social events with groups of people. And we’ve had no evidence of transmission when and many other settings at the same time people are getting infected.

Andy Slavitt  06:13

You’ve modified the Swiss cheese, I want to hear that again. So it’s number one.

Mike Osterholm  06:17

No contact with anyone who has been known to have COVID in the last few days. Number two, no symptoms, including sniffles, if you got like symptoms, it still knocks you out.

Andy Slavitt  06:29

And then number three, within six hours, you’ve taken a rapid test is okay.

Mike Osterholm  06:34

Rapid tester is okay, knowing that they’re not perfect. And you’re batting 1000 with those three pieces of cheese. Yeah, and without respiratory protection.

Andy Slavitt  06:44

Without respiratory protection, it feels like that’s a kind of sustainable model to live by.

Mike Osterholm  06:49

Well, I hope so maybe we’ll find out if it’s not. But I think you know, it’s what it’s done is it’s made people more comfortable to and you know, surely could change tomorrow. But I think that’s what we’re all looking for some normalcy, we’re looking for some way to feel like we’re not doing something wrong, or that somehow we’re doing something dangerous. And I think that’s part of the acclimation to this new day and the pandemic, because the pandemic is still here, but it’s how do you live with it? What do you do with it?

Andy Slavitt  07:17

Yeah, there’s this sort of somewhat raging battle about whether people under 50, or even under 70, ought to be getting boosted, to come down on a particular side of that one.

Mike Osterholm  07:27

You know, I, I’m one that says, you know, clearly over age 50, if you look, the data are there for 50. And I think that the data are there to show protection with current by valence, you know, that I don’t want to get caught in the debate about the by valence versus tomato, because we don’t have data to really address that. But I think the data are quite compelling, showing, at least in the short term, meaning weeks to months, that with a bi-vaillant vaccine, we are significantly reducing severe illness, hospitalizations, and deaths in those over age 65 with clear emerging evidence over 50. Below that we don’t really have the data to support it. Now part of it is fewer people have been vaccinated there. But I have to agree if you look at the deaths in this country, the vast majority are now in particularly older individuals largely who have been unvaccinated, we still see surely people dying, who have been fully vaccinated, including the bi-vaillant vaccine. But you know, the data says you have a threefold lower risk of dying if you do have the bi-vaillant vaccine. So I think that’s where we’re at today.

Andy Slavitt  08:29

And so the best you could do for people under 50, is give them full information. And, you know, really allow for the fact that it’s really open to individual decision, you know, the risk of being boosted is very, very, very low, and particularly when it’s free, and you know, you’re the kind of person that needs to show up to work physically to get paid, and you can’t afford to be away from work, you know, every little bit helps. Those are people like I think, haven’t had as much attention. Like, I think we’re right to focus on elderly people, we’re right to focus on people with long COVID. But then there’s this sort of whole group of people, you know, that are in the service sector, that are really significantly impacted, if they get sick.

Mike Osterholm  09:08

I couldn’t agree more with you. And I think that part of that is also what role does respiratory protection play? If I’m someone who has an underlying health condition, but I have to go to work. I don’t trust my vaccine to prevent me from getting infected may trust it to keep from getting serious illness. What do I do? And I think that, you know, clearly in 95 respirators while uncomfortable for some, they can give people another level of protection. It’s important. I think the other piece that we keep missing on and I know you’ve talked about this on a number of occasions, is we are dramatically under using the antivirals right now. If you look at the studies of people who were eligible to get them and who got them is deplorable what we’ve done in this country, I have many examples of friends and colleagues who are in high risk for serious illness By age or underlying health condition, where they were told mistakes You can lead by their health care provider. Well, we only give you that if you get really sick in the hospital. No, it was supposed to be given before, so you don’t get really sick in the hospital. And so I think that, you know, that combination also can help. If somebody knows that even if I do get sick, I have this opportunity to be treated.

Andy Slavitt  10:18

Is the indication still that it should be given for people who are at high risk only. That’s what the original indications were. I mean, I have friends who were well informed, you know, 40s, and 50s, a little bit sick, but not severe, but worried about getting sicker who were told by their physicians, you know, this is not indicated for you. This is indicated for people that are at higher risk.

Mike Osterholm  10:38

Well, you know, and again, I understand that they misinterpreted the data, because it does keep you from getting severely ill. But as we’ve emerged with more data over the course of the past several months, it’s become clear that this treatment also reduces the likelihood of lung COVID. You know, so I’ll take the double positive here, you know, reduce my chances of serious illness, hospitalizations, and maybe even reduce the likelihood develop lung COVID.

Andy Slavitt  11:03

I’m one of those people that’s in the category of people who can’t take the antiviral. So what I did get COVID the one time I got it, it was a time when the monoclonal still worked. And I gotta tell you, those monoclonal is worked very, very well. Now, I think they were expensive. And, you know, I’m not sure society benefited for me having the monoclonal, but I sure did. Now, unfortunately, the monoclonal are apparently no longer working. It’s the latest variance. And that puts people like me, because it is all about me, like, in a position where you have one fewer tool.

Mike Osterholm  11:38

You know, I think, Andy, one of the things that was not being discussed, or at least understood right now, is where are we going with treatment, because treatment still is important for a disease where the vaccines can reduce the likelihood of severe illness, hospitalizations, and deaths, but they don’t stop it. Number two, is they don’t stop you from getting infected or transmitting the virus. And what we’re seeing happening right now are companies who have really potentially remarkable products in the pipeline, who are shoving them, because they see no financial model that will make them bring them forward. And I think this is a huge mistake. You know, we need these drawings. And you know, how do you work in a private public partnership? You know, the federal government is you so well know, you know, this better than anybody is not likely to pay for any additional new drugs to come along? From the standard standpoint of funding for pandemic preparedness. What do we do?

Andy Slavitt  12:32

On the other hand, we are going to investigate Hunter Biden’s laptop. I have run into people who like have shown me their presentations of a drug, that’s an early stages of development. And they’re like, can you call the NIH for me and get them to? And it’s like, there’s no money.

Mike Osterholm  12:48

There’s no money. That’s exactly right. And you know, and this is Pennywise, and pound foolish. You know, and, and, you know, you and I’ve talked about this before, but I keep reminding people, this is not the big one, this is not, we need to be prepared for the big one, the big one, if you look back at SARS, and MERS, with case fatality rates of 15% to 35%, but relatively poorly transmitted viruses, if we ever see the current SARS-CoV-2 light transmission, potential match up with the case fatality rate from SARS and MERS. Boy, this could be a very, very different kind of pandemic. What happened? I don’t know. But could it happen? Absolutely. We need to be investing right now, not just for this pandemic, but for something down the road.

Andy Slavitt  13:32

Well, on that happy note, let’s take a quick break. I want to come back and Mike and I are going to do a little bit of role playing and then we’re going to talk about some of those other scenarios. Okay, Mike, let’s do a little role playing. You and I are now Chinese high level Chinese Communist officials. Okay. And we’re gonna go put forward a zero COVID policy. And then at the same time, you kind of had to a couple years later, we have not vaccinated our citizens. And under public pressure that we had to imagine was going to show up at some point, we just do a complete 180 and helped me understand the thinking going on in China over the last couple years?

Mike Osterholm  14:30

You set it very, very well. I am exactly in the same place. I cannot explain it makes no sense whatsoever. It makes you question the leadership and the thinking of the leadership in China. This was absolutely something that they had to know is going to happen if they had any science advisors who was informing them about this highly infectious OMO crime variant. So I can’t explain it either. The other thing they didn’t do is they did not prepare their healthcare system anymore. You know, they have 1/10 of the intensive care beds in China per population, as we have in the United States, they did build a number of rooms, these are just holding rooms. These are not hospital rooms, right? They’re almost like little cubicle Park apartment buildings that was not preparing them for the unleashing of the virus.

Andy Slavitt  15:18

I want to take us back to a couple conversations you and I have had about three years ago. So first one, December 2020. We’re sitting at the University of Minnesota campus, we’re celebrating some anniversary of the School of Public Health. Yep. And we’re sitting at the same table. It just so happens. This is about exactly the time in China that the outbreak was occurring. We didn’t we didn’t know it at the time. And we were talking about how public health is this sort of incredibly well-kept secret, that’s just a huge asset for the country, and how public health is underfunded. It’s lost half its funding in the last decade, we won’t be prepared for a pandemic, he made a lot of those points. I think about that conversation frequently as I kind of had three years later, public health is no longer a well-kept secret. But arguably, and I’m curious, your take on this, arguably the reputation of public health, in the minds of the public is not what we want it to be. I think, you know, some of the public sees and appreciates what public health professionals have done for us. But there’s a large part of the country whose if anything, in their trust, maybe even lower, if they had any awareness at all. Now their awareness may be negative, I’m wondering if that’s right. And what you think about that,

Mike Osterholm  16:37

you know, I think what’s happened is, is that public health never really pictured itself being in the middle of a political warfare situation. And therefore, we almost rose above it. But we don’t deal with that kind of stuff. We don’t talk about that. Well, you had no choice. And it surely is evident in the spillover today that we’ve seen with vaccines in general. It’s not just COVID vaccine, there is an anti-public health mindset today, that, you know, I’ll do what the hell I play isn’t pleased on doing and I’m going to do it. And I think that has, that mindset in the public is really a serious challenge to write and public health. Then on top of it, I think we in public health lost our way a bit, I can list out a number of circumstances where our public health leaders put out statements that were very definitive, you know, two doses of vaccine and you’re done. It’s like measles vaccine. You know, I can go through those. Yeah, we failed to have the humility, we needed to say, I don’t know, this is what we do know. So like, right now, people keep asking me what’s going to happen, SPB 1.5? Is it going to take over the country, this new variant, and I remind them of what happened in 2020 2021. And we saw alpha, raging through Europe, and said, it’s coming to the United States. And guess what it did, but it only hit Minnesota and Michigan and hit us hard, really hard. Why was it not in Iowa and Illinois and Wisconsin and Ohio and Indiana, North and South Dakota? Where was it? You know, I reminded that every day I think about his SPB going to be a northeastern United States issue. And it’ll just basically peter out before it goes across the rest of the country. I don’t know. And when we don’t do that, and we give people definitive answers about it, we’ll do this or we’ll do that, then I think we end up overall losing credibility. And I think public health has lost a lot of credibility, because of our unwillingness to be humble when we should have been.

Andy Slavitt  18:33

That’s I agree with both of those points. Let’s take him in turn the politics point. We now have someone who their platform to ride a wave to the White House is essentially in the anti-public health platform, Ron DeSantis, is riding on basically anti-pandemic response sentiment. That’s how he ran for governor. If you saw it last week, he proposed a bunch of things that legislature that were very anti-public health policies, essentially making disinformation and misinformation much more allowable pulling back on public health resources. It’s been a very effective political vein. And look, there are people who say we’ve got to blame somebody for it. And appointing […], and appointing a public health and saying, that’s our scapegoat.

Mike Osterholm  19:19

Yeah, yeah. I couldn’t say it better than you do it. And you understand that because you’ve been at the highest levels of government. And you’ve seen what really were the true measures that were undertaken to try to reduce the morbidity, mortality, this pandemic, they weren’t political in nature. They were about how do you help protect people from this virus, but to try to convince people who believe otherwise is not possible. I mean, you know, I look at today the issue around people who died suddenly from some cause or another well, you know, and immediately the anti vaxxers are attributing.

Andy Slavitt  19:55

[…] was on the podcast last week, talking about exactly this.

Mike Osterholm  19:59

So I mean, there you have an example where you don’t even have to be held accountable. You can just say, well, maybe it could be, well, if you do enough of those maybe it could be is producing you start giving people the perception that, oh, there’s a pattern here, it just, you know, it must make sense. And so I think that we are in a new era of public health. You know, I harken back to my teenage years when on TV, the oil or farm commercial used to say, you can pay me now or you pay me later. And I think that, you know, what will happen is these policies will likely take effect, these policies will become much more difficult for public health to put forward the kind of public health messages, but then we’ll pay a price for it. We’re seeing it already in childhood immunizations and the outbreaks we’re seeing. So, you know, I hope that doesn’t happen. You know, I like you, you know, I’ve served now in the last presidential administrations, without regard to politics. You know, it was my job to be a good public health soldier in this war against these infectious diseases. I served six different governors in Minnesota, you know, Democrat, Republican, and one independent wrestler. And, you know, I can say, honestly, that, again, it was nonpartisan. We’re in a new age, we’re in a place now, where we are part of the daggers that are being thrown. And that’s unfortunate, because now people don’t know who and what to trust, they don’t know.

Andy Slavitt  21:27

Take a quick break, we’ll come right back, and talk about where that goes. We were just talking about how the public turned against public health, and the dangers that this causes for the future, she said, we could have far worse pandemics. And we’re now in a position where we trust public health messengers last and we’re not investing. In some of it goes, I really appreciate the fact that you made the second point you did, which is some accountability, and some self-examination that people in public health ought to do. Because I don’t think there’s a chance to regain trust or do it better than next time. Unless we say we could have done that better. And I think too often, it’s very easy for public health people to say, Well, we said what we knew at the time, and I wish we lived in a world where that was good enough. And we lived in a world where your intention mattered more than the result. But we don’t we live in a world where if you say something, and it turns out not to be true, and you said it definitively, without the kind of humility that you talk about. It is costly. And you are absolutely right. Every time I would ask you a tough question. And I would pray you’d give me some very wise answer. And you say, well, Andy, we don’t know. And I would say come on, Mike. But what do you think? It maybe I could drag some data points or perspective out of you. But you said I gotta ground us in the fact that there’s a lot of randomness to this, there’s a lot more we don’t know than we do know. And I think, to a lot of other people, their ticket to like getting on TV and having a soapbox was to sound more confident than they actually could be. Or maybe it was wishful thinking, I don’t know. But we can’t divorce ourselves from the realities that people live, if you say, hey, let’s be extra conservative. And let’s say that this is the message we’re going to give on public health. And as a result, people’s businesses are closed, that maybe a business that someone started 20 years ago, they inherited from their family, and it was their, their family legacy and that business was their identity and it closed, then, if someone made an assessment, and that assessment they made with too much confidence turns out to be wrong. We have to look at that because there are costs to all of this.

Mike Osterholm  24:06

Yeah, you know, I think again, this comes back to the point about what do we know? You know, I wrote an op ed piece in The Washington Post in April of 2020. In which I said lockdowns, were not the answer. They were there to basically help flatten the curve, quote, unquote, if you saw a big peak of cases occurring with the idea that, you know, likely most people would get infected with this virus, so we didn’t have an effective vaccine. And so all we’re trying to do is not so even keep people from getting infected thinking that probably most would. But what we didn’t want to do is have 90% of them get infected and need hospitalization and a two to three week period. And you know, we never had that discussion. We just did it. We locked out and then we said, oh, wait a minute, we have so many essential services here. We got it. We can’t let them be locked down. Okay. And of course, who are a lot of the essential services people. And so, you know, we need to go back and revisit that we need to ask ourselves what Did we really do or not do? What could we have done better? How could we have protected people? Or could we have, and I think that that is what I’m talking about in terms of going back and reviewing what we did and how we did it. And you know, I didn’t say in that op ed, don’t ever do a lockdown. But I said, these are the conditions you need to really consider only to flatten the curve temporarily, if you think you’re going to keep people down for two years. You know, I got criticized heavily in April of 2020, when I did an interview with CNN. And I said, I think that there’ll be about 800,000 cases the next 18 months, and I gave him exactly how it came about it no black box, you know, this percent of people get infected percent of people get sick. You know, we all have vaccines and such a cetera. And you know, I just got nailed for that. 18 months later, we hit 800,000 cases dying. And you know, it was, it was just a grab bag. I don’t deserve any credit for that. But I think that that’s the part that people didn’t want to know. So you could say things that would give people a sense of dimension. You know, in January of 2021, I said on meet the press, the darkest days of the pandemic are ahead of us. You know, shortly thereafter, Nate Silver took me apart piece by piece for being a scary monger. Okay. And look what happened, of course. So I don’t want people to think you are wishy washy to the extent that you can’t say this is what’s coming, right. But you can say with precision, how is it going to play out? What is it going to look like? What does it mean? And it’s like my comments on SPV right now, I don’t know what it’s going to do. But it’s still here. And it’s truly a challenge.

Andy Slavitt  26:35

Right. You explained it to me, I don’t know if you remember this. But this is the second conversation I wanted to refer you to you constantly on this, we were both standing outside of a green room. In Minnesota, I was walking out you were walking in. And it was just starting to become clear that this was going to be pretty terrifying, that there are going to be lots and lots of people dying. And I said what’s the answer, Mike, you know, should everyone be locking down and he said, look, people will only buy in for so long, until they see it with their own eyes. And if you tell people as the SEC is going through New York, if you tell people in Tennessee, that they can’t throw out can’t go to restaurants, then when it comes time that it comes to Tennessee people are no longer even believe you. So you have to be very careful with public sentiment. And at the time, you said that I was a little bit shocked by it. Because at the time, all I was considering was, you know, this function of how are we going to save the most people’s lives? And you said, look, the thing you think you’re going to do that’s gonna save the most people’s lives actually isn’t? Yeah, it’s actually going to spend the whatever attention the public’s going to pay way too quickly.

Mike Osterholm  27:44

Yeah, you know, I think, Andy, you’ve really hit on a very important point. And part of what I think makes a pandemic, so different from a lot of other kinds of challenges take […] as an example. They tend to be much more short lipped. And so we do have that tolerance for a shorter period of time to do things that otherwise we wouldn’t want to do. But when you understood what was about to unfold with this Coronavirus, as we did with other influenza pandemics, you know, this is going to be long term. And you have to shift your thinking right away. You know, one day in my life, I was a competitive swimmer where I swam inside the walls of the swimming pool. And I had a very different mindset of what it would take me to go to the other side and back, as opposed to when I decided to do distance. So I’m going to become an English channel swimmer. And I had to have a very different mindset. Because, you know, when I was in my second hour as swimming, and I still had 12 more to go, you know, I had to have a certain mindset that was very different than if I had been swimming in a pool for two hours. We never really have discussed that in public health or understood why that is so important that you have to gauge what you do. I think the public health message is so, so important in that that’s where people have to trust you. People have to be able to say, I don’t know if I agree, whatever, but you know, okay. And then give them a reason why. And then I think the issue of humility, I just come back to that is that does not mean you have to come across weak, it doesn’t mean you are wishy washy. It says this is what I know. And this is what I don’t know. And if you look at some of the greatest leaders of our time, that’s what they did. You know, Franklin Roosevelt and give us absolutes, he said, but we can get through those. And so I think that we’re missing that right now. We still are, I worry about that, that we have not yet understood how we deal with the limitations there of what we know and don’t know. And I see it in the debate right now about the vaccines. So this is a very, very important point.

Andy Slavitt  29:42

Yeah. Yeah, it is. I’ll tell you something that was probably a place where I was naive, was, I remember when at the beginning of the pandemic, when things were really bad in New York, and people were banging the pots out the window as people were coming back from a shift from the hospital. And I remember people sewing masks, which turned out to be an effective masks, but put that aside. They were doing something, this whole notion that everybody could contribute this sort of Rosie the Riveter, World War Two feeling of we’re in a crisis. But you’ve all got a role to play. What I missed was when we moved to a place where we’re in a crisis, but we were told you there’s nothing you could do about it. And you basically said, stay home or don’t go to school, or you don’t go to work or you adjust. But we didn’t make people part of the solution that I think stole people’s sense of agency.

Mike Osterholm  30:39

You know, I think this conversation we’ve had, go back and find me one organization, one group that has been critiquing how the pandemic unfold, and what we learned a lot didn’t learn. And none of those discussions included it. That I think is the mistake I worry about, because I think what you just shared was so important. How do we do with that? What should be the psychology behind those, you know, if we can anticipate 18 or more months, like they were going to happen at the least, then we have to understand this is going to be very different. Okay. And so I worry that our critique is far too much focused on organizational structure, which is important. It’s on funding. It’s on, you know, some of the scientific questions, but we have much bigger questions to ask ourselves in that, and one of the questions is exactly what you just laid out. I think that is so important going forward. So important,

Andy Slavitt  31:34

because if you have what you described, which is something with the lethality of an earlier virus, like SARS, or MERS, and the contagion of this kind of a virus, then as good as our public health response will be as good as our vaccines and antivirals as we get them rolling, and basking and all that will be at odds with something that’s long lived, and was something that’s got a fair amount of contagiousness, isn’t it the case that we are going to be the weakest link, we ourselves are going to be the weakest link. And then that in turn means that public health people and government officials and business leaders and community leaders and church leaders need to kind of be part of this process need to be bought in and helping people along?

Mike Osterholm  32:23

Well, you know, for me, one of the things that has been most surprising is when we just looked at the last election, and we looked at inflation in the United States. And we were attributing this to this isolated administrative leadership, that was your problem. We failed to acknowledge the whole world was in the soup, Argentina 72% inflation rate go around the world. You know, we missed that very point, that if the pandemic hadn’t happened, much of this economic disruption wouldn’t have happened either. Now, granted, the war in Ukraine was still going to do something. But I think that this is where we need to be prepared for the future. If this shows up again, what should the financial world what should the economist of the World be prepared for? How do they handle it? What kind of breakers do they put in place? What kind of things do they understand? Okay, this is going to be 18 months. And you know, I don’t see again, that type of lesson learned being explored.

Andy Slavitt  33:27

Yeah. You made me think of something. Mike, when you were talking about, you know, if you knew you were in this for 18 months, what would you do, et cetera. It’s all a part of history now that we had a vaccine at the end of year one, and that saved a lot of people’s lives. But that wasn’t destined to happen. I mean, the mRNA vaccines could have failed. I’m putting a counterfactual. And then we could have gone through 2020. Again, and 2021. And again in 2022. And if that was the case, how would that play it out? Because we would have still had the death rates that we saw. But society would have been breaking at the seams.

Mike Osterholm  34:13

Yeah. And I think that’s what people when they’re, again, speaking out against the vaccines don’t understand what those vaccines did for us. You know, they were the ultimate sandbags against the tsunami. And they didn’t keep all the floodwater out, but boy, they saved a lot of people from dying or a lot of property from being destroyed. That’s exactly what they did. And I think we were fortunate that this work had gone on before. This just demonstrates the importance of r&d, you know, when you least know you’re going to need it, suddenly it’s there. At the same time, I think that what happened was again, we gave too rosy of a picture, which then led people to believe it was done and over. And you know, it’s trying to basically thread that needle of this is a really important development. This is amazing what we were able to do but it’s not going to be the final answer. There’s still more to those. And I think that that then got all caught up in the politics, as you recall very well with the summer was like that year and you know, and the President became infected and the divisive activity was going on about what public health is doing or not doing. So, yeah, you’re right. It’s amazing that we had those vaccines, and it would have been a lot worse. But we also have to be careful to lay out the expectations of what people had. So they don’t see that they were just a perfect magic bullet and why we are learning what we’re learning. But at the same time, you know, I could not be more passionate about getting people pick over age 50 vaccinated with these booster doses, because they save lives. And so I think that’s an important point. These are incredible tools.

Andy Slavitt  35:52

Well, let’s close on that because it is the most important act of message. Number one, I love your three points about how you can live a good life, live a really rich life, interact with people and do it safely. Number two, implied and all that, particularly over 50, is the notion that the vaccine and Mike I think people really do understand the fact that just because you carry an umbrella out in the rain doesn’t mean you might not get a little wet. And because you have a little wet doesn’t mean you don’t carry an umbrella. And then I think that there has got to be a renaissance around doing better in public health, beginning by self-examination, beginning with a little bit of reform. Because if you’re gonna get the support back of Congress, which you’re gonna need, then your congress is gonna want to invest in something where those dollars are being well thought about, and well managed. And right now, I think, and we need a different Congress. But that’s another story.

Mike Osterholm  36:47

You know, and I think also, we almost need a sense of reconciliation with ourselves. Meaning that we can talk about these things without blame. Even though you know, surely people could say, well, we could have done that better, so that we can actually get to the root cause of what went well, what did not. You know, I mean, when I think about these countries that go through wars, where populations have killed each other, and then they work to come to reconcile so that they can move on. And, you know, to me, I think that’s important right now, everything’s got to be on the table. Can’t put anything under the table. And we can’t blame because then some people won’t come to the table, or they’ll be defensive. I just want to know, what could work better for the future. And to me that is going to take a sense of reconciliation that I don’t hear his talking about right now.

Andy Slavitt  37:36

I love that point. I love that. I think there’s so much power to that Mike.

Mike Osterholm  37:42

Well, I’m here I’m trying. We’ll keep trying on it. Thanks, Andy. For everything you do. I mean that as a personal message, but also as a very professional message. Thank you. Your leadership has been truly one of the most wonderful parts of this horrible otherwise experience for call the pandemic for me.

Andy Slavitt  38:03

You’re my mentor, man.

Andy Slavitt  38:18

Thanks to Mike O, we have some really great shows coming up. Let me just spend a second telling you about the next four or five programs. Friday, we have the author of the world’s longest study on what makes people happy. It’s a Harvard researcher, does a study been going on since 1938, with hundreds of people, and they’ve pinpointed by following people’s lives and their descendants lives? The key to what makes people happy. How can we not bite on that interview? And it was a great one. Monday, why are some cities having big homelessness problems and homelessness crises and others not? And the answer may surprise you. It may seem obvious, but it’s a great conversation on Monday, Wednesday, long COVID with Dr. Eric Topol. And then, following that, we’ve got two more shows that will be in either order. One on the new open AI, we’re going to have a show, looking at the challenges and concerns and we’re going to have a show that will look later on at some of the positives. And we’re going to have a show coming up. As we get into the theme of the year we so far seems to be the debt ceiling. We’re going to have our first of several shows on the debt ceiling starting with a really helpful, easy to understand explainer. So those are four or five shows coming up. I think you will love them. Stay tuned. Stick with us. Have a great couple of days. We’ll talk on Friday.

CREDITS  40:03

Thanks for listening to IN THE BUBBLE. We’re a production of Lemonada Media. Kathryn Barnes, Jackie Harris and Kyle Shiely produced our show, and they’re great. Our mix is by Noah Smith and James Barber, and they’re great, too. Steve Nelson is the vice president of the weekly content, and he’s okay, too. And of course, the ultimate bosses, Jessica Cordova Kramer and Stephanie Wittels Wachs, they executive produced the show, we love them dearly. Our theme was composed by Dan Molad and Oliver Hill, with additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia where you’ll also get the transcript of the show. And you can find me at @ASlavitt on Twitter. If you like what you heard today, why don’t you tell your friends to listen as well, and get them to write a review. Thanks so much, talk to you next time.

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