Herd Immunity as a Coronavirus Pandemic Strategy

[@JAMANetwork]

Topics discussed in this interview: 0:00 Introduction 1:44 Recent US data on COVID-19 3:05 Background on The Great Barrington Declaration 6:30 Main concerns and objections (John Snow Memorandum) 10:13 Response from Dr Bhattacharya 12:05 Can we protect the vulnerable? 19:33 Schools and children, and harms of lockdowns 27:11 What does removing lockdowns look like (Dr Bhattacharya) 28:29 Is there a middle ground? 29:00 Is there a benefit to delaying infection? 30:13 Separating low-risk from vulnerable 31:26 Thinking holistically about preventing harm 35:41 Masking and other common ground 37:54 Building up immunity through natural infection 40:36 Schools 45:17 Long-haulers 48:31 Definitions of a lockdown 50:05 Outlook for next 3-4 months

[@nayanacarvalho6195]

Dr. Jay sounds so much more common sensical. Although I have considered Dr. Mark's points, the conclusion sounds more like where Dr. Bhattacharya is pointing to

[@gtcstorm40]

Jay made a key phrase, "we need to look at health holistically". Terrible diet and obesity are creating a health crisis that is going to bankrupt our system.

[@monykalynf3604]

Something also not discussed when trying to compare countries. Japan-3% obesity rate. USA-30% obesity rate. And we REALLY wonder why things are worse here??

[@Docinaplane]

At this point, I feel what you allude to is driving this syndemic more than the opportunistic virus.

[@emilyb1438]

Yes we do. But at the rate things are going, people can’t lose enough weight before they get the virus. One of many reasons why herd immunity shouldn’t be a strategy without a vaccine. Going forward? We absolutely have to look at health holistically. Unfortunately this virus gets the healthy too though

[@jolem5000]

@@emilyb1438 I hear there are vaccines coming out. You better be the first in line.

[@peterbelanger4094]

If people are going to look at heath holistically, then all the secondary effects of the measures to stop the virus need to be looked at as well. The longer this goes on the more "pandemic fatigue" will become an issue. And we need to be honest about what "pandemic fatigue" really is all about. People around the world are growing tried of government intervention into their lives, and care less and less about covid as time goes on. If you think there is too much resistance to mandates and guidelines now, just wait another year. Authoritarianism is NOT a popular thing, and the social disconnection from all of this is becoming destructive to mental health and the social fabric. Online interactions are not a viable replacement for in person human contact, something we need as much as air, food and water. Suicides, alcoholism and drug abuse are all on the increase, people are losing hope.

[@PanchoKnivesForever]

Thank you, JAMA Network, for letting such a controversial, but very popular, conversation happen. People need to see civil conversation in action, so we can be better at holding conversations with one another. Hopefully such an ability increases our likelihood of efficiently progressing out of this pandemic together.

[@harolddenver6278]

The title is misleading. Herd Immunity is the endgoal, not a strategy.

[@whiskeysprings]

Dr. Jay is on point: Practical, conscientious, and very reasonable.

[@chrisd6736]

This whole thing comes down to people like Dr. Lipsitch focusing on one disease and completely ignoring unintended consequences. Hopefully we can learn from this in the future. A holistic approach is desperately needed.

[@xponen]

That is the most sensible mindset; for Covid use the Covid solution. To create a "general solution" that solve all problem is really "dreamy" and won't work in real life.

[@Mr196710]

He probably has a vested interest in the mainstream narrative. The days of assuming all scientists are only concerned with pure science is painfully naive and makes a person willfully ignorant of history.

[@chrisd6736]

@@Mr196710 yea the politicization of science is a very dangerous thing.

[@Mr196710]

@@chrisd6736 It has been for quite some time. They have to think of their careers, families, mortgages, etc.

[@morongovalley940]

Why is Sweden always the comparison? There were more infections in Texas than in all of Africa yesterday. Thailand has had weeks of protest and yet only 8 infections today. Why is it working there, but not here or Europe?

[@laughter95]

Maybe it’s a difference in collectivistic vs. individualistic cultures.

[@palosamo]

The title is misleading. Herd Immunity is the endgoal, not a strategy.

[@monykalynf3604]

THANK YOU! a misleading title designed to divide.

[@hunniepots8062]

@@monykalynf3604 well Jay keeps mischaracterizing the other side as being for lockdowns. No lockdown is when transmission has gotten out of control because folks don't want to do mask wearing, social distancing, and other restrictions. It's very unclear whether GB defines lockdown to include any restrictions. I feel like there are less than 1% of the country currently in lockdown.

[@variant732]

Herd immunity is inevitable.

[@hunniepots8062]

Actual GB has defined lockdown. it's quite broad : Lockdowns consist of a variety of measures, such as schools and universities that are closed for in-person teaching, hybrid schools, closed or partially closed restaurants and other businesses, restrictions on sports and cultural events, extraordinary travel restrictions, work-from-home orders, cancelled medical and dental visits, curfews, quarantine regulations, etc. Technically NYS is locked down.

[@hunniepots8062]

@@variant732 question would be, how long does it take to happen naturally? There is no estimate given in the GB declaration. It's not clear if it's expected to be 2 months, a year , 2 years, 10 years, only when we get a vaccine? I guess it's not considered relevant. The idea is that lockdown - defined as any restrictions aside from focused protection on the vulnerables - is considered more harmful than any lives it saves.

[@johnmcgurran2084]

Public discussion like this has been rare. Thanks JAMA.

[@kevinmiller5467]

That's because Alphabet (KZbin, Google), Facebook, and Twitter actively ban such discussion even when it's from board certified doctors. They have chosen what they believe the science is and ban anything but what they believe.

[@raykirkham5357]

Board Certified Doctors have let an opiate addiction epidemic flower in our midst and likewise do not mind sacrificing people who they do not have to hear complain.

[@raykirkham5357]

@@kevinmiller5467 This problem (the pandemic) essentially is the result of a decayed public health system and lazy overpaid administrators. Shame.

[@kevinmiller5467]

@@raykirkham5357 The opiate addiction epidemic was caused by Purdue Pharma lying to doctors and telling them OxyContin was not addictive.

[@raykirkham5357]

@@kevinmiller5467 Purdue Pharma buys Democrats and Republicans by the carload. The opiate problem is running parallel to the Corona Virus Pandemic. Our administration has no clue about either one and frankly they do not care if YOU DIE.

[@52marli]

In the last 3 months I have lost 3 friends and 1 relative. The relative was a 96 year old active, living at home with his wife, still drove, still mowed his own yard, that didn't go for treatment of his pneumonia because he was afraid of covid. He did not have covid. In fact,none of them died from covid. We have never been completely open. I can't breathe with a mask, so I'm stuck at home most of the time. If my risk of death is only 5% I really don't care anymore. I can't do another year of stuck in my room. Many of my favorite restaurants have gone out of business. Some states have remained in a hard lockdown. The bright spot in our community is schools are open, the kids have the option of online or in person schooling. And our churches are still closed.

[@52marli]

@@jakemccluremd those that I lost did not have covid.

[@monykalynf3604]

I am sorry for your losses. This is something none of the 'experts' determined to retain power and control will NOT acknowledge, like this tool Lipstick

[@kathybrady4033]

Very sorry for your losses. I know a lovely older lady who decided life was not worth living during this horrid time in history, mainly due to isolation.

[@danag812]

Sorry for your losses. Many feel like you. They would rather take the risk and LIVE their lives. Sending warm wishes to you.

[@danag812]

@@kathybrady4033 ugh...that is so sad. These arent being taken into account.

[@BarbarraBay]

Lipsitch lost credibility as soon as he mentioned "Sweden". Aged care homes everywhere have been affected. Sweden self-admittedly did not originally make a proper effort to protect the aged.

[@JosephDungee]

18:00 I don't understand what Marc is saying when he said that there was a loosening of restrictions when the fact is there was an increase in restrictions during the Summer months here in the U.S. and THAT is what was making the econocmic destruction worse.

[@gtcstorm40]

The restrictions seemed to be increasing in the south while decreasing in the northeast where the virus had already hit hard. The death rates were much lower in the south and that is when they started focusing on "cases".

[@jakemccluremd]

@@gtcstorm40 He’s saying that restrictions were loosened to early. Community spread was still increasing throughout much, if not all, of the south in May/June. Predictably, there was unmitigated spread throughout the region, and not surprisingly, mortality metrics have been worse in the south-TX, FL, GA are all in the top 5 for # of excess deaths. The economy and morbidity/mortality metrics for this pandemic aren’t mutually exclusive-all across the world countries who’ve managed to contain community spread have also had the smallest declines in GDP.

[@jglammi]

Bhattacharya is an example of an academic who is NOT neurotic/narcissistic

[@cwfilli]

What a great conversation. Civilized, fact-based and open-minded. I continue to be astonished, however, at how little attention (for the most part NO attention at all) is given to the underlying causes of poor health outcomes, namely how people take care of their health to begin with, so that their immune system can be more resilient. It's baffling to me that in a 1-hour conversation neither of these doctors even mention the importance of diet, exercise and other essential measures (such as clean air, clean water, etc.) that could make our society healthier. This should be the number one priority of government, corporations and public health experts, and yet, 10 months into this crisis, it still doesn't make headlines.

[@laughter95]

They tried this in the UK with the Get Healthy campaign. Boris realized he was too close to death from COVID and that a huge contributing factor was that he is obese. But lifestyle changes for better health is very hard to do. You’re right though. But I don’t need a government to tell me to adopt a proper training program, eat and sleep well. I think most people by now realize being obese will land them in hospital if they get COVID, but the vast majority would find it easier to stay on their couch at home than to get into the gym and expose themselves to greater risk. Likely harder to get them to exercise effectively outside, esp with little to no guidance.

[@josebocanegra4477]

Lipsitch says that since we cannot carry out a differentiated approach for differently at-risk groups, then a one-size-for-all, across-the-board approach is what we have left and is easier to do given our limitations. With resignation, "we wish we could use a scalpel, but all we have is a machete or a scythe in some cases, like in New York".

[@goteburgigram]

Egotistical medical ‘experts’ in local counties love their newfound attention, and they’re prone to only recommending the most severe, harsh restrictions. In wealthy areas this ‘safety first’ is widely embraced. People can’t grasp complicated ideas about the cost of these unnecessary precautions on the disadvantaged.

[@monykalynf3604]

They don't WANT to grasp the difficulties-to do so would admit they actually DGAF as long as their way of life isn't disrupted...

[@goteburgigram]

monykalyn f yes - they take the easy way out ‘wear a mask’ that’s all they say, and when things look worse in the media they say ‘blame your neighbor for not wearing a mask all the time’. I hope they are held accountable at some point.

[@stephanieczachor106]

@@goteburgigram And they don't follow their own restrictions--like Gavin Newsome, Cuomo, Pelosi and many others.

[@punditgi]

The choice is not binary between death and mild or no symptoms from COVID-19. Many people, including younger ones, survive but with significant long-term symptoms that interfere with life and work and sometimes organ damage that could be long-term or even permanent.

[@humanperson5134]

I'm 73 with 100% of the vulnerable comorbidities for SARS-CoV-2 to go wild. I will not go inside a commercial building. I cannot find a practice in North Carolina that will allow phlebotomists to go out of doors to draw blood. Therefore I cannot get a blood work done, can't determine other health issues, can't get script renewals. Protecting the vulnerable? Not quite.

[@BarbarraBay]

@Human Person - yes. my mother had a blocked carotid artery and was unable to see a specialist for over 6 months due to Covid lockdowns. my mother could have died. this said my mother can die anytime due to a variety of causes. covid is just another disease and the public should be educated as much as possible about it because untreated non-covid diseases will probably kill more people than covid

[@rhallah2]

So lockdowns have led to your current situation. Confused how your statement argues against the GBD

[@olafusleftutoobe8964]

I'm early retired type of age, lung cancer... comorbidities. A clinical lab scientist (lab test folks who often draw blood too). I go straight into my hospital to a cancer center, as a patient, with no fear. I was also a medical research genetic engineer, who worked with pathogens. The nurses, phlebotomist, clerks, doctors... all of the staff, are excellent at following procedure. There Is a point, and I say this as someone in research who will dig and dig to research something... There is a point, where you just let it go, and let the professionals, the specialist in their field and their job, take care of you. I let it go, researching my own cancer. My type A self, put my care in other's hands. They have not let me down. Please consider letting them help you and get your tests and prescriptions. Beth

[@Diamonddavej]

@@BarbarraBay Would that be any different without a lockdown though, hospitals will still have to mitigate infection rates and infected medical staff? Do they try to ignore the virus and the risk of infecting patients? Also, does a no lockdown affect people's confidence accessing medical care, it might. But I doubt a soft approach in the wider community would be copied in hospitals, they have to avoid infecting patients. Also, the average age of hospital patients is about 60 years, about the same age as a cruise ship and not far younger than a retirement home. They a vulnerable group, it's where sick people go.

[@mattregan3394]

The more you listen to Jay speak, the more you realize the absurdity of the ad hominem attacks against him. He is reasonable and thoughtful.

[@patmonahan6844]

Also, incredibly intelligent. Not to mention, an actual doctor of medicine, unlike Lipsitch or most epidemiologists.

[@Mr196710]

@@patmonahan6844 AND has a PhD in Economics which allows him to see an even bigger picture of the landscape.

[@maxdurk9611]

A great example of having disagreements without being disagreeable. One thing that hasn't been talked about is how to protect the non-elderly vulnerable, especially with asymptomatic transmission. Nobody is going to know that a person is undergoing chemotherapy or have diabetes. How do you protect them when you deliberately do nothing to prevent community transmission? Also, we all agree lockdowns cause harm. But we can use public health measures to slow community spread without lockdowns.

[@monykalynf3604]

And what did these people do before covid? contrary to belief-coronaviruses/influenza are here year round-we jsut didn't have a super hyper specifically focuses media shouting OMG all the time? THOSE viruses are community transmitted, airborne etc AND can be JUST as deadly to that population. We had ILLNESSES and DEATHS before covid!

[@kathybrady4033]

We should provide N95 masks for anyone who has a high risk condition.

[@jakemccluremd]

@@monykalynf3604 Please read about the concept of Excess Death. We have 300,000 of them since the beginning of the pandemic. That’s because we haven’t had SARS2 in the US before despite the narrative you’re trying to spread that we’ve always had this virus circulating in our population.

[@david.juillet]

21:20 Re: Suicides. Just an observation on the contrary (at least in some places). Data tracked by Canada's B.C. Coroners Service shows that the number of suicide deaths from January to August of 2020 decreased by seven per cent compared to the same time period of 2019. “There is a very predictable effect whenever there’s a crisis: it’s called the ‘come together effect.’ It’s been seen during floods and hurricanes and wartime,” said University of British Columbia associate professor in suicidology and child psychiatry Dr. Tyler Black (CTV News, October 22, 2020).

[@jakemccluremd]

Multiple states have shown a similar decline this year as well.

[@drgaubi]

Thanks to mention this. I've read similar publications about decreases in suicides. I would like to ask where Jays number "1 in 4 children have suicidal thoughts" comes from exactly?

[@jakemccluremd]

@@drgaubi Survey of adolescents & young adults if I recall correctly. And, not to be overlooked: thoughts don’t necessarily = attempts

[@ctwofirst6635]

If so, you're lucky. Here in the UK, suicides are up massively. I've seen a 40% increase estimated in some areas, although we will not have definitive figures for a while.

[@david.juillet]

@@ctwofirst6635 Context please, and source? Data published by the Office for National Statistics on 1 September 2020 showed that in 2019 (not 2020) the suicide rate among men and boys in England and Wales was 16.9 deaths per 100 000, the highest since 2000 and slightly above the 2018 rate of 16.2 per 100 000. The suicide rate among women and girls was 5.3 deaths per 100 000 in 2019, up from 5.0 per 100 000 in 2018 and the highest since 2004. The ONS also published provisional data for the second quarter of 2020, the peak of the Covid-19 pandemic. It showed that there were 6.9 deaths by suicide per 100 000 people. This was the lowest of any quarter since 2001, but the ONS said that the lower number between April and June should be interpreted with caution. Given the length of time it takes to hold an inquest (around five months), we do not yet know the total number of suicides that occurred during the coronavirus pandemic.

[@teaburg]

Seems to me the lockdowns happen when people don't follow all the guidelines in the first place. A pro-active approach works to at least slow infections down in the entire community. Then it can be easily managed with trace, test, isolate (tetris). The idea of having a virus rampant, anywhere, is not practical.

[@goteburgigram]

Seems that lockdowns have a 0% success rate, look at Peru, Columbia & Czech; and the areas such as Belarus, Sweden and Tanzania which openly refused any containment are now doing best

[@kathybrady4033]

Now that Biden won we can back on a total US shutdown!!!

[@sandylewis8897]

Thank you JAMA for your fair and balanced conversation without censoring opposing voices!!

[@Amazing_missB]

None of these work without a functional central government and a united society willing to fund the vulnerable, provide adequate testing. Also nursing home employees make so little, many work multiple jobs and prisons are overcrowded in appalling conditions. How do you protect these vulnerable populations.

[@ony583]

Herd Immunity is not a strategy, herd immunity is simply “when a large enough proportion of a population are immune that an infection does not spread so easily or it can actually die out.” So “herd immunity” refers to the outcome, not the route we might take to achieve it.

[@monykalynf3604]

Something those advocating for complete lockdown, mask wearing forever (because really-there will ALWAYS be a reason for it) NO family contact (they can die of loneliness and depression-that is FINE per the SNOW declaration because it wasn't COVID) also will NEVER acknowledge-especially this tool Lipsitch

[@danag812]

Yes! As Jay says. Lockdowns delay cases. When we were told to "flatten the curve" (which was reasonable at the time so medical systems could prepare) what people didn't think about was that the AREA under the curve (i.e. the #of ppl getting infected) would be the SAME, just horizontally, rather than vertically. Same # of cases, but drawn out. Very complex situation and I appreciate the creativity of the authors of the Great Barrington Declaration 👍

[@jstasiak2262]

This discussion is about re-inventing the wheel. Many Asian countries-Japan, Taiwan, South Korea, Vietnam, Singapore, Hong Kong and dare I say China-have figured out how to deal with this pandemic with few or no lockdowns. These economies are growing and are no longer contracting. It is clear how they did it: They got the population to cooperate with well known, well understood, low tech, mitigation measures: universal masking, distancing, avoidance of crowds, hygiene, etc. Some countries used coercion (China, Singapore) to gain cooperation of the population, but most didn’t. It is clear that what these countries did worked extremely well. Why aren’t we trying to emulate one or more of those models instead of trying to invent another solution that may or may not work? Also, I think that is way too premature to speculate on the presence and efficacy of a vaccine. The development, manufacturing, logistic, and deployment obstacles are extremely daunting and cannot be blithely taken for granted as Dr. Bhattacharya is doing. Furthermore, there is the issue of the inevitable late discovery of adverse reactions which will discourage many people from getting the vaccine. It is foolish to base a mitigation strategy on an intervention that does not yet exist and may not exist for a long time, if ever. If it doesn’t exist, then you should assume that it doesn’t exist. Lockdowns are an act of desperation to forestall a looming catastrophic collapse of the healthcare system. They never were intended for nor practical for use as a primary mitigation strategy. Dr. Bhattacharya keeps trying to use this as a straw man argument. A good solution vigorously applied now is far superior to a perfect solution applied next week, next month, or next year.

[@ajp3333]

I agree with your points. It might be that this is not a viable route now for the US and other European countries because in the Asian countries you mentioned the infection rates are comparably much lower so contact tracing is actually effective and testing capacity is not a limiting factor?

[@michaeltrumper]

Also appears to be blessed with large proportion of the population with preexisting immunity due to prior exposure to corona viruses.

[@jakemccluremd]

@@ajp3333 We had the same number of per capita cases as Singapore back in early-mid June. Combined with enforcement of their mitigation measures, supplementing incomes, and a relentless expansion of testing, they now have to test ~4000 ppl to detect 1 case. In the US, that number has never been greater than 25. With a multifaceted mitigation strategy, a devoted, compassionate community of individuals can collectively drive down community spread, and thus long-term complications of disease and death-same infectious burden 5 months ago…now Singapore 5, USA 710 deaths per million.

[@jstasiak2262]

@@michaeltrumper As far as I am aware, immunity to SARS-CoV-1 does not translate into immunity to SARS-CoV-2. In fact, because of virus mutation appears that it is possible to get SARS-CoV-2 more than once.

[@patmonahan6844]

@@jstasiak2262 Well, you just blew any credibility you might have had. I hope everyone reading this understands that a myriad of studies show cross immunity from all beta coronavirus infections to Sars-Cov2. The first study actually was done in April and now there have been many more. Also, you clearly do not know what strawman argument means. You are 100% wrong in assessing that lockdowns were not meant to mitigate, they absolutely were as the new ones are. They not only have not mitigated anything, they have only delayed the infections. We know this is seasonal, and we pushed more susceptible hosts into the new season by not allowing them to get lower inoculum during the warm seasons in the northern hemisphere. BTW, Sweden is currently experiencing their their 3rd least year of death per capita ever. September was their lowest month every for death per capita. Lipsitch is an epidemiologists and not a medical doctor, while Jay actually is a medical doctor. Perhaps the biggest problem with this or any disease is listening to epidemiologists who are social scientists, not formal scientists. My guess from your writings is that you think Epidemiologists are MD's. They are not.

[@drmarkberber]

Excellent respectful conversation, very well moderated. If there was to be a "winner" it was Jay whose arguments just made the most sense, at least to me. I have already witnessed the psychological effects of lockdown, especially in youth, at our hospital. Mark Berber MD, MRCPsych(UK), FRCP(Canada)

[@emilycasanova8512]

The "vulnerable" are being spoken of as if they comprise only a tiny fraction of the US population-- but the elderly, obese individuals, people with cardiovascular disease, asthma, etc.... these are all major risk factors for COVID19 complications. The "vulnerable" I would imagine would compose a sizable minority in this country! And when we speak of mortality rates, why is morbidity almost completely ignored? People are not scared solely of dying from this disease but of being disabled by it. Cardiovascular damage, brain damage, pulmonary fibrosis, long covid... It's not solely about death rates anymore. The death rates may well be lower, but for those who survive now who wouldn't have back at the beginning of the pandemic, what is their quality of life?????????

[@skim3291]

THANK YOU SO MUCH for this session. Your closing comments were the best. In the long run, that may be the most important take away from this.

[@douglynch8954]

In theory, Jay Bhattacharya's idea of focused protection makes wonderful sense. But politically? Where are the resources and the political will to underwrite the protection of all of these folks? Spend money to protect poor black people? I'll believe it when I see it. Let's stay in reality folks.

[@somashekharnimbalkar585]

Before this discussion I would never have given Barrington a chance. But Jay is sounding smart while Marc seems SJWinf via words such as fringe, absence of science, etc and being essentially condescending!

[@ardvarq9027]

I think Marc's criticism of the declaration's wording is valid though...it makes them seem like a bunch of anti-maskers, which they're obviously not. The disagreement about whether school-aged kids should be exposed to covid is perhaps moot...they will be, unless you want to shut schools down for the next several years. Not too many people have asked what is the morality behind making minors suffer for something that has no effect on them. And (just curious) has anyone ever asked why we would be asking people of younger age groups to take vaccines for diseases that don't affect them? Where do we draw the line for this?

[@jolem5000]

@@ardvarq9027 You are right. They need to be clear regarding the health hazards of masks. Suffocating and poisoning children in the name of "safety" is an atrocity.

[@ardvarq9027]

@@jolem5000 Mask wearing is a minor temporary issue that followers of the trump cult have seized on for some reason. The science isn't great either way on whether they work or do much harm. Much more interesting is the ethics behind our new messianic viewpoint that the young must make enormous sacrifices (and must take medications) for the sake of the older population. Vaccines used to be to protect children from horrific disease. The Barrington declaration implies this problem, but they could perhaps be more specific on this point.

[@monykalynf3604]

Georgia-villified for starting schools, loosening restrictions this summer....and not going through a huge fall (expected seasonal) spike, Florida-allowing residents/businesses to set their guidelines...not seeing huge spike (expected fall/seasonal small increase).

[@jakemccluremd]

FL & GA are the 3rd and 5th worst states in the country for excess deaths. Not exactly the desired outcome we should strive for.

[@monykalynf3604]

@@jakemccluremd yeah also check age/where deaths occuring/obesity rates. No one EVER mentions these factors just a simple cherry picked one number with no analysis. I'm sorry the 85 year old died with a positive covid test-truly! but did we REALLY expect EVERYONE to live forever?? When did we become such wusses and think NO one should EVER DIE? Unfortunately no DOES care about ANYTHING but a COVID death. 4 people killed in ACCIDENTS this week just in my area-no running tally on lives lost due to car crashes

[@monykalynf3604]

@@jakemccluremd AND-their death rates are falling and continue to do so....Yes there will be EXPECTED and NORMAL SEASONAL "surges" -same as EVERY YEAR BEFORE THIS ONE.. .difference is we didn't have national news media picking the outliers and constantly touting it as usual.

[@jakemccluremd]

@@monykalynf3604 Motor vehicle deaths have decreased in 2020

[@michaeltrumper]

@@jakemccluremd Florida aslo has the oldest population in the country. Excess deaths track very closely with age and health.

[@52marli]

Jay...at least you sound reasonable. Thank you.

[@ctwofirst6635]

Many people concerned about the negative impact of lockdowns are reasonable people. While the discussion here in the UK is also politicised, it's not the same as in the US. There are people on the right and on the left (myself included) who are extremely concerned by the massive impact of lockdowns on the low income and the poor, especially in developing countries.

[@monykalynf3604]

did anyone ask (FEar is my middle name) Osterholm that 194 kids died of FLU last year and NO SCHOOL shutdown??????? The WORST decade for FLU in 10 years!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[@jakemccluremd]

“The worst decade for flu in 10 years” ??? 🙋🏻‍♂️A decade lasts 10 years.

[@ctwofirst6635]

@@jakemccluremd A mistatement. We all make them on occasion.

[@dystoniaify]

Am I the only disabled person who has become permanently crippled since the shutdowns? Poverty, disability, isolation,worsening disability in my dark prison apartment without a yard..I just turned 40, and I'm one of the fatalities of the shutdowns. This is hell on earth. I'm going to end up with dementia,bllind,crippled, and thrown into a nursing home for the poor (medicaid ) if this continues. I had a rare Hypoxic-iscemic brain injury result in Parkinson and dystonia at age 30. Now I'm going blind due to poverty and stress. I used to be an OT. I lost everything. In Portland, OR we never went beyond phase 1 and now are shut back down. I'm no longer comfortable in society. Portland has been locked down since March I just turned 40 last week, and my future is suicide.

[@BarbarraBay]

31:10 17,972 under 55yo, compared to around 340,000 deaths per annum in that age group

[@MichaelRoach73]

I love this Dr. Bhattacharya! I agreed with everything that he said. He has a clear ability to see issues in a more holistic manner and had many great recommendations for focused protection. Sure those recommendations would be more difficult to implement logistically than the simple lockdowns we've been subjected to (and I prefer his definition of a lockdown over Dr. Lipsitch's definition) -- however, these recommendations would allow the vast majority of us to return to a normal life. He understands clearly the devastating effects these lockdowns have had, and continue to have. He illustrated this beautifully with facts and stats, with no emotion involved. It seems to me that Dr. Bhattacharya would have been an ideal choice to lead the U.S. Covid-19 task force.

[@stephend7420]

I should say - thank you for this fascinating dialogue. Great to see opposing sides addressing each other's arguments rationally and with evidence.

[@ctwofirst6635]

Certainly nice to have lockdown sceptics not immediately demonised and accused of "wanting to kill Granny." As if.

[@josebocanegra4477]

Lipsitch misunderstands the causality of consumer confidence. First, consumer confidence is influenced a great deal by economic aggregates, including inflation, real interest rates, and unemployment, so that if lockdowns and other public health measures reduce real incomes and increase unemployment, then these could decrease consumer confidence. Second, consumer confidence can be prospective, responding to stock market movements and expectations of future trajectories of the economy. Third, consumer confidence can respond to political and other events, including pandemics, in a manner that decouples it from how the current economy is performing, but impact of these political and public health events will be mediated through economic variables. Therefore, the pandemic itself does not clearly, directly reduce consumer confidence; instead, the pandemic leads to governmental responses whose effects are filtered through economic aggregates that indicate future economic performance, thereby shifting consumer expectations about the future of the economy, thereby moving consumer confidence today.

[@judyzehr]

I thought they actually had a lot in common, just using different terms. Both men were informed and had strong points. My concern is the politicization of the Freat Barrington declaration, and that it was funded by a Koch brother.

[@krikeles]

Is Dr. Bhattacharya under the impression that everyone over 65 lives in a nursing home? Presumably all nursing homes would be isolated, with anyone entering would be instantly SARS-COV2 tested. Will he provide income & other resources for the vulnerable to be able to stay at home or is that against the beliefs of the Hoover institute. Can he provide enough PPE for the hospitals and other people providing care to the infected as these facilities will likely again be swamped with patients. Why is he not looking for ideas from the countries that have managed to tamp down the infection. I do wish Dr. Bachman would ask more pointed questions. Has there ever been an infectious disease that has reached herd immunity without a vaccine.

[@jakemccluremd]

Bingo. Let ‘er rip to herd immunity strategy conveniently never gives granular solutions nor allocates resources to achieve their exalted “Focused Protection”

[@rhallah2]

He clearly states old people are working in low income jobs. Right now the UK is paying 80% salary for ALL furloughed employees in lockdown but your saying it’s not possible to financially assist just those 65 and older?

[@jakemccluremd]

@@rhallah2 How much has Congress allocated to that group thus far?

[@genesis650]

What are they doing for the over 65s now? Jay is just saying continue with the same help the elderly are getting now, and try to imporve it, whist letting those under 60 get on with their Normal lives.

[@jakemccluremd]

@@bundokman 🤦🏻‍♂️. focused protection: 1200 deaths/day and climbing Back in mid-April, we had the same number of per capita cases/day as Singapore (they were actually soaring past us). They tightened up restrictions, enforced them, covered furloughed wages, and massively expanded their testing volume. Current cumulative per capita deaths (per mil): US 710, Singapore < 5

[@Al-zy6xv]

This should be titled: "Lockdown as a pandemic strategy."

[@Al-zy6xv]

They can't even agree on the definition of lockdown.

[@brettkistner1525]

doi: 10.15585/mmwr.rr6601a1

[@hunniepots8062]

​@@Al-zy6xv exactly, according to Jay's definition, any restrictions on businesses or "normal" like occupancy restrictions, mask mandates, or social distancing requirements is considered lockdown. By this definition much of the US has been in lockdown since March. That also means Sweden is currenlty in lock down. This makes it hard to compare lockdown vs no lockdown or to separate policy from the overall effects of the epidemic as there are very few places with no restrictions at all.. perhaps some states in the US like North and South Dakota.

[@chinoto1]

United States prides itself on being a free country, I think that is why people here consider what we're doing to be a "lockdown". Whereas in China, they did a bonafide lockdown and got the virus under control that way. I doubt US citizens would obey a true lockdown, so we might as well try quickly building up herd immunity among the healthy instead of half-assing this and prolonging the virus so it can more easily reach the vulnerable.

[@stephanieczachor106]

@@hunniepots8062 Florida has no fines for not following mask and social distancing rules. Actually they are not rules there. I know a few people who live in Florida and everything is left to the individual. Many still choose to wear masks.

[@BlueberryHobbit]

They know that young people work in nursing homes... right? With the herd immunity situation for me as a young person: I go to a movie, but I then go to work (at a NH) and 30 of my residents die.

[@jakemccluremd]

Unfortunately, no; they never acknowledge these facts about exposure risks from NH employees.

[@BlueberryHobbit]

Jake McClure, MD It’s been our nightmare since March. We (staff) are trying to take care of people but end up unknowingly carrying in the virus that kills them. Even the best screening and frequent testing couldn’t fully prevent the virus from getting in. (And once it was inside we were fielding literally 2-3 deaths per day).

[@jakemccluremd]

@@BlueberryHobbit Screening appears to be mostly show with minimal influence on detecting new cases, especially since most are asymptomatic when most infectious. Out of curiosity, how often are employees tested?

[@BlueberryHobbit]

Jake McClure, MD it’s mandated weekly in my area based on positivity rate in the county but in practice it has been 2-3 times per week with the rapid tests (if available) and a follow up PCR if the rapid indicates positive or inconclusive.

[@jakemccluremd]

@@BlueberryHobbit 👍🏼

[@michelemenditto8405]

Interesting that Dr. Jay Bhattacharya ‘ is also a former research fellow at the Hoover Institution, a conservative think tank at Stanford where Scott Atlas, MD, of the White House coronavirus task force, is currently a senior research fellow.’ As per MedPage

[@hectorgonzalez6651]

So which of his points do you disagree with exactly, and how is that relevant.

[@marirossi]

But...how do you protect fragile people? Do you lock them down in big hospitals? Should they stay completely isolated away from their relatives? I think it's quite difficult to do it practically...dont you think that they could be psychologically affected by loneliness?

[@hank-uh1zq]

Exactly! The old would suffer immensely with isolation. The only way is to lower the overall transmission.

[@marirossi]

@@hank-uh1zq lets hope vaccine will do its work

[@rdv141057]

In my community, the physicians had weekly meetings with the healthcare department communicating our observations in the frontlines; the healthcare department inform us the public health issues. After a strategy is implemented, we observe the impact. Good outcomes at the end from an initial disaster.

[@osirismarbles5177]

When regions have lockdown and then come out, there will always be a spike in cases because there's been no gradual buildup of immunity. Of course any heavily locked down region will experience this spike because it only takes 1 contagious person to start a pandemic among thousands of non-exposed people. A sponge that's already wet can't get much more wet. But leave the sponge hard and dry and get what? It goes from completely dry to very wet very very quickly.

[@SpineGevity]

This is a public health issue that is worsened with myopic views. Hopefully Mark will remove his blinders and view the world as a whole. If our brightest people who are influencing policy are just now defining “lockdown” our world is in big trouble. The experts have very few leaders who understand the larger damage to people not caused by a virus.

[@touficfarah7075]

It would be good if Dr. Howard Bauchner could always begin his podcast by mentioning the date of his interview. Otherwise, we thank Dr. Bauchner very much for his efforts and insights.

[@JAMANetwork]

You can find the recording date for every episode in the description.

[@rossmurray9654]

The failures which resulted in second (or third) waves across Europe and US are not that there were lockdowns; the failures were with governments' inability to use the extra time that the initial lockdowns provided to get effective testing and contract tracing systems in place. The govts of Japan, South Korea, Taiwan, Australia, and New Zealand all have very low rates of infections and deaths. They pursued policies which were aggressive enough to suppress spread of the virus, and they're now all reaping the benefits of lower deaths AND stronger economies.

[@patmonahan6844]

Wrong. Science is leaning heavily toward the fact that Asians had much more cross immunity than everywhere else. See Japan. No lockdown, barely any death. Also, New Zealand is a small island, and Australia is a big Island. Isolated populations are not comparable and are in fact, all still susceptible.

[@martypoll]

I live in Thailand. I agree with you. Asians are not less susceptible. Plenty of people died in China. The recent lockdown in Victoria, Australia has been effective. Lockdowns work if widespread infection has not spread too much. Strong measures implemented early can work. You don’t have to live on an island. Thailand has effectively closed its borders. Everyone, including Thai citizens, could not enter without entering a strictly enforced 14 day quarantine which is still the case.

[@alanrcrews]

Dr. Jay has great “ideas” that in reality require fundamental changes that require changes in law & society that are long, long timelines; that means “you effectively can’t get there from where you’re at”...

[@genesis650]

Dr. Jay advocates for a safe and effective way to end the lockdown. Lockdowns are a mass experiment and have never been tried before in history. Locking everyone down, harms everyone.

[@monykalynf3604]

@@genesis650 Nor will those advocating for lockdowns EVER admit that they are extremely harmful. AND never ever have they ever been proposed when a pandemic is widespread. People have lost their GD minds over this virus and allowed the media to hype hysteria and fear vs actual facts.

[@Loctran23]

I’m ready for the followup conversation.

[@leanneoud]

Very good discussion between both sides, both are valid. However I agree with Dr Jay. It is a classic iceberg effect.

[@chrismoore9223]

CA and NY, and therefore the vast majority of the population have indeed been locked down since March

[@BagOfEyebrows]

thank you for having a civil discussion on this matter -

[@imgonnawin555]

There is not civil conversation about it, given the context that these morons are portraying it in the "Barrington Declaration". Herd immunity is obviously the end goal, but via a vaccine, ONLY. Just looking at it from a purely practicality standpoint, it would take 6+ more years to infect 250 million people, and that is IF we jump up to 200,000 infections a day. Secondly, you CANNOT "protect" groups of people. These people taking this seriously are a complete joke.

[@pozzo1979]

@@imgonnawin555 Argentina and Peru are perfect examples of how lockdowns work in "protecting" groups of people!

[@ctwofirst6635]

@@imgonnawin555 Excuse me, calling people who disagree with you "morons" means YOU are not interested in civil conversations, only insults.

[@stephanieczachor106]

@@imgonnawin555 Pfizer and Moderna have both stated in December 2020 that there is no evidence that their MRNA vaccine protects against transmission of Covid 19 nor does it guarantee lasting immunity. It also only helps create antibodies which, again , may not last more than a few months. Only time will tell.

[@cb2667]

Why the worry about cases? Can someone explain to me why we worry about cases, when we can clearly see a massive rise in cases does not lead to a massive rise in hospitalizations, ICU admittance, and deaths? WHY THE WORRY with cases?

[@morlidor]

Probably because of hysteris and fear! Which is largely unjustified.

[@stephanieczachor106]

Agreed. In Ontario there is over 5 times the daily testing that there was back in the Spring, and also we have 5 times the daily cases compared to back in Spring and yet daily deaths are down by more than 50%. "Cases", many of which are false positives due to a 38 CT on the RT PCR is driving policy. Even Fauci says anything above a 35 CT means you are likely not sick nor contagious.

[@morlidor]

Because most politicians doctors and professors know very little about this but understands that they can use the Panicr to further their own causes.

[@humanperson5134]

If part of the GBD strategy is to protect the vulnerable then enabling outdoor blood work nationally would go a long way for the elderly in lockdown to acquire conventional medical care and prescriptions.

[@alanrcrews]

Jay & Marc need to sit down with Tony Fauci in 6 months and start working on a plan & the required law & societal changes for the next pandemic...

[@morlidor]

Fauci should not be involved. He is a disaater and should have been fired a long time ago.

[@coahuiltejano]

This is an amazing discussion, which the BS media will never show. Wish we would have more of these debates because it demonstrates to the public where the debates/differences are at. Please do more!

[@gtcstorm40]

Yup, there should have been a panel of scientists put before the people, giving us an array of opinions and suggestions. Instead we were force fed the dictates of a few. I do not want to live in a dictatorship run by scientists.

[@rodolfonetto118]

Dr. Jay Bhattacharya did something strange: at first, on a Hoover Institute video(1), he was of the opinion that social distancing was not necessary BUT he wanted to have the antigen test results first. After he got the results, he also went into the Hoover Institute KZbin channel(2) to say (paraphrasing) "The IFR is very low but the level of hospitalization needed is much more severe than that of the common Flu, for instance, and if the health care system colapses that IFR will quickly jump". Months later, there was this declaration. IMHO, Dr. Bhattacharya is a good doctor but he's also an economists and economists often fold to peer pressure - Allan Greenspan did this in the 1990s when he decided to change his opinion about the "irrational exuberance". I am not a specialist but I did study a bit of Operational Research and what they are proposing is impossible to implement - at least in Brazil and many other countries. I would say that even in the US this would be a impossible task. 1) kzbin.info/www/bejne/Y4ayZIqaatqlnZI 2) kzbin.info/www/bejne/aGmcf4qjbZqYl9U

[@floatingleaf9672]

Thanks for having this conversation:) We all have different perspectives, here is mine. I am at low risk of complications and low risk of exposure to others who are at high risk. I am capable of determining my own risks with advice from my doctor. As was the case prior to covid, acquiring essential items may expose those who are at high risk from respiratory illness; however, this risk can be mitigated with self monitoring by the general public, support for services to those at risk so they can avoid high traffic areas (for example supplementing their income if their employer is unable to modify duties, having essential items delivered if they choose, and providing them with the tools to improve their health on a case by case basis). This is obviously a simplified "solution" but something like this could be "easily" applied and adapted. Any action above this in my opinion is unnecessary. Could infection spread? Of course, this is expected with other respiratory illnesses. Could there be long term consequences? Of course, as is the case with many respiratory infections. Could people die? Of course, we are mortal. If we are really concerned about saving lives we could save some of the 25,000 who die every day from hunger. This would cost about 7B/year. Totally worth it! In Canada, an entire community has been forced to leave because they don't have access to clean drinking water and haven't for many many years. This is the case in too many First Nation communities. A water treatment facility costs about 200M. GAVI received 600M from Canada and we are not any healthier because of it. In my province of Saskatchewan more children have died this year while in the social services system then deaths due to covid. Those in healthcare and government have had months since knowing of covid and years before to prepare. It is my own personal observation that, through the years, health has taken a backseat when it comes to funding. This has directly impacted the ability of our healthcare system to operate on a daily basis let alone during a potential crisis. Our family has been relatively unaffected thankfully, no one I know has tested positive, my husband is still working, and I am fortunate to be able to homeschool, I couldn't imagine having to choose between feeding them or protecting them from being treated as disease vectors. When will this end? I have asked my MP and MLA but they have no answers. Is there some epidemiological "sweet spot"? I have seen articles and comments saying that children should be taken from their parents if vaccines are refused, vaccinated, then returned. We need to retain the right to decide (without coercion) what goes in or on our body as well as retain the rights to make those choices for our dependants. In Canada on Novemeber the 11th we thank veterans for their sacrifices for our freedoms. You may not feel as if your rights are being taken away now but I certainly do and see a dangerous trend in the minds of those around me who seem so scared of something we still know so little about. Where else in history have we been told how many people we can contact, what items can be sold, how far we can wander from home, what items we must wear to access essentials, courts being closed, hospitals limiting access, children being denied access to school? If you have read this far, thanks:) All the best to you and yours. 11:11💫

[@nicholascasella9228]

Dr. Lipsitch, would your opinion on lockdowns change if you were one of the millions of Americans and others worldwide who lost their job, savings, or business they built for years overnight? Would you still be on board for forcing business to close or be at restricted capacity? Very easy to advocate for policies that disparately impact the working class and minorities from your Ivory Tower.

[@ameliablack4613]

Have we compared the effects of various lock downs from one community or state to another? There is certainly a range across our country.

[@joshuafaulks7230]

Jay is the man. IMO, maybe people would be more supportive of less restrictive measures if Jay was in Scott Atlas' position. Scott has the right idea, but his Twitter activity is unbecoming of someone in the role he's in.

[@tashok61]

Herd immunity is not a strategy it's simple biological fact..grow up man

[@philaypeephilippotter6532]

I couldn't agree more. The lockdown slows herd immunity but can't stop it.

[@stephend7420]

It's a pity you did not really discuss the herd immunity concept in more detail.

[@martypoll]

I will state that lockdowns do work if community transmission is low enough. Thailand had an outbreak in March and implemented a lockdown that was more stringent than in the US but less so than China. The community transmission has been effectively zero since May and life is largely back to near normal except for one thing - closed borders. Thailand has kept Covid out of the country with strict 14 day quarantine for all travelers entering the country. This, of course, has severely impacted the tourism industry which is not insignificant. I suspect that Covid has entered the country since May but as long as R0

[@logistaur]

Didn't watch all of it, but I like what you said in the end about people not agreeing but still having a civilised discussion. I wish more people would take that advice :)

[@alanrcrews]

Jay needs to move to Sweden for 5 years, so he would actually recognize the massive societal & personal psychological differences. Swedish & Norwegian friends have trouble explaining the differences...

[@jakemccluremd]

Based on the stark differences in their numbers, I believe you. Could you elaborate on some of those soc-/psychological differences?

[@goteburgigram]

Not mentioned often is Belarus where early on the leaders kept schools open, encouraged church and held large soccer matches. No masks. No Covid crisis at all despite early on having it worse than neighboring countries. Sweden gets all the attention. Lockdowners often say well Swedes are a special culture. I just don’t see it. My daughter went there on student exchange and I’ve been 3 times over the years. Public transit is heavily used and mask free. Schools are open. Housing is small apartments, tight. This is a human virus challenge and should be observed in that context; don’t be eager to dismiss the luxury of a control group as some kind of cultural outlier that doesn’t matter, because what they did proves we made a mistake. Buck op, admit we were wrong. If anything it’s American culture always thinking we’re superior and not wrong, which is causing the most harm.

[@jakemccluremd]

@@goteburgigram cumulative: Swe 600 deaths/mil v Finland 65 & Norway 53. They’re neighbors; please explain the discrepancy in these outcomes.

[@omerk789]

@@jakemccluremd Denmark is 128. Why is the infection rate in Copenhagen, Denmark higher than that of its direct neighbor of Malmo, Sweden? (They're about 6 miles apart and connected by a bridge). In short, most infections in Sweden were centered in Stockholm and it's the most populated and busiest metropolitan in Scandiavia. There are other, much better comparisons in Europe.

[@mulmini29]

@@jakemccluremd sweden didn't lock down strictly, is more densely populated. It also has quite a lot of multi-generational families due to immigration in the last decade. Grandparents of families like this were hit hard I believe. Sweden has had just 351 deaths since September from Covid...their numbers are remarkably similar to seasonal flu....a smidge under...an equivalent for the USA would be 11,583, you've had 59,000.

[@jeanplante1816]

So you are saying that most of the Elderlies are doom! where do we go, how to we do our grocery? and other activities with of such of a threat to our life?

[@Lichenlikenedlich]

The thing I worry about is not as much practicality, it's will. Does my country's leadership care to stop people from dying? No, it's demonstrated they don't. We could protect those at higher risk, and we can support people who would starve. We honestly don't have to choose who gets sacrificed, let's ditch neoliberalism.

[@jakemccluremd]

🎯👍🏼

[@colincharan-kumpula6424]

Thanks for covering this, good convo. No easy way out.

[@PraiseB2Allah]

criminal how few views this has. maybe the most important debate on covid policies

[@manuelseniceros9550]

Sweden had high death rates in nursing homes? but so did new york!

[@jt21419]

Isn't this an old age crisis? Keeping humans alive well beyond their shelf life may be proving unpractical. The debate should be about dignified death.

[@PanchoKnivesForever]

No. This crisis also includes young people with health problems such as immune system issues, heart issues, asthmatic issues, and others, as they are also highly at risk to die by COVID-19 if they contract it. It depends on what you consider to be beyond a human's shelf life. Let's just say humans living past the average global life expectancy, which right now is 72.6 years according to the UN, is living beyond their shelf life. It is not impractical keep them alive because, historically, the average human life expectancy (AHLE) has been increasing all over the world for over a hundred years now decade to decade and continues to today, so such an increase would arguably never be happening if humanity deemed keeping humans alive past such an age to be impractical. Just 20 years ago the AHLE was around 65 years, and in the 1950's it was 45 years! Imagine if people were deeming other people's lives impractical to keep alive just because they were 45? In 1925, it was around 37 years - that's around the time my grandpa was born, and he made it to 90 while still being very active! Keeping people alive longer just demonstrates how well the field of medicine continues to evolves over the decades. Therefore, keeping people alive past the AHLE, or what I'm defining as beyond their shelf life as an example to your case, is indeed practical. I made this case only because the people around the age of 75 years and up is the largest group of people with the highest risk of dying by COVID-19 (and 75 is not too far from 72.6). Explain by what you mean by dignified death, please.

[@davideddy2672]

Agenda 30

[@informationsdienstdeutschl1874]

@@PanchoKnivesForever wrong. 1) life expectany increases behause of less infant deads. 2) people with massive health problems can make their own choice.

[@unreliablenarrator6649]

Lockdowns have worked. The effectiveness of combatting COVID in China, Vietnam & other Asian countries that implemented lockdowns, widespread mandatory mask wearing, contact tracing & quarantines before any vaccines were available speaks for itself. The problem with lockdowns in the USA & some European countries was poor execution. I raise one interesting counter-point JAMA & associates should consider: while Western media and commentators have severely criticized the "draconian" measures taken in Asia, particularly China, and questioned how Asians can tolerate such heavy-handed policies, perhaps a better question to ask is how Americans and some Europeans can tolerate such "draconian" rates of of infection and mortality, and how they can accept the deliberate and careless disregard recommended measures in public place that spread the virus? Lastly, the fact that some Asian nations took strong measures early and rigorously enforce them enabled them to resume normal activity much sooner; in China and Vietnam students returned to school by summer. With all due respect to Dr. Bhattacharya, he is comparing the results of poorly executed lockdowns to make his argument and ignores the good public health and economic outcomes they produced. Can we conclude the poorly executed lockdowns are ineffective? Yes. Is that valid argument against doing things right? No.

[@bobmester3475]

Thank you for providing a thoughtful discussion. People of good will need to start working better together to minimize the damage. This type of discussion and problem solving is just what is needed. Thank you!

[@TealJadeTurquoise1]

In the school where I taught, teachers and principals were deathly afraid of teaching the young students. I fear this interruption of learning will undermine the process of learning that will have unforeseen dire consequences.

[@youtubecomenter3655]

Very good discussion! Jay is convincing!

[@DalePitman]

It would of been better if Jay had answered the actual questions he was asked.

[@rishabhdutt7377]

I think he was very clear. We should look at the big picture here.

[@awakeadventurer9198]

He was very clear.

[@marg716]

Slow the spread. Wear a mask. Wash hands 20 seconds. Maintain distance. Minimize unnecessary activities. Have fun safely and often. Pray safely and often. Learn safely without required SOLs. BE CREATIVE & SCIENCE OUR WAY THROUGH THE NEXT YEAR.

[@214kennedy9]

@8:20 "...nursing home residents are not tested upon arrival..." Could this hamper the labor force that refuses access to immigration employment physicals?

[@opotopo1]

Thank you for doing this. Its only through conversation and debate will we get to the best overall and balanced solution.

[@eelkeaptroot1393]

Fascinating discussion, docs! Thanks for sharing.

[@carolineallen5062]

I wish that Dr. Bhattacharya weren't speaking as though the entire US were taking the same measures. Iowa businesses, churches, and schools have not been closed since June. In fact, Iowa has largely been following what he says we should do, and our cases are exploding and our hospitals are on the verge of being overwhelmed. The idea that people will take precautions because they've been told the risks just isn't true.

[@Mr196710]

Sounds as if Lipswitch has a vested interest in the narrative. I would love to see his email correspondence with his administrators, stocks owned and grants he has received from the govt. in the past. These people are not beyond reproach.

[@stephanieczachor106]

that's exactly what i was thinking!

[@drstellakwong]

Victoria, Australia ,has 3 months of lock down. Now zero community transmission in the last 12 days ( from 750 per day before lockdown)

[@martypoll]

👍 congratulations from Thailand.

[@phillipivy9780]

How are people getting tested if they're locked down?

[@LJ-ot5lm]

Thank-you for this information.

[@monykalynf3604]

Hard to listen to Lipsitch as he just spouts party line with zero thought or coherent argument. And he is very very clearly NOT listening to the question but has his pat answers all ready to go!!

[@jeanplante1816]

I agree with Dr Jay Bhattacharya that the virus is there, so we need to find strategies and measures that will protect the vulnerable individuals, but it is almost virtually unfeasible.

[@TJ-hz8gy]

Thank you!

[@Hiker_who_Sews]

Thank you for creating this video and making this knowledge available to all.

[@DrTodd13]

About the fact that some people will die if we open things up for those in the low-risk categories, just explaining things to people at an intellectual level might not matter because people, especially with this disease, seem to be reacting emotionally and then back justifying their preformed opinion with selective data. However, the explanation is quite simple. We knew that raising the speed limit to 65 would cost lives and we did it anyway. We know that lowering the speed limit to 45 would save lives and yet we don't do it. How do you compare apples and oranges like death versus people getting somewhere faster? It is up to humans collectively to put a convenience cost on a life and that's what we do with the speed limits. Same thing here...there's a bunch of negatives associated with lockdowns and the fact that people violate them shows that they are valuing other things more highly than an increased risk of death. Science doesn't make value judgements like this. Science can make predictions of what would happen in either scenario but it is up to people to decide which one they prefer.

[@garlicgirl3149]

The Barrington theory sounds like it could work but we did not prepare. All the steps that would need to be taken seem to be on the premise you are prepared (my assessment from discussion). The best discussion I saw on YT was a TED-Talk from 11-12 years ago from a scientist on how to prepare for a pandemic and she listed all the steps and we the USA have failed in every single category she mentioned. So, for me the Barrington would not work because the things we could/should have had in place were not in place despite being warned. Also, I did not feel either person truly addressed the issue for the teachers who are over 60 and those with chronic disease that work in schools. Yes, they should/could be open but do we really want to see those teachers die/or incapacitated for a season? Great discussion. Enjoyed it.

[@chrisc1811]

Unfortunately for this discussion, Mark doesn’t miss an opportunity to wander off into partisan political talking points like “teachers are underpaid and poorly treated” , or our federal government has lost credibility.

[@susanbeever5708]

The people I know who are against lockdown or quarantine also refuse to wear a mask. So voluntary mask wearing is not an option when you look at the big picture. Here in Texas the first 2 weeks of school brought 5,000 covid cases, half were staff. How many asymptotic children and staff went home to infect their vulnerable contacts?

[@ArtStoneUS]

The motorcycle gathering in Sturgis was the ideal experiment. The attendees left and returned back to their communities. There is relatively little evidence that the infected reignited widespread infections.

[@jakemccluremd]

Open your eyes. Look at the per capita death rates in the Dakotas.

[@morlidor]

@@jakemccluremd And you are sure this is because of that meet? I call BS!

[@judyconte6566]

Jay is talking about protecting the vulnerable. I am vulnerable. I am 66 years old.I am high risk. And I have not heard a single word in the news on how to protect myself, other than washing my hands and segregating myself from people by staying home. They need to be a detailed extensive list for seniors on how to protect themselves and still interact with the community and herd immunity is not going to help seniors.what your basically saying it's OK for me to die so that you can live

[@morlidor]

Stay healthy by excersising eating right and quit smoking if you do.

[@humanperson5134]

Thank you. Will try!