Name: Joe Rogan Experience #1439 - Michael Osterholm
Uploaded: 2020-03-10T19:00:05.000Z
Description: Watch the stand-up comedy video 'Joe Rogan Experience #1439 - Michael Osterholm' from PowerfulJRE on Comedy Buff. Published 2020-03-10. Transcript available.

Watch the stand-up comedy video 'Joe Rogan Experience #1439 - Michael Osterholm' from PowerfulJRE on Comedy Buff. Published 2020-03-10. Transcript available.

Joe Rogan Experience #1439 - Michael Osterholm

all right here we go so what you said when you sat down was absolutely perfect
that the timing
could not have been better well tell everybody what you do Michael well thank
you I'm a for a
black for better term a medical detective I've spent my whole career tracking
infectious diseases
down trying to stop them trying to understand where they come from so we can
make sure they
don't happen in the first place but most of all trying to respond to situations
just like this
just like this and just off the bat how serious is this is this something that
we need to be
terrified of or is this overblown or how do you stand on this well first of all
you have to
understand the timing of it in the sense that is just beginning and so in terms
of what hurt pain
suffering death as a cat happened so far is really just beginning this is going
to unfold for months
to come yet and that's I think what people don't quite yet understand what we
saw in China
I'm convinced as are many of my colleagues as soon as they release all of these
social distances these
mandated stay in homes haven't left your home in weeks and weeks kind of thing
when they go back
to work they're on planes trains subways buses crowded spaces manufacturing
plants even China is
going to come back again and so this really is acting like an influenza virus
something that transmits
very very easily through the air we now have data to show that you're
infectious before you even get sick
and in some cases quite highly infectious just breathing is all that you need
to do
so from this perspective I can understand why people would say well wait a
minute flu kills a
lot more itself every year than this does and already remind people that's just
the beginning
probably the best guess that we have right now on what limited data we have
would say
this could be at least 10 to 15 times worse than the worst seasonal flu year we
see
10 to 15 times worse in terms of fatalities yeah yeah and just illness in fact
I just I brought some
numbers we conservatively estimate that this could require 48 million hospitalizations
96 million
cases actually occurring over 480 000 deaths that can occur over the next three
to seven months with this
situation so this is not one that to take lightly and I think that's what I can
understand if you say
there's only been 10 deaths or 20 deaths or 50 deaths just remember two weeks
ago we were talking about
almost no cases in the United States and now that we're testing for it and
watching the spread as
it's unfolding those numbers are going up astronomically three weeks ago Italy
was just living life just
fine now they're literally in a virtual shutdown in the northern parts of Italy
and that's the challenge
with an infectious disease like this it can spread very quickly and it also can
affect people I think
maybe to put this into modern terms because this is something we think of often
when we think of
of you know pre-antibiotic days you know the old time medicine we have an
employee at our center for
infectious disease research and policy at the University of Minnesota and she
has a dear friend who lives in
Milan Italy and she works at a hospital there and she texted us to this
employee of ours last night
and this was an email that came out yesterday from one of their physicians in
Milan at the
largest hospital there and he said I just got a very disturbing message from a
cardiologist at one
of the Milan's largest hospitals they're deciding who they have to let die they
aren't screening the
staff anymore because they need all hands on deck and they have very small
areas of the hospital
dedicated to non-COVID patients where they still screen doctors everybody else
is dedicated to COVID patients so
even if they're positive meaning that they're sick they don't and but they don't
have a severe cough
or fever then they have to work he says that that they're seeing an alarming
number of cases in the
40-something range range and is horrible cases so we need to stop thinking that
this is only an old
person's disease this is what's going to unfold not just in Wuhan it's
unfolding in Milan it's unfolding
here in Seattle and this is what's going to continue to rollingly unfold
throughout the world
yeah where did this rumor come from that it's a an old person's disease is it
just because the
majority of the people that have died from it so far have been older yes in
fact that's the primary
risk factor for dying is being old and then having certain underlying health
problems for example in
China those men over the age of 70 who also smoked were eight to ten percent of
them died 65 percent of
older Chinese men smoke the case fatality rate or the percentage of people who
die in women that same
age group was only about two percent in that case very few women smoke now the
challenge we have is that
that's the Chinese data but there are a series of risk factors that we worry
about that if they overlay on
this disease are going to cause bad outcomes and we happen to be right at
ground zero for one of the
major ones here in this country that's obesity we know that obesity is just
like smoking in terms of
its ability to really cause severe life-threatening disease and 45 percent of
our population today over
the age of 45 in this country are obese or severely obese and there's men and
women so one of the concerns
we have is we're going to see more of these uh what i guess i would call very
serious and life-threatening
cases occur in our country because of a different set of risk factors than we
saw in china now you
mentioned that there's some sort of an incubation period before people become
sick they're still
contagious what is this incubation period and how do we know about it when we
call something an incubation
period we're talking about from the time you and i got exposed meaning i was in
a room breathing the
air that somebody else who was infected with the virus was expelling out i
breathed it in how long
from that time period till the time period that you get sick and what is that
it's that's we call the
incubation period so that's when case numbers can double or triple in every so
many days in this case
it's about four days so and we actually have data there from people who are
exposed one time or one
time only and we know when they were exposed where they were exposed and how
soon do they get sick
afterwards so the chauffeur in the car where an individual was sick or showing
symptoms then the
chauffeur gets it four days later you know they were there one time one time
only and if the chauffeur
does not show any symptoms he's still contagious he could still he could also
be contagious too or he
and that's one of the things that's challenging here is you and i might get
exposed to somebody who is
totally asymptomatic no symptoms that virus would appear well that's not a very
strong virus but in
fact when it infects us it could kill us so we've seen cases of a fatal disease
that were exposed to
people that had minor symptoms themselves wow and this is what's unfolding here
and this is where i
think is such an important and i said why the timing is so important because
you know joe we've really
got to get information out to the public there is so much misinformation right
now and you know we're
going to be in this for a while this is not going to happen overnight and i
worry i keep telling people
we're handling this like it's a corona blizzard you know two or three days we're
back to normal this is
a coronavirus winter and we're going to have the next three months or more six
months or more that
are going to be like this and you know so far this thing has been unfolding
exactly as we predicted it
we and our center put out a piece on january 20th and said this is going to
spread worldwide
at the time people said no it's just china we put out a piece the first week of
february and said this
is going to pop probably the last week of february first week of march because
what happens is it has
what's called an r naught or a doubling time of of these every four days so two
increases doubling
every four days so if you go from two to four to eight to sixteen it takes a
while to build up but
when you start going from 500 to a thousand to two thousand to four thousand
that's what we're seeing
happen in places like italy we're beginning to see it in some ways up in seattle
that's what happened
in china and you know when people are confronted with that suddenly this low
risk phenomena that everybody
talks about isn't so low anymore and that's what you need to prepare people for
now what can be done
like what what can the average person do i see people walking around with masks
on wearing gloves is
that nonsense largely yes first of all um let's step back the primary mechanism
for transmission is just
the respiratory route it's just breathing um in studies in germany which just
have been published
literally in the last 24 hours um they actually followed a group of people who
had been exposed to
somebody in an automobile manufacturing plant and then they had nine people
that with this exposure
he said if you have any symptoms at all contact us we want to follow up and
they all agreed well they
got infected and so in the very first hours just feeling bad sore throat they
went in and sampled their
throats their their saliva their nose for virus they did blood they did stool
they did urine and they
found that at that very moment when they first got sick they had incredibly
high levels of virus
sometimes 10 000 times that we saw with sars in their throats meaning they were
infectious at that
point already and they hadn't even had symptoms yet of really any nature they
weren't coughing yet
wow and and that's where we're concerned because that's the kind of
transmission it's you know
i always have said in trying to stop influence virus transmission likes trying
to stop the wind
you know we've never had anything successfully do that other than vaccine and
we don't have a vaccine
here so what's happening is that people in public spaces are getting infected
and the way you need
to address that is unfortunately if you're older over 55 you have some
underlying health problems which
unfortunately a lot of americans do we have uh obesity then right now you don't
want to be in large
public spaces you're trying to potentially get infected so you can take care of
that part as far as what can
public health do we're not gonna we can talk about this we're not gonna have a
vaccine anytime soon
that's happy talk um what we you know we can close schools one of the big
challenges we have right
now if we close schools what do we accomplish in influenza virus when you we
close schools during
outbreaks because it turns out kids are get infected in school and they're like
little virus reactors
you know they come home and they transmit it to mom and dad and brothers and
sisters
and uh so we close school sometimes christmas breaks are always great for kind
of putting the damping
effect on flu in this case kids are not getting sick very often at all which is
one of the really
good news features of this disease in china only 2.1 percent of the cases are
under 8 19 years of age
why is that you know we don't completely know uh and and i'm going to come to
that in a second because
they're getting infected it turns out one study showed that they still get
infected with the virus but
they don't get sick and we have that happen there's a disease called infectious
hepatitis hepatitis a
where we have outbreaks in daycares and the way we know i have an outbreak is
because it's transmitted
through the stool fecal oral his mom and dad and the daycare providers all get
sick and the kids those
symptoms we go in and test kids are all positive so some diseases will manifest
my primarily when you're
adult but not as a child this one appears to be the same so do we close schools
or not if we're not
really spreading the disease because it turns out that if we close schools we
had a recen