How to Survive a Pandemic: Michael Greger, MD

A powerful primer on all matters pandemic pertinent, today Michael Greger, M. D., FACLM returns for his fourth appearance on the podcast to answer all your coronavirus queries and more. A graduate of Cornell University and Tufts University School of Medicine as well as a founding member and Fellow of the American College of Lifestyle Medicine, Dr. Greger is the nutrition science wizard behind NutritionFacts.org — the world’s most authoritative, non-profit, science-based public service destination for all things nutrition, health and disease prevention. His massively popular books, including How Not to Die, How Not To Diet, and their cookbook analogues, all became instant New York Times Best Sellers and crowned Dr. Greger a media darling, his excitable face popping up everywhere from The Dr. Oz Show to The Colbert Report. Less well known is the fact that, prior to his focus on nutrition, Dr. Greger had an entire career as an internationally-recognized expert on public health. A specialist in emerging infectious diseases, he's been sounding the pandemic alarm for over a decade. Back then, nobody was listening. Now they are. To wit, Dr. Greger's latest release, How To Survive A Pandemic, now available in audiobook and kindle with a paperback version hitting the shelves August 18, forms the basis of today's conversation. Today's exchange is hyper focused on the public and political health disaster that is the novel coronavirus. The even more deadly impending H7N9 bird flu. And the common thread between these and other zoonotic diseases: humanity's broken relationship with animals. In general terms, I seize the opportunity to ask Dr. Greger his expert opinion on all my (and perhaps your) lingering questions about what exactly is happening. Where it started. Where it's going. How we prevent future pandemics. And how we survive this one. And perhaps the most fundamental question of all, how can we stop the emergence of pandemics in the first place? The answer begins with the dismantling of our industrialized factory farming infrastructure. Not only are America’s factory farms vile for the animals and the workers that slaughter them, but they are essentially breeding grounds for future pandemics. This is a call for the eradication of these systems--a moral imperative if we want to preserve not only our environment but the long-term viability of our species. This is an important, alarming, and downright terrifying moment of truth. So pay attention. The visually inclined can watch it all go down on YouTube. And as always, the audio version streams wild and free on Apple Podcasts and Spotify. If you're new to the show and interested in exploring Dr. Greger's work in nutrition, jump back to RRP #7, #199, and #522. It’s scary out there folks, but Dr. G, ever the enthusiastic optimist, remains hopeful. That gives me hope. And hopefully gives you a little. hope too. In the meantime, be kind. Peace + Plants, Rich Roll Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Rich Roll?

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• 0:44Rich Roll?

  It's kind of an amazing thing. For listeners of the show, all you special people, we're offering an exclusive $20 off an annual subscription right now. To get it, go to meals.richroll.com, take your quick personalization quiz, and enter promo code RICHROLL20 at checkout.

• 1:05Michael Greger?

  Here over the last few decades, human pathogens have emerged at a rate unheard of in human history, mostly from animals. So, you know, HIV has been traced back to the butchering of primates in the bushmeat trade in Africa. Mad cow disease was because we turned cows into carnivores and cannibals. SARS and COVID-19 have been traced back to these exotic live animal markets. But you know, our last pandemics, mine flew in 2009, arose not from some backwater wet market in Asia, but was largely made in the USA, right here on industrial pig operations in the United States. So when we take thousands of animals and cram these filthy football field-sized sheds to lie beak to beak, or snout to snout atop their own waste, it's just a breeding ground

• 1:50Michael Greger?

  for disease, right? It's not just the sheer numbers and the overcrowding, the stress crippling their immune systems, the ammonia from the decomposing waste burning their lungs, the lack of fresh air, like a sunlight. Put all these factors together, what you have is kind of this superstorm kind of environment for the emergence of spread of super strains of influenza. Tragically, we don't tend to shore up the levees until after disaster strikes. And the bottom line is it's not worth risking the lives of millions of people for the sake of cheaper chicken. This is the time, if you're ever going to start a exercise program, or stress reduction, or get your sleep schedule right, or reduce stress, or start eating healthy, this is the time. Let's take advantage, for those of us who are privileged enough not to have

• 2:33Michael Greger?

  to be out on the front line, to clean up our act, to not only protect us against the current infectious disease threat, but from chronic disease threats in the future. We really have to accelerate the movement away from animal agriculture towards plant-based milks, plant-based meats, plant-based egg products. And so, this message to better take care of ourselves and family has never been more poignant.

• 2:57Rich Roll?

  That's Dr. Michael Greger, and this is the Rich Roll Podcast.

• 3:12Rich Roll?

  The Rich Roll Podcast. Greetings, fellow sequestered earthlings of the coronavirus universe. I remain Rich Roll, this is still my podcast, and you, my friends, are always welcome. Today, my good friend, Dr. Michael Greger, returns for his fourth drop on the pod. The king of how not to books, books like How Not to Die, How Not to Diet, and also, the man behind nutritionfacts.org is back, and he's got a new how-to book for a refreshing change. It's called How to Survive a Pandemic, to be specific, which I think just as easily could have been titled, How to Be Very Timely and on Point.

• 3:57Rich Roll?

  Given what we are all collectively enduring right now, I think this one is important, it's super instructive, it's powerful. And if there's anything certain in the known universe, given what Dr. Greger will soon inform you about, the relationship between animal food production and the advent of zoonotic disease, it's a conversation that will leave you highly motivated to, once and for all, put those animal products in the rearview. But how? How do I do it, Rich? I get that question a lot. So to answer your prayer at scale, we created an easy to use digital platform that takes all the guesswork out of starting, and most importantly, sustaining a healthy plant-based diet.

• 4:40Rich Roll?

  It's called the Plant Power Meal Planner. And what it does essentially is craft highly customized menus for you from our huge library of recipes, literally thousands of recipes. It also creates grocery lists to make shopping for ingredients hassle-free, and even grocery delivery integration in tons of metropolitan locations, which means everything you need to eat right just shows up at your doorstep. It's really an incredible, powerful tool. I'm really proud of it. And it's crazy affordable, just $1.90 a week. So listen to Dr. Gregor, and when that's done, go to meals.richroll.com to learn more and sign up.

• 5:29Rich Roll?

  Dr. Gregor. I feel like he was just on the show, because he kind of was, but I just had to bring him right back for a powerful primer on all matters pandemic pertinent. Because here's the thing. We all know the good Dr. G as a nutrition expert, but less well-known is the fact that before all of that, he basically had an entire career in public health specializing in infectious disease, including sounding the pandemic alarm. In fact, Dr. G wrote a whole book about this back in 2006, but nobody was listening then, and now they are. So Michael dusted off that 2006 book.

• 6:11Rich Roll?

  He got to work dialing it up to date with the latest science and put it into the world. It's called How to Survive a Pandemic. It's available as an audiobook or on Kindle with a paperback version coming August 18. So this podcast is basically my opportunity to ask all my personal coronavirus questions, questions you likely have as well about what exactly is happening, how we got here. Hint, it has something to do with human interaction with animals and animal agriculture, how we prevent things like this from happening in the future, like maybe start putting an end to factory farming, there's one idea, and what we need to know

• 6:51Rich Roll?

  to be and stay safe. Like, what is the difference between COVID and a typical flu? How is it being transmitted specifically? And why do some people fall gravely ill while others experience only mild symptoms? What's the deal with herd immunity and what's it going to take to get there? How do we make sure our immune response is intact and healthy? What's the deal with all these different kinds of tests and when is it appropriate to get tested? Do I need to constantly disinfect everything like my groceries? How important is hand washing? What exactly is the utility of masks and what kind of masks should we

• 7:33Rich Roll?

  be wearing and when should we be wearing it? Perhaps the most fundamental question of all, how can we stop the emergence of pandemics in the first place? Again, let's look at our dysfunctional relationship with the animal kingdom. And a good place to start is the eradication of factory farms. It's scary out there, but Dr. G, ever the enthusiastic optimist, is hopeful. That gives me hope and hopefully gives you a little hope as well. So here we go, round four with the great Michael Greger, M.D. Back in the house. Ready to rich and roll.

• 8:16Rich Roll?

  So good to see you. I feel like I just saw you, but it was a little while ago. It wasn't that long. The world is very different. It's pandemic time. It's all out the window. What's super interesting about you is that we all know and love you as this nutrition specialist, expert, the man behind nutritionfacts.org. But actually, you earlier in your career had this whole path in public health specializing in emerging infectious diseases and you've been...

• 8:46Rich Roll?

  Shouting from the mountaintops about pandemics for over a decade. So here we are. And suddenly that book that you wrote back in 2006 is more relevant than ever. You've got this new book out, so I can't wait to just roll up our sleeves and get into what exactly is going on right now.

• 9:05Michael Greger?

  Well, yeah, I mean, the first half of my professional life was all emerging infectious diseases. In fact, I mean, that's most of my scientific publications. That's how I got on Oprah. That's how I got on, you know, all the, I mean, that, that was really, that was, and no one was listening. Right? I mean, yeah. In fact, the whole public health community was warning people about the coming pandemic. No one listened. And I was like, all right, um, you know, I'll, I'll, I'll let me, let me default to the leading cause of death every single year from, from 1919 to 2019. For the last hundred years, always realizing in the back of my mind, well, you know, the reason that heart disease wasn't the leading killer for the last 101 years is because in 1918, there was a pandemic flu.

• 9:48Michael Greger?

  And the next one's coming. And when it comes, all right, then I'll find out. Maybe when people listen, um, I'll be able to delve back. And that's how I was able to, you know, scramble to write a book in such a short time. It's because the research was done. It was just a matter of, you know, throwing together a few chapters on the, on the current situation.

• 10:08Rich Roll?

  Right.

• 10:08Michael Greger?

  And, you know.

• 10:09Rich Roll?

  Well, the first book was really focused on bird flu, right? Do you think if at that time, people really perked up and paid attention, that that would have shifted your whole career trajectory? You would have stayed in that field?

• 10:21Michael Greger?

  No, I think so. Yeah. I mean, because, I mean, it's as critically important today as it was back then. In fact, the leading candidate, according to the CDC, of the next pandemic after COVID is a bird flu virus by the name of H7N9, which is 100 times deadlier than COVID-19.

• 10:43Rich Roll?

  Is that the one with the 50% death rate?

• 10:45Michael Greger?

  No, it only has a 40% mortality rate. So H5N1 was higher, but has, has dwindled as H7N9 has

• 10:56Michael Greger?

  Taken to the forefront of a global spread. And so that's the leading candidate, although H5N1 still may be waiting in the wings of chickens, of course. Um, eight, seven to nine seems to be the most likely. And so instead of one, 250 people dying, a hundred times dead, like 40%. And so, you know, as devastating as COVID-19 has been to lives and livelihoods around the world. Um, you know, uh, you know, imagine a pandemic, uh, you know, uh, that, that, that, you know, that

• 11:26Rich Roll?

  Every other person.

• 11:27Michael Greger?

  Right. So, so the, well, so, you know, uh, you know, 1918 had a 2% fatality rate.

• 11:34Rich Roll?

  Mm hmm.

• 11:34Michael Greger?

  Um, and so, yeah, but imagine a pandemic where billions are infected, but 40% people die. And that was, and that was the last time a bird flu virus jumped directly to humans and triggered pandemic. It caused the deadliest plague in history, the 1918 pandemic. Um, and so it's, you know, uh, you know, it's, it's just a, it's just a matter of time. And so, but there's, the, the good news is there's something we can do about it. You know, just like closing down live animal markets and, you know, the wild animal trade will reduce the risk of future coronavirus pandemics. Reforming the way we raise domestic animals for food, uh, may help forestall the next killer flu.

• 12:16Rich Roll?

  Well, that's a good place to start. You know, the very, uh, root cause of what's leading to these pandemics that, you know, ultimately are an inevitability. So let's start there. I mean, we're all kind of familiar with what, uh, triggered COVID with the pangolins. I guess that's the reigning theory of the moment as to how this began. But there's a larger issue at play here, which is the institutionalization of animal agriculture and how we're creating, you know, on a systemic basis, the breeding ground for the next pandemic and the next pandemic and, you know, perhaps much more virulent strains of, of virus that are going to be far more deadly.

• 12:58Michael Greger?

  Here over the last few decades, human pathogens have emerged at a rate unheard of in human history. Um, and it's emerged from where? Mostly from animals. So, you know, HIV has been traced back to the butchering of primates and the bushmeat trade in Africa. Mad cow disease was because we turned, you know, cows into carnivores and cannibals. SARS and COVID-19 been traced back to these exotic live animal markets. But, you know, our last pandemic, swine flu in 2009, arose not from some backwater wet market in, in Asia, but was largely made in the USA, right here on industrial pig operations in the United States. Now thankfully, swine flu only killed about a half million people, but the next time,

• 13:43Michael Greger?

  we might not be so lucky.

• 13:44Rich Roll?

  Well, it just came out that last week, this new story about pigs in China and, and a couple slaughterhouse workers getting sick.

• 13:53Michael Greger?

  Yeah.

• 13:54Rich Roll?

  This is very alarming.

• 13:55Michael Greger?

  So it's actually, yeah, it's a, it's actually a new mutation of that very swine flu virus, this triple hybrid mutant, which contains genes from both human, pig, and avian flus, that was new enough to the human immune system that was able to, to spread around the globe and is still with us to this day as a seasonal flu. But, but all it has to do is, you know, change enough to kind of overwhelm the pre-existing immunity. But, but yeah, so, so, but we happened to pick the two species that are, that are vulnerable to the virus, the only known virus on the planet capable of infecting billions of people within months of time, and that's influenza.

• 14:36Michael Greger?

  And so, most species actually are, don't get the flu, very few species. So it's pigs, and it's birds.

• 14:44Rich Roll?

  Birds. Chickens too, or chickens are something different?

• 14:47Michael Greger?

  Chickens, yeah, no, so, so chickens emerges in waterfowl, but in fact, as a waterborne innocuous aquatic virus, and only travels to the lungs when placed in a land-based bird, a terrestrial bird like chickens. And how would a duck and a chicken ever get together? At, on live animal markets. It's a way to pack them both together. And once the virus finds itself in the guts of a chicken, it no longer has the luxury of easy waterborne spread, right? Chickens aren't paddling around in the pond. Also, it's a fecal-oral route in ducks and waterfowl, as it existed for millions of years before we domesticated ducks. Once it finds a way into a chicken, it needs to

• 15:28Michael Greger?

  mutate or die. It has to find a new way to travel and does that by changing to an airborne virus, actually infects the lungs, and that makes it that much more risky for terrestrial mammals such as ourselves.

• 15:42Rich Roll?

  So what?

• 15:43Michael Greger?

  Yeah, so it goes into, you know, chickens as this harmless virus comes out as the flu.

• 15:50Rich Roll?

  Uh huh. And what is it specifically about CAFO's animal agriculture that's fomenting this? Is it just the crowded conditions? Is it the way that they're, you know, immersed in their fecal matter? Is it the way that they're fed or treated? Like, what are the contributing factors?

• 16:06Michael Greger?

  So, yeah, all the above. So when we take thousands of animals and cram these, you know, filthy football field-sized sheds to like beak to beak or snout to snout atop their own waste, it's just a breeding ground for disease, right? It's not just the sheer numbers and the overcrowding, but the, you know, the stress crippling their immune system, the ammonia from the decomposing waste burning their lungs, the lack of fresh air, lack of sunlight, put all these factors together, what you have is kind of this superstorm kind of environment for the emergence of spread of this perfect storm environment for the emergence of super strains of influenza. Tragically, we don't tend to shore up the levees until after disaster strikes, and the bottom line is it's not worth risking the lives of millions of people for the sake of cheaper chicken.

• 16:51Rich Roll?

  Mm-hmm. And I suspect that when you have so many of these animals in these types of conditions, that that then creates a situation in which you're kind of exacerbating the potential for mutation, right? Because if it's getting spread amongst that population, then there's an exponential amount of it, and so it's replicating more rapidly.

• 17:15Michael Greger?

  It's like crowding a thousand pigs in an elevator, right? And one of them sneezes, like, what do you expect would happen? It's really the perfect, if you want, if you were a mad scientist and wanted to breed a deadly, um, uh, you know, flu virus, this is exactly the kind of conditions where you do. In fact, they actually do these so-called serial transmission studies in a lab where when you want to make a pathogen, uh, more deadly, more lethal, more virulent, what you do is you pass it from animal to animal. Normally, virulence is a control, there's a, there's a, there's a, there's kind of a balancing act, a, a, a, a teeter totter between virulence and transmissibility. If the, that's why in its natural state, influenza is completely harmless. Ducks never get sick.

• 18:00Michael Greger?

  No waterfowl gets sick because a dead duck can't fly. That virus wants to get to the next lake. How's it do that? By completely being innocuous, harmless, no symptoms, the duck doesn't even know it has it, and just multiplies in the intestinal wall and, and goes on. Okay. But only when forced into an environment where there is no cost to the virus to get virulent. I mean, the, the virus would like to get more virulent, the more virulent it is, the more it can produce titers of virus, you have a huge viral load, but it has to be really, really quiet about it. Because it might not spread as far, but as soon as you remove that restriction, remove that constraint, when a virus can knock you like a two by four and still transmit to the other because you're so pack.

• 18:43Rich Roll?

  Approximately.

• 18:44Michael Greger?

  Right. Because even immobilized hosts can spread. When that happens, then there's no limit to how virulent the virus can get. And that's what we had in the trenches of World War I, which is where, um, we think the 1918 virus emerged from the trenches. And basically, from the virus's standpoint, those same trench warfare conditions exist today. In every industrial chicken shit, in every industrial egg operation, confined, crowded, stressed, but by the billions, not just millions.

• 19:14Rich Roll?

  That's fascinating. Yeah. I never thought about it in those terms. Normally, yes, the virus would not want the host to perish because then the virus perishes. But when there's a Population of, you know, hundreds of thousands of these animals. What's one dead animal if it can jump to the next one and continue to populate?

• 19:32Michael Greger?

  So there's a evolutionary advantage. There's a selection pressure to get even more violent, to kill the animal quicker, to make this violent hacking cough, I mean to you to. And so it just ratchets up, but only in those kind of rare circumstances, either in the lab, where you can literally dose an animal, you you stick a needle down their throat. And then, and then you can take, they take their lungs and you grind them up in a blender and you stick that needle down another animal. But you do that, you do that 10 times. You can have a, and you can take a harmless virus turned into a lethal virus, kills 100% of the animals because which virus is selected for? When there's guaranteed transmission to the next one? The one that that outcompetes the others, right?

• 20:16Michael Greger?

  Otherwise, normally, it would, you know, if if in the millions of years where influenza existed naturally, if some crazy mutant strain came up that was more, it would instantly be selected against and die there with that animal because it's just not going to spread much farther. But we just created this system to create, you know, virulent, particularly virulent pandemic. So we may always have pandemics, but there's a difference between a pandemic with a 0.4 case fatality rate, 1 in 250 people dying, and something like, like so-called category

• 20:56Michael Greger?

  five pandemic, that's the CDC's, has a pandemic severity index similar to the hurricanes severity index with categories one through five. And a category five pandemic starts at 2% mortality. So 19, there's only been one category five pandemic in 1918. And that's, but that's just where category five starts at 2%.

• 21:16Rich Roll?

  Wow.

• 21:17Michael Greger?

  And so.

• 21:17Rich Roll?

  Covid's, Covid's a two, right?

• 21:19Michael Greger?

  No, Covid's 0.4.

• 21:21Rich Roll?

  Oh, okay. But a category, what category is it in?

• 21:24Michael Greger?

  So, oh, so, so that makes it a category one pandemic. Right now, we are in a category one pandemic, which is less, oh, category, sorry, category two pandemic, point, under point five. So we are category two pandemic. And, and never before has there been flu viruses.

• 21:45Michael Greger?

  With a fatality rate on order of something like Ebola or untreated HIV. I'm assuming you have the worst of both worlds, something like the common cold, a respiratory virus, easily transmitted, infecting a significant percentage of the population within months, and a virus with just unprecedented lethality with H1N1, H7N9, and 10 other bird flu viruses that have emerged completely unknown in the last few decades, ever since we started exporting our Tyson model of industrial poultry production to South Asia.

• 22:19Rich Roll?

  It's terrifying. It's absolutely terrifying. What determines the jump to humans? How does that work? Because we hear about these wet markets in Asia, and that's really about one species to another species, and then a subsequent jump to humans.

• 22:35Michael Greger?

  Right, right. And so, right, there's been three deadly coronavirus outbreaks, SARS, MERS, and COVID-19, and they all seem to have evolved, it seemed to involve this transitional species, starting in bats, the reservoir species, just like for influenza, it's ducks and waterfowl, shorebirds, I think. But, yeah, but the virus is so far removed from something that can infect humans, there has never been a single reported kind of human clinical infection from a duck virus. I mean, they all, all influenza viruses thrive from duck. There's one case of someone cleaning out a duck barn, got a little piece of straw in there, I got a little conjunctivitis, a little pink eye. That's the worst a duck virus has ever been able to do, only through these land-based,

• 23:20Michael Greger?

  terrestrial birds like quail and chicken, is the virus able to mutate into the flu, a respiratory pathogen that can infect humans and pigs and other kind of land-based mammals. So, in coronaviruses, bats are the original. And the reason why bats and ducks are, have these herd viruses is because...

• 23:42Michael Greger?

  They congregate in massive, in the huge herd and some bat roosting colonies can be a half million bats together. And only under those kinds of circumstances can you get a, you get a

• 23:57Michael Greger?

  viral pathogen able to infect large populations. Because normally, if there's just small colonies of various animals, everyone gets immune to the virus, the virus dies. So you don't have, so you can't really have kind of a herd virus. But when you have these massive colonies of hundreds of thousands of ducks or bats, they can develop, they can start basically an infection on one side, go all the way to the other side of the population, and then this one loses immunity and can go back and forth and it can exist. So in bats, we have these coronaviruses, but it takes, but people aren't getting infected directly from bats. They're an intermediate species, kind of halfway between, kind of the stepping stone species between bats and people. In the case of SARS, it was this cat-like creature

• 24:41Michael Greger?

  called the civet cat raised in these live animal markets. In the case of MERS, the Middle East Respiratory Syndrome virus, it was camels, it was bats to camels to people. In the case of COVID-19, leading candidate for the intermediate species is these pangolins, these scaly anteater type creatures, again, in these live animal markets, where you can get this kind of confluence of unusual species that you'd never really get together in nature and can, and create these viruses with characteristics we haven't seen before.

• 25:10Rich Roll?

  And what is the degree of difficulty for, you know, the virus that's, you know, being harbored in the chicken farms, the pig farms, to jumping to humans? Like, what are we looking at in terms of, you know, we've had swine flus, etc. We've never seen a true pandemic emanate out of factory farming yet. I mean, you're painting a-

• 25:31Michael Greger?

  2009.

• 25:32Rich Roll?

  So that-

• 25:32Michael Greger?

  2009 was our first factory farming pandemic. We just got lucky. That was a category-

• 25:36Rich Roll?

  There is a narrative that that came out of China, though, but did that actually come out of United States?

• 25:42Michael Greger?

  So it was actually-

• 25:42Rich Roll?

  Factory farms, or what's the origin story there?

• 25:44Michael Greger?

  Six out of eight genes. So influenza viruses, influenza virus has a segmented genome. There are eight genes. I mean, six- Six out of the eight came from a triple mutant hybrid. This was a never before described bird, swine, human virus, a virus with genes from all three species. That arose in North America. And in fact, the first, the double hybrid first was discovered in this factory farm, a gestation crate facility of pregnant pigs in Newton Grove, North Carolina. Very rapidly, this triple hybrid mutant spread throughout North America. And then we exported it to Mexico.

• 26:25Michael Greger?

  We exported it around the world, where it mixed with a Eurasian swine flu to create the pandemic virus. But six out of eight of the pandemic virus came, was birthed in, here in North America.

• 26:39Rich Roll?

  Well, given that factory farming is essentially how, you know, most Americans are getting their food, and the prospect that this is a breeding ground for future pandemics, what do we do? I mean, is there a solution short of eradicating this entire system? You know, I want to talk about Cory Booker and Elizabeth Warren's new bill that they just proposed to eradicate. I'm not sure exactly what the details are, the Farm System Reform Act and what's packed into that. But, you know, what is the path forward? What is the solution to this? Knowing that we can't flick a switch and end factory farming overnight, how do we get on, you know, the right side of history with this?

• 27:22Michael Greger?

  So, well, it's important to realize that the public health community has been, has a consensus. So, the American Public Health Association, which is the largest and oldest association of public health professionals in the world, came out over a decade ago, calling for moratorium on factory farms, no more factory farming. So, the public health community has recognized the risk and has been shouting from the rooftops, and no one's been listening. So, this is, I mean, this is, this is what the public health community understands to be the risk, not only for the emergence of antibiotic resistant bacteria, but because of the threat of pandemic flu, both from poultry production and from pig production.

• 27:59Michael Greger?

  And certainly, there are things we can do to reduce the risk. So, for example, there are studies showing that just providing straw bedding for pigs so they don't have the immunosuppressive stress of lying on bare concrete their whole lives significantly reduces swine flu transmission rates. The Pew Commission on Industrial Farm Animal Production came out specifically against these extreme confinement practices like the gestation crates for pregnant pigs, these kind of veal crate-like boxes that are where pigs, pregnant pigs are kept for months at a time, specifically because of the human health risk of putting animals under these kind of conditions. Right.

• 28:42Michael Greger?

  And so, you know, the animals need a little social distancing, frankly. They could use a little breathing room at this point. But if we really want to eliminate this threat, we really have to accelerate the movement away from animal agriculture towards plant-based milks, plant-based meats, plant-based egg products. And for those of you thinking that such a move is a pipe dream, have you looked at a dairy case lately, right? Major US dairy companies declaring bankruptcy because of crashing fluid milk sales because

• 29:23Michael Greger?

  of this preponderance of new consumer choices. And we're seeing that same kind of increase in consumer choices in the meat aisle as well. And ironically, who is leading this charge in innovating us out of this precarious situation? Tyson, Purdue, Smithfield, Hormel, JBS, the largest meat packers in the world, all, right now, have plant-based meat products out now. JBS, the largest meat packer in the world, just came out with their own line of plant-based, you know, Smithfield is partnering with KFC in China to put plant-based chicken nuggets on the menu.

• 30:07Michael Greger?

  And these are, so this isn't like the Tofurkeys of for some vegetarian niche product, right? They are recognizing, particularly with the pressures on the, you know, the source chain that this pandemic has shown, it's more profitable, it's less labor cost, less food safety issues, I mean, all down, on down the risk of the externalities of business as usual, they see the writing on the wall and they're reorienting themselves as protein companies rather than meat companies. And so that, so they're the ones that are really leading the charge in terms of putting these, these products into the hands of kind

• 30:51Michael Greger?

  of, you know, regular, you know, regular consumers. And now from a personal health standpoint, you know, it'd be better if they just ate some black beans, but from a pandemic threat standpoint, zero risk.

• 31:05Rich Roll?

  Yeah, I think it's, it's imperative that these companies pivot and evolve. They're just responding to market pressure and consumer demand. They see that this is the direction that people are moving in. They understand that they're going to quickly become antiquated unless they diversify their product line. And it's working and that's why they're doing it, right? We all hear about the Beyond Meats and the Impossible Foods, but it is interesting that these stalwart, you know, gigantic conglomerates that have been around forever are also waking up to this reality and making these pivot shifts.

• 31:39Michael Greger?

  Yeah.

• 31:40Rich Roll?

  The question is, are we going to do it fast enough?

• 31:43Michael Greger?

  Well, I mean, the clock is ticking. I mean, that's why, and but if they're, so what we needed is some kind of kick in the pants, some kind of dress rehearsal, some kind of fire drill to wake us out of our complacency, right?

• 31:57Rich Roll?

  Uh huh.

• 31:57Michael Greger?

  And to really rethink the food system. And frankly, if this doesn't do it, right?

• 32:03Rich Roll?

  I don't know if it is it?

• 32:06Michael Greger?

  Well, but I mean,

• 32:07Rich Roll?

  You would hope it would unite us.

• 32:09Michael Greger?

  It would really take something like this, serious enough to really get people to rethink, wait a second, where did this come from? What can we prevent future much potentially worse threats down the road? But now the idea of a pandemic is not some just, you know, something on policy papers and people have been yelling about in the scientific literature. Now it's real life.

• 32:29Rich Roll?

  Yeah.

• 32:29Michael Greger?

  And so, and we can, and we can see what kind of viruses are in the pipeline. And realize, um, and look, even more innovative approaches. I mean, for those out there who are like, you can, you can yank that pork chop from my cold, dead hands is the cultivated meat, um, revolution. The thought that look, which Winston Churchill, right? Wrote in this 1932 Popular Mechanics article, you know, well, we will escape the absurdity in 50 years of growing a whole chicken just to get a wing or a breast or whatever. Well, now that we're making real meat with animal cells, right? With muscle cells, right? Why make, why make a skeleton? Why make all that stuff you're gonna eat? Um, and again, from a personal standpoint, right? Meat is meat.

• 33:14Michael Greger?

  Um, certainly from a food safety standpoint, it'd be safer. I mean, there's, you don't have to worry about intestinal pathogens like E. coli, salmonella, when you're making meat without intestines, right? You don't have to cook the crap out of the meat if there's no crap to begin with, right? Um, and just like you don't have to worry about brewing up new respiratory viruses when they're, you're making meat without the lungs, right? Um, and so that may, that, that's another route to, to escape us from this sword of Damocles dangling over us, which hopefully finally people will recognize.

• 33:45Rich Roll?

  Yeah. Well, a year ago, the Booker Warren bill would have seemed preposterous, but here we are. The world is very different. Um, people are, are, are paying attention to this in a new and different way. We all saw the news articles when the meat producers were putting out, you know, ads about, or there were articles coming out about the supply chain problems and the threat to the workers. And there was this sort of conversation around, should these people go back to work? Should they not? I was looking at videos of some of these slaughterhouse workers who are basically putting themselves in harm's way and frustrated that the meat packer, uh, employers were not enforcing some level of social distance or, or kind of health standards to protect its workforce.

• 34:30Rich Roll?

  Like this is, you know, Also about those workers who are in peril as a result of this. And I think it is good that we are talking about these things. What do you know what the Booker Warren bill is proposing?

• 34:44Michael Greger?

  So it's proposing reforms like the elimination of some extreme confinement practices, which would help. I mean, so anything, reducing broiler stocking density, in terms of meat type birds. I mean, and we can show in laboratory settings, you double the space per bird and you can dramatically drop influenza transmission rates in these birds. And so, I mean, look, you know, anything, the situation is so dire.

• 35:16Rich Roll?

  Anything is better than what's happening right now.

• 35:18Michael Greger?

  Anything we can do. And this is the time to have this opportunity. And look, right now is the last. At this point, the last thing we need to do is prop up the meat industry, even for the current pandemic. I mean, look at the comorbidities, the underlying health risk factors, increasing one's risk of COVID-19 severity and death. Type 2 diabetes, heart disease, obesity, high blood pressure, all of which can be prevented, arrested, or even reversed with a healthy enough plant-based diet. I mean, and look, you don't even have to be obese. Just being overweight at a BMI of 28 puts you at nearly six times the risk of a severe course of COVID-19. So that's being about 175 pounds at the average American height. Nearly six times the risk of a severe course.

• 36:02Michael Greger?

  You know, the average BMI in the United States? 29. So being skinnier than the average American could still leave you with so much excess body fat that puts you at nearly six times the risk. And yet, so, you know, so this is the time to, you know, if you're ever going to start an exercise program, or stress reduction, or get your sleep schedule right, or, you know, reduce stress, or start eating healthy, this is the time. Let's take advantage, for those of us who are privileged enough not to have to be out on the front line, to, you know, clean up our act, to not only protect us against the current infectious disease set, but from chronic disease threats in the future.

• 36:54Rich Roll?

  I want to get into some of those practices, but before we do that, I want to talk about where we're at right now. We're looking at the potential of 100,000 new cases a day. Anybody who's looked at any of these graphs is seeing this spike upward. That's relatively, it's pretty alarming. Clearly, we've done a poor job at containing this. It's been a political disaster, a public health disaster. What is your sense of where we're at, how we've handled this, and what we should be doing?

• 37:28Michael Greger?

  Not just a poor job, but the poorest job on the world over. So you look at, I mean, you don't have to go dig up South Korea, and Singapore, and Australia, and these countries.

• 37:42Rich Roll?

  New Zealand.

• 37:43Michael Greger?

  Look, look at Europe, for example. About the similar population as the US, Western Europe, and they got caught unawares, just like everybody, and had the spike, but came back down. They truly have a wave, right? We're talking about is there going to be a second wave? The first wave in the United States never went away.

• 38:01Rich Roll?

  We're still in the first wave.

• 38:02Michael Greger?

  We're still in the first wave. And so if you look at the pandemic, the epidemic curves around the world, they go up, they come down. Even with comparable population sizes, except the United States, which continues to rage on. But you know, you look at Japan, where, oh my God, they had 10 deaths. Or Australia, 100 deaths. The milestone, they reached 100 deaths. And they say, yeah, they have 10 times smaller population. Yeah, but we have 1,000 times more deaths. I mean, you know. And so when you hear, oh, South Korea, they're having problems again. Oh, they had two, you know, they had five cases

• 38:42Michael Greger?

  somewhere. And, you know, my concern is not just these deep red states, you know, like Arizona and Florida, but look what's happening in California. And I think it's because Californians never saw what New Yorkers saw. I mean, they never saw the hospitals overrun, right? Because we caught it early enough in California, the first state to really take action, that it worked too good. And so people didn't see the hospitals overrun. People didn't see, you know, doctors having to make triage decisions as to who gets the ventilator and who doesn't. And so there was this complacency. That in this kind of black and white thinking, like we're just back to business, as opposed to still taking precautions, particularly for those who are elderly, particularly

• 39:26Michael Greger?

  those with these underlying risk factors, who are still at great risk.

• 39:30Rich Roll?

  Right. And once the protest began, the floodgates opened, it's very hard to put that back in the bottle.

• 39:36Michael Greger?

  Right. Although, you know, now that we're weeks out, thankfully, we did not see the uptick that was suspected by many. And we think it's because of being outdoors. So in 1918, a lot of the transmission was actually driven by these war bonds marches, where they got people together during the pandemic to raise money for World War I, and was and that was implicated in a lot of spreads. So even outdoors. But now with the current virus, whatever the transmission, it really does seem the high risk is enclosed, indoor, poorly ventilated, crowded spaces for extended periods of time. That's where these so-called super-spreader events are happening. That's where you can get, you

• 40:20Michael Greger?

  know, 60% of people walking out of a bar, and later coming down affected. Whereas, despite the crowded conditions outdoors, you have, once you're outside, you have the ultimate ventilation, one little air current in your, you know, any little respiratory droplets, or aerosol that gets, you know, that you breathe out, even if you're chanting, even if you're yelling, even if you're hacking because of tear gas. These are, I mean, these are conditions built for the virus. You, the, you know, all you need is a little breeze. And we did not see that kind of, thankfully.

• 40:53Rich Roll?

  Right. It seems that we're, every week, we're learning a little bit more, and we're having to figure out, you know, how to dismiss what we thought was previously correct. You know, we were disinfecting all our groceries, and we don't do that anymore. And I thought, are we supposed to be doing that? Should we be doing that? Or am I just being lazy? You know, wearing masks, of course, is a given. But I think it would be helpful to just point people in the right direction in terms of, you know, just kind of piggybacking on what you just said. What are the most effective things that we should be doing? What are some of the things that we're doing that perhaps we don't need to? I just don't know where that demarcation line is. There's a lot of, and I'm trying to educate myself and I'm still confused.

• 41:37Rich Roll?

  You know, I know that I need to wear masks. I've watched videos of where you can see how it impedes the expectoration of your breath. But, you know, if somebody's smoking a cigarette, you know, 100 yards away from me, I can smell it. So if I'm smelling that, does that mean that if that person is infected, that I'm potentially breathing that too? Like, it's, it's very confusing even for somebody who's actively trying to get to the best practices.

• 42:04Michael Greger?

  Right. So, right, even the most conscientious among us are still having difficulty separating kind of the wheat from the chaff and knowing what do we know, what we really don't know. And so I think early on, when we really didn't know the transmission characteristics of this virus, now all past pandemics have been influenza pandemics. And we know so much about influenza, it was easy for us to know, okay, we know exactly how it spread, we know exactly how to clamp it down. But this is a new virus. And so we really didn't know the transmission characteristics. And so something like the surface disinfection of anything coming into the house. I mean, I think early on, that was a legitimate act because we just didn't know how much the so-called fomite transmission, the doorknobs and light switches and toilet flushes and gas pump handles. We didn't know how much was contact, you know, then touching our mucous membranes, eyes,

• 42:49Michael Greger?

  nose, and mouth before disinfecting our hands. Now we know that is, that is not the primary means of transmission. And so, and now that we've had enough time where people have been isolated in home and their only contact with the outside world was delivered groceries and delivered food, and there, we have not seen validated cases, even among people that aren't taking any special precautions. Okay, so now we can breathe a sigh of relief and we can, and we can take in this information, realize, okay, now we, we know what to prioritize in life in terms of, of reducing our risk. And what's the priority? Distance, distance, distance. That's really, I mean, there's this really overinflated reliance on masks that give us a false sense of security. Remember, the masks are not to protect us.

• 43:33Michael Greger?

  The masks are to protect other people from us, right? It reduces those respiratory droplets that come over our mouth with conversational speech, or just normal exhalation. And the thing about this virus, as well as influenza, is you become contagious before you start showing symptoms. And so, days after being exposed to this virus, you can feel perfectly fine, look perfectly fine, and be exhaling virus with every breath. And that's why if you don't know who's infected and who's not, that's where the social distancing coming in. Without sufficient testing, you don't know who's infected, who's not infected, so you just have to try to keep everybody away from everyone else. That's what the social distancing measures were implemented for, and still the most

• 44:14Michael Greger?

  important thing we can do to protect ourselves is, I mean, it's the good news. You cannot get the virus if the virus cannot get to you. And how do we get the virus? From other people. So, reducing as much as possible our contacts outside of our household, and if we have to have contacts outside of our household, it's for a shorter time in as well-ventilated areas possible, particularly for those that are vulnerable, or for those who come in contact with those who are vulnerable. And so, there's gradations of risk, there's the riskiest behavior, there's the riskiest

• 44:52Michael Greger?

  populations, and then all the way down to maintaining a sense of social cohesion. But, I mean, you realize, as bad as COVID-19 has been, right? We still, the grocery stores are still being restocked. We still have electricity. We still have clean drinking water. Doctors are still showing up to work. You have a pandemic with something like H7N9, H5N1, when case fatality rate is like literally a flip of a coin, whether or not you die from this virus, then you can imagine how much worse the situation could be. That's why it's so critical.

• 45:29Rich Roll?

  Yeah, it would be straight up apocalyptic if that was going on right now. And you hear stories, like I just read a story the other day about a super-spreader event, a wedding in India, and I think 90 people contracted the virus as a result of attending that event. But there isn't some situation in which every worker at Ralph's is suddenly in the hospital, which is interesting. Like, I'm like, well, those people are kind of around people all day, they're wearing masks, but...

• 46:00Rich Roll?

  You know, I haven't heard of any grocery workers, at least on at scale, contracting the disease.

• 46:07Michael Greger?

  So we

• 46:07Rich Roll?

  And they're indoors, but I guess they're all wearing masks.

• 46:10Michael Greger?

  So we're still trying to understand what's behind the super spreading event. So some of them like this, this famous coral group where 80% of those are like got infected in one coral singing session. And you think, oh, well, not only indoors in one room, but they're, you know, they're, they're, they're, they're spewing virus out into the air. And so that would, that would, that would make sense that that would be. And then you look at the meatpacking plants where it's so loud, you have to talk really loud, shouting to people's ear, and they're so packed tight. And it's, and it's chilly, which actually may play a role in enhancing viral stability. And then the prisons are now becoming hotspots. Again, that just makes sense.

• 46:53Michael Greger?

  And so we can explain a lot of these, but there may be characteristics of certain people or certain strains of the virus that do in kind of whatever situation that would have been in could, you know, lead to mass infection. And imagine being the bride and groom of that, right? Inviting people, I mean, or, or any kind of function, right? I mean, we really need to think before we have that, you know, before we bring over people to the house party.

• 47:18Rich Roll?

  Yeah.

• 47:19Michael Greger?

  And just, we should think, you know, God, what if our, what if we hurt one of our dearest friends, right? Or our family? So, um, you know, we just, this is the new normal.

• 47:30Rich Roll?

  But Americans want what they want, when they want it.

• 47:33Michael Greger?

  I know. And this is, this is the

• 47:35Rich Roll?

  We're seeing a little evidence of that.

• 47:37Michael Greger?

  We, we, but this is the wake up call. This is, I mean, it's really, and it's not going away anytime soon. Right? I mean, I talk about in the book written months ago that, you know, that there's no reason we should expect that this should go away in the summer. Other coronaviruses don't do blah, blah, blah. And here it is, continuing to rage on during the, during the hot summer months. And so, and so the only way to stop pandemic. Is through herd immunity, having a certain portion of the populace immune to the virus. An infection can only burn through a population if there are enough susceptible individuals for viral sparks to jump from one person to the next. Immune individuals who can't get or transmit the virus act as fire breaks to slow the

• 48:22Michael Greger?

  spread, or like control rods in a nuclear reaction to break the chains of transmission. Now ideally, this herd immunity is achieved through mass vaccination, right? Vaccines are the way to use like fire to fight fire. You use the virus to fight the virus by generating the benefits of infection, immunity, without generating the risks with disease and death, right? Without a vaccine, then herd immunity is only achieved the hard way through mass infection. But looking at the characteristics of the virus we have now, we suspect herd immunity will be achieved when 60 or 70% of the population is infected. When there's that many people who are immune, this is assuming that we have some kind of

• 49:06Michael Greger?

  at least short-term immunity, once 60 or 70% of the population is unable to get or transmit this virus, then the 30 to 40% who are completely susceptible are protected by everybody else and the virus stops. The pandemic ends. And so, the goal, particularly if you're older, particularly if you're sick, any of these underlying risk factors, you want to end up in that 30 to 40%. Where at the end of all this, the pandemic is over and you never got infected. You never were at risk, right? That's the goal, and hopefully we'll be able to get that through vaccines, but we need to realize, reality check, vaccines historically taken 11 years, that's the average, and has

• 49:51Michael Greger?

  a 94% failure rate, meaning 94% never made the market. Now, this is a totally different situation. We have literally 150 candidate vaccines in the pipeline, so the whole world is jumping on this, so we should certainly see an accelerated timeline. But you know, you have to test on enough people to ensure sufficient safety, and so we should not expect to have a warhol vaccine for the general population till second half of next year.

• 50:20Rich Roll?

  Yeah, it's a long way off, and herd immunity is a long way off. Short of that, what would have to happen? I mean...

• 50:27Michael Greger?

  So we're about 5 to 8 percent. 5 to 8 percent of Americans have been affected so far. Now, unfortunately, some of the early data on immunity, it's possible that immunity to this virus may be short-lived. So we're seeing that a lot with coronaviruses. There's other coronaviruses for which you come back months later. So like common cold coronaviruses, 45 weeks. So 45 weeks immunity and then you're just susceptible again. So it's possible we get into a flu vaccine kind of scenario where you'd have to get vaccinated every year to maintain immunity to this virus. But some of the early data suggests that some of the people that got infected early

• 51:09Michael Greger?

  may now start to become susceptible again based on the level of so-called neutralizing antibodies in their blood, the ones that really target kind of the receptor mechanism of this virus. We have yet to test what's happening with their T cells. There's actually two memory immune systems in the body. The antibodies and the T cells both can retain memory of infectious exposure and give that lasting immunity. So far, we've tested the antibodies and they've been disappointing. May only last weeks in terms of infection. So then herd immunity is much more difficult to achieve. But we have yet to really see what's happening with these memory T cells. Maybe that will give us the... And that's what we saw with SARS. SARS antibody levels went down.

• 51:54Michael Greger?

  They had some memory Ts. Thankfully, we eradicated SARS from the planet. And how could we get rid of that deadly coronavirus? And we're having such problems with this one? Because with that one, you only became infectious after you started showing symptoms. In fact, peak infectivity was 10 days after you started coughing. Cough fever, 10 days later, you're spreading it. Ah, put up fever monitors in airports. You stop it. I mean, still, 8,000 people got infected and killed about 10 percent. Killed about 800 people. But we could stop it. We didn't know that we could have a coronavirus where we'd have the flu-like infectivity during incubation period. Infectious before show symptoms.

• 52:33Michael Greger?

  And that's, that's what, that's why we're in the situation we're in today.

• 52:35Rich Roll?

  Right. Well, it would seem important to be able to answer that question about whether we can contract it again.

• 52:41Michael Greger?

  Critically important.

• 52:42Rich Roll?

  How long that immunity lasts.

• 52:43Michael Greger?

  Critically important.

• 52:44Rich Roll?

  Right.

• 52:44Michael Greger?

  For, yes, for vaccines, for everything. So having, you know, there was this talk of having an immunity passport, right? Proving I have immunity. I mean, of course, the concern, if that gave you some kind of perks, you had better jobs or whatever, people would infect themselves. Like I have like Corona parties to, and then you could get the little immunity path. But if we really don't have lasting immunity, if it only lasts for a few months, then what does, what does it even mean to have gotten the virus if you can get it again a few months later?

• 53:11Rich Roll?

  Yeah, we've been doing antibody testing here and with regularity, people are disappointed to find out that they didn't have it. Everybody, you know, thinks, oh, in February I had a, you know, I was sick. So I probably had it.

• 53:25Michael Greger?

  I woke up with a sniffles, one of these. Right, right. But, and, and, and it's possible that having an asymptomatic case, like you test positive, but you never really, or you had a mild case symptoms, you actually may even get less immunity from that. And that it really may take, because it kind of passed under your immune system radar and you just had, and that, that your body was able to squash it so quickly that your, your body didn't have to mount much of a response at all.

• 53:53Rich Roll?

  Right, right, right.

• 53:54Michael Greger?

  And so it, it, it considers it such kind of a mild, I'm not even going to worry about mounting this constant, like right now, your, your bone marrow is pumping out anti-chicken pox vaccine, antibodies right now and will for the rest of your life. If you had chicken pox as a child, as almost everybody has. And your body's wasting lots of energy every single day, making chicken pox, making measles, making anti, and it's a lot of generates, a lot of, in fact, immune cells expend more energy than your heart cells, which are pumping every single day. These are huge. They're literally pumping out millions of antibodies every minute. It's just these little, you know, I mean, but that's because that was our, one of our primary threats to our existence on this planet historically throughout evolution were the infectious disease threats because

• 54:39Michael Greger?

  bacteria and viruses multiply so much quicker than we do. And so we had, it was this back and forth. You know, they'd get a little better, our immune systems would, you know, catch up. But they've got a few billion year head start on us. Evolutionarily, and so that's why we use our brains to develop technology to be able to squash it. And vaccines are the technology that allowed us to, for example, eliminate smallpox from the planet Earth. Literally, hundreds of millions of people used to die because of a disease that is now gone from the face of the Earth, except in some biowarfare labs. And, you know, 1976, I think it's the last case ever, thanks to vaccines.

• 55:23Michael Greger?

  So anyone says, you know, questions vaccines, you know, that was probably the greatest public health victory of all time, was the elimination of smallpox. There is no longer a disease, and that was thanks to vaccination. And so, we should, we should, we should hope and pray we have a safe and effective vaccine for this in the future.

• 55:43Rich Roll?

  On the, on the subject of herd immunity, what do you make of Sweden's strategy?

• 55:49Michael Greger?

  Well, you can ask what they made of it, and they, they now realize it was a mistake and have some of the highest infection and death rates in, in Europe, in fact, around the world. And so they, they, but, but-

• 56:02Rich Roll?

  But if we, like, we're looking at that at a discrete point on the timeline, two, three years from now, if we're still grappling with this in a, in a, you know, in a material way, and they're not, you know, I feel like, you know, are we able to really evaluate the merits or demerits of that strategy right now?

• 56:21Michael Greger?

  Well, even, even in the most infected, so even in Stockholm, which I think has the highest post-infection rate, they were still only at 25%. So they're raging now, and so they are still, now, we're much farther from a herd immunity situation. But the point is to keep the disease and death at a low enough rate until we achieve that, until that level of herd immunity is achieved. I mean, that has to happen kind of across the board, unless you completely close off your borders, like they were able to do very successfully in New Zealand.

• 56:53Rich Roll?

  So if Trump called you up in the middle of this podcast and said, Gregor, I'm, I'm, I need you in the White House, tell me what to do. What, you know, if you're in charge, if you're sitting in Fauci's situation right now, what's the, what's the program?

• 57:08Michael Greger?

  Well, first of all, I'd say, look, I'm in a Rich Roll podcast, I got my brothers here-

• 57:13Rich Roll?

  You gotta wait until we're done.

• 57:14Michael Greger?

  Right, but, but, all right, but when I have a moment- Well, it's really putting the experts back in charge. So, I mean, in any other circumstance, the CDC would have been leading this charge. I mean, they've been effectively silenced.

• 57:29Rich Roll?

  Right.

• 57:30Michael Greger?

  And the same thing with, I mean, you know, it's like the CDC can't even do-

• 57:33Rich Roll?

  Rand Paul told Fauci he was not being optimistic enough or muzzle them?

• 57:37Michael Greger?

  I mean, and so when we don't have the experts in charge, I mean, this is, and this has not just happened in the US, it happened to a certain extent in Brazil, in UK, in a number of places where they can have this kind of, this kind of autocratic response, instead of listening to the two experts who've been spent, you know, their lives doing this. And so there are good sources of information. I do want to put a plug in for the Center for Infectious Diseases Research and Policy at the University of Minnesota. Michael Osterholm has a weekly podcast. So is one of the sanest voices, been doing this work for 45 years. And I remember when I was doing my work, I mean, this, you know, 20 years ago, I mean,

• 58:21Michael Greger?

  he was leading, you know, leading the charge way back then and was, you know, with HIV and on down the road. And so it's people like him and Fauci who have, they've spent their entire lives studying this. And so then to have pandemic preparedness, you know, documents going back when I was writing about this and, you know, I was kind of late to the game 14 years ago or so, you know, we had, I mean, you know, but then we had all this, you know, these plans and they just threw it out the window. I mean, we just didn't follow what we needed to do. And, I mean, it's very difficult politically because if it doesn't, if you're not, if it doesn't look like you're overreacting, then you're not doing enough, frankly. I mean, because we have, it's the mathematics of exponential spread during a pandemic.

• 59:05Michael Greger?

  And now in retrospect, we know, oh, when we had one case, we had 10,000 and when we had, you know. And so you're always late to the game, but it always looks like you're, you're, you're, you know, you know, Chicken Little, because, oh, there's only a few cases, you know, why? I mean, you know, let's not, you know, let's not, you know, the impact of the economy is such. And this was certainly a new virus. I mean, so they certainly, for early missteps, there's, you know, you know, very few places around the world were ahead of the curve. And the ones that were, like Hong Kong, Singapore, South Korea, they had recently

• 59:44Michael Greger?

  suffered deadly coronavirus outbreaks. So South Korea in 2015 had this MERS outbreak. Some businessman came back from, from the Middle East and started spreading. And so they had this testing and tracing, public health infrastructure intact. The other countries suffered recent SARS outbreaks, right? So they had experienced this firsthand on their soil. Their populace was ready. They understood the risks and were ready to do whatever the experts were told was necessary. And so they were able to jump ahead of the curve. And you get on this, you start these social distancing measures two days, three days early, and you have this mathematical modeling suggesting you could literally, you know, prevent millions of cases in the long run if, you know, a week earlier you did this,

• 1:00:27Michael Greger?

  a few days earlier you did this. And that's because, once it spreads out of control, it's very hard to kind of put the, put the lid back on.

• 1:00:34Rich Roll?

  Right. I think that's what we're experiencing now. I mean, the difference being that there wasn't that kind of popular will because the SARS and the MERS, like, we knew about them, but they didn't really land on our shores in a meaningful way.

• 1:00:46Michael Greger?

  Right. Right. In fact, right, SARS never did. So SARS hit Canada, never actually made it into the States. And so, right, so we didn't have that, that history. But we certainly had experts who spent their whole lives preparing for that situation. In fact, I was part of these, we, there were, you know, these governmental drills where we all got together, oh, we have these, you know, sick chickens in Maryland and, and what's going to happen and what kind of decisions we have to make. And there was all this kind of, you know, wartime game planning for, you know, you know, departments. And, but, you know, it just, it just went out the window. And so, okay, so early missteps, right, we, you can forgive around the world for countries that have not had a recent history.

• 1:01:29Michael Greger?

  But then, right, but now even even a few months ago, we were far enough in to realize the situation we were in and had to take it much more seriously.

• 1:01:38Rich Roll?

  Yeah.

• 1:01:38Michael Greger?

  But you know, there was this sense of, well, we just have to lock down for, you know, 10 days, or we just have to do this, and it's going to be very temporary. And like, and all the scientists are looking at each other saying like, what world do you live in?

• 1:01:48Rich Roll?

  Right.

• 1:01:49Michael Greger?

  But having said that.

• 1:01:50Rich Roll?

  Well, the messaging is so confusing, and it's not cohesive, and there is no sense that there's a real plan. So we kind of did that for a while, and then we kind of tiptoed out, and then suddenly we're protesting in the streets. And now we're like, well, now we see the spikes, but are we going to go back home? And nobody's really, you know, taken the reins to articulate in a clear cohesive manner what the steps are that we all have to get on board with in order to get on top of this. So I just feel like it's just gonna, it's gonna run its course, and people are gonna do what they're gonna do right now, short of some, you know, catastrophic spike that's gonna get people to wake up

• 1:02:31Rich Roll?

  again. Because getting them to go sequester in place after the many months of, you know, what we've been experiencing, I think is going to be very difficult.

• 1:02:40Michael Greger?

  Yeah. Yeah. But I mean, that's, I mean, but that's, if you can, the fewer people you come in contact with, the further non time outside, I mean, and the farther you can be away, and the more, I mean, that's just, you know. Now, having said that, if you are under the age 50, none of these comorbid conditions, the chances of you dying from this virus, one in a thousand, right? I mean, we are talking about a, in the scheme of things, a wimpy virus, a category two pandemic. But, you know, we should all be, you know, well informed as to what's risky, what's not risky, what can we do to reduce our risk? Should we have to come intact? And then the, you know, you know, it's kind of.

• 1:03:21Rich Roll?

  Right. Well, setting aside the comorbidity factors, you know, if you're not obese, have high blood pressure, heart disease, etc., if you're not in a nursing home, you are in a much better position to combat this, should you come into contact with it. But we've all heard the stories of young, fit people who have either perished or gotten so tremendously ill that they're having trouble recovering. So. Let's talk a little bit about this narrative that it's just like the flu, or it's just a little bit more serious than the flu. Like, what is the difference between the flu, like, as we kind of understand it as Americans, versus the experience of contracting this disease? And what happens to your body when you have it?

• 1:04:03Michael Greger?

  Yeah, so, I mean, so, for those in the public health community, even saying something is as bad as the flu as a way to minimize it, doesn't... For infectious disease folks, flu is a scourge that kills tens of thousands of Americans every, you know, every year. And, you know, unfortunately, the annual flu vaccine is not very effective. Between 30 to 50% decreased risk, which, hey, better than nothing. But, you know, we're unable to really put a lid on this virus, come surging back every year. And it's one of the leading causes of death. That's why I have a chapter on it now, "Not to Die," because it's one of the leading causes of death of, you know, this low respiratory tract infections or pneumonia primarily caused by influenza.

• 1:04:46Michael Greger?

  And so, but this is, but a bad flu year has a .1. Case fatality rate, 1 in 1,000 people getting it. Whereas for COVID-19, we're looking at .4 now, so at least four times worse. And of course, it depends on what age group you fall in, but that's kind of all across the board. Unfortunately, here in the United States, even without taking obesity into account, over age 50, most Americans actually have some morbid condition, either high blood pressure, or heart disease, or diabetes. And so, yeah, and so, you know, all these lifestyle medicine pushes to enhance, you know, to increase our resistance against chronic disease sometime far in the future, now is helping us right here and now.

• 1:05:31Michael Greger?

  And so, you know, this message to, you know, better take care of ourselves and family has never been more, kind of...

• 1:05:37Rich Roll?

  There isn't enough discussion about what we can do to buttress our immunity, or make sure that our immune response is intact and healthy. And a corollary to that is also, I think there's this idea that we want our immune system to be as robust as possible, but is it possible that it can become too robust?

• 1:05:58Michael Greger?

  Yeah, that's the irony here. So we have amazing studies showing that simple foods can boost one's immune function. So I have videos, nutritionfacts.org, talking about randomized, double-blind, placebo-controlled trials showing that, for example, broccoli sprouts can reduce viral loads for influenza, decrease virus-induced inflammation, boost antiviral natural killer cell activity, but this isn't the flu. Unlike other common viruses, coronaviruses have not been shown to cause more severe disease in immunocompromised people, those with HIV, those on chemotherapy, right? You think they're vulnerable to other infections, not to coronavirus infections, including COVID-19. You say, wait a second,

• 1:06:39Michael Greger?

  how does that make any sense? Because it's your own immune system that's the primary driver of lung damage during infection. During the second week of infections, during the second week of symptomatic infection with COVID-19, the virus can trigger what's called a cytokine storm, which is like an autoimmune reaction, where your body overreacts. And in attacking the virus, your lungs get caught in a crossfire. And in burning down the village in order to save it, we may not make it through that process. So while I'm

• 1:07:19Michael Greger?

  certainly in favor of common, you know, common sense, generalized, you know, advice to stay healthy, such as sufficient sleep, and staying active, and reducing stress, staying connected, albeit remotely with friends and family, eating healthy, but I would not, you know, take a specific supplement, go out of your way to take a specific supplement, or to specific food to boost some element of your immune system, until we know more about this virus.

• 1:08:00Rich Roll?

  Potentially, we could be doing more harm when we're well intentioned and trying to do good. I've been hammering the broccoli sprouts and also vitamin D. We're hearing a lot about vitamin D. So what are your thoughts on that?

• 1:08:11Michael Greger?

  So there are a number of vitamins and minerals that are critical for optimal immune function. Vitamin D is one of them, vitamin C, zinc, selenium, but there's no evidence to suggest that supranormal levels have any benefit. So you need sufficient for a functioning immune system. So all the studies that show, for example, zinc improves hard outcomes for diseases. So you give zinc to children with pneumonia, significantly decrease mortality rates. Randomized placebo-controlled trials, zinc versus sugar pills to children with pneumonia, those given the zinc significantly less likely to die. But where has every single one of these studies been done? Sub-Saharan Africa, Ecuador, places where there is micronutrient

• 1:08:56Michael Greger?

  deficiencies. So if you find a deficient population not getting enough zinc, giving them zinc can bring them up to immune. But if you have someone with functioning immune system, would adding zinc do any good? If you have enough vitamin C, have enough... There's no evidence that having higher levels. So having said that, vitamin D deficiency is rampant.

• 1:09:19Rich Roll?

  It's rampant.

• 1:09:20Michael Greger?

  Even in, you know, the probably the shining example of this is there was a study of skateboarding teens in Hawaii, right? And you just imagine them shirtless all day, and even they had these high rates.

• 1:09:34Rich Roll?

  Why is that?

• 1:09:36Michael Greger?

  Well, it's because we evolved running around naked in Equatorial Africa, being baked in the sun all day long. And so if you want to know what normal vitamin D levels are, you measure people who work outside all day long. I mean, that's kind of a natural level of vitamin D. And so we were never meant to have these winters and inside and wear clothes and all these things that cut down on our natural vitamin D production. And so for people that don't get sufficient midday sun... Particularly those with darker skins, particularly those who are older, particularly those with more body fat, may need to supplement with vitamin D. So I would recommend 2,000 international units of vitamin D3 a day for those who get insufficient sun. That's what

• 1:10:20Michael Greger?

  I do because I'm inside all day. I got my D levels tested once before I supplemented and I had the D levels of an institutionalized elder, like these people who are like in nursing homes and literally never get outside. That was me in front of my laptop.

• 1:10:35Rich Roll?

  Mr. Nutrition.

• 1:10:36Michael Greger?

  Right, stuck in an airplane. Right, I mean, I just never got outside. I got work to do. I got a book to write. What do you mean? And so, right, so in fact, 2,000 was enough for me. So 2,000 will get most people from the general level up to optimal level.

• 1:10:49Rich Roll?

  Right.

• 1:10:50Michael Greger?

  But for me, who got no sun, I had to take even more.

• 1:10:53Rich Roll?

  So a couple of questions on that. It's not about mega dosing. It's about just making sure that you're not deficient, but I think it's probably safe to presume that there's a good chance you are deficient because so many people are sort of getting a blood test to determine that. If you are depleted or deficient, how long does it take to restore, you know, that balance? Does that happen quickly or does it take time?

• 1:11:20Michael Greger?

  In fact, so rapidly that you can actually randomize people with infection to vitamin D while they have the infection and improve disease outcomes. And so

• 1:11:29Rich Roll?

  Well, that's good news.

• 1:11:30Michael Greger?

  You increase their levels while they, I mean, while, I mean, so literally within the days, your immune system's like, come on, people, we need some vitamin D right now.

• 1:11:38Rich Roll?

  Right.

• 1:11:39Michael Greger?

  And so, right, so, so very rapidly were we able to improve. And the same thing with these zinc studies, right? They gave them to kids not before they got infected to see how they, if they got infected, how they do. Literally, they were already sick, gave them zinc, and then a few days later, they were live or dead, whether or not they took zinc. So, and another problem with zinc is there isn't even a blood test. So you can get tested for zinc sufficiency if you want to. But if you are, so, but if you're eating a nutrient-rich diet, right, which is where, where all vitamins and minerals come from, with only two exceptions, which is from the ground. And so by eating them in plants, I mean, that's where the, that's where we should get, ideally with the two exceptions

• 1:12:23Michael Greger?

  of vitamin D, the sunshine vitamin, and vitamin B12, which is made by microorganisms, which blanket the earth, but we now chlorinate our water supply. Don't get a lot of B12 in our water, don't get a lot of cholera either. That's a good thing. We have a nice sanitary system, but again, because the way we live in our modern world, like with vitamin D, because we live in our modern world, we have to make sure we get a regular, reliable source of vitamin B12.

• 1:12:44Rich Roll?

  What other, what other food should we be mindful of making sure that we're getting that are nutrient rich in the way that we want or need it, given what's happening?

• 1:12:53Michael Greger?

  So fruits, vegetables, legumes, the same litany, right? Beans, lentils, chickpeas, split peas, whole grains, nuts and seeds, herbs and spices, mushrooms, real food grows out of the ground, fields, not factories. I mean, it's the, you know, it's the

• 1:13:06Rich Roll?

  Basic stuff.

• 1:13:07Michael Greger?

  It's the basic stuff, right? This is where the nutrition comes from.

• 1:13:10Rich Roll?

  Do you ever get tired of talking about this stuff?

• 1:13:11Michael Greger?

  Oh my God. Well, I mean, but it's even more relevant now. And if, and if people are going to start eating healthy now because they don't want to die from the virus and, and my, my secret plan is for them not to get breast cancer in 10 years and not to get, die of a heart attack. Look, whatever it takes for them, right? I would appeal to vanity, tell people helps with acne. I mean, anything to get people to eat healthy because I know it's going to save their lives later on. And so maybe this will have the side benefit of starting some healthy habits. They're going to stick with them and thanks to the pandemic are not going to, you know, croak in 10 years from a stroke.

• 1:13:44Rich Roll?

  What about viral load? We hear a lot about viral load, right? You, you touched on it a little bit ago that, that, you know, we want to avoid these, you know, indoor kind of hotspot settings where we're in close proximity to each other. But I'm not sure I fully understand the, like, the idea is that you could potentially come into contact with the virus, but if it's in a passing way, if it's not, you know, in one of those cloistered kind of settings, that perhaps you're not going to contract the disease.

• 1:14:13Michael Greger?

  That's your smoker 50 foot away. Right. We have this sense that one, one viral particle, we get exposed to the virus and all of a sudden we, we get infected. And you must realize that even if someone with active tuberculosis coughs in your face, the chances of you getting tuberculosis is like 1, 200.

• 1:14:32Rich Roll?

  Really?

• 1:14:33Michael Greger?

  Because you have an immune system. Now, if you have HIV or some, some, you get impaired, that's what our immune system is for. We, we were built to fight off. Invaders, right? And so only under certain circumstances when we have sufficient, that was called the viral load. When there's sufficient, and so you can pick a pathogen and there's an average viral load for E. coli bacteria. One E. coli bacteria, the odds of that's going to trigger infection, even though they multiply like crazy. Or one salmonella, no, it's, it's, you need, you need a sufficient dose. That's why, um, like pasteurization, that's not about sterilizing milk. Cooking, it's not about sterilizing the meat. I mean, it's about reducing the, the, the number of infection, so that is below the infectious load.

• 1:15:18Michael Greger?

  And so when it comes to respiratory pathogen, it's not that you, you have to prevent yourself from breathing in one particle. It's you have to reach a sufficient number of infectious particles. Um, and whether that's a thousand, whether that's 10,000, we unfortunately don't know yet with COVID-19, but we do know it for other respiratory pathogens. And you can, I mean, you could dose it out and how do you do it? Well, um, they do studies with influenza, they young, healthy people that are really low likelihood of suffering. And they literally drip it in their nose. So they drip a thousand in the nose to see how many percentage of a hundred people dripped a thousand in their nose. They drip 10,000, right? And you can find out exactly how much. Um, so we don't have that data yet because we have a new virus. But we always know that, I mean, otherwise the, the, the disease would spread even more rapidly than it is.

• 1:16:01Michael Greger?

  So it is, um, intensity of exposure and it plus duration of exposure. So everyone's freaked out about elevators, right? But how, how long are you in that elevator, right? Um, it's so it's, if you have someone in your home who is infected and you have a studio apartment and they're not in their own room and they're hacking away and they, yes, they have a, they have a face, a cloth face covering. And they're, we're trying to wipe down all the doorknobs and we have the windows open and the exhaust fan on the stove going. And in the bathroom going, you have an air purifier and like you were trying to do the best to maintain ventilation. You're living with that virus for a long period of time and that puts you at extremely

• 1:16:45Michael Greger?

  high risk, these crowded settings. And in fact, they do that. Now, we have these beautiful studies where, you know, we've traced everyone back to one of these restaurant events and they have the little map of all the tables, all the people at all the tables, and here is the index case, and everybody over here got it. No one, even sitting next to them over here, got it. Why? Because the airflow is going this way. Right? Here's the air vent, here's the air vent. Everybody got it this way. And the person sitting three feet away, on the other hand, didn't get it. It's because these little tiny, these are like little dust motes that you see when the sun rays come in, they just kind of float around. But one little teeny breath would just, you know, blow them to one end of the room or the other.

• 1:17:28Michael Greger?

  And so, but it's just being in this cloud of little dust motes, breathe in one, breathe in two, breathe in three. And so, when you look at these contact tracing apps and contact tracing protocols, they're asking, who have you been close to, that's the intensity, under six feet, and for more than 15 minutes? Who've been close to, so is less than 15 minutes?

• 1:17:50Rich Roll?

  Is that random, or is that calculated? Like, is there a scientific basis for the 15-minute window?

• 1:17:56Michael Greger?

  Not scientific basis for COVID-19, because we don't know. We don't know the parameters yet. But so that's based on other respiratory pathogens. So basically, all this modeling has to do, we have other respiratory pathogens. We have common cold viruses, we have influenza viruses, and so we have other data from viruses we think transmit very similarly, based on the data we have so far. So based on that, you know, we're not even going to call on the phone someone you spoke with directly, face-to-face for 10 minutes, two days ago, and now you're in the hospital. They aren't even, the likelihood that they're infected.

• 1:18:31Rich Roll?

  They didn't meet the 15-minute threshold.

• 1:18:32Michael Greger?

  But so 15 minutes, and they had to be close. So 15 minutes, you spent all hours, but you were outside on a porch with someone who was eight feet away from you? Not even got called.

• 1:18:40Rich Roll?

  Then what about, well, look, we're seeing a clampdown now on indoor dining. A lot of restaurants in, you know, in California, at least, they're closing. Some have opened, they're closing back down. There's, you know, every state's different, but...

• 1:18:55Rich Roll?

  Airplanes seem like a bad idea. Recycled air, we're seeing these airlines announce that, you know, they're not going to restrict their seating. You just were on a plane. I mean, that just seems like the worst idea.

• 1:19:07Michael Greger?

  So, um, there's, uh, there's, it's safer than being in a similarly confined space just because of the, um, they're actually HEPA filtered through the air system. So you actually should have those. You can imagine being in a plane, not wanting that recycled air in your face. No, that's exactly what you want in your face. You should open all three of those nozzles. If you're not sitting next to someone, point them all towards you. You have this wave of air pushing past your nose for someone, someone walks down the hall.

• 1:19:37Rich Roll?

  Does that air, is that air recycled though?

• 1:19:39Michael Greger?

  That is completely recycled.

• 1:19:40Rich Roll?

  So somebody in the back is coughing and it gets through.

• 1:19:43Michael Greger?

  It's through HEPA filter, which is not a perfect filter, but it, it does filter out the majority of the type of droplets we think are carrying this virus. And so you have this semi purified air that's a buffer blowing your face.

• 1:19:56Rich Roll?

  It's pushing everything else away.

• 1:19:57Michael Greger?

  Pushing everything else away. Now, that is not a, I would not consider that a low risk scenario. But look, when you're gonna be on the Rich Roll Podcast, you take, you run the cost benefit.

• 1:20:10Rich Roll?

  You showed up, man. I appreciate that, taking that risk. What about, uh, what about masks? Okay, so you go out in the world, you see all variety of masks from the guy with the, who's got the bandana around his neck, covering his mouth, but not his nose. You've got cloth masks like this, you've got the N95s. Like, how important is it to have a high quality mask? What should we be thinking about when we're making that decision about what kind of mask?

• 1:20:42Michael Greger?

  So the only mask actually designed to protect the user.

• 1:20:49Michael Greger?

  The wearer are these N95 masks, um, which were specifically designed for that purpose. They filter the air. They filter the air coming in. Hmm. Um, and so that is what's being recommended for medical personnel. Um, and but those, that's not something you just, you know, the, the, it has to be something that has to be fitted to your face, actually go through a fitting process in the hospital to make sure you have the right size for your face. You can't even have a day of beard growth. So everybody with any facial hair covering that, that area is completely, I mean, that, it breaks the seal. This is a, meant to be an airtight seal and the material has this electrostatic charge that traps these microscopic little floating particles, um, such that you can wear it

• 1:21:34Michael Greger?

  with someone coughing active TB germs, um, and, and been very effective for COVID-19. Now, of course, you can infect yourself taking it on and off and, you know, you can, you can, there can be an inadequate seal for whatever reason. Um, you really shouldn't use it. It's meant to be disposable. Now we don't have enough even for medical professionals and so they have to reuse the masks and we don't have enough data to show how many times you can reuse it and how soggy it can get and what kind of protection, um, still exists and can you reuse it after you decontaminated it, on and on and on. And that's why, so no one is recommending N95 masks for the public, not because they don't work, but because we don't have enough to go around. Now, that's not our fault, right? That is a failure of the national stockpile.

• 1:22:15Michael Greger?

  Um, we should have had the N95s for, for, for all medical professionals as have other countries. Mm-hmm. In fact, other countries have provided, you know, surgical masks for their entire populace for free. Um, um, and so now surgical masks are meant to protect others, um, from the wearer. So that's why surgeons wear them, so they're not, um, breathing germs into an open surgical wound. That's at least the theory, although there's only been two randomized controlled trials and there's actually no drop in infectious rates during surgery, um, surgeons wearing masks versus not wearing masks. Oh, wow. So even surgical masks are of questionable utility, um, for cutting down on disease

• 1:23:00Michael Greger?

  transmission and the cloth face coverings, there's no data to suggest that they're useful. Certainly during, uh, 1918, they were found not to be successful. Um, Um, the, uh, the benefi- so my concern is this false sense of security. Mm-hmm. The critical factor of getting infected is distance, distance, distance. Like, the time and distance. And so if you, if you feel invulnerable, or you feel lower risk because you have a mask on, and you would go places you would not normally go, or you would stay longer, or be closer to people than you normally would, that's how a mask could actually increase your risk of infection. Right. All indirect ways it could decrease risk of infection, the people who really need

• 1:23:44Michael Greger?

  to be using, like the surgical masks, the cloth face covering, are for people who are actively hacking, coughing, actively symptomatic. They're re- I mean, they are spewing out virus like crazy. They really need to be wearing masks. If you go outside, no one's wearing a mask, and you know you're infected, and you have a fever, and you're coughing, but you need to go to the drugstore, you live alone, you need to go outside, and no one else is wearing a mask, the social cost of no one, you know, of putting on a mask and flagging, "I'm infected," um, you can imagine how people might not do that. Whereas, if by law, or by decree, or by social contract, everyone's wearing a mask, you are more likely being symptomatic to wear a mask and protect others.

• 1:24:30Michael Greger?

  And so that's a way how masks could really help, even if it doesn't necessarily cut much down on the asymptomatic transmission, which is what we're hoping. We're hoping that those tiny little respiratory droplets that we spew out of our mouth during normal conversational speak, we're gonna trap some of those with a cloth face covering. Do we have data showing that's the case? We do not. And so when the CDC came out and said, "We changed our minds, uh, based on the new data, or based on the latest science, um, we are, we are going to recommend everyone wear cloth face coverings," and you say, "Well, you go to the CDC website, what's this new science?" They cite the National Med- uh, National Institute of Medicine, um, and you go there and say, "What did they do?"

• 1:25:14Michael Greger?

  And they came out, said, "Masks are probably a good idea," based on what data, but they're very clear saying, "We have no data showing that they actually work." Theoretically, it could cut down on some of this transmission, again, not- Not helping the wearer, but helping other people from the wearer if they're infected and not even knowing it. But, but this, but my biggest concern, false sense of security. I have something over my face so I can go to the grocery store twice as many times as I did before and I don't have to exactly stay as far away from other people as I, you know. That's how masks can be a problem.

• 1:25:48Rich Roll?

  Yeah, I think of it much like, it's basically a tool for social distancing. Like it's sort of buying you a foot or two, right? Like, instead of making sure that I'm, you know, six feet apart, maybe I can be five feet apart, but it's not doing anything more than that. Is that?

• 1:26:10Michael Greger?

  Or, or, or you could imagine it working even better. The presence of mask reminding people, you're during a pandemic. It looks weird, walking around, like cashiers, people are on the street.

• 1:26:21Rich Roll?

  It's amazing how quickly we normalize to it. And I don't think, now I just, yeah, I think of it's normal.

• 1:26:26Michael Greger?

  Right, I mean, it's funny, when you look at these nineteen, so I was at the National Archives when I was writing the book and doing talks about it and going through and seeing all the, you know, major baseball, you know, back in the 1918, everyone's wearing masks and spectators, it just looks so weird to have people with, you know, billy clubs and masks on, but now, right, it's amazing how quickly, but if it reminds you, for example, wearing, wearing gloves on your hands. And the reason to say, well, there's no point in wearing gloves on your hands in public because you can just as easily infect, you know, rub your eye with your gloves as with your hands and so you have to wash your hands gloved or not. But if having bright pink gloves on your hands as you go to rub your, oh, you know, I mean, if that reminds you, and you just look down and it feels weird and it's awkward

• 1:27:09Michael Greger?

  and everyone's looking at you because you've got bright pink, if that keeps you mindful of the position of your hands, that could be a good thing. That could cut down on rates of it, you know, just because you're not, you know, it's not business as usual. If masks make it not business as usual, I mean, it's just a little, you know, it's constant reminder, oh, maybe I should be a little more careful in this situation or not go somewhere, then that could help.

• 1:27:34Rich Roll?

  Testing, testing, testing. We need more testing. Testing is the way that we're going to get on top of this. When should we get tested? What kind of test should we take? There's all kinds of tests out there. What are these tests telling us about how we're responding to this problem? Right? Like, I think, like, oh, testing, testing, testing. I've gotten an antibody test a couple of times. I've been negative. I haven't had the full swab test. Do you wait until you're symptomatic? Like, when is the appropriate time to explore that? And, I don't know.

• 1:28:09Michael Greger?

  Yeah, so, testing, testing, testing only makes sense if it depends what you're gonna do with those results. And so, testing is critical to know what's happening with the virus. And without that information, then you're flying blind. So, you wanna know if some kind of stay-at-home order actually helped or not. You wanna know, be able to say, with these protests, would that lead to a big spike or not? It's still so early on, we're gathering data, we're gathering intel on our enemy. And so, without testing, we're completely flying blind. And we just don't know. How far are we away from herd immunity? What's helping? What's not helping? What are those super-spreader events? How can we avoid those? What kind of occupations?

• 1:28:54Michael Greger?

  What kind of restaurants are good, bad? We don't know that if we don't have sufficient tests. And so, we have been, and so, the countries that have done the best, so, South Korea, for example, they were ramping up to test literally within 10 days. They were doing thousands of tests a day. We weren't testing at all at that point. And it's interesting, they actually had the, we had our first cases on the same day, South Korea and the US. And you look at our curves, I mean, it's completely, they basically vanquished it. And we're still raging on. So, what are you gonna do with that testing? And so, so, basic, what's called seroprevalence testing, you just wanna know, you wanna do random sampling as part of an experimental setup in various areas of the country on a consistent basis to know what's happening with the virus where.

• 1:29:37Michael Greger?

  And so, we can gauge that against our hospital capacity. How many ventilators we have in that county? How many ICU beds? And then, we can make these decisions. Do we open? Do we close? When? Should we be pumping the brakes on this kind of socialism? Obviously, we won't want as little as possible. We want to be able to have as much freedom of movement and continue the vitality of the country as much as possible, unless we're gonna start running out of beds, right? Until, I mean, that's the whole point of flattening the curve. You're not necessarily reducing the number of people that are gonna die or gonna get sick. You're spreading them out. You're just, we know this many people are gonna die, but if they all die, but if they

• 1:30:19Michael Greger?

  all come in the hospital this week, then more are gonna die than if they come out over the next 10 weeks. Now, it's possible if we slow it to the extent that we hit a vaccine, aha, that's the game changer. So if we can slow things down enough, then that slowing, flattening the curve strategy, then does indeed result in fewer deaths overall, because, ah, then we finally have a method to stop the virus without getting people infected. And so, there's certainly a place for testing, in terms of individual testing. Right now, there isn't sufficient tests available, and this goes back to having enough swabs, enough reagents, and now we're dealing with this with a future vaccine.

• 1:31:00Michael Greger?

  We don't have enough glass vials in the world to even put the vaccines in. So then, if you're gonna use one, if you're gonna stick needles into one vial instead of having single-use vials, and you have to add preservatives, that's another safety issue. I mean, so, basic, and of course, the public health community's been shouting about this forever. I have this in my book 14 years ago. The supply chains are not sufficient to have enough masks, to have enough PP, to have enough of the basics we need. So that's what we're running into, the testing. And so, it's like masks. What are the best masks? Oh, N95s. So shouldn't everyone have an N95? No, we can't, because we need them for the frontline workers. Even surgical masks, which are better than cloth masks, we're telling people not to

• 1:31:44Michael Greger?

  use those because we don't have enough for the medical workers, and so that's why, you know, DIY, make it at home with a sweatshirt, even though we don't have data showing that's necessarily as effective as people think it is. So, same with testing. What would we like? We want weekly testing for everyone in the country, right? I mean, then we could, but we don't have that capacity. So who should get tested? It is people that are coming in contact with vulnerable individuals. That is the highest. So people working in a nursing home, we want that staff tested. Because one case in that just can explode, right?

• 1:32:22Rich Roll?

  Right.

• 1:32:22Michael Greger?

  So people in prisons that haven't already been overrun like San Quentin, you know, it's kind of, at that point, it's almost too late. What we're seeing in some of these. But it's those kind of high-risk scenarios. These are the people we want regularly tested so we can pull them out of circulation. It's ironic, it actually goes back to the porn industry and HIV. That's how the porn industry has worked. There was a deadly virus and there was, yet there was an industry where you had to continually put yourself at risk to be in there. So what did they do? They instituted a mandatory testing. I forget exactly how frequently you need to get tested. And you could not work unless you come back with a negative test. And you would be out of work.

• 1:33:03Rich Roll?

  And they figured out the interval, right? I think it was every two weeks or 10 days.

• 1:33:06Michael Greger?

  Whatever it was, and so they could constantly, and so that's what we need. And so that's actually the.

• 1:33:13Rich Roll?

  We should let the porn industry, they're always out front with these technological breakthroughs.

• 1:33:20Michael Greger?

  The whole concept of testing and tracing actually came from the STD world. I mean, that's what you know, you have a case of gonorrhea. We need to find everyone you slept with recently and we need to honestly call them on the phone and say, someone you've been with recently had gonorrhea, you need to go get tested. So you don't then spread it to everybody else. That's the concept of testing and tracing. It's so much more difficult now with this respiratory virus because it spreads so much quicker. And so you can imagine, how many people have you, you know, had this kind of 15-minute window in close proximity in the last, and you're like, well, I just went to this wedding, right? And then all of a sudden, you can imagine how all of a sudden, one wedding just makes this explosive number of contacts. Whereas if you have been trying to distance as much as possible, as far as possible,

• 1:34:04Michael Greger?

  from as many people as possible, it's like, who have you been with? Ah, there's just been one, you know, one or two. We could contact those people, they could, and we could imagine how you can. But yeah, even, I mean, we need 100,000 workers and it's, and the problem is, and then you call people up and you say, someone you've come in contact with in the next few day, in the last few days, has tested positive, so you should quarantine for 14 days. Who wants to get that phone call? Right? Okay, you get that phone call. What are you gonna do with that information? Are you really gonna do it? You're gonna, all of a sudden, it's not no fault of your own. You're going on your own business. Someone tells you and now you gotta lose two, two weeks of work? Well, obviously you should be compensated for those two weeks of work. I mean, there's ways you can make it easier, but you can

• 1:34:45Michael Greger?

  imagine, even in the best case scenario where it all works, we're all testing people, you can still imagine how difficult this to kind of put the rabbit back in the hat.

• 1:34:54Rich Roll?

  What about some of these non-vaccine drug protocols that we're hearing about? I just read that the USA acquired the entire stock of remdesivir.

• 1:35:05Michael Greger?

  Yeah, for $1900.

• 1:35:06Rich Roll?

  What's going on with all of this?

• 1:35:08Michael Greger?

  Yeah, well, I mean, that's, yeah, I mean, that's, that's, that's the US healthcare system, right? So yeah, so this company comes out with this drug, has, there's no drug cocktail to date that in peer reviewed studies actually shown to decrease mortality. I mean, that's, that's the, I mean, that, that, that should be the standard. I mean, so what remdesivir is shown to do is decrease the number of days in the hospital. So number of days that, that you're sick. And look, if you're sick with this virus, sure, give me something that cuts a couple of days, but does it actually help people live through this virus? I mean, that, that's the, that should be kind of the gold standard.

• 1:35:42Rich Roll?

  Treat like one aspect, like, like alleviate some of the symptoms of, of the disease? Or what is it doing?

• 1:35:48Michael Greger?

  But it's, it seems to be slowing the virus down such that your immune system can get a, can get a, can get a, you know, and similarly, there's a, there's a drug called oseltamivir or Tamiflu for influenza does a very similar thing. Does not actually decrease mortality from influenza, but may shave a day or two off of, of hospitalization of a severe corus. So they still give the drug, but whether or not the government should be spending, giving billions of dollars to big pharma to buy these drugs. So they're selling these, the remdesivir for $3,000. Of course,

• 1:36:18Michael Greger?

  And so, and, and, but if it's not actually showing to saving lives, couldn't that 1.5 billion dollars be spent in a way where we could, um, you know, and so there's, there's, you know, I mean, we just need to, I mean, it's possible that before vaccine, we will have an effective treatment, bi effective treatment, we actually reduces the risk of death. We do not have that yet. Um, we do have a, a decreasing number of the, even though we have an increasing number of cases in the U. S. Deaths have gone down and flattened and largely that's because younger people are becoming affected now. As soon as the kind of relaxation, social distancing, people getting in bars and younger populations are getting, so the cases are scouring, but mortality is still staying relatively low. Um, and the, in large part,

• 1:37:02Michael Greger?

  that's because younger, younger populations are getting affected.

• 1:37:05Rich Roll?

  What are some of the wrong headed kind of ideas that you see percolating around? Like in the news cycle, you read, oh, you know, we should do this, we should do that, or, and you just think, why are, you know, this is not right. Like, all we need to do is this. Like, I'm trying to give people, um, you know, just some really tacit advice that can alleviate some of the confusion.

• 1:37:29Michael Greger?

  I mean, look, in the nutrition space, we know of just the crazy ideological frenzy by which people attached onto crazy ideas, right? And defend them at all costs and the confirmation bias. But I have never seen the kind of crazy that I've seen in response to, so now I have a whole series of COVID-19 videos. I kind of switched the research team to be working on the, on, so we have like a series of 17 videos or something. And the response, now I put up a video saying broccoli is good. I get, I get the trolls come out. I mean, you know, it does not take much, but, but.

• 1:38:04Rich Roll?

  It's at a whole new level now, my friend, because you hit a, you hit a nerve with this.

• 1:38:09Michael Greger?

  Right. So I am a China operative, one moment and, uh, you know, whatever.

• 1:38:14Rich Roll?

  Yeah. The Bill Gates, 5G, you know, Soros axis of, you know, Illuminati here.

• 1:38:21Michael Greger?

  And, and that, and, and I think a lot of that comes from just this terrible crisis communication at the highest level. I mean, yeah, I mean, you, I mean, the worst thing you do.

• 1:38:31Rich Roll?

  Or a concerted effort to weaponize misinformation and create division because. This is something that should not be politicized and it's been unbelievably politicized.

• 1:38:40Michael Greger?

  To a level that I think surprises everybody. Like, I mean, that's kind of a consistent message. So not much surprised the public health community, who the whole time could write just a big, carry a big "I told you so" sign all day long, every day. But that's something that really has surprised. And, look, there's always been scapegoating. So, you know, the so-called Spanish flu, 1918 is the only reason they called it the Spanish flu, was because that was a neutral country and so it was the only one that wasn't censoring the news. And so everyone else, the US is like, "We don't have any flu." You know, and the Germans were, "We don't have any flu." So, I mean, it just got out. But, of course, in Spain, they called it the French flu.

• 1:39:20Michael Greger?

  And, you know, I mean, and there's always scapegoating of Jews during, you know, horrible epidemics. There's always been this kind of nasty, something about crises like this that kind of bring out the worst in people as well as the best in people. But, yeah, but this is certainly at a level. And so that just makes it even more important to get information from, you know, decent sources. And I think we have this, there's this like, "Well, look, you do your research, I'll do my research." Kind of thing, like, like, as if, like, what exactly is your research? Like, you do your Google search.

• 1:39:56Rich Roll?

  Says the guy in his mom's basement to the guy who spent his entire life studying this.

• 1:40:00Michael Greger?

  Exactly, right. And so this really shows the, you know, look, I'm, I'm, I'm as opposed to as anyone, this kind of "I told you so because I'm an authority." I mean, we've seen where that has gotten us in trouble. But we should, when someone says, "I'm an authority," you say, "Show me your sources." Like, you weren't born with this information. How did you come across this? And, and argue to me why this really is the best. And any expert worth their salt should be able to say... This is how I arrived. Here's the data. Here's the science that shows that this is the right course of action. And, but, I mean, that should be the, for whether you're talking about nutrition, whether you're talking, show me the data. Where did you get this

• 1:40:44Michael Greger?

  from? Did you get it from your tinfoil hat friend? Someone told you at the gym? Or, you know, some checkout on magazine telling you this? Or did it actually have some basis? I mean, if there's any decision to be made based on science, based on the best available balance of evidence, it's something that affects the health and well-being of yourself and your family. I mean, that, I mean, that should have a different bar of evidence than an Amazon review for a new toaster. Like, I mean, that's like, in that case, opinions of total strangers could be useful for you. Oh, you liked it because, oh, okay, thank you. Right? But we've gotten to this culture of just like, oh, random strangers have ideas that are useful to me. And then, and somehow translate that into-

• 1:41:23Rich Roll?

  Well, yeah, we've, we've arrived at this moment where, for whatever reason, we've developed this profound distrust of, of experts. And that's highly problematic in terms of seeing our way forward as a society. Not just experts in science, but experts across the board in, you know, a wide variety of disciplines.

• 1:41:43Michael Greger?

  In their defend, in the, in the defense of that is, experts have done a terrible job. I mean, so the, so the corporate world-

• 1:41:50Rich Roll?

  Well, this is a shit show. So we're giving people plenty of reason to distrust the experts.

• 1:41:55Michael Greger?

  Right. And historically, I mean, it was, it was the tobacco industry that weaponized, first weaponized science. And it is the tobacco industry textbook that has been used by every corporate entity from then on.

• 1:42:07Rich Roll?

  Our product is down.

• 1:42:08Michael Greger?

  Whether you're talking about the sugar industry, whether you're talking, it's all about, they realize that policy is being made, but based on the science. And so you, you control the science, you control the mess. And so there was Tobacco Research Institute. They funded millions of dollars, paid off the AMA. And so when the AMA says smoking moderation is good for you on balance, not just neutral, but actually smoking is good for you. Most doctors smoked. So, and now we say, trust the experts, right?

• 1:42:34Rich Roll?

  Right.

• 1:42:34Michael Greger?

  I mean, you understand why, why, wait a second, the experts were saying that Coca-Cola- was good for me. And that's because of the corporate takeover over science, evidence-based medicine, et cetera, et cetera. And so there is good reason to be skeptical when these decisions are made where there is industry stakes by the billions. So something like, should we get mammograms? Okay, that should seem like a simple question of the science. When, when there's a billion-dollar industry, then you need to, you need to not just take the expert's word for it, but really dig into the science, right? If it's a question where there really is no, you know,

• 1:43:18Michael Greger?

  climate change, when there's a billion-dollar industry on one side of the issue, you always have to question until you see what the best available balance of evidence is. And so the industry, so you can see how that, that skepticism of Big Pharma completely based in, I mean, we've been screwed over by Big Pharma, over and over. So in fact, the Tamiflu fiasco. Who stands to benefit? In 2006, in my book on pandemic preparedness and Pepper's way back then, I talked about the wonders of this drug Tamiflu. And now you should, you know, talk to your doctor about getting you a prescription of, of this drug because there were 11 randomized controlled trials

• 1:44:03Michael Greger?

  that showed that it significantly decreased mortality and morbidity, it saved lives from the flu. And I, and so the science in the peer-reviewed literature was absolutely dead-on clear. Roche, one of the biggest drug companies in the, in the world, had, they of course funded them, all 11 studies, but that's what drug companies do. Kind of the only industry we put in charge with their own self-regulation. But, I mean, but this wasn't some fly-by-night company. This is, you know, company's been around, okay. And so then, and so here I am, writing the update, right? For, for, for how to survive a pandemic. So I'm looking at Tamiflu chapters. Oh, what's, what's been happening in deravul lately, right?

• 1:44:43Michael Greger?

  In 2009 with swine flu, a group of scientists, collaboration, kind of the gold standard, evidence-based medicine, well, let's review what's happening in Tamiflu because with swine flu, governments were making billions of dollars of purchases of this drug for their national stockpiles. And some pediatrician in Japan said, oh, there's these 11 trials, can we see the data, please? Went to Roche and said, let's see the data of 11 trials. If you say there's 11 trials, they all show that reducing. And Roche refused to give them the data. It's like, whoa, wait a second. Now, at the time, way back when, it was still early and we just believed them. Okay, but now, when they were making big purchases, okay.

• 1:45:25Michael Greger?

  And they knew, every moment, they could delay releasing the data, they could get billions more in sales. Every year, they released billions more in sales. And it took them years. And so it was only until 2014, until they finally were forced from national pressure, international pressures, scientific community to release the data, and guess what? It showed the opposite, zero benefit in terms of mortality. But they had made this calculus, they were going to bring in so many billions of dollars that they were going to just flat out lie to the governments of the world and say they had this pandemic, this drug that was going to save people from pandemic flu, and just raked in. And they knew it was based on a total lie, but, and it was this one little pediatrician

• 1:46:10Michael Greger?

  who was like, can we just see the data? Just like, and that's what started all, we finally know it was a sham. And it works like this remdesivir, it shortens the period, but it doesn't actually result in moral in lives saved. And so now it's referred to as the Tamiflu flu fiasco. That was modern-day Big Pharma pandemic drug, screwing the populace, screwing taxpayers, screwing governments the world over. And so you say, I don't believe Big Pharma, I'm skeptical about vaccines. That's a legitimate, that's a legitimate place to be coming from. We want the skepticism, but the skepticism shouldn't be, I'm not going to let Bill Gates, you know, whatever Bill Gates is doing. But it should be-

• 1:46:52Rich Roll?

  It just makes it hard. You don't know who to trust.

• 1:46:55Michael Greger?

  I want to see the data.

• 1:46:56Rich Roll?

  Right, but you're my, you, Dr. Gregor, are mired in the data. The average person is scrolling through their Twitter feed, just trying to make sense of the world. You mentioned- Osterholm.

• 1:47:09Michael Greger?

  Yeah.

• 1:47:09Rich Roll?

  Like, who are the people that we can, you know, safely pay attention to and feel confident that we're getting the right message? Who are those people in science? And who are those people in the media who are delivering this information? Like, who is the measured person where we can turn on the television and not have to be, you know, cocking our, our head every time they say something? And just have some level of confidence that we're getting the truth?

• 1:47:40Michael Greger?

  Yeah, so there's actually been a number of journalists that have been really stellar when it comes to this. And so Stat News is probably the source. So that's the source I go to.

• 1:47:49Rich Roll?

  So. Statin News?

• 1:47:51Michael Greger?

  Stat News. S T A T News is kind of a medical news source that has prided itself on having really evidence-based, balanced analysis. So they've probably been the, done the best work, not saying everything they've, they've put out is, is right on the message, but they've really done some of the best reporting to date.

• 1:48:14Michael Greger?

  And, and in terms of Scientific Kennedy's, Sid Rap, Center for Infectious Disease Research and Policy at the University of Minnesota, Johns Hopkins School of Public Health has a website, puts out some excellent information. And so in this way, you don't have to, even me, look, even I, so right now, there are 800 articles in the peer-reviewed scientific literature coming out every day, 800 every day. And that's not talking about pre-prints, all the stuff in the pipeline, just being published every day. So even I can't stay on top of that. And so even I have to rely on, on this kind of collective group effort of let's all go through these 800 pages every day, papers every day, and really pick out what's going

• 1:48:58Michael Greger?

  to be a kind of changing in terms of practicality. What is this new information that's reliable? And that's where these, these, these important, you know, expert sources. And, and the CDC, despite some.

• 1:49:13Michael Greger?

  Flubs early on with testing and despite the, the kind of wishy washy mask recommendation has, has put out some consistent, good work as well.

• 1:49:24Rich Roll?

  Is there anybody just in mainstream media? Like, I feel like Sanjay Gupta has been pretty measured in how he's communicating around this. I mean, I, you know, who do you think is?

• 1:49:34Michael Greger?

  Yeah. So I've, I've not been following the mainstream, who's in the mainstream.

• 1:49:39Rich Roll?

  You're deep in the journals.

• 1:49:40Michael Greger?

  Right, in the journals and, and in this, in the scientists. And so, right, unfortunately, now there are people with PhDs and MDs at the end of their name and they think all of a sudden that they're infectious disease experts or, or, you know, aerosol experts or, you know, occupational safety. I mean, there are people who spend their whole lives figuring out transmission of disease and just because you have an MD doesn't mean you're an expert in this at all. And they just keep spouting nonsense about all sorts of things and put out mathematical models that, you know, they're computer scientists and they suggest that their modeling says do this as opposed to this, where they really don't have expertise in that particular area. So even, you know, just trust the experts. I mean, that's not just by credentials.

• 1:50:20Rich Roll?

  What does that even mean?

• 1:50:21Michael Greger?

  It's like, right. I mean, but it's people, but there are career, you know, scientists that this is what they've done their entire lives, like Osterholm, and they've been through it all, right? And they've, and, and, you know, there are a few that have this, this past record of not taking the easy road of not just going along with everyone. So for example, Osterholm is famous for coming out and questioning the efficacy of flu vaccines. And so until like 2011, they did this, this very influential landmark paper in the Lancet saying that, you know, flu, we tout the flu vaccine, but it's actually based on kind of crappy testing such that if you actually use better testing, it really only works, you know, 30, 50% of the time in terms of decreasing risk, 30, 50%. Now, still in favor

• 1:51:05Michael Greger?

  of flu vaccines, he gets it every year, but, you know, we, we need better flu vaccines. We need to communicate to the public what the truth is and we need to do better. And we just keep convincing ourselves we're actually doing better than we are. We're, you know. That was incredibly controversial at the time and now it's just, it's just understood and it's kind of part of the thing. But I mean, we can look back in history of those who are mavericks and really stuck to the science against the political winds. And, and, and, and you can always go to, to know they're not going to give you the comfortable message. They're not going to give you the message. They're not going to give you a message that they have more certainty that, that they, that there really is and they're going to say they don't know.

• 1:51:46Rich Roll?

  That's always a good signal.

• 1:51:47Michael Greger?

  That's a good, I don't know. I'm not an expert in this, but let me, you know, show, you know, point you in the, in the direction of an expert in this. Yeah. I mean, and this is the time, right? If there's any other issue, if it's any less important, but this is the time. We really need the best information. Um, and, and it's, it's really even, right? Even for me, for us presumably, but even, I mean, we know the craziness on the internet, but it has reached a level.

• 1:52:12Rich Roll?

  It's, it's

• 1:52:13Michael Greger?

  And it's, and it's, and it's a life and death issue.

• 1:52:15Rich Roll?

  Whole new thing.

• 1:52:16Michael Greger?

  It is a whole new thing. Like, oh, I, you know, I was, I was with you, Dr. Gregor, but now you are one of the lizard people who's gonna, you know.

• 1:52:25Rich Roll?

  Well, it's a function of this intersecting with a lot of other issues that's tapping into, uh, you know, a repressed rage that's just underneath the surface. Like, we've all seen the videos of people, you know, losing it in Target or, you know, Trader Joe's on the whole mask thing and how the mask thing has been politicized and, and, uh, it's concerning, you know, because this shouldn't be a political issue. We should all be on the same page in terms of how we're navigating this.

• 1:52:54Michael Greger?

  This is the time

• 1:52:55Rich Roll?

  In the common interest of our society.

• 1:52:56Michael Greger?

  To be kind, right? I mean, this is the time to just be extra kind and extra and to realize, I mean, this should wake us up to the plight of our essential workers who have basically been at the

• 1:53:08Rich Roll?

  Hundred percent.

• 1:53:09Michael Greger?

  You know, the bottom of our society and ignored and even now ignored. Are they getting hazard pay for being the ones that are

• 1:53:15Rich Roll?

  Well, this is the bigger conversation about how we're structured. When we realize that our essential workers are, you know, these people who are getting paid less than everybody else to perform these things that are required to keep our, the gears of our society moving. We need to reform how we're treating these people.

• 1:53:33Michael Greger?

  So this could be the, I mean, so we can use this as an opportunity. This is the opportunity, although, yeah, but, but it's, yeah, it's bringing the best and worst. And I'm afraid at this point, the worst is overtaking. There were some beautiful bests at the beginning. The clapping for the healthcare workers and all, I mean, all this like.

• 1:53:52Rich Roll?

  Singing.

• 1:53:53Michael Greger?

  Oh, but they, yeah, but now they, and, and, and, yeah.

• 1:53:57Rich Roll?

  There's a half-life on that stuff. But I remain optimistic and we're going to land this plane. I think, I think, you know, listen, get your sleep, eat your veggies, make sure you're getting enough vitamin D, B12, whatever it is. Like what else? Like, what are the simple things? Like, wear your mask in public.

• 1:54:16Michael Greger?

  Wear your mask in public. Sign of respect, right? Because I am keeping you safe. That's what the mask says. I care about you. And if there's one thing we need right now in society is more messages. I care about my fellow human being.

• 1:54:31Rich Roll?

  Hmm. That's a good place to end it, I think. I love you, my friend. Thank you so much. Come back anytime. I think we should do a check-in every six months or so.

• 1:54:41Michael Greger?

  I don't have to come out with a new book just to, alright.

• 1:54:44Rich Roll?

  Well, the, at the rate that you're cranking these books out, you're gonna, you're gonna be back here next month.

• 1:54:49Michael Greger?

  Yeah, that's right.

• 1:54:50Rich Roll?

  The book is called How to Survive a Pandemic. It's out now in audiobook and in ebook, right? Hardcover's coming out when? In the fall?

• 1:54:57Michael Greger?

  August 16th. August 16th. Ah, yeah.

• 1:55:00Rich Roll?

  Soon. Amazing, man. So, pick it up, Amazon. Oh, it's on your, is it, you get it either Amazon or on your website?

• 1:55:07Michael Greger?

  Oh, Amazon, any online retailer.

• 1:55:09Rich Roll?

  Cool. Thank you. Alright.

• 1:55:11Michael Greger?

  Peace, plans.

• 1:55:17Rich Roll?

  How'd you guys like that blast? Are you feeling okay? How is the noodle doing? That was a lot. Things are heavy right now. Please make sure you're taking good care of yourself and those you love. I hope Dr. Gregor's wisdom was helpful and will help guide you more effectively through all of this. And meanwhile, Try to be nice out there. Kindness is key. Let Dr. Greger know how this one landed for you. You can find him on Instagram, @MichaelGregerMD and @nutrition__facts on Twitter. Check out his new book, How to Survive a Pandemic, on Audible and Kindle. And of course, links to everything we discussed today can be found in the show notes on the episode page at richroll.com.

• 1:56:01Rich Roll?

  If you'd like to support the work we do here on the show, subscribe, rate, and comment on it on Apple Podcasts, on YouTube, and Spotify. Share the show, or your favorite episode, or this episode with friends, or on social media. And you can support us on Patreon at richroll.com/donate. I appreciate my team who works very hard to put the show on every week. Jason Camiolo for audio engineering, production, show notes, and interstitial music. Blake Curtis for videoing today's podcast. Jessica Miranda for graphics. DK for advertiser relationships. And theme music by Tyler Pyatt, Trapper Pyatt, and Hari Mathis. Thanks a lot. Love you guys. See you back here next week with another mind-blowing episode. I'm not gonna let the secret out, but it's a

• 1:56:42Rich Roll?

  good one. Until then, be kind, be nice. Peace. Plants. Namaste. Wear a mask.