Speaker 1: Welcome to off the cup with me, se Cup. How
Speaker 1: is it going. I'm in the Northeast, and I'll tell
Speaker 1: you it feels like the weather is just against us.
Speaker 1: We get like a minute of sunshine and spring, and
Speaker 1: then it's rainy and freezing again. Can we just fully
Speaker 1: move into warm already? It's May, School's almost doubt. I'm
Speaker 1: in sweaters and rain boots. I haven't been truly warm
Speaker 1: since last fall. I'm just over it. Let's lock in,
Speaker 1: lock into warm weather. It's not great for my mood.
Speaker 1: How have you been feeling. I know we're doing more
Speaker 1: politics here, but I'm also I'm checking in on your
Speaker 1: mental health. There's a lot of shit happening in the
Speaker 1: world and in the news, and I get it if
Speaker 1: you're feeling overwhelmed. I think between the news and the weather,
Speaker 1: it's pretty bleak out there. But I do hope to
Speaker 1: have some good news for you today on a few fronts.
Speaker 1: On politics, I'm going to give you what I think
Speaker 1: is some good news, and on health, I think I
Speaker 1: may have some good news. On the other hand, we
Speaker 1: learned this week the President Trump is not thinking about
Speaker 1: you at all, not not even a little bit. Trump
Speaker 1: was asked about the Iran war, which is entering it's
Speaker 1: eleventh week, and whether the economic pain it's caused Americans
Speaker 1: is part of his thinking as he enters negotiations. Take
Speaker 1: a listen. It's a little hard to hear he's standing
Speaker 1: in front of a helicopter when you're invocating with Iran
Speaker 1: that your president.
Speaker 2: What extent are American financial textmation motivating you? The NATU up,
Speaker 2: not even a little bit.
Speaker 1: The only thing that matters is we're I'm talking about Iran.
Speaker 1: They can't have a nuclear weapon. I don't think about
Speaker 1: American financial situation. I don't think about anybody. I think
Speaker 1: about one thing. You could not let Iran have a
Speaker 1: no clear weapon. That's all I mean. There it is.
Speaker 1: It's in black and white. It's crystal clear. Your economic
Speaker 1: pain is not part of his calculus at all. Now,
Speaker 1: that's either a very bold thing to say in an
Speaker 1: election year or a pretty stupid thing to say an
Speaker 1: election year. I'll let you decide. But one thing it
Speaker 1: isn't is surprising. Trump wasn't thinking about you or me
Speaker 1: when he decided to go to war with Iran. He
Speaker 1: was thinking about himself. What can distract everyone from the
Speaker 1: Epstein files and this terrible economy I've created thanks to
Speaker 1: my dumb tariffs. I know I'll start a war. I
Speaker 1: promised I wouldn't, and that's how I got elected. But
Speaker 1: who cares. It's what's best for me. I think the
Speaker 1: greatest trick that Trump's managed to pull off is the
Speaker 1: one where he convinced millions of Americans that he cares
Speaker 1: about them. He's never cared about them. He didn't care
Speaker 1: about regular people when he was building casinos and underpaying
Speaker 1: his employees. He didn't care about regular people when he
Speaker 1: was charging exorbitant amounts of money for Trump University courses
Speaker 1: that were fraudulent. He didn't care about his own voters
Speaker 1: when he told them the twenty twenty election was rigged
Speaker 1: and stolen, inciting thousands of them to go commit crimes
Speaker 1: at the Capitol. He didn't care about them when he
Speaker 1: took millions of their hard earned dollars to help quote
Speaker 1: stop the steal, and instead use their money to pay
Speaker 1: his lawyers in Millennia's stylists. He didn't care about America
Speaker 1: when he incited an insurrection against it. He doesn't care
Speaker 1: about anyone but himself. We've known that for decades. This
Speaker 1: isn't new information, and yet people seem surprised and indignant
Speaker 1: that he's not like more worried about your gas prices.
Speaker 1: He doesn't give a shit about your gas prices. But
Speaker 1: if you go and listen to like Joe Rogan or
Speaker 1: some of these MAGA influencers that were once you know,
Speaker 1: wholly unquestioning of Trump, they're like shocked, what is he doing?
Speaker 1: Why doesn't he care? He's never cared? What are you
Speaker 1: talking about? What do you mean?
Speaker 2: Like?
Speaker 1: Trump was never here to make America great again? So
Speaker 1: if this war screws us, he doesn't care. If tariffs
Speaker 1: screw us, he doesn't care. He's off spending billions in
Speaker 1: taxpayer dollars on ballrooms and reflecting pools and vanity projects
Speaker 1: to put his name on stuff. Of course, he's not
Speaker 1: thinking about your finances or my finances, of course not
Speaker 1: No what else He's not thinking about midterms? That's obvious
Speaker 1: because no president or party leader who cared about the
Speaker 1: outcome of an election would be saying and doing the
Speaker 1: things that he's saying and doing. And Republicans know he
Speaker 1: doesn't care about the midterms, which is why they have
Speaker 1: to rig them with these redistricting orgies. Think about it
Speaker 1: this way. If Republicans, and I'm talking about elected lawmakers,
Speaker 1: if the GOP believed that Trump cared about the midterms,
Speaker 1: wouldn't they be super confident that they could win them.
Speaker 1: If Republicans believed Americans liked their ideas, liked Trump's agenda,
Speaker 1: wanted to give them all two more years, they wouldn't
Speaker 1: need to redraw the maps to suppress Democratic votes. They
Speaker 1: know they can't win on their ideas. They know that
Speaker 1: Trump is tanking them back home and he's not gonna stop,
Speaker 1: so they have to cheat. And here's where we get
Speaker 1: to our first bit of good news, because I've been
Speaker 1: talking to a lot of Democrats who are really down
Speaker 1: in the dumps about these redistricting wars, and I understand it.
Speaker 1: They were feeling really good about the midterms and then
Speaker 1: Republicans won a bunch of redistricting battles and Dems lost
Speaker 1: a few in Virginia at the Supreme Court, in those
Speaker 1: Indiana state primaries. So the mood among Dems is down.
Speaker 1: It's bad. They were thinking, God, we're going to win
Speaker 1: the House back, maybe even the Senate, and now they're
Speaker 1: worried Republicans could keep both scary and unimaginable but a possibility.
Speaker 1: But I have what I think is a silver lining,
Speaker 1: and I don't hear a lot of people talking about it.
Speaker 1: So let's talk about it, and let me just get
Speaker 1: this out of the way, and let me say it
Speaker 1: from the beginning in case I have to, but I
Speaker 1: shouldn't have to. I hate these redistricting pissing contests. They're undemocratic,
Speaker 1: they hurt every voter. I don't like Republicans doing them.
Speaker 1: I don't like Democrats joining them to do them. We
Speaker 1: are supposed to choose our candidates. We the voters, get
Speaker 1: to choose our candidates. This is candidates choosing their voters.
Speaker 1: It's not how it's supposed to work. And I hope
Speaker 1: someone runs in twenty six or twenty eight unending jerry
Speaker 1: mandering period. But all that said, there is a world
Speaker 1: in which the rights over zealous consolidation of power here
Speaker 1: through redistricting actually helps Democrats. There is a world in
Speaker 1: which Democrats, I believe, actually needed this fight. Hear me out.
Speaker 1: Let me take you back to two thousand and eight.
Speaker 1: Barack Obama won the presidency in two thousand and eight
Speaker 1: with ninety five percent of the black vote that year.
Speaker 1: It was a new zenith, It was a new high.
Speaker 1: But that number has dropped precipitously over the next few
Speaker 1: cycles that followed. In twenty twenty four, Kamala Harris won
Speaker 1: just eighty three percent of the Black vote. That was
Speaker 1: down from Joe Biden's eighty seven percent in twenty twenty,
Speaker 1: so a swing of more than ten percentage points from
Speaker 1: two thousand and eight to twenty twenty four. Okay, more
Speaker 1: than ten percent of the Black vote either stayed home
Speaker 1: or left the Democratic Party for the Republican Party. We
Speaker 1: know that Trump's picked up some of those black voters,
Speaker 1: but we also know many just stayed home. They were
Speaker 1: disillusioned with the Democratic Party. They were telling us. They
Speaker 1: were saying that a party had taken and then for
Speaker 1: granted and was no longer like showing up for them.
Speaker 1: That's how they felt. You remember all the talk in
Speaker 1: twenty twenty four around the Democratic coalition kind of dismantling
Speaker 1: a bit. Now, I assume that's worrying for Democrats, but
Speaker 1: I don't know for sure, because they decided not to
Speaker 1: release their autopsy for some insane reason. I also assume
Speaker 1: they have a plan to recapture those disaffected black voters
Speaker 1: that they lost in twenty twenty four, but again, who
Speaker 1: knows what that plan might be since they won't share
Speaker 1: the autopsy. Again, the dumbest idea I've ever heard, but
Speaker 1: I think the redistricting worst can help. Republicans have been
Speaker 1: targeting these very voters, carving up predominantly black majority districts
Speaker 1: all over the country, especially in the South. This attempt,
Speaker 1: I think to further disenfranchise black voters by Republicans could
Speaker 1: end up motivating them to turn out for the twenty
Speaker 1: twenty six midterms in ways they might not have planned to.
Speaker 1: After all, remember, polling was showing Democrats were poised to
Speaker 1: crush Republicans in the midterms before the redistricting, Democrats were
Speaker 1: going to kill it. So, if you're a disaffected Democrat
Speaker 1: who maybe stayed home for the presidential who's one of
Speaker 1: the folks giving very low approval numbers to Democrats right now,
Speaker 1: are you really running out to vote in the midterms
Speaker 1: if you think that the party is a lock on
Speaker 1: taking the House, maybe you don't feel like you have to.
Speaker 1: But now that Democrats are back against the wall and
Speaker 1: the very voters it lost in twenty twenty four are
Speaker 1: the same voters being targeted by Republicans. Well, this feels
Speaker 1: like a very important turnout driver to me. One Democratic
Speaker 1: strategist put it this way to Politico. He said, Democrats
Speaker 1: are going to be able to go into African American
Speaker 1: communities and say Republicans are doing everything they can to
Speaker 1: take away your political power. And that's a really salient message.
Speaker 1: He says, Yeah, it is. And Democrats I keep saying
Speaker 1: this midterm election is not going to be I don't
Speaker 1: think either party is trying for or should try to
Speaker 1: capture independence. I think both parties need to turn out
Speaker 1: their bases for this midterm election. They need to double
Speaker 1: triple down on their base voters, get every single one
Speaker 1: of them out to end up winning. And Democrats especially
Speaker 1: need Black voters to turn out because that's part of
Speaker 1: the base that they need to count on. And turnout
Speaker 1: among Black voters in the last midterms dropped by ten
Speaker 1: percentage points from fifty one point seven percent turnout twenty
Speaker 1: eighteen to forty two percent turnout in twenty twenty two,
Speaker 1: and in that same period, white turnout drop just one
Speaker 1: point five points. So it's not symmetrical. The gap. In
Speaker 1: twenty twenty two, the racial gap between black voters and
Speaker 1: white voters in terms of turnout. That gap was the
Speaker 1: largest in any election, presidential or midterms since two thousand.
Speaker 1: So Democrats have a problem with their black voter base.
Speaker 1: They need it to show up. It has been precipitously
Speaker 1: showing up less. Okay, And the last two examples, the
Speaker 1: presidential in twenty four and the midterms in twenty twenty two,
Speaker 1: were really really bad for the Black vote and the
Speaker 1: Democratic Party really bad. And I hate to tell you
Speaker 1: there's more sort of bad news in this. Democrats simply
Speaker 1: don't have a transformational figure like an Obama or a
Speaker 1: Bill Clinton waiting in the wings to rebuild the black coalition.
Speaker 1: They just don't Who is that candidate? You can't name it.
Speaker 1: I can't name it. So if they don't have the messenger,
Speaker 1: and they don't have the message, as far as I
Speaker 1: can tell, I'm not sure what their message is to
Speaker 1: win back black voters. I haven't heard it. They got
Speaker 1: to go with what they do have, and what they
Speaker 1: have right now is a crisis. Redistricting is an existential crisis,
Speaker 1: and it's aimed at suppressing the black vote. Democrats should
Speaker 1: harness this moment turn it against Republicans so that Democrats
Speaker 1: and black voters in particular turn out in record numbers
Speaker 1: in November to make all the millions that Republicans have
Speaker 1: spent on rigging these elections moot completely moot, because you
Speaker 1: can't override the will of the people. But that will
Speaker 1: has to be there. Democrats have to make the case
Speaker 1: that Americans are fighting for representation, fairness, democracy, and they're
Speaker 1: voting against the party that wants to take all of
Speaker 1: that away, and a party, by the way, that doesn't
Speaker 1: care about your economic pain, not even a little. I
Speaker 1: think that could actually boost Democrats in a way they
Speaker 1: didn't have. They didn't have that way. They didn't have
Speaker 1: a way to win back the voters they lost. They
Speaker 1: were just hoping that Trump would be bad enough. That
Speaker 1: didn't work. In twenty twenty four, he wasn't bad enough
Speaker 1: that every Democratic Coalition voter turned out and voted for
Speaker 1: Kamala Harris. That didn't work. So let's try something different.
Speaker 1: Let's try motivating voters to go out and vote for something,
Speaker 1: not just against something. What do you think does that
Speaker 1: sound like a plausible thing? That could happen. Does that
Speaker 1: sound like the juice the Dems need right now? I
Speaker 1: do want to know what you're thinking about all of this.
Speaker 1: Write us it off the cup, Cup with two piece
Speaker 1: at gmail dot com. Tell me if you like this
Speaker 1: idea or not? And what you think Democrats should do
Speaker 1: about redistricting because they've tried tried doing it themselves, not
Speaker 1: completely successfully. What do they do? What do you think?
Speaker 1: What do you think should happen? All right, when we
Speaker 1: come back, I'm going to try to bring you some
Speaker 1: more silver linings, this time on the health front. Stay tuned,
Speaker 1: Welcome back to Off the Cup. I know that in
Speaker 1: addition to politics, there's some other scary news out there
Speaker 1: that you're probably worried about. I am too. It's the
Speaker 1: hand of virus. Honestly, for me, this is just another
Speaker 1: reason to never go on a cruise. I'm sorry. Between
Speaker 1: Hanta and poop cruise, do we really need to be
Speaker 1: doing these? I get it, it's self contained, it's all inclusive,
Speaker 1: it's one stop shop for family fund. But it's also
Speaker 1: a living nightmare when anything goes wrong, so count me out.
Speaker 1: But anyway, more than half a dozen US states are
Speaker 1: monitoring individuals who have either been exposed to or are
Speaker 1: exhibiting symptoms of hand virus as a result of exposure
Speaker 1: on that MVY Hondias ship. The majority of American passengers
Speaker 1: are now quarantining in Nebraska. Two were sent to Atlanta
Speaker 1: for further assessment. Hantavirus is usually transmitted to people through
Speaker 1: contact with rodents, urine, feces, or saliva. So what does
Speaker 1: it mean for you? Well, I'm excited to welcome my friend,
Speaker 1: doctor Jeremy Faust. He is editor in chief of MedPage Today.
Speaker 1: He's an emergency physician at Brigham and Women's Hospital. He's
Speaker 1: also an assistant professor at Harvard Medical School in the
Speaker 1: Division of Health Policy and Public Health. Welcome to Off
Speaker 1: the Cop doctor Faust.
Speaker 2: Good to see you.
Speaker 1: Okay, So I want to ask you about this and
Speaker 1: some other things, because it's not every day we've got
Speaker 1: one of the greatest doctors in the country on Off
Speaker 1: the Cop. No, you are, It's cool. So let's talk
Speaker 1: about hannavirus. People are very worried. Should they be or
Speaker 1: are they overreacting?
Speaker 2: I think we should be concerned about the people who
Speaker 2: are on that ship. We should be concerned about people
Speaker 2: who've come into contact with people who are on that ship,
Speaker 2: and we should be thinking about what qualifies as a
Speaker 2: contact because I think this is a moment when the
Speaker 2: dogma begins to get questioned. Right, we went through this
Speaker 2: with COVID say oh, it's not airborne. Oops, it's going
Speaker 2: through the air And so I don't think that that's unexpected.
Speaker 2: I think that that's just what happens when we get
Speaker 2: enough cases, that outlier events can happen, and that we
Speaker 2: learn more. So my major concern is for anyone in
Speaker 2: a high risk exposure, And then the next level is
Speaker 2: do we need to modify what we consider to be
Speaker 2: a high risk exposure and who are those people?
Speaker 1: So if you weren't on the cruise, if you weren't
Speaker 1: in contact with one of the people on the cruise,
Speaker 1: but you live in a state or a city where
Speaker 1: those passengers are quarantining or being assessed, should you worry
Speaker 1: at all?
Speaker 2: Or no? I'm not changing my behavior in those situations.
Speaker 2: I'm not advising people who live in California, my relatives
Speaker 2: that they need to change their behavior. But I think
Speaker 2: that this is one of those things where we want
Speaker 2: to be we want to be helpful So when people
Speaker 2: say should I be worried? If I say no and
Speaker 2: ten people die, they're going to say you told me
Speaker 2: not to worry.
Speaker 1: What's wrong with you?
Speaker 2: And if I say, hey, you should worry and then
Speaker 2: only ten people die, they say, oh, you were just overreacting.
Speaker 2: So I think what's on people's minds is the question
Speaker 2: you asked Essie, which is like, what should we do
Speaker 2: with our behaviors? And to me, like the average person
Speaker 2: doesn't need to change anything. What needs to change I
Speaker 2: think is a little bit more of a serious assessment
Speaker 2: of who the contacts are and what they ought to do.
Speaker 1: Okay, good, I've been reading right. It's hard to spread
Speaker 1: to humans actually, And there was an outbreak of the
Speaker 1: Andy's strain in Argentina in twenty eighteen. If this originates
Speaker 1: in Argentina and they know that, why hasn't it been
Speaker 1: more destructive in Argentina? Like, explain that science to me.
Speaker 2: These viruses that have a natural reservoir in animals like rodents,
Speaker 2: they jump when they have an opportunity. It happens sporadically,
Speaker 2: and then the question is is that a dead end
Speaker 2: or not? And that can be for different reasons. That
Speaker 2: could be the person who happened to be infected just
Speaker 2: didn't shed a lot of virus. It could be that
Speaker 2: the person who got infected really didn't feel well so
Speaker 2: they didn't infect anyone else. They just like didn't go
Speaker 2: out the house, yep. Or it can just be a
Speaker 2: random thing like they infected one or two people, but
Speaker 2: then those people also infected zero one and it died out.
Speaker 2: But if once in a while it infects somebody who
Speaker 2: right when they're shedding a lot of virus, happens to
Speaker 2: be in a crowded place, and that's why an outrek
Speaker 2: can occur. But like it doesn't happen all.
Speaker 1: The time, necessarily have to write okay, And then for
Speaker 1: people wondering, like with all the flashbacks and PTSD from COVID,
Speaker 1: how is this like COVID, how is it not like COVID.
Speaker 2: Well, I think the biggest difference that we know right
Speaker 2: now is that the amount of time it takes for
Speaker 2: each case, because that's such a big difference. When you
Speaker 2: have a virus that is spreading from you to me
Speaker 2: like five days apart, then if it's doubling every five days,
Speaker 2: it's two, four, eight, sixteen thirty two one twenties. You know,
Speaker 2: sixty four one twenty eight thousands millions. Okay, if it's
Speaker 2: every twenty days, sure that can happen, but you have
Speaker 2: much more time to track everything down and have awareness
Speaker 2: and so to me, and this was the big problem
Speaker 2: with the New York Times up ed by Xana Tafechi
Speaker 2: about this, where she said, you know, these these two
Speaker 2: pathogens might have similar reproduction numbers, that is, the number
Speaker 2: of people that they infect. First of all, that's not correct.
Speaker 2: I think that COVID has a much higher reproduction number.
Speaker 2: But even if they were, the difference is really baked
Speaker 2: into that interval of like how long it takes for
Speaker 2: each generation to occur, because that gives us an actual
Speaker 2: chance to stop this.
Speaker 1: Thing, right, And if it's a faster period, you just
Speaker 1: can't catch it.
Speaker 2: Yeah, And there are examples of when slow doesn't necessarily
Speaker 2: mean good. Like generally it's the case when something moves slowly,
Speaker 2: we think, oh, that's a good thing. I don't want
Speaker 2: to like, I don't want to dance in the end zone.
Speaker 2: Because there are times when things that move slowly ultimately
Speaker 2: cause a long problem like HIV. Right, you can have
Speaker 2: a very slowly developing problem, and the dynamics matter, which
Speaker 2: is like how much spread is happening when people are
Speaker 2: feeling well enough to go spread it? Yeah, So in general,
Speaker 2: it's not exactly just.
Speaker 1: The slow so they know they have it correct.
Speaker 2: So it's not just the slowness. It's not just the
Speaker 2: symptomatic nature of it. It's all these combinations of biological
Speaker 2: and behavioral things that make it so that in the
Speaker 2: past outbreaks like this, you know, this just haven't happened.
Speaker 1: Yeah, okay, okay, that's good. I think a question that
Speaker 1: a lot of people have as well, and this is
Speaker 1: an unfortunate one, But it's about the political environment in
Speaker 1: which this is happening. So is this administration which left
Speaker 1: who in January? Is this HHS Secretary RFK Junior? Is
Speaker 1: this CDC? Are they going to be able to manage
Speaker 1: this well? Is this? Are we in good hands? Tell
Speaker 1: people what you think about that.
Speaker 2: They are getting lucky right now. And if this were
Speaker 2: a different pathogen, we would be hosed. And what I
Speaker 2: will just say is, I'll just give you a quick
Speaker 2: indicator of this. There are a bunch of Americans who
Speaker 2: are now back. They are people who had what we
Speaker 2: consider to be higher risk exposures. This government is afraid
Speaker 2: to tell them to quarantine. They will not say the qword.
Speaker 2: They're saying, if you're a higher risk, we would like
Speaker 2: you to do this, stay home.
Speaker 1: And that's for politics.
Speaker 2: I think it's because they are preternaturally determined to never
Speaker 2: have another COVID happen, because what they think of COVID
Speaker 2: is not that millions of people died. They think of
Speaker 2: COVID as we had to stay home. That's the injury
Speaker 2: to them and the kids. You know, the kids miss school,
Speaker 2: which is true that happened, and we could have opened
Speaker 2: school a lot earlier. But they're so their value system
Speaker 2: is not about saving lives per se. It's about avoiding
Speaker 2: a shutdown. And so if they just I'm looking at
Speaker 2: the document that they put out and it's like, and
Speaker 2: I'm going to write this in my newsletter on inside Medicine. Okay,
Speaker 2: they they're like, it starts with Q and rhymes with quarantine.
Speaker 2: But we don't want to say quarantine because that would
Speaker 2: be that would be a lockdown. And the leader of
Speaker 2: the CDC rode to power by claiming that he had
Speaker 2: to get papers to walk around Stanford, when in fact
Speaker 2: he didn't write. And so Jay Abadachari is so anti
Speaker 2: lockdown that he's unwilling to say to people who are
Speaker 2: high risk, you need to stay home. And I'll just
Speaker 2: give you another example. Wow, right now, if you came
Speaker 2: from the m behind us and you are in the
Speaker 2: in the bio containment or the quarantine center, you can
Speaker 2: choose to go home in the next seventy two hours,
Speaker 2: right And that's fine. We think people will do the
Speaker 2: right thing. If someone wants to leave their house who's
Speaker 2: in that group and go to church, it's that's legal.
Speaker 2: There's no legal problem with that, and so this government
Speaker 2: doesn't want to do anything about that. That's the first problem.
Speaker 2: The second problem is this, if there were to be
Speaker 2: an outbreak of any kind that was scary, whether it's
Speaker 2: this one or another one. One of the great lessons
Speaker 2: of COVID nineteen is that we at any given time
Speaker 2: may be one hundred to two hundred days away from
Speaker 2: a life saving vaccine, and mRNA technology is probably the
Speaker 2: fastest one. We have an HHS secretary who thinks that
Speaker 2: mRNA vaccines are dangerous, and we have a CDC leader
Speaker 2: who actually basically doesn't agree with that, but guess what. See,
Speaker 2: Jay is not the acting director of the CDC. That's
Speaker 2: another thing that people don't remember. He says he is,
Speaker 2: but on paper he's not, and he's which means that
Speaker 2: vaccine decisions do not go to anyone else in the CDC.
Speaker 2: They reflexively go up to the Secretary. So it bothers me.
Speaker 2: Is if we had an outbreak and operation warp speed,
Speaker 2: the decision about whether to implement that life serving vaccine
Speaker 2: would be in the hands of Secretary of Robert F. Kennedy.
Speaker 1: Is chilling.
Speaker 2: That bothers me?
Speaker 1: Well, that bothers me. If it bothers you, it bothers me.
Speaker 1: So it's like it does.
Speaker 2: We don't have it. There's no vaccine for this, and
Speaker 2: there's no need at the moment. But when you ask
Speaker 2: me about what does it say about the politics?
Speaker 1: Yeah?
Speaker 2: The two biggest things I say that bother me are
Speaker 2: that they are letting ideology drive their guidance. They will
Speaker 2: not say quarantine for people who for them very very
Speaker 2: small number of people who need to they won't say.
Speaker 1: It who should obviously do it right correct?
Speaker 2: Wow? And then if this got bigger, I'm not confident
Speaker 2: that they would have the scientific chops to get us,
Speaker 2: to manage us, to get us a safe vaccine, or
Speaker 2: to make other decisions that would keep us safe.
Speaker 1: Okay, fingers crossed, we don't get to that point. This
Speaker 1: is somewhat related. The World Cup is coming to the
Speaker 1: United States, and here is a headline I recently saw
Speaker 1: New York hospital is gearing up for nightmarish World Cup
Speaker 1: disease as fans descend on metro area.
Speaker 2: Ah, I'm going to take a slightly less alarmist approach
Speaker 2: to this.
Speaker 1: Good because I mean, let's direct let's direct some criticism
Speaker 1: at the news. Okay, because I don't like that headline either,
Speaker 1: and I could kind of sense that it was a
Speaker 1: little alarmist.
Speaker 2: But you tell me, the World Cup is happening, people
Speaker 2: are going to come to the United States of America.
Speaker 2: But it's not as though tourism is not already a
Speaker 2: really big part of our lives anyway. Yeah, So if
Speaker 2: this were some country that never has tourists and this
Speaker 2: is their one big flash where everyone's finally going to
Speaker 2: visit this nation that otherwise doesn't get people from all
Speaker 2: over the world, then yeah, it's a new entrance. It's
Speaker 2: a new flow of potential exposures. But come on, You've
Speaker 2: been around New York. There is constantly that people are
Speaker 2: coming here. Now. Granted, the current administration I think is
Speaker 2: making tourism less popular and people don't feel like dealing
Speaker 2: with that, But I tend to think that we should
Speaker 2: prepare for the World Cup. There's it's always an opportunity
Speaker 2: because there's a different kind of exposure. It's younger people,
Speaker 2: and there might be they might be the kind of
Speaker 2: people who might engage in super Spreader. By the way, Yeah,
Speaker 2: so I'm not saying that anyone who's doing World Cup
Speaker 2: preparation is doing something performative or something that's not valuable.
Speaker 2: But I think that it's a It is an added risk,
Speaker 2: but it is not taking the risk from low to high.
Speaker 2: Does that make sense?
Speaker 1: Yeah, okay, yes, another item. We talk a lot about
Speaker 1: mental health here because I've struggled with mine and I've
Speaker 1: talked about that. RFK Junior is targeting SSRIs. Those are
Speaker 1: common medications prescribed for depression and anxiety and other mental
Speaker 1: health disorders. He says they're over prescribed and claims that
Speaker 1: withdrawal from SSRIs is similar to heroin, which has been
Speaker 1: criticized by some health experts as untrue. What do you
Speaker 1: make of this attention now to SSRIs by RFK Junior.
Speaker 2: Well, RFK Junior has absolutely no relevant training regarding this
Speaker 2: position that he's been confirmed by the US Senate to
Speaker 2: carry out. And the person who is responsible for that
Speaker 2: is Senator Bill Cassidy, a physician and Louisiana senator, who
Speaker 2: thought that he could believe RFK when he said that
Speaker 2: he wouldn't go after vaccines, and who thought that he
Speaker 2: would appease the MAGA movement by not stopping that appointment.
Speaker 2: And of course it's in classic fashion, he's now not
Speaker 2: getting any benefit from that in terms of his election prospects.
Speaker 2: We'll see what happens. That's your feel about mine, but
Speaker 2: he certainly regrets it in terms of what's happened to
Speaker 2: the country since then. And so Robert F. Kennedy has
Speaker 2: not only does he have no training, no expertise, he
Speaker 2: seems to have a very poor command of judgment end
Speaker 2: of the literature. He doesn't surround himself with people who
Speaker 2: help him do that very well, and so he gets
Speaker 2: himself into conspiracy theory territory by getting in rooms with
Speaker 2: people who convince him that they note something, and that's
Speaker 2: how we ended up with this idea that using Thailand
Speaker 2: during pregnancy would be associated with changes in rates higher
Speaker 2: rates of autism later on, which which has been repeatedly
Speaker 2: shown to not be the case, or at least there's
Speaker 2: no great data to say that. And I'll just mentioned
Speaker 2: since we're in this little nook that it's not a
Speaker 2: situation in which the precautionary principle applies, meaning well, just
Speaker 2: to be safe, don't take it. It turns out it's
Speaker 2: equally possible, if not more possible, that untreated fever during
Speaker 2: pregnancy is a problem worse, and so it's probably worse.
Speaker 2: And so then so quote don't take tialanold just to
Speaker 2: be safe actually ends up backfiring because they either take
Speaker 2: nothing and that's the problem, or they go to something
Speaker 2: that's actually less safe in pregnancy, like another medication class
Speaker 2: like advil, which we don't recommend because of other risks.
Speaker 2: So RFK is a disaster. What I wrote the other
Speaker 2: day on my social media was the best case scenario
Speaker 2: for us is when he's useless, because because there's sometimes
Speaker 2: when he's right and fine, everyone would have gotten that.
Speaker 2: There's never a situation in which he's correct and no
Speaker 2: one else figured that out. Everything that people every time
Speaker 2: he says anything that people go, well, he has a point.
Speaker 2: I just say, well, when Michelle Obamas said that thing
Speaker 2: about exercise and eating vegetables, you acted like she was
Speaker 2: some kind of communist. So why And now he's turned
Speaker 2: his attention to something else to get away from what
Speaker 2: really matters, which are things that he wouldn't want, things like,
Speaker 2: let's actually expand access to health care, let's actually help
Speaker 2: people get things that work. So he wants to blame
Speaker 2: pregnant women taking Kyle and all for one problem. Now
Speaker 2: he wants to say SSRIs are bad. Look, there's a
Speaker 2: world I see in which SSRIs are being overprescribed. That's possible, sure, right,
Speaker 2: that is absolutely possible, and there are committees and experts
Speaker 2: who should look at that. When RFK says it, and
Speaker 2: the way he says it, he's basically shifting blame. And
Speaker 2: then he's also just to that point you made that
Speaker 2: he said that withdrawal is worse than heroin. This is
Speaker 2: difficult for RFK to achieve. But that's one of the
Speaker 2: dumbest things he's ever said. And he said a lot
Speaker 2: of dumb shit, and so for when he said that,
Speaker 2: I thought, boy, I am I just I must have
Speaker 2: missed all those cases that came into my er people
Speaker 2: in SSRR withdrawal, compared to all these people who either
Speaker 2: are in heroin overdose because they actually their withdrawal was
Speaker 2: so bad that they actually relapsed and the dose that
Speaker 2: used to be safe for them killed them, or they're
Speaker 2: in such bad withdrawal that they're and they actually need
Speaker 2: to be the ICU. I have never, a single time
Speaker 2: in my life admitted a patient to the ICU for
Speaker 2: SSRI withdrawal. It has happened at zero times. I have
Speaker 2: people have withdrawal symptoms, and that's real. And again I'm
Speaker 2: not saying that there's not some grain of truth, but
Speaker 2: I have many times admitted patients to the hospital or
Speaker 2: the ICU because of heroin withdrawal. And I've also seen
Speaker 2: this other thing, which is the withdrawal is so bad
Speaker 2: that they relapse and then they accidentally overdose. So when
Speaker 2: he said that, I was I was just livid because
Speaker 2: it was so stupid and danger irresponsible and irresponsible, and
Speaker 2: that guy needs to be fired.
Speaker 1: I just don't understand. You're not a psychiatrist, but but
Speaker 1: the hubris of being appointed to a position you definitely
Speaker 1: should not be in, and on some level he must
Speaker 1: know this. He must he must know he doesn't have
Speaker 1: the qualifications or training, and yet he's just wildly, unabashedly
Speaker 1: irresponsibly telling people what to do with drugs and medicine
Speaker 1: and vaccines. And I just can't get into the mindset
Speaker 1: of someone like I feel sometimes I've been covering politics
Speaker 1: for twenty years. Sometimes I feel like, Hm, should I
Speaker 1: go out on a limb with this political take? Like
Speaker 1: I'm in a position of of you know, expertise, and
Speaker 1: I want to be responsible about the things that I say,
Speaker 1: and I just can't get in the mind of someone
Speaker 1: like him who does not belong in this position and
Speaker 1: is abusing it.
Speaker 2: Well, I think that's the real problem with this administration
Speaker 2: compared to the first time that Trump was president. The
Speaker 2: first time Trump was president and did a lot of
Speaker 2: things I disagree with, But basically when you look at
Speaker 2: who was the FDA commissioner, for example, it was Scott
Speaker 2: gottlieb By Scott Gotieb' is a reasonable, normal human being
Speaker 2: who has smart ideas, Like I don't see eye to
Speaker 2: eye on everything with Scott Gottlieb, and you know, we're
Speaker 2: friends and we can get through a conversation. Whereas you
Speaker 2: look at somebody in this administration, it's not only just
Speaker 2: that that expertise is ignored, it is disqualifying, correct, because
Speaker 2: because it gets in the way, it gets in the
Speaker 2: way of the vibes that that drive what they want
Speaker 2: to do and the manipulation.
Speaker 1: And you know Trump, Trump wanting certain outcomes, and yeah,
Speaker 1: he can't hire the best people anymore. They don't want
Speaker 1: to work for him. They know they have to lawyer
Speaker 1: up when they do. They don't have to say things
Speaker 1: that are untrue, and you absolutely have to in this administration.
Speaker 1: And so we're not getting any of the best people.
Speaker 2: But can I just say the double speak drives me
Speaker 2: crazy because he will say, oh, I'm not a doctor,
Speaker 2: don't listen to me. And even Trump has said, I'm
Speaker 2: not a doctor. Listened to me. And then they go
Speaker 2: out and they tell you what they think and what
Speaker 2: they what they want you to do, and as if
Speaker 2: people aren't going to listen. And my colleagues and I
Speaker 2: studied that, like we literally looked after the press conference
Speaker 2: in September when they said yelling don't take Tyler and All.
Speaker 2: We looked at whether there were changes in tail and
Speaker 2: All use and there were immediately, and we publish that
Speaker 2: in like the top medical journal in the world at Lancet.
Speaker 2: And these people have to I want them to know
Speaker 2: that their words carry power and that people listen. And
Speaker 2: so they do that they have the hubris and then
Speaker 2: and then they act like they are the transparent one
Speaker 2: and they are the humble ones. I am going to
Speaker 2: I'm going to call out the current lead official at
Speaker 2: the CDC, Jay about Acharia. Yeah, because Jay is so
Speaker 2: humble that he has to tell you how humble he
Speaker 2: is all the time. And literally the opening of his
Speaker 2: last op ed in the Washington Post was we have
Speaker 2: to have humility. And I'm saying, I'm reading this from
Speaker 2: a person who is currently the top official at both
Speaker 2: the NIH and the CDC as if sort of gives
Speaker 2: Trump vibes of only I only I can achieve us alone,
Speaker 2: I alone. And Okay, if you're so humble, then why
Speaker 2: do you think you have to run both agencies? And
Speaker 2: by the way, his appearance on State of the Nation
Speaker 2: on CNN was atrociously bad, not just on the facts.
Speaker 2: He said they've been tracking the hant of virus for weeks.
Speaker 2: We didn't even know about it two weeks ago, so
Speaker 2: that's just weird. And he sounded tired, and he sounded
Speaker 2: really just he was blundering through everything. And Jay about
Speaker 2: Acharia is not a person who is bad on the microphone.
Speaker 2: He's very smooth. He actually makes me kind of angry
Speaker 2: sometimes because, oh, that sounds it good. He's people are
Speaker 2: believe what he just said. He's so good. So for
Speaker 2: him to go on the air and admit that he
Speaker 2: was tired and sound terrible was a very clear example
Speaker 2: of him admitting to us that he is. He's spread
Speaker 2: to thin.
Speaker 1: Over his head.
Speaker 2: Let's have some humility and let's have someone dedicated to
Speaker 2: doing the job.
Speaker 1: Sorry, Okay, okay, I think we got a little We
Speaker 1: got a little reassurance about about hauntavirus. I think for
Speaker 1: my for my audience, but also I think you're reaffirming
Speaker 1: what we already know and think about this administration. Before
Speaker 1: I let you go, we're going to take a mental
Speaker 1: health minute with you. I'm going to ask you a
Speaker 1: few lighter questions.
Speaker 2: Okay, I hope answer.
Speaker 1: What is your favorite movie about medicine or public health.
Speaker 2: Movie about medicine or public health. I don't know. My
Speaker 2: TV show is The Pit.
Speaker 1: Okay, I was going to ask you, Okay, favorite TV
Speaker 1: doctor or t the hospital drama? It's the Pit.
Speaker 2: Yeah. For me, it's the Pit. By far.
Speaker 1: Is it really realistic? That's what people say.
Speaker 2: It's got a lot of realism. It covers things that
Speaker 2: no other show has ever done. Okay, they're just as
Speaker 2: likely to spend time on a crazy case as they
Speaker 2: are on the bread and butter problems, like somebody is
Speaker 2: here about to die because not in some rare condition,
Speaker 2: but because medic kid cuts meant that their dialysis center closed,
Speaker 2: And that is so realistic and just there. It just
Speaker 2: it's clearly the inside job. It's it's the best rendering
Speaker 2: of the stresses of the job. There's some there's some
Speaker 2: artistic license. So my answer is the Pit.
Speaker 1: I love that outbreak or contagion, I haven't.
Speaker 2: I haven't seen either since I became a doctor.
Speaker 1: So I actual way, Oh you got to go back.
Speaker 2: I know. It's funny, Like I will say, I used
Speaker 2: to watch none of these because it was like I
Speaker 2: wanted it so badly, and then I would watch them,
Speaker 2: and then now that I do it, I have to
Speaker 2: go back and say, like, oh, what was that? Was
Speaker 2: that good or not good?
Speaker 1: You have to go back. Well, I've seen both. Contagion,
Speaker 1: I'll say, is scarier outbreak. It has some comedy, you know,
Speaker 1: it's Dustin Hoffman. There's like and he's got a love
Speaker 1: interest with Renee Russo, so there's some like later moments.
Speaker 1: Contagion is full one hundred scary.
Speaker 2: I read, I really, I read a lot of books
Speaker 2: about medicine and outbreaks, but I don't watch the movies.
Speaker 1: Did you like Michael Crichton, Like Crichton books about like oak.
Speaker 2: Like Andrama, strange and all that stuff. Yeah, but again
Speaker 2: I read all that stuff before I became a doctor.
Speaker 1: How fact we need? We need Doctor Faust's opinion of
Speaker 1: contagion and outbreak. Okay, what is your favorite tip for
Speaker 1: people who are overwhelmed by bad news, especially news like
Speaker 1: this like hunt uh and other kinds of medical issues.
Speaker 2: Like for their own personal kind of mental health protection
Speaker 2: kind of thing.
Speaker 1: Yeah, yeah, give us some advice. How should we ingest
Speaker 1: all of this terrible news and still go on with
Speaker 1: our lives?
Speaker 2: I think there's a difference it's healthy to be concerned
Speaker 2: on behalf of others, to say I'm worried about people
Speaker 2: on that ship, But that doesn't necessarily mean that you
Speaker 2: personally yet have to freak out that your days are numbered.
Speaker 2: So I think that we can thread that needle of
Speaker 2: saying you can be concerned, it could be interested. You
Speaker 2: can be bothered by certain things, but you do not
Speaker 2: need to actually start to get your affairs an order.
Speaker 1: There's a difference, right, Don't borrow other people's problems is
Speaker 1: a familiar therapeutic phrase. And also, I can speak from
Speaker 1: experience someone who lives with severe anxiety disorder. Worrying about
Speaker 1: something does not prevent it from happening. Okay, And you
Speaker 1: know this was a trick I used to play, you know,
Speaker 1: in my own head. If I worry about it, it
Speaker 1: won't happen. And if I don't worry about it, I'll
Speaker 1: invite it. And obviously that's irrational. And there's only so
Speaker 1: much worrying you can do that until the tipping point
Speaker 1: where it becomes self destructive and not actually help healthy
Speaker 1: and help helpful, and you're not actually preparing for anything,
Speaker 1: you're just driving yourself nuts.
Speaker 2: Yeah, and i'd say, look for people who are measured
Speaker 2: and balanced and listen to what they have to say.
Speaker 2: I do the same thing, right, Like, if if Bahuma
Speaker 2: Ta Tangy is really really worried, I will.
Speaker 1: Be okay, you know what I mean. Yes, I'm going
Speaker 1: to take it one step further. If you're really worried,
Speaker 1: I'll be really right right because I don't know, I
Speaker 1: appreciate that, or she's amazing. Yeah great, but I know
Speaker 1: you yeah, okay. And finally, this is a question that's
Speaker 1: always very important to me. We ask it at the
Speaker 1: end of of a lot of our podcasts. Says nothing
Speaker 1: to do with anything except me. When, in your opinion,
Speaker 1: is it iced coffee season?
Speaker 2: July?
Speaker 1: It gets a month, Oh, that's when it starts. That's
Speaker 1: when it starts. Okay, When does it go? When does
Speaker 1: it end?
Speaker 2: September?
Speaker 1: July to September. Okay, that's the incorrect answer. The correct
Speaker 1: answer is year round. It's year round. But I appreciate
Speaker 1: that at least you allow for a couple months of
Speaker 1: drinking iced coffee.
Speaker 2: But what about July chips? What about what July chips?
Speaker 2: There's a brand called July Chips, and I'm always like
Speaker 2: they do they get a bump in July and then
Speaker 2: like they do not get a bump the rest of
Speaker 2: the year.
Speaker 1: And chips like potato chips.
Speaker 2: They're called July chips. They used to sell them on
Speaker 2: like the United Airlines that are like, oh you.
Speaker 1: Know, oh right, that's interesting.
Speaker 2: And you know about you know about the seafood rule
Speaker 2: about oysters, right, you know that one what the rule
Speaker 2: on oysters is that they're in season in any month
Speaker 2: that has the letter R. September, October, November, December, January, February, March, April,
Speaker 2: but not May, June, and July, August.
Speaker 1: Mains in July and August is when I eat them mostly.
Speaker 2: Well, then the caveat to that is you can eat
Speaker 2: them at the source. So the issue is not the source.
Speaker 1: I'm in Connecticut.
Speaker 2: I'm at the source, so if it's local, it's fine.
Speaker 2: The problem becomes like the and the distance from all
Speaker 2: that stuff.
Speaker 1: Yeah, few, I mean, I don't I don't know that
Speaker 1: we've discussed this, but like, eating oysters is religion where
Speaker 1: I live, like that is a very important part of
Speaker 1: our lifestyle.
Speaker 2: Yeah, And I and I am a I'm a big
Speaker 2: oyster stan and I've I've never had a bad oyster,
Speaker 2: and I fear that I fear that I will and
Speaker 2: that we'll. It will change my tune, but generally I'm
Speaker 2: a I'm with you.
Speaker 1: You will the more the more you eat, obviously, the
Speaker 1: closer you get to the roulette of getting the bad one.
Speaker 1: But uh, okay, that's all very good to know, doctor
Speaker 1: Jeremy Fous, Thanks so much for coming on Off the Cup.
Speaker 1: It's always great to talk to you like we thanks messy,
Speaker 1: all right. I hope I gave you guys some reassuring
Speaker 1: news on a few fronts, a political silver lining to redistricting,
Speaker 1: some relief maybe over hauntavirus. Can't do anything about the weather,
Speaker 1: but here's hoping that that turns around to Thanks for
Speaker 1: tuning in. We'll see you next week. Off the Cup
Speaker 1: is a production of iHeart Podcast as part of the
Speaker 1: Reason Choice Network. If you want more, check out the
Speaker 1: other Reason Choice podcasts Spolitics with Jamel Hill and Native
Speaker 1: Land Pod. For Off the Cup, I'm your host, Si Cup.
Speaker 1: Editing and sound design by Derek Clements. Our executive producers
Speaker 1: are me Si Cup and Lauren Hanson. Rate and review
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