Deep Dive
Shownotes Transcript
What's up, everybody? Welcome back to The Honest Drink. I'm Justin. We got a very special guest for you today. I had such a great time talking to him and having him share his experiences with us. He is a retired American physician, epidemiologist, and biostatistician. He has had over a 30-year career conducting federally sponsored research. He has worked with the FDA and pharmaceutical companies and has served as expert witness in both state and federal cases. He's a
He has spent many of his years also investigating cell therapy for heart disease and teaching graduate classes in epidemiology and biostatistics. And if you're not sure what epidemiology is, it's really the job of investigating patterns that affect public health. So for example, whether that be studying the behaviors of infectious diseases in society or the fact that we can't smoke in public indoor areas. This is all the great work of epidemiologists. Our guest is also an author. He has written a bunch of books, including an award-winning book,
about his experiences as part of the relief effort during Hurricane Katrina. He has some new books coming out that we get into on the show. We cover a lot of ground on this one. We talk about the rising instances of natural disasters. So we get into Hurricane Katrina and the recent winter storm in Texas. We talk about weakened infrastructures and how they're set up to fail during times of crisis. He shares with us the moral and ethical dilemmas of the FDA approval process and pharmaceutical drug companies. And
And of course, we get into the current COVID pandemic, vaccines, variants, future pandemics, and the politicizing of public health. We did this episode online as our guest is in the US, so the audio quality isn't as good as we would normally like it, but this was such a fascinating conversation. It was such a pleasure to talk to this man. This one was hosted by Howie and myself. So without further ado, please welcome Dr. Lem Moyet. ♪ I'm looking at a girl ♪
Howie, did you have a question? Yeah, just what brought you out to Arizona? Well, that's a good question. So to make a long story short, my wife and I have been living in Houston for 34 years.
And over the decades, and I built a career there, Houston was very good to us. But Houston was growing beyond the infrastructure's ability to sustain the population, number one. And I was retiring in 2019 anyway.
And so my wife and I talked about doing what older people are told they should never do, which is just pick up lock, stock and barrel and move. So we were on the fence about it until Hurricane Harvey came through and blew us off the fence. And we decided looking at our community, which looked like I mean, sad to say, it looked like a war zone.
with debris fields 15, 20 feet high, with water standing in the street. And it's not just water. It's water with snakes, water with fire ants. And fortunately, we did not flood, but neighbors did flood. And so I just asked myself, how much more evidence do I need? I mean, do I really want to spend my seventh decade learning how to put drywall up?
And so we decided to move out. And so we moved out in, she came out in November 2018 because I had to finish up my work. And when I finished my work in February 2019, I came out. So did, I mean, I've read that obviously you have an award-winning book from your experiences with Hurricane Katrina and the relief efforts there.
Did that prepare you in any way for this or was that just a completely different experience altogether? Good question. Good question. Looking at, and I just looked at the video that we all looked at in, I think it was 2005, you know, with the, with the looking at the result of the levees breaking and how little infrastructure there is to support you. You know, the infrastructure is,
is broad, but razor thin. So once you have a calamitous event, such as a flood, or most recently, my unfortunate friends in Texas had with this terrible winter storm, there's not much support for you. And Texas is known as a low service, low overhead state. So no income tax. They
Keep taxes, fees low. But that means if there is a debacle, then there are no resources to support you. And the older we got, the less willing we were to rely on essentially an invisible infrastructure.
So it's really kind of like, you know, and I've said this before because I felt it in certain ways. You know, society as a whole is kind of just hanging on by a thread, you know, and we think of it as this kind of robust system, this really robust structure that we can all depend on. But in light of, you know, events that you just mentioned and obviously most recent events with the coronavirus, like you can see how
Like we're all just kind of hanging on there by like the skin of our teeth in many ways. I absolutely agree with you, Justin. I think of it as, you know, New Orleans is known for many things. One thing it's known for is termite problems. And you can walk into your home as you have for many years and step on one part of the floor and have your foot go right through the rafter because the termites have eaten through.
And that's how I think of infrastructure here. We have thought because it's never really been tested and we've been assured that these resources would be available, that we've always trusted they would be. But when you actually put the weight of your foot on it, you find out they're not available at all. Is this an ugly truth that you've been
You've witnessed time and time again, repeatedly through, let's say, your personal experiences with Hurricane Harvey, you know, the Katrina disaster and tragedy, coronavirus. I'm sure there's countless other experiences I don't even know of that you've been through in your lifetime. Is that something that rings true consistently to you or not? Yes. Yeah.
The experiences that I've had have been reinforcing experiences. So we went through a powerful rainstorm in 2001. June 2001, it wasn't a hurricane. I remember the name of it in a minute. But in a space of 48 hours, it dropped a trillion gallons of water.
a trillion gallons of water, a thousand billion gallons of water. And I can't even, you can't like wrap your mind around that kind of volume. Exactly. Exactly. And you know, everybody's hurt, everybody's damaged and the infrastructure response is weak. It's, and, and the, the,
I'm maybe not fair to say excuse, but the reason given is that this event is so calamitous that there's no way we would have resources to be able to deal effectively with this. So I guess that gets into a little bit of a global warming thing or climate change. Then in 2008, we had Hurricane Ike and Hurricane Ike, we lost power for three weeks.
Again, wholly unprepared for that. And Houston at that point, we expected to lose power. You lose power at the drop of a hat, really any hat. But it comes back in two hours, 12 hours, but it comes back relatively quickly. Here it didn't come back for almost three weeks. And day after day goes by.
And you begin to feel like you're not in the United States because the experience is so different than the expectation. And then we went through, of course, Harvey in 2018.
And Harvey really was the backbreaker. I mean, there were unfortunate people. I mean, my wife and I were really very lucky. There are unfortunate people. There's a lady who was living in a structure. Let's just call it a structure, which had four wood posts and sheets that didn't cover all four sides.
And she would have to try to negotiate how to take care of her personal hygiene in a circumstance, in this terrible circumstance. And this was occurring not days, but months after the event. And there's, but it's the same story, Justin, a huge, a hue and cry about we can't go through this anymore.
And then when that dies down, the economic interests begin to rear their heads. The folks who want to redevelop land so that it could be sold for profit principally. And there are people, real estate groups in Houston, who are trying to sell plots on land that had flooded during Harvey.
How in good conscience can you do that? Because you're setting another family up for disaster and you're hoping, well, maybe it won't flood for three years or five years or nine years. But the fact is, it is going to flood again. But they cannot develop a long term solution for this kind of problem in Houston, because just like in.
New Orleans at the end of Katrina. There was a hue and cry to just abandon New Orleans. New Orleans is a lost cause. Katrina is not the last. It's going to be, it's one in a sequence of powerful storms. Let's just move everything north to maybe Shreveport or other points north in Louisiana. In fact,
What happened? Cultural interest argued against it. Political interest argued against it. And in the end, that was the inertia that kept New Orleans where it was. And so these poor people, actually, the population in New Orleans now, I think, is about maybe 70 percent of the peak pre-Katrina level. They are...
vulnerable they continue to be vulnerable you know what what good does it do for you to rebuild a your home on your block if you're the only home rebuilt and all the others are debris and they're wiped away what kind of you mean you have no community what kind of phone service do you get what kind of cable do you get what kind of infrastructure support do you get is this uh
I'm sorry. Go ahead. Oh, please. Oh, go ahead. Is this is this why you wanted to you decided to write a book about Katrina? Actually not. I wrote a book about Katrina because my experience with the Katrina evacuees was far different than what the media was telling us.
When I went to volunteer at the Astrodome, the Astro Arena, Houstonians were being told that there were 700,000 hungry, angry African-Americans descending on Houston. These people, we were told, left their children behind, left their wives behind, had no regard for family, and were now descending on Houston. That's what we were told.
The people I interacted with, it was another dimension. Let me give you an example. This is my first example of the character of these people. When we heard they were coming, we knew that they needed support. We knew they needed shoes, underwear, toiletries, clothes, food.
And so we were told there was a staging area at a Toys R Us parking lot. So my wife and I bought some personal hygiene equipment and went over to drop it off. Now, I fully expected this was going to be a melee, that people were going to be fighting each other to get at this stuff. When I got there, I saw that no one
had taken anything for themselves. What they were spending their time doing were organizing the piles of clothes. So you had children who were making sure that when socks were balled together, they matched, who were making sure that a left shoe and a right shoe were always put together. And they spent hours doing this before anybody took anything.
Now, the impact of that is that, my God, these people, one could argue, have every right to be angry because they've been rejected by what culture, society, infrastructure, whatever.
They have every right to be angry, are showing far more compassion for each other than anybody thought was possible. The impact of that is that if these people can be that way, then I can be that way. I mean, it was a direct heart-to-heart transmission. So many folks...
Left, many of the Houstonians who brought support left, came back with cookers to cook food for. Now, when they cooked this food and they organized it, there was no melee for food. Individuals, evacuees, would take plates heaped with potato salad and barbecue, take it to others who could not walk to get the food for themselves.
You know, this was a story that wasn't getting out in the news. I was really nonplussed by this. So I said, well, of course, as a physician, I'm going to move forward with volunteering to help. And the volunteering led to some incredible stories that break your heart as these people of sublime character
did the very best they could to survive the storms. I don't know, maybe I have to say, maybe I was just wholly ignorant of what the culture of African Americans in New Orleans was, but that culture shined for the next two weeks.
And none of that ever came out. What did come out is occasionally you'd have somebody who was a drug dealer who came with the evacuees who was trying to now set up shop in Houston. Now, that's the story. But the but the real story of the heart and the the the insight and the the terrible wisdom
That people that is pounded into people who have been inflicted with such grief. There's terrible wisdom that comes with that. That did not get out. And that's why I wrote the book. Well, thanks. Thank you for sharing that. I mean, that was beautiful and tragic in many ways as well. And I feel like that's usually kind of the tragic truth of.
what we see play out today is the disconnect between the media and its reporting and the stories and the clickbait headlines you see versus the reality on the ground. You know, whether we're talking about political issues or current events or, you know, kind of, you know, natural disasters, you know, and it shapes, like, unfortunately, you know, you were fortunate enough to be there in person to witness what you saw and the positivity that
you saw in all of that. But the sad truth is most people aren't there. And they are going to read the news. They are going to see the headlines that you saw before getting there. And that's what they're going to believe. That's exactly what they're going to believe. And I mean, obviously this goes on to a much larger issue. I mean, there are no experts in this. We don't seem to be able to
To appreciate the limitations of the media. And by that, I mean specifically this, that the media is a terrible way to learn about people. The only way to learn about people, be they Ethiopians, be they Palestinians, be they Aleuts, be they poor whites in Appalachia, the only way to learn about them is to be with them.
It's to experience what they go through. And you realize, you know, we are all human here. I mean, if I were in their position, I would likely feel the same way they do. You know, we need to have... But instead, what happens, I think, is that we wind up getting siloed and we get our information digitally and it is a poor translation. Now, I want to get into...
the work you're doing now and kind of the mission you're on now, you know, you know, in your words, um, you know, I think you have a mission of like, you want to, you want to show people the role they play in, in the world, right? Like everyone plays a part and you want to kind of shine a light on how important and crucial everybody's part is in this changing world that we're living in. Um, you know, what,
Is this something that's always been inside you that you've always wanted to pursue? Or is this something through your whole entire, you know, let's risk career that you've come to develop? It's a combination of things. I ate and failed as an acolyte member and physician to really articulate what I was trying to say and trying to develop as a thesis.
And the thesis really asked the question, what is the role and fate of good people on this planet? Many of us believe we're good people. We don't rob banks. We don't kidnap. We don't we're not involved in heinous crimes. We make money legally. We're honest. And we try to absorb the best parts of the Koran or the Old Testament or the New Testament. But.
people like that are ruined by this demented slaughterhouse of a world by thousands, by the hundreds of thousands. And I was asking myself, almost like an Ecclesiastes question, you know, what's going on here? You know, these people are working as best they can. And ultimately what happens, I think, is that good people are commonly given a terrible choice.
And this is what I'm trying to bring forward in my books, in my novels. And that terrible choice is you can do you are asked by the system to do something that you know is wrong. It's against your principles and you have a choice. You can do.
Stand for your principle and you can say, look, politician, look, boss, I'm sorry. This is wrong. This is why it's wrong. I think you should know that. And I'm not going to do what you should do, what you told me to do. And you pay a horrible price for that. I mean, it's not just a wrist slap. It is a terrible price. If you look at the Catholic priests.
who stood up in 1938 against Nazism in Germany and stood to take the side of the Jews, well, they were incarcerated with the Jews and they were murdered with the Jews.
So that is a terrible price to be paid. I mean, you just don't lose an income tax deduction. You know, you really have to, you really wind up, I mean, not just an income tax deduction, you lose a kidney, you know, or your family is ruined or your career is horribly mischanged. So that's terrible. But look at the other choice you have. You can go along with the system. You can say, oh, you know, this is a small thing. I can really live with this.
This is really not against my principles. I'm sure we'll be able to straighten it out later. And you take that choice and you lose yourself. This is a indescribably disappointing choice that good people have to make.
Do you have a specific example of what you're talking about? Because I get you all the way, but were there certain events or things that you witnessed or maybe things that even happened to you personally that you can kind of shine a light on that you're talking about? Sure. I'll give you one example of me, and then I will point to an example in...
in public health. So one opportunity I was given was to work for, become a special government employee for the FDA. And my particular role would be to try to help answer questions about new drugs that were political hot data's for the FDA. And so in 1996, I was asked to help rule on a drug
that was actually, it's very popular right now. It's called Carvedilol for heart failure. And I was asked to review the data and see if the data supported what the company said it supported. And I looked at the data, looked at the data and I said, you know, I don't see how I can get where they are from this data. But other committee members seem to have no problem with it. So I'm wondering whether I really am, have I missed something?
Or is my perspective so skewed that it's unhelpful? Is this something I should just keep my mouth shut about? And I decided, and I actually got very angry with myself. I said, look, this is what you stand for. These are the statistical probability principles, epidemiology principles you've built your career on. Are you really going to abandon them now? And I decided, no, I would not.
And so when time came for public statements, and these are public statements now that are in an FDA building, an auditorium, it's got maybe 700 seating, 700 audience capacity. And most everybody is from the pharmaceutical industry. Or at that point, they were stockbrokers because we didn't have cell phones.
So they'd have to listen and then run out to the lobby to make phone calls to their investment houses in New York. But I just held forth and said, look, these are the principles that are epidemiologically valid. They have been handed down to us over the years. We all use them. We trust them. We can understand results based on the
based on their use. And this is not a time to abandon them. And so I led the committee in a vote against the drug, against the drug. Well, a couple of things that happened. The stock of the company dropped 12% that night and the company hit back hard. You know, I remember getting a letter from an individual who,
who began his letter with, thank you, Dr. Moyet, for killing my father. And the argument was his father had heart failure and would have survived, but for my push at the advisory committee to have him have the drug not approved. I also got over a week, this was a very tough weekend. I got a
12 letters from statisticians across the country lacerating me from my point of view. Now, these are statisticians I respected. You know, I learned from their books. You know, I trained on their teachings. I'm sitting there, look, I said, my God, Lem, what have you gotten yourself to here? And I finally realized, I finally realized they had been paid to write the letters.
I mean, these folks aren't writing me out of a sense of moral outrage. They've been paid. How do you find out about this kind of stuff? How would you come to the idea that they were getting paid? Because these are letters that are so unusual in the field. So they don't have to tell me they're being paid. I just came to the conclusion that 12 letters at once
come from, I mean, they come in one packet from 12 different people. This is all externally organized. It was all directed to me to show me that, in fact, I made a mistake. I was removed as a voting member from the committee. I was not permitted to
re-up, be re-nominated as a committee member. And any opportunity I had for consulting went right down the drain. So in the end, I lost, well, let's just say I lost up to $10 million in consulting fees.
So what was your response at the time? I mean, when these letters were coming in from other scientists and other biostatisticians that, you know, some people that you even respected in the field, when these letters were coming in, was your first kind of initial reaction was to kind of try to convince them and defend yourself with the data, with the evidence? That was not my first reaction. My first reaction, to be quite honest, was self-repudiation.
"My God, Lem, how could you get this so wrong? That these eminent people are gonna take time out of their day to come down and school you on the basis of epidemiology and biostatistics." That was my first year. - So you just thought you were wrong. You just thought you got it wrong. - That was Saturday's reaction. That's correct. That was Saturday's reaction. It was a very mean day for me. And then I recognized that in fact, the principles I was standing for were correct.
My stance on this drug was correct. Maybe the drug is good, maybe not. But the data that they showed us suggested that it wasn't and that I had no alternative but to stand, take a stand. That was my only alternative. And when I came out of the weekend on Sunday, I felt much better. During this process, were you like, was there any type of, I guess, attempt at
or bribery or anything like that? Uh, before you came out with your stance? No, no, no. I, I have to say that these folks in this industry are very subtle. They are not going to say to me, Hey, Dr. Moyer, you know, we got a new yacht and we really would like your help in writing an endpoint, uh,
End point definitions with some members of our group. So can you spend a week on our yacht with us while we do that? You know? Yeah. I mean, then they could do that. But it was, well, we're more than happy to support you, Dr. Moyet, in your work and give you opportunity for career growth. We just need your help on this issue. And it was an issue that I just couldn't provide it to you.
Did this permanently change the trajectory of your entire career? I would say it did because I probably wouldn't have worked as long as I had if I had the opportunity to consult for the industry. So the principal impact was economic. There's also an administrative impact.
And that the FDA is an administrative group and administrators don't like troublemakers. And I was tagged now as a troublemaker. So this actually just, my theory, because before we got on the podcast, I was kind of going through kind of your biography and just going through the synopsis of your writings and the books you've written. And I had formulated a theory about you that I think is pretty accurate. You can tell me.
But, you know, all of your books, with the exception of just two, and you've written a ton of books, but just with the exception of two are nonfiction books. They're scientific books. They're academic books, professional, expert books.
And then all of a sudden, out of nowhere, to me at least, it felt like all of a sudden now you have two fictional novels that you're writing. And I read the synopsis of both novels. And there's a very common, there's a common theme that runs between both of those books. And it's kind of centers around, I guess, the moral and ethical fallout.
you know, that surrounds the entire system in how drugs are developed, how they're tested, how they're funded, and how they're ultimately approved. And it seemed to me, I got the feeling that
Okay, I think this is something that Dr. Moyet probably witnessed and experienced in his real life, but he's kind of writing it under the guise of a fictional novels as to maybe not get into too much trouble, maybe. Is that accurate to say? I don't worry too much about trouble. A couple of reasons. One, I'm retired.
So it's not like they're going to take grants from me or going to have some impact on me, economic impact on me. I don't worry too much about that. And all the trouble that they could produce for me, they already have when I was a junior scientist. So I don't worry too much about that. But I will agree with you in that there has been this rumbling in me, this ceaseless rumbling.
that I need to write about the scientific industry in a way that lay people can understand. So that they can, so these need to be emotional experiences about circumstances that the lay person can understand. And then ask themselves the question, well, what would I do if I were in that circumstance?
The books give examples of people who make the wrong decisions and who have just disastrous consequences happen to them. And the voice in their head was, oh, this will be nothing. This is no big deal. Don't worry about it. You know, nobody's going to remember this. Just move on. And in fact, the matter is it winds up having a.
tragic consequences for them. So yes, and I'm writing a three-volume novel now, and I'm talking, I talk about, and I trace the development of scientists who actually focus on doing, being true to their principles and the terrible prices they pay, and the scientists who are not true to their principles who lose themselves.
And that book is, well, those series of books is called Catching Cold, right? Yes, that's right. The first volume, Breakthrough, is out. And I'm in the middle of writing the second volume, Rivers of Redemption. And then you also have another book, another novel coming out, Saving Grace. Yeah, Saving Grace. Now, Saving Grace is my first novel. It's kind of my labor of love.
You know, I first wrote it. I didn't know how to write novels. I started writing it in 2005, I think. And it was a real chew job.
And I would come back, and I'd come back to it, and I'd learn something else about novel writing and come back and come back. And then this was bedeviled by copy editing. We finally got it together. And so it's re-released this year. But it is about a young scientist who has a terrible experience. She does what she believes is the right thing, and she is vilified for it. She loses her job over it. And she then decides to take the other path
And there's nothing but sorrow for her there. Yeah, the stories that you're writing about seem actually really dramatic and very interesting. But they seem very real, right? Like you said, I haven't had the luxury of reading one of your books yet. I will, though. But even just the synopsis, it paints a picture that is very believable.
And, you know, it really just all centers around kind of walking that ethical and moral tightrope. Yes. You know, and one slip to either side and, you know, you could be screwed. Yep. And so what I have to do, and I haven't done in my books yet, Justin, is to deal with the other shoe. So if one accepts my representation that if you're a good person, these are the two alternatives. Yes.
And this is coming for you. How on earth do I manage this? You know, and I think the answer is you have to be prepared to know what you need and know what you can leave behind.
So let's get into the – when it comes to like the United States and the FDA, because obviously the FDA, Federal Drug Administration, I guess. Is that correct? Food and Drug Administration. Okay, I sound like an idiot. But Food and Drug Administration. But you seem to be overall quite –
quite critical of, I guess, the system in which things, food and drug products are tested and approved. What is that system like? Because, you know, you have firsthand experience and knowledge into the system. What is the testing system? How are these clinical trials being done? And how are things ultimately getting through and into market? Sure. So let me give you an example.
Let's say that you, Justin, are the CEO of a drug company. Okay, let's just say you're the CEO of a drug company. Your job is to two things. One, make products that are safe and effective. But two, money for your shareholders. You got to do both. If you do the first one, they'll say, nice job, give you a nice plaque and say goodbye. So you have to do both.
So you have molecules that scientists tell you are promising. One molecule is promising for perhaps central nervous system effects and treating mental illness. Another molecule is promising for heart failure. So you spend money to develop the chemistry for these molecules. Okay. And
Most times, the chemistry fails. The molecule can't live in, I'm sorry, I don't mean live. It can't keep the right configuration for in the pH that is in the central nervous system, for example. So there went $90,000 down the chute.
Okay? And you have a few other molecules you work up, and now those molecules seem to be able to function in vitro, and so now you begin animal studies. And in the animal studies, the animal studies fail. So the animal studies cost you maybe $175,000. If you get that far,
Then you're able to start some phase one human studies. These are studies in primarily normal volunteers who take this drug and are monitored very carefully for any effects, for any effects, okay? And so the drug that we thought might have been effective for heart failure causes seizures. Well, nobody anticipated that.
And so that fails. And now you're talking about up to a half million dollars of investment down the tube. And you then go to phase two studies. Phase two studies cost hundreds of millions of dollars. These are studies, small studies in patients, not normal volunteers, but patients who actually have the disease. And you find that most phase two studies fail.
So now you're in the order of hundreds of millions of dollars down the tube. Then you come to the phase three study for one. And one drug gets to phase three. It's a large study which replicates the phase two result. So again, looking at sick people, we now know the dose of the drug to give and we assess them for benefit.
And the phase three study looks promising. Unfortunately, there's a relatively rare adverse event that occurs. And now the question is, what is the role now of the company? Now, shareholders, first of all, I am not a fan of shareholders. Shareholders to me are interested in money. OK, so I get capitalism, but I am not a fan of shareholders. Shareholders don't care about adverse events.
You know, they want return on investment, you know, and they will say to you, Justin, are you really telling me that you invested $1.1 billion in this product and you're going to sink it because of this rare adverse event? You're under a lot of pressure there. Oh, yeah. Right. And likely you make the wrong decision. You wind up losing your job and you won't be CEO anywhere else. So what do you do?
Most drug companies, most drug companies are interested in getting the drug approved. And so they try to pitch the corners and they say, well, you know, maybe we could do a post-marketing study just to see after you approve the drug, just to see how serious this adverse event really is. Or maybe what we do is, excuse me, is
Treat people with a relatively harmless intervention that will help reduce the likelihood of this serious adverse event. Maybe we can give them shots and it would help decrease the likelihood of this. The temptation is to downplay
the serious adverse event because you want your return on investment. And you want the return on investment, Justin, not just on the 1.1 bill you put into this, but on all the other drug failures. Nobody paid you for that. You know, when the animal studies failed, the government didn't say, well, Justin, I'm really sorry about that. Let us reimburse you for that. You absorbed that.
And so, you know, as a CEO, you are in a really in quite a crucible here to decide what's in the best interest of the company, what's in the best interest of of public health and what's in your best interest. You know, my thesis is that the only way you can fairly answer that. And just that I would say, if you're just thrust in this position, how terrible is that?
Because you haven't thought about this before. These are titanic concepts for you, and you hadn't thought about it. My thesis is, as you develop as a scientist, you are always asking yourself, where is my ethical position? Have I crossed my ethical line? And what am I willing to give up for my principles?
You know, for somebody to take you out of it, for a CEO who decided that money is everything, the decision is easy, right? Let's just approve this baby. For somebody who has decided I really am concerned about public health implications, then I'm willing to give up my CEO position. They've already agonized through this.
develop the wisdom and are willing to say, you can have this like JFK sold Congress during the Cuban Missile Crisis. You can have this lousy job.
I would have to assume that most people probably fall somewhere in the middle, right? They're not completely, just completely driven by money 100%, but they're also not just driven by their moral and their principles and their moral compass 100%. They probably skew somewhere in the middle as I would. And when you're put into that position, I can only imagine that, God, it's after hearing what you said, it must be so hard to,
and so rare to have a promising drug that actually makes it through all those phases. And when you finally, and after all those failures that don't even make it that far, after all those failures, when you finally get one that passes through and it shows a lot of promise,
And then it's, and then you have a hiccup of, you know, something adverse effect at the last stage. I mean, God, you got to just be pulling your hair out and your whole world kind of distorts in terms of what you should do and what is the right choice. And you have pressure coming so many ways internally. You're probably just being torn apart. I just, yeah, I feel bad. I feel bad for people in that position. So, but Justin, I absolutely agree with you.
That was how the Carvada law people looked at me. They had just gotten their way. You know, it's the football player who breaks all of these tackles and gets to the five-yard line and Mouier has him by the ankle. Red zone defense. You got good red zone defense over there. Who the heck is this guy? Where did he come from? Why should we allow him to ruin
to essentially destroy this drug's development. You know, that was their point of view. And that's why these FDA meetings can be so cataclysmic because you have public health perspective from the one hand, rigorous methodology on the one hand, and you have market forces on the other, you know? And most times they're kind of just glancing blows, but every now and then there's going to be a rumble.
Well, what's the, I don't expect you to necessarily have an answer, but what's the solution to this? I mean, is it something as paradigm shifting as when it comes to drugs and drug development, it maybe shouldn't be privatized because private companies are always going to have a financial interest.
You know, they're always going to have a financial interest to survive and make a profit. And as you said, shareholders, that's always going to be the case. That's always going to be the reality. The only way I see out of it is that you it cannot be privatized and it has to fall under some sort of federal or central control when it comes to drugs. Well, I agree. I mean, you have to tear the economic heart out of the system.
Because this all goes away if it's not an issue of money. Companies will look at a lot more molecules if they're not losing money on each molecule that fails. So you have to take the money out of it. Now, how one takes the money out of it, there are, I mean, there is take all the money out and have the government pay for everything, you know, that which would be the alternative. But find a hybrid.
Find a hybrid that works. And maybe the hybrid is something like the government's willing to put a greater percentage of money in early drug development, a lower percentage of money as you go through. So the accumulated cost to the company is not so great. I mean, there are all kinds of different economic models that could be studied and applied to this. But there has to be...
There has to be the rationale for and the motivating, the power of motivation for the drug companies to say, look, we've had it. We can't do this anymore. And they're not there yet. There's always somebody, God bless Microsoft, there's always somebody who manipulates a hyper Excel spreadsheet and shows how we can really make money if we do something like this.
It's like the cherry picking of information, right? The cherry picking of data to show one story. Just like what we mentioned, kind of like almost like you can draw parallels to media and how it spins stories and how it spins the narrative. Well, people do that with numbers and figures and research data too. Yes, absolutely. Absolutely. Well, Dr. Moye, I want to switch to a slightly different topic of discussion and
To me, this is kind of like the elephant in the room, I guess. But before we get there, I want to talk about your work and your experiences as an epidemiologist and biostatistician. But before we do, because I don't want to put words in your mouth, can you kind of just in layman's terms describe
explain what epidemiology is. Sure. Let me, let me correct our record that 2001 storm was tropical storm Allison. I couldn't remember it 40 minutes ago, but tropical storm Allison. Okay. All right. Uh,
Well, just before you get there, I mean, that just proves there's so many storms, especially, I mean, when I was growing up and I was a kid, I don't remember there being all these natural disasters so closely one after another. And it seems like within the past couple of decades, it's
There's just so many where you even forget the names. I mean, any one of these storms alone back a long time ago would have just been a huge event in itself. And people would remember, like it wouldn't be like forgotten amongst the mountains of other, like all the other storms that have happened. Yes. So, I mean, I just wanted to make that comment. I mean, you know, that's absolutely true. And rather than, you know, I think Americans are,
have a wonderful capacity to solve problems. You know, you give Americans a problem, a current problem to solve, either making a vaccine or coming up with a new traffic light or working on a new communication system for a satellite. Americans love to solve problems. I think our difficulty, our weakness is that we cannot appreciate problems that aren't on our plate.
COVID, a year ago, we were told you will have multiple waves of this. This will likely last into 2021 or 22, and you have to take steps now. People yawned. And climate change, as you point out, is another issue. I was surprised to learn, Justin, that at high tide, Norfolk, Virginia floods regularly.
At high tide now. Water is in the street. I didn't know that. You know, also I've heard, but I don't know. I heard the same thing in Miami about three years ago. And also somebody told me that Wall Street was that way. Wall Street. Wall Street? I haven't heard that. Really? In New York? Yeah, in New York. So at high tide, there are streets in Wall Street. I mean, the subways don't flood, but there are streets in Wall Street down by the Battery, which have water on them.
And rather than have this be, oh, my goodness, now we've got to do something. People just shrug it off and say, well, well, OK, pay attention to when high tide is that determines what shoes I wear.
Yeah, it becomes normalized and then it's not even a thing anymore. Right, right. But let me get back to your question. So epidemiology and biostatistics are about the same thing. They are about trying to determine the true nature of a relationship. Some relationships between exposures and disease are wholly coincidental. Some relationships are absolutely causal.
like cigarette smoking and lung cancer. It's the causal ones we have to identify because if we can interrupt the chain of causality, we can improve life. That's the idea. But it's very tough sometimes. I'll give you an example, more like a detective story.
a lady, a businesswoman hurrying to the airport, gets out of her Uber and crosses the street into the terminal. Okay, gets in, goes through security, checks her luggage, has a few minutes. So she goes to a kiosk, drinks some orange juice and she dies dead on the floor. So why did she die? So there are lots of questions you have to ask.
Did she die of natural causes? Did she have an arrhythmic death? You know, if your heart suddenly stops beating, you're dead before you hit the floor. She had an arrhythmic death? Well, that's possible. Was it some kind of quick-acting poison? Well, okay, I guess that's possible. So what would that be? And it took a long time to learn that somebody found a swelling on the back of her neck where a bee had stung her.
when she was coming in from the Uber to the terminal, and she had anaphylactic reaction and she died. So it just takes some clear-headed scientific reasoning and discipline to eliminate all of the other suspects and narrow yourself down to what the cause is. I don't know if you all remember
Well, I guess you probably wouldn't. In '76 or '77, these veterans got together in New Orleans, sorry, in Philadelphia for a huge conference. They were called legionnaires, they were called legions. These veterans got together and they began to get this strange pneumonia that included vomiting and death in four or five days. And nobody knew what it was.
It was epidemiology that determined that there was a brand new bacteria, brand new bacteria that lived in the HVAC units of the hotel and was spread from the HVAC units into the surrounding environment, caused infections and killed them. And it's called Legionella hemophilia.
When I was an intern, nobody could understand these weird lesions that were appearing in homosexuals in San Francisco. They're called Kaposi's sarcoma. Nobody knew that. Nobody, we hadn't seen it before. And it was epidemiologists who determined that, in fact, this is the cause of an infection, a very unique infection that affects the immune system.
So it's epidemiologists who do that kind of work, who are called to the scene of the crime. They get together all of the suspects, try to winnow down what the causes are, and then make a determination. Biological detective. Yes, that's exactly right. And epidemiologists are commonly known as disease detectives. I mean, coronavirus, of course, it starts in China.
And when it gets out of the lab, it becomes less a problem of virology and more a problem of epidemiology. Is it spreading? How fast does it spread? How sick do people get? How likely is a person to be hospitalized? How likely is a person to die? It all is about observation and careful measurement. So...
positivity rates are epidemiology concerns, R-naught rates are epidemiology concerns, as we develop these models that provide some broad idea of what the future may hold. I know you're retired, but because of COVID, do you ever get like, because of COVID, did you have that itch to kind of, I don't know, sink your teeth into this one? Oh, sure, sure. I had a
So you did get tempted to put my, get my teeth back in Arizona, never really organized. They didn't call retired docs, pre-graduates to come and help. But you know, the more I thought about it, I said, look, I'm 68. My wife is 72. She has pulmonary problems. Is this really the wise thing for me to do? That kind of reasoning kind of pulled me back from trying to force my way into being a volunteer.
So, yeah, I mean, you know, I mentioned the elephant in the room before and, you know, how we brought it up is that, you know, as an epidemiologist and you've been in this field for over 30 years, but now, you know, you're retired and, you know, now in the last year or so, you see the coronavirus playing out the way it did and the way it's still playing out.
I mean, what's going through your mind when, you know, as now more of a just a citizen and just an observer, you know, with all the experience that you have, like what's going through your mind as you see it play out in terms of how the U.S. has responded, both the people or the government or, you know, whatever it is and how people are taking it and how the response has been? Yeah, I'm disappointed.
I think the U.S. response has been inchoate, principally for two reasons. One, an administration that wallows in misinformation and disinformation, there's a lot to blame for that. But also, it comes down to the American people. The American people don't think much of education. The American people don't think much of expertise.
And we are paying the price for that. We are the only developed country that doesn't value, where the citizenship doesn't value education. And it has been a problem in this country for, well, since the founding fathers. This has always been a problem in this country. And there are lots of different reasons for it. But
It is part of the core of many Americans who just don't think much of education. They don't think and they don't think much of what education will get you. They have a very different metric for life and they are putting themselves at risk. I remember when crack addiction was ravaging the inner city communities, primarily African-American inner city communities.
And the only and nothing worked. In the end, pestilence wipes out the susceptibles. You do what you can. But if people are susceptible, pestilence is going to wipe them out. I think the lack of education, the lack of interest in public health, the assault on public health workers is going to come back to bite these people. They're going to be.
get ill, critically ill. There won't be hospitals nearby. There won't be healthcare workers nearby. And sadly, they're going to die. And they're going to complain bitterly, of course. But we make our own, you know, we made our bed. Do you attribute it? I mean, you mentioned, you mentioned it just now before, but do you attribute it in terms of
And I tend to agree with you. I'm just curious as to what makes you say there's Americans in general don't have really an appreciation for education. Is it the fact that they're so...
easily convinced and quick to believe misinformation and how easily misinformation spreads out there? It's because I think, Justin, they don't even know to question. You know, with education, you learn to read critically. You learn to ask questions as you read.
You learn to discern what is likely to be very true, whereas what is likely to not be true at all, but is the author's opinion. You learn to do that. And then you apply that tactic to everything else you're exposed to, to speeches, to Facebook.
And we know, and therefore we can make some progress because we all have a common fact set. But there are people who don't care about facts now. There are people who operate as though what they believe has value. And the fact is, Justin, there are 8 billion people on this planet. Not one of them cares what I believe. They care what I can prove. They care about what I can prove.
If I can bring facts to the table, I've got some attention. If I'm simply expostulating about I think or I believe, nobody really cares. Even that might be giving them too much credit. I mean, I'm a little even more extreme in my thoughts. I think people don't even care what you can prove. They just care what side you're on now. It's like pick a side and they want to know what side you're on. It doesn't matter what you can prove. It doesn't matter what you think. They just want to know what side you're on.
And, you know, public health has been so politicized. Yes. And it's it's it's insane. It's insane. And I just I'm just wondering, like, you know, it's insane for me. I can't imagine how you feel about that. Yeah. You know, the fact that public health workers are assaulted, that they are spat on is is is just one more barometer.
of one more measure of how in fact this country or many people in this country don't value the contribution or the sacrifice of others. Are these occurrences you've seen and heard about through your circle of people you know in the profession and in the industry,
Or is this also just information you're getting through the news, though, in terms of public health workers being attacked, being spit on, things like that? Because to be honest, I haven't heard much about that. Yeah. Yeah. So it's been it's been pretty much my circle. There are public health workers, nurses who were spat upon, especially now with this issue of the politicization of masks.
And, you know, the notion of whether you can, whether you should or should not wear a mask, you know, masks have become when that became a political statement, public health became a political statement. And to go back to what we were talking about earlier. So what should the response of public health be? Right. I mean, public health is an organized practicing discipline.
There needs to be a response of the discipline, and there needs to be a response of politicians supporting the discipline. I mean, look at poor Deborah Birx, right? Head of Medicare, an absolute track record, a perfect track record of research, of an intellectual discipline. And she got tagged along with Fauci.
to be part of this coronavirus task force and she commonly appeared with Trump. Now, here she is, someone who absolutely understands what public health teaches about discipline and what public health teaches about infectious disease.
And therefore, there is a need to stay apart. There is a need to avoid large gatherings. There is a need for masks. And she's standing there with a man with tremendous power who is dissing all this. You know, what is her role in this?
No, I don't think I'm saying, though it would have been great to see her turn around to the president and say, Mr. President, look, I'm sorry. You are 100 percent wrong on this. And frankly, I told you this before. You're standing here talking about this now. You know, if she had done that, we would not have seen her again. Right. Not a senior again. But she would have been true to her core.
And she probably still she would have had a lot of support, even if she had done that. I think a lot of us watching those press conferences were probably screaming at the television, wanting, you know, either Dr. Fauci or herself to kind of speak up, you know. And, you know, when Trump was talking about what was it, lights in the body or drinking cleaning fluid.
That would help bleach to help you fight the virus. And she's sitting right there. And, you know, she's got to be thinking, my God in heaven. Why is this man? You know, but but she never got up and said that she never got up and said. And so many people understand why she didn't do it. But look at her now. I mean, now she's just trying to find her way through the wasteland of her life.
uh unwillingness to speak out it's almost like a lose-lose scenario i mean again again you're exactly right it is i mean for good people it is clearly a lose-lose scenario and so you just have to be ready to decide what you're willing to give up for your principal you know speaking of masks oh go ahead no go ahead howie okay well speaking of masks the um
This morning, I don't know if you heard yet because it's still like, you know, just six something o'clock over there. Texas. Yeah.
is today announced this morning fully open and they have lifted their mask mandate. So they have completely 100% lifted the mask mandate and all businesses are 100% back to a full capacity. Everything's been open. And it's a very controversial move. I'm sure from a public health perspective, it seems like a very foolish move.
But it just keeps going to what you're saying. There's this and people are cheering and whenever and people are still like when people are asked to wear masks, at least what I see in the media again, you still see a lot of people booing, booing people, asking them to put on masks.
And it's this whole politicized thing. And it's, you know, Howie and I are here in China. And in Asia, wearing masks was part of the culture even before COVID. Yes. Because of the pollution, because of SARS. You know, in the Japanese in particular, they were always big on just wearing masks in general. Right.
So for us, we see it as like such not a big deal. You know, to me, it's like when it's raining outside, you bring an umbrella and it's as simple as that. No one's going to argue and holding an umbrella when it's raining is not going to be politicized. And to us, that's how we see wearing a mask during a pandemic. Yeah.
So, it's mind-blowing from our point of view over here how it's still an issue. Well, it's mind-blowing in most states here, too. But Texas likes to, at least the Texas leaders, like to hold themselves out as independent thinkers, which means...
You don't take advice from anybody else. That's not independent thinking. Yeah, right. That's an independent thinking means you consider advice from people and you take the best advice. Texans like to treat themselves as insular and they want to treat themselves as separate from the federal government until there's a disaster when they go to the government with their hands out.
So I did hear about Abbott and also the state of Mississippi is also giving up masks.
Now, the state of Texas, I expect moronic behavior from these people. I mean, really, they mismanaged, they wholly mismanaged this last winter crisis, even though they had one eight to 10 years ago. They wholly mismanaged it. And this is going to be another example, like they did last April. They opened up and sure as the world, here's a surge in May.
And they have to close back down, you know. So Texans have the opportunity to throw these people out, get rid of this point of view, and bring themselves into the modern era. But many Texans are stubborn. There are 30 million Texans. And many Texans look at what Abbott does, look at what Cruz does,
has comments that Cruz has made, and they wholly support it. So how do you see this playing out in the months to come? I mean, is it pretty predictable? I think so, yes. Yes, many Texans primarily, I mean, it will be very difficult for Randalls or CVS to enforce masks
when the governor says you don't have to wear a mask. That's going to be very difficult to enforce. So I think the local businesses are going to give way and they're going to allow people in without masks. And this virus is going to resurge
Because it's all about the ability to infect people who haven't been infected. And infect rates are going to increase. Hospitalization rates are going to increase. And Abbott's going to have to decide that, well, you know, we're going to have to step back a little bit.
I think that's the way it'll play out. Viruses are pretty clear. They don't care about mandates. They don't care about, you know, viruses. They exist to infect and reproduce. And all they need are more people to infect.
Now, Biden has promised that by this summer, I think by May or June, he said there will be enough vaccines for anyone that wants them. Have you got vaccinated yet? I have not. My wife is going to get vaccinated. She decided when we became available because of our age range.
Vaccines were available to us. It's a question of how, whether you can get an appointment. So my wife is looking at CVS and will likely have an appointment in the next, well, maybe this week. I had decided I wanted to wait until a million people had been vaccinated and we had six months of data on them. So that will likely happen in late May.
And if the data all look good, I'll go ahead and get vaccinated. I get vaccinated for the flu. I mean, I had two flu. I never want to go through that again. I'll take two vaccine shots for flu. You know, I really... So I'm not against vaccines. I just want to make sure I understand what the data show. I mean, do you think there's any type of shady business going on with that from your perspective? Well, good question.
I would say I have no evidence of that. But I would say that you take a process and you compress the timeline. That does not help quality. It doesn't help quality. And so I just want to wait and watch and see.
You want more data. That's right. Just want some more data to see what's going on. If in fact it all looks good, then I'm talking about adverse events here now, then I'm all for it. But you know, what is it? J&J, their vaccine is 50% effective if you're over 65. 50%? I mean, the flip of a coin? Really? Yeah.
So I want to hold on that. I just want to hold. And also, we have to see how these new variants do. So far, these variants are pretty minor. And the scientists and virologists tell us that the vaccine should still cover the mutation. Viruses, while they are not alive, they are amazingly adept. And they are always looking for a hook and an angle to get at us.
Have you been doing research on all the different types of vaccines? Because, for example, what China has created, what America has created, all the different corporations around the world so far have created the differences. Yeah, I have. And the differences are fairly technical. The antigen is the viral particle itself. So the question is, do you inject part of the antigen
messenger RNA from the virus, or do you inject part of the surface coat of the virus? And what kind of antiviral responses do you get from these different types of antigens? Oh, these are all very legitimate avenues of exploration. I wish we had another 18 months
to assess which was going to be better than the other. But trying to assess it right now, it's like trying to decide who's going to win a hundred yard dash after the first second. You know, somebody's ahead, somebody's behind, but you got another 90% of the race to go. That's a great analogy.
But also a comment you made earlier, you said a lot of these companies are claiming that the current vaccine should also be able to cover variants and mutations of the virus. I mean, that sounds like a very blanket statement that like, how could they possibly know that? Right. I mean, that's a good point. So if I have a part of the viral coat that
And I'm using that as my antigen. And the mutation doesn't change the viral coat, but it does change the messenger RNA a little bit. Then as long as it doesn't change the viral coat, I'm still in good shape. So the question is, just what does the mutation do? But guys, I mean, this is a game the virus ultimately is going to win, you know, because it's
We shouldn't think of our nasal cells as being, say, infected by coronavirus or infected by adenovirus or pecanovirus. Our nasal cells are infected by all of them. So these viral particles get within the cytoplasm of the cell. They're not segregating. They're mixing up.
And so you can have a virus that has part of the adenovirus RNA and part of the pecanovirus RNA that will be completely different type of infection. So these viruses are, the degrees of freedom they have to develop new viruses vastly outstrip our ability to manage them, which is why masks always work.
Vaccines don't always work. The virus may pitch the corner on a vaccine and the vaccine may not work, but masks always work. On the other hand, just as a humorous aside, there's one virus I was reading about that when a cell, it produces 10,000 copies of itself.
And the cell, it gets so distorted, it ruptures. And these 10,000 copies affect other cells. 90% of those copies are defective. It's like Agent Smith in The Matrix. Yeah, that's right. That's right. They don't work the way they thought they would. Yeah.
Leave it to me to put in a Matrix reference. So in your opinion, Dr. Moye, what's the end result here with coronavirus? I mean, as time plays out, is COVID just something we have to live with for the rest of time now? Is it here to stay? And it just depends on herd immunity or will it go away? No, no, the virus won't go away. Virus is here to stay. It's got a foothold.
in humanity, and it's going to continue to work like common cold viruses continue to work to get at us. So the only thing that what works best for them is a combination of mask distancing, which is not a bad idea, even without coronavirus. You know, one of the reasons that flu is not an issue in the United States is because people masked up.
And we usually don't mask up for flu, but they masked up and flu virus is much less of an issue. So the things we can do are flu viruses and continuing to work on the best vaccines. But the virus is always going to be around like the poor will always be with us. And there'll be other viruses on the way. So this is just a new way of living. That's right. That's right. You know, if you look at.
Viruses have been, mankind, our species has been here, let's say, giving us the benefit of the doubt 90,000 years. 90,000 years. Viruses have been around for billions of years. They infected dinosaurs. They infected plants. If you name an organism, you can find a virus that infects that organism. Viruses infect bacteria.
Pneumonia bacteria, tuberculosis bacteria, viruses infect them. You know, viruses infect mosquitoes, which actually I'm okay with because mosquitoes are no good. But viruses infect pretty much everything. And they will, they infect plants, fish. They've been doing it for billions of years. Man's 80,000 year reign is not going to stop them.
Well, in many ways, I think maybe we got lucky with coronavirus that it didn't have a higher death rate than it does, right? I mean, it could have easily gotten a lot worse if it was something more serious. Sorry, I didn't mean to cut you off. Absolutely. You know, if the coronavirus case fatality rate was 75%, I mean, it would change our world. Yeah. I mean, a dramatic reduction in population. Now,
Like to think that there are people in the U.S. would say, oh, you know, masks are really a good idea. So is there a is there a greater focus now? OK, so now that coronavirus is a reality and a lot of people, I think that probably weren't in your field, just normal people got a huge wake up call over the last couple
a year really. Do you think there's a greater focus now in the scientific community to kind of try to find out what the next pandemic might be and how to prevent that? Is that even possible? It is possible. It requires vigilance and it requires solid communication. The most recent viruses have been viruses that have jumped mammal to mammal, right? So bat to man.
And most viruses cannot do that. But if you say 90% of viruses can't do it, but there are a million viruses that are trying, well, then you can expect there are going to be viruses that are going to jump and they're going to have the impact. What we have to do, which we find so difficult to do, is to manage our response. What do you do about airline flights?
You know, it takes that many. Watching the world manage airline flights is watching the proverbial farmer chasing the chicken with his head cut off. You know, we just keep swiping at it and swiping at it, but we just can't do it. We need to have a uniform approach to shutting down flights. And there needs to be an expectation among us all, vacationers in the business community, that don't be surprised if your flight is canceled.
Don't start complaining if your flight is canceled because of a concern about a virus. Because by doing that, you go a long way to removing the pandemic from the viral infection. You know, if the viral infection, Ebola, for example, Ebola is so dangerous that any community that's found to have it is isolated. And so that's why
Ebola didn't spread around the world because we understood the danger and you shut down flights coming from the affected communities. But I think Justin said to say coronavirus wasn't dangerous enough. You know, if the reports coming from China said that 90% of people had died, then there would be a huge and massive response.
But if it comes out and says, well, you know, for 85% of people, it's just like the common cold, that's essentially a kiss for any kind of coherent response. Because everybody knows you can't do anything about the common cold. You endure it for five to seven days and you move on with no consequences.
Yeah, I think there was initially, there was also kind of mixed messages, right? So I think the initial reports, you know, it didn't paint it as serious as maybe it was. But at the same time,
The whole world saw China completely shut down Wuhan. I mean, the whole city of millions and millions of people completely locked down. I mean, in my opinion, if that didn't send a clear message like, hey, we're taking this seriously, this is a serious threat. I mean, just think about the logistics to shut down an entire city like that overnight, basically. I mean, but I think the common...
response globally, at least in the Western world that I saw was that people were kind of just criticizing the move, maybe laughing it off in a way and just not taking that kind of that move seriously in the sense that they decide, oh, there goes China again, you know, that's communism for you or whatever, you know, whatever their opinions were at the time.
And but instead of taking it, be like, look, think about the logistical nightmare it is to do that. They're probably doing it for a reason. And it's probably serious. Otherwise, you know, it wouldn't happen.
I agree. I mean, I was affected by that. And also the notion that the Chinese were putting up new hospitals within 10 days. Yeah. The fact that they were doing that, I mean, it says to me, my God, you know, listen, the Chinese are taking this seriously. Forget about what they said the first 18, 24, 36 hours. They are taking this seriously. These countries all need to take it seriously. But again,
The business interests argue, well, why are you doing this? Why are you making us all shut down? China is 7,000 miles in that direction. You know, if it gets bad over here, we'll do the right thing. And there's no, in this country, the government doesn't have the, they have the authority. They don't have the courage that says, look, thanks for your input. You're shutting down.
And I mean, it was the same thing in 1918, too. You know, just people weren't prepared and the government didn't have the authority. I mean, they had the authority. They just weren't willing to put their political necks on the line and say, listen, we are shutting down, period. The looking forward besides covid, I mean, as a public health professional, like what do you see are the largest threats to public health?
going forward besides the coronavirus? Oh, okay. The most likely infectious disease problem will be a viral problem. So putting all that aside, the rest is easy. Nutrition is a huge problem. Nutrition and starvation is an unforgivable problem because we know what to do. And frankly, we just don't care enough to do it.
Really. The next thing is gun violence. Again, we know what to do. We just don't care enough to do it. You know, I get that people need to protect themselves. It's a violent world. But my goodness, do I really need to have 15 assault rifles in my house?
Well, are you, you're living, I assume, I'm not too clear on it, but I assume you're living in a region of the country where that's not a very popular opinion. Is it true? People, fortunately, people don't ask me very often, so I don't have to say. That's right. That's right. You know, people, it is, guns are prevalent. And I appreciate that. I live in a community where if we have a
some problem with violence, I call 911 and the police are here in three minutes. You know, three minutes. If you're living out north of Flagstaff or if you're living way west of Peoria, police will get there maybe in an hour and a half. So you've got to have something to protect yourself. I get that.
And, you know, and as long as and America has been a violent society since before its inception. So as long as we're violent, we need ways to protect ourselves. But I don't think you need to have a howitzer.
I think to kind of wrap it up, I know you got a busy schedule. I don't want to take up too much of your time, Dr. Moy. But I think going forward, when you look forward and in the context of disease and viruses and public health or global health really at this point,
Do you see a pathway to more cooperation between countries and between different agencies of different countries?
to kind of communicate in real time. I mean, I know it's already, there's a structure and there's a system already there. Um, but I think a lot of people because of the coronavirus don't have a lot of confidence and faith in that system. Um, and whether they're right or wrong, probably think that the system underperformed in this particular example. Right. Right. So, uh,
What took us, what undermined us all was the politicization of this. The unwillingness to accept the common set of facts
the unwillingness to sacrifice for other countries, to share resources with other countries, that set us back a long way. And that's a human problem. But it's up for Americans. It's up to us. You know, if we're embarrassed...
And we are ashamed of the government for how it conducted its coronavirus response. Then we changed the government, which is what we did. And now we are getting cooperation with WHO. And we are having less encumbered, more scientific conversations with fellow scientists. So, I mean, that was a step in a good direction for us.
And you attribute that change to the change of administration? Yes. Okay. All right.
Well, look, Dr. Moye, I mean, honestly, I can talk to you for hours upon hours. I honestly, I thoroughly enjoyed this. It was really an honor to talk to you. You know, I would love to have you back at some later point. We can talk about some other things whenever you'd like to come back on the show. Okay. But, you know, thank you. Thank you for being on the show, and we should definitely keep in touch. Okay, absolutely. I apologize about the confusion, the initial confusion about today.
But I enjoy talking to both of you and would welcome a chance to come back. I feel like we just scratched the surface, you know? Yeah. Right. Yeah. We took a very broad approach this time. We had to cover a lot of ground, but we didn't dive too deep on anyone. But we can talk forever on any of the topics we've discussed today. And I would love to get into more with you. You're a fascinating mind. How can people find you, Dr. Moye? Well, I have a...
A website, which is just principal-evidence.com. And my email is lemoyer at principal-evidence.com, no hyphen. And your new books coming out, how can people find those books? Oh, those books are on Amazon and Kindle. Amazon and Kindle. Okay. Are they going to be on Audible? I have an Audible subscription, but I'll get the Kindle. I'll get the Kindle.
I will have to check. I don't really know. Good point. Very good question. You should look into audiobooks. I'm a big audiobook guy because I like, obviously as a podcaster, I like absorbing my content through audio, but I need to do some more reading. I'm definitely going to pick up your books and start reading those. I mean, they tell a very fascinating story. Again, thank you, Dr. Moye. Thank you for your time. Thank you. Thank you. Thank you, Dr. Moye.
Okay, thank you. Thank you, Justin, and thank you, Howard. Take care. Thank you so much. Bye-bye now. Bye.