A Conversation with Siddharta Mukherjee About the Pandemic

Siddhartha Mukherjee is the author of

Siddhartha Mukherjee is a cancer physician, researcher and author spoke with Sam Harris about the Covid-19 Pandemic on August 13. The podcast helped me clarify my thinking about the virus and reopening school.

  • Covid-19 is unusual in that asymptomatic people can spread the disease. The only other disease I can think that is like this is HIV. Because of this, testing plays a vital role in controlling the spread of the virus.
  • All organizations (governments, CDC, WHO, businesses, etc.) made many mistakes throughout this pandemic. From the WHO recommending not to wear masks, to the CDC producing tests very late, to Chinese officials withholding information, to the US government applying a travel ban within 24 hours from Europe, driving many Americans together at crowded airports, etc. We have learned much in the past six months are learning more about this now, not-so novel coronavirus.
  • A key statistic is the number of deaths, which are not dependent on the amount of reliable testing in a country.
  • The overall case fatality rate (number of people with Covid-19 who die) is 0.7% and this rate is pretty steady around the world. Rates are higher for susceptible populations, including elderly and co-morbidity conditions.The good news is 99.3% of people that contract Covid-19 survive, the bad news it is 7x more deadly than a regular influenza.
  • The immunology of this coronavirus is not normal. One study shows up to 1/3 of people generate antibodies against coronavirus, but doctors are not sure if they are totally immune and how long it lasts. Another study shows 40% of people tested, naturally have T-cells that recognize Covid-19. These are not antibody producing cells like B Cells and it is a mystery as they have never experienced this virus before. A final peculiar trait is the reaction of the innate part of the human immune system. Some people do not produce interferons to signal the immune system to kick in, and they do not do well with the virus. Other people’s innate system produces too many weapons against the virus that also causes a severe reaction.
  • Another factor of this disease, is we are not sure of the long-term effects of contracting coronavirus. So even though most people will have a mild form of the disease, there may be long-term effects, including vascular damage, changes in the microsystems of the brain, etc. So we cannot say that this is just a version of influenza that is a little stronger. For example, patients may develop vascular problems 10-20 years in the future. We just don’t know at this time.
  • He believes a vaccine can be developed and he trusts authorities (FDA,others) that it will be safe. Protecting the vulnerable people will be the first priority when a vaccine is produced.
  • His advice on school reopenings…he is not convinced that schools can reopen safely, especially in the USA with lax enforcement of hygiene and distance measures.

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