August 10, 2021
American Thought Leaders
“Those who are pushing these vaccine mandates and vaccine passports …
they’re doing so much more damage to vaccine confidence than anybody
else,” says Dr. Martin Kulldorff, one of the world’s leading
epidemiologists.
In this episode, we sit down with Dr. Kulldorff for a deep dive on
COVID-19 immunity, vaccines, the Delta variant, and why he believes the
global COVID response has been the “biggest public health fiasco in
history.”
Dr. Martin Kulldorff is a professor of medicine at Harvard Medical
School and a biostatistician and epidemiologist at the Brigham and
Women’s Hospital. He helped develop the CDC’s current system for
monitoring potential vaccine risks, and he is also one of the co-authors
of the Great Barrington Declaration, which argued for “focused
protection” of the most vulnerable, instead of lockdowns.
Jan Jekielek: Dr. Martin Kulldorff, such a pleasure to have you on American Thought Leaders.
Dr. Martin Kulldorff: It’s a delight, thank you for having me.
Mr. Jekielek: We’re about a year and a half into the
coronavirus pandemic. We’ve had lockdowns. We’ve had an emergence out
of lockdowns right now in places like New York. We were getting closer
to some kind of semblance of normality, and now we have the Delta
variant and there’s discussion of lockdowns again.
We have countries that actually have been in perpetual lockdowns.
You’ve described the global COVID response as, and I’ll quote you here,
“The biggest public health fiasco in history.” That feels like a big
statement to make. Tell me more.
Dr. Kulldorff: I think it is, without a doubt. There
are two aspects of that. One is, while anybody can get infected by
COVID, there’s more than a thousand-fold difference in the risk for
death between the oldest and the youngest. So with the naive belief that
these lockdowns would protect everybody—which now, obviously, we know
that didn’t work—a lot of people got COVID, and a lot of people died.
But there was this naive belief that they would protect the older
people. Because of that, we did not implement basic public health
measures to actually do what was necessary to protect those older
high-risk people. And because of that, many of them died unnecessarily
from COVID. The other aspect of it is the collateral damage from these
lockdowns.
For example, children didn’t go to school. The children are at
miniscule risk from this disease in terms of mortality. They can get
infected for sure, but the risk from COVID for children is less than the
risk from annual influenza, which is already very low for children. So
for them, this is not a risky thing. And one example is Sweden.
From the first wave in the spring of 2020,
Sweden was the only Western country that did not close down all the
schools. So schools and daycares were open for children ages 1 to 15.
Among the 1.8 million children in Sweden during this first wave, there
were exactly zero deaths from COVID. And that was without using masks,
without social distancing and without any testing. If a child was sick,
they were told to stay home. That was it.
So this is not a serious disease for
children, which we should be very grateful for. Also young adults have
very low risk for mortality from COVID. But the collateral damage has
been enormous from these lockdowns.
Cardiovascular disease outcomes and heart
disease has been bad during this pandemic because people don’t go to the
hospitals. The health care that they need is just not available, like
for diabetes patients, for example.
Cancer has actually gone down in 2020 and
2021, but that’s not because there is less cancer. It’s just that we’re
not detecting them. And if we’re not detecting them, we’re not treating
them either. This is nothing that shows up in the statistics this year,
except to a very small extent. But let’s say women who didn’t get their
cervical cancer screening might now die three or four years from now,
instead of living another 15, 20 years.
So the collateral damage on public health
from these lockdowns is something that we’re going to have to live with
and die with for many, many years to come, unfortunately. Then of
course, there’s the mental health aspect, which has been enormous and
tragic.
This has really been an awful response to the
pandemic which goes against the basic principles of public health that
we have followed for many decades. So it’s very unfortunate.
Mr. Jekielek: That’s very
interesting. You would think that the basic principles of public health
would be implemented and enforced in this situation. So why has that not
been done?
Dr. Kulldorff: That is a
very good question. To be honest, I don’t know the answer. To me, as a
public health scientist, it’s stunning that we suddenly threw out these
principles we have used for decades to deal with public health issues.
One is, public health is about all health outcomes. It’s not just about
one disease like COVID. You can’t just focus on COVID and then ignore
everything else. That goes against how we do public health.
Another thing is we have to look at it
long-term and not just short-term. People were obsessed with the
mortality for a particular month, comparing countries and so on. But
what’s important is not the count for a particular month, it’s long-term
overall mortality during the whole pandemic until it’s over.
Another thing is public health is about
everybody in society. With these lockdowns, we have protected the Zoom
class who can work from home—people like you, journalists, people like
me, scientists, but also bankers and attorneys.
While those who prepare food, people in
supermarkets, in the meat factories, people who make sure we have
electricity, they have had to work. So the burden has been put on the
middle class and the working class.
And of course the burden is also put on
children who need education. It has long-term consequences if you don’t
give children the proper education, and schools are very, very
important.
For rich people, they can put their kids in a
private school, or they can hire a tutor or they can afford to have one
parent at home to homeschool them. That’s not possible among those less
affluent. So the working class children have been especially hard hit
by this response to the pandemic.
Mr. Jekielek: You’re saying
that the effect of COVID or the risk of COVID for this young age group
is less than that of annual influenza? I don’t think that is something
that’s generally known.
Dr. Kulldorff: By now it’s
about 350 or so reported deaths by COVID in the U.S. for children. We
don’t even know how many of those are truly COVID, because nobody has
bothered to go through all those electronic health records, which I
think CDC should do, as Marty Makary, a professor at John Hopkins has
been urging, but that hasn’t been done. So we don’t know exactly how
many, but it is at most 350.
If you look at annual influenza, basically
two seasons or one-and-a-half years, if we look at the annual influenza,
depending on the severity of the particular strain, the particular
year, between 200 and 1000 children die from annual influenza every
year. Of course, every death is very tragic, whether it’s influenza or
COVID.
And of course, death of children is
especially tragic, but we never closed down schools for the annual
influenza. Actually there would be more rationale for doing that because
the influenza is actually spread a lot by children.
So the schools and children are one of the
drivers of the spread of influenza, but the opposite is true about
COVID. Most children who are infected get it from some adult. The
children are not very good at infecting others, so it makes no sense to
close schools. We saw that from other countries who have kept them open.
We should never, ever close any of the schools for COVID.
As we go forward, they should be open. We
should let the children be children. Education is very important and we
should let them get that in-person education. We know that both teachers
and students have said that online teaching is certainly not as good as
having personal teaching, but it’s also not good for their social
development and hanging out with their friends.
Mr. Jekielek: We’ve been
hearing a lot about the Delta variant, a lot of scary headlines about
the Delta variant. Maybe we’re going to need to go back into lockdowns
in the U.S. You’ve described some of the collateral damage and some of
the issues. What do you think about this discussion that’s happening
now?
Dr. Kulldorff: For any
virus, there are going to be mutations, so there are going to be
variants. And some variants will be more successful than other variants
in spreading among the population. Therefore it’s not surprising that
you have variants and some variants sort of takeover. This is not at all
surprising. The Delta variant may be somewhat more contagious, but
that’s not the game changer.
What would be a game changer is if you’ve got
a variant that started to kill young people, started to kill children.
The Delta variant is not doing that. What would also be unfortunate is
if you have a variant where the natural immunity that you have from
COVID or from a vaccine doesn’t work with the variant.
But we know that if you’ve had COVID, you
have very good immunity, not only for the same variant, but also for
other variants, and even for other types of cross immunity to other
types of coronaviruses.
We know for example, that if you had a
COVID-19 SARS-CoV-2, you have also have immunity to SARS-CoV-1 which we
had earlier, a few years ago. It also provides protective immunity to
the other four common coronaviruses that are endemic that we’ve all been
exposed to, and that we will continue to be exposed to.
So I don’t see any problem with Delta variants or any other variant that changes anything. It’s not a game changer.
The best approach is to make sure that our
old people get vaccinated to protect them. And then we should not have
lockdowns. We should let people live their normal lives.
And if they are an old person who hasn’t been
vaccinated, they should get it, and then wait two weeks. And two weeks
after vaccination, they are protected and they can also participate in
society. But until they are vaccinated, of course, all people need to be
very careful.
Mr. Jekielek: I want to talk
about natural immunity in a moment. This is very important because
there’s been a lot of different messaging about that. But before we go
there, in places like Florida and Louisiana, for example, right now
there is a surge in cases. Your thoughts?
Dr. Kulldorff: It’s
important to differentiate between cases and mortality. The fact that
somebody tests positive is not necessarily a worry, and it’s something
that we would expect. It’s something that’s going to continue to happen.
Because as COVID-19 becomes endemic, people are going be infected. If
you test them, they’re going to test positive.
They may even have the virus replicate before
the immune system kicks in. Maybe some of them might even spread it.
But as long as people are asymptomatic or mildly symptomatic, this is
nothing that we should worry about.
What we do have to worry about is mortality
and also hospitalizations. The benefit of being immune, whether it’s
because you had COVID or because you’re vaccinated is not to avoid being
infected and test positive. That is going to happen.
The key thing is if you had had COVID
already, or if you are vaccinated, that protects you against severe
disease and mortality and death. We can see that cases on mortality are
starting to decouple out now.
For example, in the UK, there was a wave of
cases that peaked in the mid-July. It was a very sharp increase and now
it’s going down sharply. For mortality it is just a tiny blip. So this
is a contrast to before the vaccines and before focused protection, when
cases rose and their mortality also rose in parallel. But the vaccines
and the immunity from people who’ve had COVID is decoupling that.
We can see it in Sweden, which had the first
wave. In the second wave there were increasing cases, and there was also
an increase in mortality corresponding to that. But then there was a
third wave that peaked in April. There was a third wave of cases, but
mortality just kept going down and it’s now has been close to zero for
more than a month. So there was also a decoupling.
That was actually the Delta variant that was
the third wave. That was predominantly the Delta variant that was the
increasing proportion of those cases in the third wave.
We see the same thing here in the U.S. now in
the summer wave that we see in the southern states. There has been
quite a few increases in cases. For the mortality there’s a blip because
not everybody’s vaccinated, not everybody has had the disease, so not
everybody’s immune.
So there’s a little bit of a blip, but we
don’t see the same close correspondence between cases and death as we’ve
had in the past. So that’s a very positive thing and a very good thing.
It shows that we are on our way from the pandemic phase to the endemic
phase.
We will always have COVID-19 with us. It’s
not going to go away. We can’t eradicate a virus like this, so it will
always be with us. When people get exposed to it for a second time, a
third time, a fourth time, the immune system helps, making sure that
it’s not a serious illness or death.
Of course, new people are born every year and
they are susceptible. They haven’t had it. So when children are born,
they don’t have the immunity to this particular virus, but we know that
it’s very mild for children.
So it’s a very good thing that this virus is
not harsh on children when they get it the first time. If there’s some
way you try to stay away from it until you are 80 and haven’t been
exposed to it—that would be impossible—but if you could do that, then of
course, when you’re 80 and susceptible, you would be of high risk. But
as long as you’re very exposed as a child, and your immune system was
built up, then the next time you will be protected by the immune system.
Mr. Jekielek: You mentioned
that the virus will always be with us, so to speak. I’m very curious
about that because it appears that in some of the public messaging,
we’re attempting to eradicate the virus entirely. Let’s put a
placeholder on that for a second. I want to talk about the natural
immunity that you mentioned.
There’s been a lot of conflicting messaging
about natural immunity. You’re saying that it’s strong and vibrant and
useful. Yet at the same time, there’s a kind of push to vaccinate
people, whether or not they have natural immunity. Am I seeing this
correctly? What’s going on?
Dr. Kulldorff: First of all,
we expected that we would have good natural immunity from a virus like
this. So it’s not a surprise that we do have it. There have been studies
showing that we have good immunity from having COVID before. People can
be reinfected and test positive, but there’s very few cases where
somebody had it and then they get the serious disease afterwards. There
are millions of people who have had COVID.
So if this was a common thing, it would have
shown up all over the place, but it hasn’t. So it’s very rare. Once
you’ve had it, you have good protection from your immune system for a
serious disease or for mortality. There has been some direct comparison.
There was some data from Israel that came out
recently showing that if you have had a vaccine, you’re 6.7 times more
likely to be reinfected than if you have had the COVID disease itself.
So we would expect that you get better immunity from the disease than
you do from the vaccine. And of course, there’s only that one study.
We don’t know exactly, but we can confidently
say that having had the disease at least gives you as good and probably
better immunity than the vaccine. Empirically, we know that if you have
a disease, you have at least one-and-a-half years of good immunity,
because the virus has been with us for that amount of time. So we know
that there’s long lasting immunity from having had COVID disease.
From the vaccine, we have less information
because it only came in December. So it’s a bit over half-a-year. So we
know that there’s good immunity for six months. Hopefully it’s longer,
but we don’t have the same amount of data, the same evidence as we do
for a natural immunity from actually having the disease naturally.
But for public health scientists, it’s very
surprising that this is not recognized. We are forcing people who had
the disease, who have good immunity to take a vaccine, even though they
have an immunity that’s better than, or at least as good as those who
have only had the vaccine.
At the same time, there are a lot of people
who need these vaccines who are not getting them. People in India,
Nigeria and Brazil, where a lot of older and especially poor people do
not get the vaccine because they don’t have enough doses.
So those are the ones we should emphasize
being vaccinated. Then we should view this as a global effort to
vaccinate the old everywhere in the world, instead of vaccinating people
that already have very good immunity against the disease.
Mr. Jekielek: You mentioned
that people are being forced to take a vaccine. I don’t know of anyone
in the U.S. actually being forced to take it directly. Tell me what you
mean when you say that.
Dr. Kulldorff: There’s a
push both for vaccine passports and vaccine mandates. If people want to
have a job and stay at the job, they are required to take the vaccine or
they’ll be fired. If they want to study at the university, many
universities are requiring vaccines for all the students.
So there are these vaccine mandates and
vaccine passports. In New York City, for example, now they’re requiring
restaurants to require vaccinations for people who go to the
restaurants.
That is a very coercive way to get people to
vaccinate. And that’s very bad for public health. One question is, “Why
do you coerce people who are immune or people who are young, who have
very small risk, when the vaccines are much more needed in for older
people in other places?” So that’s an ethical aspect of it. I think it
is very unethical to do so.
The other aspect is that if you force
something on people, if you coerce somebody to do something, that can
backfire. Public health has to be based on trust. If public health
officials want the public to trust them, public health officials also
have to trust the public. I’ve been working on vaccines for almost two
decades now. One thing that we’ve always tried to do is to maintain good
confidence in the vaccines.
For example, measles vaccines are very
important, as well as polio vaccines. There is a small group of people
who are very vocal, who don’t like vaccines, but they haven’t really
been able to put any dent in the confidence in vaccines. It’s very high
in the U.S. So we’ve been very successful in maintaining that
confidence.
But right now with these vaccine mandates,
and vaccine passports, this coercive thing is turning a lot of people
away from vaccines, and not trusting them for very understandable
reasons. “Why do you have to force somebody to take the vaccine, if it’s
so beneficial to you?” That’s one rationale.
Those who are pushing these vaccine mandates
and vaccine passports—vaccine fanatics, I would call them—to me they
have done much more damage during this one year than the anti-vaxxers
have done in two decades. I would even say that these vaccine fanatics,
they are the biggest anti-vaxxers that we have right now. They’re doing
so much more damage to vaccine confidence than anybody else.
Even if they manage to coerce somebody to get
the COVID vaccines, because of people saying, “Okay, I have to take it
because I need to go to a university or I have to, because I want that
job, or I want to go to restaurants,” even if they manage to get those
people to take the COVID vaccine, it will turn them off from public
health. It will make them distrust public health and turn them off from
other vaccines that are not mandatory.
So it has ripple effects in other aspects of
public health that are very unfortunate. I’m a native of Sweden. so I
know a little bit about Sweden. Sweden has one of the highest
vaccination rates in the world, and the highest confidence in vaccines
in the world.
But there’s absolutely no mandate. It just
doesn’t do it that way. It’s completely voluntary. If you want to have
high confidence in vaccines, it has to be voluntary. There shouldn’t be
any mandates.
Mr. Jekielek: Let’s talk
about this. You said there’s a thousand times difference between the
risk of a young person to that of an old person, broadly speaking. So
where is the cutoff ? Is there a high risk area? I assume you would
suggest that most people should be vaccinated. And there’s a very low
risk area. Tell me how that works.
Dr. Kulldorff: The way I
reason about this is that whenever there’s a new vaccine on the market
or a new drug for that matter, we know that it works. We know there’s
efficacy. We know about common adverse reactions.
For some vaccines, you might have some sore
arm or some rash or a fever, for example. But we don’t yet know about
rare but serious adverse reactions when the vaccine or the drug is first
approved. It takes a couple of years to do that.
So now, if we look at somebody who is 76
years old, if they get infected by COVID, it’s not extremely high, but
they could very well die from COVID. So then if it’s a small risk from
the vaccine, it’s a no-brainer.
The protection from COVID is much more
important than even if there is a small risk from the vaccine. So people
in their 60s, 70s, 80s, should, in my mind, definitely take the
vaccine, because the benefits are large. There might be some small risk,
but the risk is very small.
On the other hand, if we then go to the other
side of the spectrum to the children, we know that the risk of
mortality from this is minuscule. They can get it, but many will be
asymptomatic, or they will only be mildly asymptomatic.
The risk from serious consequences is very,
very small. So then even if there is a small risk of serious adverse
reactions from the vaccines, we don’t know what the balance is. We
didn’t know that when the vaccines came out, but we learned more and
more about the adverse reactions.
We now know that in young people, including
children, Pfizer and similar vaccines can cause myocarditis, which is an
inflammation of the heart. That’s something we would like to avoid. So
it’s not at all clear for children, what is the balance of the pros and
the cons of these vaccines?
So, there could, of course, be another
adverse reaction that we don’t know about yet. So to vaccinate children
at this point doesn’t make sense. You asked about the cutoffs and I
don’t know where that is, because it’s sort of a gradual thing. It’s
clear cut on these two ends, but the middle is less clear.
I can’t say what that is, but we have to be
honest about those things. Let’s say you’re 25 and you have very low
risk for mortality from COVID. On the other hand, if you work in a
hospital or as a nursing home staff, then you should certainly have the
vaccine, not necessarily for your own protection, but to protect the
older people that you’re working with in the nursing home or in the
hospital.
Mr. Jekielek: What about
this case then? This is probably a case many people are asking
themselves about today. You have a older relative, for example, a
grandmother. Grandma has been vaccinated with one of the vaccines and
you have a small child or a 25-year-old, or a 30-year-old that wants to
visit with grandma. For that reason, should they be vaccinated? How do
we think about that?
Dr. Kulldorff: Grandma
should be vaccinated. That’s the important thing. That’s what is going
to protect her, whoever she meets. I’m sure grandma wants to see her
grandchildren and she should do that and she should enjoy them. When it
comes to COVID, the children are not very good transmitters of the
disease.
Now, if you’re old or you’re frail, your
immune system goes down. A lot of old people die from some coronavirus
that most of us are able to handle because we still have a good immune
system.
Who knows where that older grandma will get
that virus from. It doesn’t have to be COVID, it could be something
else. It could be the flu, but it could be one of the other
coronaviruses or any other virus.
They will catch it from somebody, somewhere,
but we shouldn’t start blaming children, for example, if it was a child
who happened to be the carrier, or if it was somebody in the
supermarket, or maybe the neighbor. It could be any of those things, but
we have never started to blame these people for killing grandma and we
should never do that.
Mr. Jekielek: I want to
reiterate this because this is not commonly known. We keep seeing these
headlines that this politician, despite being vaccinated, has tested
positive for COVID. Apparently that’s a normal thing. Grandma could get
it from someone that’s vaccinated, someone that’s not vaccinated, or
could be exposed to it somehow. It’s not clear that how much the
vaccination would help with that.
Dr. Kulldorff: Yes. The
immune system works to prevent serious disease and death, but it doesn’t
prevent you from being exposed or from having the virus enter the body,
because the immune system can’t go into action until the virus is in
the body.
And depending on how long it was since you
had COVID or since you had the vaccine, the time it takes to beat off
the virus when it comes might vary. If you have had it very recently,
you still have all these antibodies and it might be very quickly taken
care of.
But if it has been some time ago, the virus
may still start reproducing in your body and your cells before the
immune system kicks in and takes care of it. For somebody that has had
COVID or has had the vaccine and tested positive for COVID, that’s what
you would expect to happen. So there should be no headlines about that.
If we did that with all the viruses that we
have—we deal with dozens of them—if we tested for all of them, and if
there was a headline as soon as a politician tested positive for one of
them, a scary headline and scary newspaper article, then we would all be
hiding under our beds all the time.
We can’t do that. This is part of society and
part of the situation that we deal with all these viruses. We have an
immune system and that is a beautiful thing. It’s a fantastic thing,
biologically. It’s a fantastic thing, how it operates. We have lived
with that for hundreds and thousands of years, and we should continue to
do that.
What’s new with this COVID-19 is that it was a
new virus where everybody is susceptible. Nobody has immunity towards
this. There are some people who had cross immunity from other
coronaviruses. When so many people are susceptible, they then get these
waves and this pandemic.
It started in Wuhan in China, but then there
was an outbreak in northern Italy, as well as in Iran. As soon as I
heard about those outbreaks in northern Italy and Iran, it was clear to
me that this was going to be a worldwide pandemic, because nobody knew
how it arrived there.
We don’t know who brought it there. It was
clear that this was very contagious and that it would eventually reach
all parts of the world. And that’s exactly what happened.
Mr. Jekielek: There seems to
be a focus on this concept of breakthrough infections and as if that
would be a significant problem with respect to the efficacy of the
vaccine. Is this some kind of misconception?
Dr. Kulldorff: Yes, I think
it is. I don’t think we should be so preoccupied with that. The key
thing is that both natural immunity from having had Covid as well as the
vaccines protect you from having severe disease and death. That is the
most important thing.
We expect that even if you have immunity, you
can still be exposed and you can still get the virus in your body
because the immune system doesn’t go into action until the virus is in
there.
And depending on how long it was since you
had the vaccine or how long since you have had COVID, your immune system
might react really quickly, or the virus might actually start to
replicate in the cells, so it will take little bit longer. But your
immune system is still there taking care of it, and protecting you from a
bad outcome.
Mr. Jekielek: Tell me about
this—that it will always be with us. There’s a lot of confusion about
policy and what it’s actually trying to accomplish. Are you seeing the
policies trying to eradicate this virus entirely? Is that even possible?
You said earlier that it’s not possible. What should be the goal, if
that’s not correct?
Dr. Kulldorff: For example,
Australia has had a goal of eradication. You can see it in two ways. You
can see that, no, they haven’t succeeded because they still have it. Or
you can say that they’ve been very successful because they’ve done it
six times. Every time there’s a lockdown they eradicate it, and then
they repeat and eradicate many times. No, it’s not possible to eradicate
it. It will be with us.
The key thing is once we all have immunity
from having the disease or from the vaccines—usually if you have the
vaccines, you’re going to be exposed the second time—you will hopefully
improve your immune responsive even more. That is going to happen. It
will be like the other four coronaviruses that we are already dealing
with and that we have dealt with with a long time.
There are only two diseases that have been
eradicated. One is smallpox, which took a normal effort, but it was also
a much better candidate. The other one that we have eradicated is
rinderpest, which is a disease in cattle.
Those are the only two diseases that have
been eradicated. For a long time we have been fighting to eradicate
polio. I think it is possible to eradicate polio and we should continue
those efforts during this time.
Mr. Jekielek: What about the
countries or states that are in these successive stages of lockdowns?
Is this a kind of a “lockdown forever” model? What can they expect, if
as you said, this virus will be in those societies forever? It seems
there are huge, as you mentioned, collateral costs to doing that.
Dr. Kulldorff: The question
I’m going to have to ask Canada and Australia is, “What’s the end game?”
Because you can’t keep locking down forever. Australia had an advantage
because it’s a seasonal disease.
It’s a smart thing that Australia was to
position themselves in the southern hemisphere, because COVID came when
it was the winter in the northern hemisphere, when it spreads very
easily. So in the northern hemisphere, it was impossible to suppress it.
Because Australia got it in the summer, they
were able to suppress it their first summer, which was winter for us.
They closed the borders with hard quarantines. So they had the advantage
of being able to do that, and quite successfully. On the other hand,
they weren’t able to keep it out. It comes back and they have to keep
doing the lockdowns.
So without a vaccine, they would then have to
do that forever, which doesn’t make any sense. We were very lucky, that
has been a huge success during this pandemic, because there have been
so many fiascos.
But the vaccine has been a huge success, to
quickly get a vaccine. What Australia must do now is to say, “Okay,
everybody should be vaccinated. All the older people should be
vaccinated.” Then remove the lockdown and open up. Protect those older
people who are at high-risk through vaccines. If they don’t want to get
vaccines, they have to protect themselves through physical distancing.
But they should get the vaccine and then open
up and it will be endemic in Australia, just like in every other
country. But obviously, because they have suppressed it so much, they
don’t have the same levels of immunity as we have, for example, in the
U.S. or in the UK, or in Europe.
Mr. Jekielek: That’s pretty
fascinating. Basically, you’re saying that by doing the lockdowns,
you’re just delaying the inevitable process. Do I understand that
correctly?
Dr. Kulldorff: Yes. There’s
of course a lot of damage during this process. So you could argue and
say that you do this serious suppression until you get the vaccines.
With that logic, they should now open up. But then the question is how
long is it worth waiting for the vaccine? And the collateral damage from
the lockdowns is quite severe. It has been severe in Australia, and
even more so in Canada.
Maybe it’s worth doing those lockdowns for
two months until you get the vaccine, but to wait a whole year, there’s
too much collateral damage from the lockdowns on public health, as well
as on education and other aspects of society. It’s too much damage so
it’s not worth it.
It would have been better for us to do
focused protection or protecting those who are vulnerable and do a good
job at that, which we didn’t do.
Mr. Jekielek: Jumping into
these collateral damages, you mentioned the mental health costs. I
remember reading the statistic, which I’ve said a number of times in
interviews, in this one study 25 per cent of teenagers had suicidal
ideation, one in four. I didn’t even know what to think about that. Can
you expand on the mental health collateral costs?
Dr. Kulldorff: Yes, that’s
very tragic. The normal number was like 4 or 5 per cent and now, it’s 25
per cent. So that’s very tragic. And we have had a lot of mental health
consequences. There’s also been opioid overdoses that have increased
now. Of course, a lot of that is not very measurable, because a lot of
it is hidden.
As a society, we have to really try hard to
repair the damage and overcome that. Not just psychiatrists and
psychologists and counselors, but all of us have to take on that role
with our neighbors, with relatives, and with people at work. The church
and other religious organization have an important role to play in
helping.
That’s something that we collectively as a
society have to try to repair—all that mental health damage that we have
seen during this pandemic.
I have three children, my oldest is 18. I was
never worried about him because of COVID because he’s young, and in
effect he would do well. But I was very concerned about his mental
health. So I was urging him through the whole pandemic, “Yes, go out.
Play basketball with your friends, hang out with them and do these
things. Do these activities. “ Because that was my concern. I wanted him
to have a normal life as much as possible.
Mr. Jekielek: A number of
people I’ve spoken with, including on this show, have mentioned that
with the CDC and the FDA, some of the data that should be collected to
get the full picture of the reality of this disease and the vaccines
simply isn’t being collected. What do you think about this?
Dr. Kulldorff: That’s true,
unfortunately. There are a few key things that should be collected. It’s
the role of CDC to do that. One is to take regular surveys of the
prevalence of immunity of antibodies, as well as T-cell immunity, so
that we know what is the level of immunity in the population in
different states, but also random surveys, across the country, and over
time.
Spain did that in the spring of 2020, they
did a random survey of 60,000 people, different ages and different
locations. It has been done in some places. My colleague, Jay
Bhattacharya, did an early survey in Santa Clara county, but those are
things that CDC should do. They should do it across the country and at
regular intervals. So that’s one thing.
Another thing that we failed to collect data
on is the reported COVID deaths. Many of them are truly due to COVID,
but some are not. Some died with COVID. We don’t have a good idea of how
many belong to each group. So it might be the primary cause, it could
be a contributing cause, or it could be completely unrelated.
Again, we can’t do everybody, but we could do
random surveys from different places and different age groups to see
how many of those who were reported to have died from COVID actually
died from COVID, rather than with COVID. For children, there’s about 350
children who have reportedly died from COVID.
We should examine everybody, as has been
proposed by Marty Makary from John Hopkins University. It’s something
that CDC could easily do. They have the resources. They have the
personnel to do that and go through the health records and see how many
of those actually died from COVID versus from something else, but with
COVID. You need this kind of basic information during a pandemic to help
decide what strategy to use. This data hasn’t been collected the way it
should have been.
Mr. Jekielek: What about on the vaccine safety side of things? This is actually a big area that you’ve been involved with for a long time.
Dr. Kulldorff: The best
system we have for having vaccine safety is the vaccine safety data
link, which is run by the CDC. It’s an excellent program. I’ve been
involved in it for almost two decades, developing many of the methods
that are being used. They use electronic health records to see exactly
who got vaccinated, and who didn’t.
Then they know exactly what happened to them
afterwards. Did they have a stroke or a seizure or a heart attack so
many days after the vaccine? Then you can compare that with what would
be expected by chance, because you also know what is the background
population of those who didn’t get the vaccines.
So that’s a very good system and it’s being
used very well for COVID. The only problem is that it covers 10 million
people, about 3 per cent of the U.S. population. So that sample size is
such that it takes time to get the information.
The VAERS system, [Vaccine Adverse Event
Reporting System] which is the more well-known system is less reliable
because those are spontaneous reports. Anybody can report in, so there’s
under-reporting.
But it also doesn’t have any good
denominators. It’s hard to come up with what the expected numbers should
be. There’s been a lot of misconceptions and misunderstanding about
this system because each report is publicly available.
So you see there were so-and-so many heart
attacks or so-and-so many deaths after the vaccine, but they obviously
are going to be just by chance. So CDC reports those raw numbers of how
many there were, and that’s sometimes misunderstood to mean that all of
those were actually caused by the vaccine, which is not correct.
So what CDC is not doing, which the CDC
should do, is to get some kind of a denominator. It’s not so easy to do,
but it can be done. Is this actually something unusual that we have to
be worried about, or if is it just by chance?
If you give a million people a vaccine, some
of those are just going to die the next month, and it had nothing to do
with the vaccine. There’s a certain number of people who die every
month. So there’s been a lot of misunderstandings about it. When CDC
does give some kind of background rates, it invites people to
misunderstand it and draw wrong conclusions from the data.
Mr.Jekielek: There does seem
to be a spike in reporting in the VAERS system. I was looking at a
graph that shows a baseline of reporting, and then COVID vaccines come
along and there’s a big spike in reporting. What does that mean?
Dr. Kulldorff: I’m not
surprised by that, or that the spike is bigger than you would expect.
I’m not surprised that it’s increasing and that you get more reports
from COVID vaccines than from the average vaccine. Because most vaccines
are given to children and not very much tends to happen. They show up
usually very healthy. And if they have any infection or something,
that’s usually not reported.
But when you give vaccines to people in their
80s, health events happen to people in their 80s. So you will expect
that there’s a lot more deaths by chance. There’s a lot more events when
older people get a vaccine than when younger people get a vaccine.
So in that sense, I’m not surprised that
there is a spike. Obviously a lot of this is because it’s a new vaccine,
and there’s a lot of attention on it. So that can also increase the
reporting.
With the virus, there’s a lot of bias in
terms of who reports, how much people report, and what do they report?
That has to do with the reporting nature of the system. So that’s why
the vaccine safety data link is much better because it’s not based on
people reporting something.
It’s based on the normal behavior of going to
the hospital and to the doctor for whatever you have, so there’s less
bias there, Because if you have a heart attack, you go to the hospital,
whether or not you have the vaccine or not. It’s recorded whether or not
you have a vaccine.
So there’s all this reporting bias that makes
VAERS a difficult system to use. It’s still very important for things
like happened soon after the vaccine. For example, we know that the
COVID vaccines can cause anaphylaxis, usually within 30 minutes after
the vaccine. We know that from the VAERS system.
As long as people hang around, and they can
get the proper treatment, it’s not life-threatening. So for those
things, it’s useful. But for many other things, the VAERS system is not
very useful, especially the way that the data is presented at the
moment. It could be done much better.
Mr. Jekielek: You’re one of
the authors of the Great Barrington Declaration. That’s where you
outline this idea of focused protection with Dr. Jay Bhattacharya and
Dr. Sunetra Gupta. There’s a significant backlash to getting this
information out and making it prominent. Tell me about what you’ve
experienced.
Dr. Kulldorff: First of all,
there was nothing really novel in that Great Barrington Declaration,
because it basically said the same thing as the various pandemic
preparedness plans that different countries had prepared before COVID.
So there was nothing new or novel. There was nothing there that we
hadn’t said before, or that other people hadn’t said in similar works.
What was very frustrating was that in the
media, there was this perception that there was a scientific consensus
in favor of lockdowns. However, my colleagues and I, plus other
infectious disease technologists, the majority thought that lockdowns
were not the right approach, and that focused protection would be more
important. But when anybody spoke up, they would be ignored or silenced,
or, “Oh, that’s just one crazy person.”
So what we did with the Great Barrington
Declaration, there were three of us who stayed together, and we all have
been working with infectious disease technology for a long time. So
they couldn’t dismiss us for not being in the right field of science.
Coming from Oxford, Stanford, and Harvard, they’re all reasonably
respectable universities, so they cannot dismiss us because of that.
So that was the goal—to take what a lot of
people already thought and make it impossible to ignore. And I think
that has succeeded. There was a huge backlash from the media, from some
politicians, and also from a few fellow scientists. But there was also
enormous support.
So very quickly we got over 10,000
signatures, co-signers who were scientists, public health scientists,
and technologists. At the same time, we have received 850,000 plus
signatures from the public as well, in total.
So there was a lot of support from the
scientific community and from the medical community for the Great
Barrington Declaration, but it was vilified in the media. And at the
time in October of 2020, our philosophy was to make it clear that there
was no scientific consensus for lockdowns. Then they can say whatever
nasty things they want about us.
To get that message out, that there is no
scientific consensus for lockdowns, was the most important first step at
that time. And I think that we succeeded.
So in that sense, we’re very pleased with the
outcome. There were personal attacks, but we maybe expected that. I’m
surprised that it was mischaracterized and vilified for things that it
wasn’t, instead of taking it as a serious discussion of how to better
protect the older people.
We had some very concrete proposals, which
obviously had to be adapted to the different countries. We had some very
concrete proposals for people in nursing homes, and for people living
alone at home.
That discussion never happened,
unfortunately. That’s tragic because that would have saved many lives
during the second wave that we knew was coming. That’s why we wrote the
declaration in October, because we knew that we’re having another wave
now in the winter in the northern hemisphere.
But there was censoring by Twitter, by
Facebook and by Google-owned YouTube. So as a simple [inaudible]
scientist, it was a bit of a shock to suddenly be in such a situation. I
thought I would be a simple scientist for the rest of my career, and
then I would retire. So it’s a very strange situation to be in, but
that’s what happened.
Mr. Jekielek: Why do you think they were so determined to censor you and these other scientists.
Dr. Kulldorff: Because they
don’t have any good public health arguments. They couldn’t respond with
public health arguments saying that we should do it because of this or
that, because the lockdowns go against the principles of public health,
while the focused protection that we proposed is very much aligned with
traditional public health thinking.
So they really didn’t have any good
scientific or public health arguments. If you don’t have that and you
still want to push back, and you can’t ignore it anymore, you can’t
silence people anymore, then you have to use either slander, or you have
to use censoring.
Mr. Jekielek: But why not just consider what you were proposing?
Dr. Kulldorff: That’s a good
question. I don’t know, because there’s no public health reasons for
it. So that’s politics. And I don’t understand what the politics behind
that was. There must be something, but as a journalist, you probably
understand politics better than I do as a scientist.
So there are not public health reasons for
it. There’s no biological reasons for it, and no scientific reasons for
it. Obviously there’s some political issues going on, which I really
don’t understand. Other people will have to try to figure it out and
explain it, but that’s outside my area of expertise.
Mr. Jekielek: But the cost of it is some countless number of lives?
Dr. Kulldorff: Yes. The collateral damage is enormous and it’s long-term. We’re going to have that with us for a long time, unfortunately.
Mr. Jekielek: There’s a
curious element here. The implementation of these vaccines, effectively
does this sort of focused protection, doesn’t it?
Dr. Kulldorff: Yes.
Mr. Jekielek: That’s very interesting how things played out.
Dr. Kulldorff: Yes. When the
vaccine came out, that was the best tool available for focused
protection or protecting the old. There were other things we could do
before that. But of course, when the vaccine came, that was an ideal
tool for protecting the old high-risk people. So that was a very good
thing, it was a great thing. And I think the vaccines have saved many
lives.
Mr. Jekielek: What I’m saying is that in some way the Great Barrington Declaration was actually implemented despite being so maligned.
Dr. Kulldorff: It was in
many places. It was implemented in terms of the vaccines, and in terms
of other ways to protect the old. There were some places that
implemented it, for example, Florida.
Mr. Jekielek: Directly in that case, right?
Dr. Kulldorff: Yes. With the
vaccines, most places did put some emphasis on the older people, but
it’s a little bit varied. For example, Sweden and Florida put a lot of
emphasis on getting the oldest. They had a very strict order in which
they distributed the vaccines. In Sweden, there were even some people
who lost their jobs because they sneaked in and took care of the vaccine
when they weren’t supposed to, because they hadn’t reached their age
group yet.
In India, a lot of young people got
vaccinated before the old people. So it’s varied in different places.
But in many places, thankfully, they focused the vaccination efforts on
the old people, as well as the caretakers of the old people.
Mr. Jekielek: You said
something earlier that I want to build on here. I pulled something from
one of your writings. Here’s what you wrote, “Ultimately, lockdowns
protected young low-risk professionals working from home, journalists,
lawyers, scientists, and bankers—on the backs of children, the working
class, and the poor.
In the U.S., the lockdowns are the biggest
assault on workers since segregation and the Vietnam war. Except for
war, there are few government actions during my life that have imposed
more suffering and injustice on such a large scale.”
Dr. Kulldorff: It’s very sad
and tragic. There’s a fair amount of hypocrisy going around. For
example, there was one tweet from about a year ago. This was from a
fellow academic who said, “Well, here’s one thing that everybody can do.
When you take an Uber, roll down your window.” Well, everybody cannot
take an Uber. Taxi drivers are among the most exposed to the virus, in
terms of different occupations.
So here we have a person, a very pro-lockdown
public health scientist, who still wanted to have that convenience of
taking an Uber and not realizing that they’re privileged. While the
person driving that Uber, they don’t have a choice. They have to feed a
family. The scientists have had the privilege of taking an Uber or a
cab, while children are not allowed to go to school.
So it’s a disconnect among those, who I would
say are in a minority of the scientists who were favoring or arguing
for lockdowns, but there’s a disconnect because of the life they lived
with being able to work comfortably at home. I’ve been able to work very
comfortable at home, and most generalists have as well.
Another example is the New York Times had a
story about what you can do. You should order your food online. Well,
that was the recommendation to the Zoom class who can order online. It
wasn’t a recommendation to the people that actually deliver that food,
or to the people who were cooking the food in the kitchen or the
restaurants.
So there has been a really huge disconnect
between the scientists and journalists and politicians on one end, and
the majority of the population that has lived a very different life
where they have lost jobs. Small businesses have gone under, while the
big businesses have flourished. It has been driven by fear, this whole
thing. I don’t know what the rationale is, but it has been driven by
fear.
When I was my 20s, I worked for human rights
organization in Guatemala, and the way that the military dictatorship
kept control over the population was through fear. They made sure that
not only the leaders of the opposition were hit, but also the regular
people. So it would be a fear within the whole population.
With COVID, there has also been this driving
fear about COVID. For example, older people should be very cautious and
take precautions because they are high-risk. But a lot of young people
have gone around being fairly fearful of this virus, even though it
poses much less risk to them than many other things that they do in the
daily life. Driving a car has a risk with it and so on.
So it’s a very strange time we have entered
into. It’s a strange from a personal perspective, but it’s also strange
as a father, and with neighbors. It’s also very strange being a
scientist with this very illogical situation, where basic principles of
public health are thrown out the window, while the working class is
thrown under the bus.
One of the principles that would probably
help is that this is about everybody in society. Public health should
take care of everybody, not just a small group of people.
Mr. Jekielek: On this theme,
another thing that you said earlier, that it it’s unethical to
encourage or force younger people to get the vaccine, when there’s older
people around the world who don’t have access to it. Those vaccines
could be better used for the people that need the focused protection.
Tell me more about this.
Dr. Kulldorff: Yes, it is a
problem. It is unethical. So now we are giving the vaccine to people in
the U.S. or in western Europe, to people who have had COVID already. So
they already are immune. They don’t really need the vaccine. We’re
giving you to students were forced to take it to go university classes,
even though their risk from COVID is very, very small.
At the same time, there are many older
people, poor people in India, in Africa, in Brazil, and in South America
who do not have access to the vaccine and who are dying because they
don’t have the vaccine.
So while we have been successful when it
comes to doing a vaccine rollout to prioritize the older people within
the U.S., and within most countries in Europe, we have failed on focused
protection when it comes to the vaccine on a global scale.
I don’t understand how a university can
demand and require a young student—who probably had COVID and they have
natural immunity—to take the vaccine. Even if they haven’t had COVID,
they are at a very small risk, but they are forced to take the vaccine
if they want to go the university, while there are older people around
the world who have not had the chance to get this vaccine yet.
It’s unscientific, because it’s basically
denying the existence of natural immunity from having had COVID disease.
And it’s unethical because it’s leading to more death in other
countries. So I think the universities should all change their policy to
not having any of these vaccine mandates, if they want to live up to
the age of enlightenment where we actually believe in science, including
natural immunity, as well as behaving in an ethical manner. It’s very
surprising that universities would make these requirements.
Mr. Jekielek: Presumably, as
these vaccines have been effective at protecting the old, they would
provide some sort of opportunity for vaccine diplomacy. That’s usually
described in a more pejorative sense in terms of, for example, what
China has been doing. But in this case, I imagine it would be seen very
positively by people in these countries that need it.
Dr. Kulldorff: Yes, and it would be the right thing to do.
Mr. Jekielek: We’ve received
all this conflicting information from public health authorities. And in
some cases, the guidance didn’t seem to have much to do with public
health policy. There is a general distrust that I’ve been hearing all
over the place, the general feeling that there isn’t a trust in these
agencies which are responsible for these things, from the WHO, all the
way down. You say trust is so critical. So what happens now?
Dr. Kulldorff: It’s not a
surprise that the trust has plummeted for public health agencies and
public health officials because of these mixed messages, and also things
like not taking a natural immunity from having had COVID disease into
account and still forcing people to vaccinate.
So it’s very understandable that the trust
has come down. Both within the scientific community and the public
health community, we have a lot of work to do to regain that trust. It’s
going to take a long time, but it is important to do that and to try to
regain that trust.
The only way to do it is, one; to be very
honest and straight with people, two; to trust the public, and three; to
actually listen to the public and not just make public health policy
based on the Zoom class, which is like scientists and journalists and
their neighbors.
But to really listen to everybody in society
and especially those who are less affluent workers, and of course
children and old people. That’s a third failure during this pandemic.
Public health officials have a tendency to dismiss people when they have
concerns. For example, not listening to them when it comes to vaccines.
Vaccines are one of the greatest inventions of mankind as they have
saved countless lives.
But when people are concerned about the
safety, that’s a serious things. I’m obviously very sad about it because
a lot of what I do in science is to study the safety of vaccines, but I
had to take people’s concerns seriously, and then to be honest about
it. So as public health scientists, we have a lot of work to do for many
years to come to regain that trust, because the loss in trust is very
understandable.
Mr. Jekielek: Dr. Martin Kulldorff, it’s such a pleasure to have you on.
Dr. Kulldorff: It’s been a delight talking to you. Thank you so much
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