← The Peter Attia Drive

#192 - COVID Part 2: Masks, long COVID, boosters, mandates, treatments, and more

Jan 24, 2022 2h 52m 27 insights
<p><a href="https://peterattiamd.com/covid-part2/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220124-pod-covid2&amp;utm_content=220124-pod-covid2-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220124-pod-covid2&amp;utm_content=220124-pod-covid2-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><strong>Episode Description:</strong></p> <p>This episode is a follow-up to <a href="https://peterattiamd.com/covid-19-current-state-omicron/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220124-pod-covid2&amp;utm_content=220124-pod-covid2-podfeed">our recent COVID-19 podcast</a> with Drs. Marty Makary and Zubin Damania (aka ZDoggMD). Here, we address many of the listener questions we received about our original discussion. In addition to Marty and ZDoggMD, we are also joined by Dr. Monica Gandhi, an infectious disease specialist and Professor of Medicine at the University of California, San Francisco. In this episode, we talk about new data on Omicron, long COVID, masks, kids and schools, vaccine mandates, policy questions, and treatments. We also discuss some of the most prevalent misinformation and spend time talking about claims made by Robert Malone. We end with a conversation about our exit strategy. </p> <p><em>Please note: we recorded this episode on January 17, 2022, and in an effort to get it out as soon as possible, this won't have full show notes or a video. Additionally, Monica was only able to join us for the first section of the podcast, so you'll hear her drop off partway through.</em></p> <p><strong>We discuss:</strong></p> <ul> <li>Severity of infection from Omicron—reviewing the data [5:15];</li> <li>Factors contributing to the relative mildness of Omicron infections [8:30];</li> <li>Is SARS-CoV-2 evolving to cause less severe disease? [13:00];</li> <li>Potential of Covaxin—an inactivated virus-based COVID-19 vaccine [17:45];</li> <li>How B cells and T cells work together to defend against viruses [22:00];</li> <li>Comparing COVID-19 vaccines, and the rationale for the time between doses [25:30];</li> <li>Reviewing the purpose and effectiveness of boosters for reducing severity and transmission [32:30];</li> <li>Debating vaccine mandates, and putting COVID's mortality risk in perspective [41:00];</li> <li>Why the topic of COVID has become so polarized [1:03:15]  </li> <li>Reviewing the data on masks for protecting oneself and protecting others [1:06:30];</li> <li>The inconsistent logic used for mask mandates [1:16:00]; </li> <li>Long COVID and the potential for vaccines to reduce risk [1:21:45];</li> <li>Risks for children and policies for schools [1:27:30];</li> <li>Reviewing the outcomes from Sweden, where the government didn't impose lockdowns [1:31:00];</li> <li>Draconian measures implemented in Canada [1:38:15]; </li> <li>Antiviral treatments for COVID and a common-sense approach [1:42:15];</li> <li>Importance of ending tribalism and having rational discussions with humility [1:47:30];</li> <li>Treating infection with monoclonal antibodies and convalescent sera [2:01:45];</li> <li>Reviewing claims made by the controversial Dr. Robert Malone [2:11:15];</li> <li>A potential exit strategy from the current situation [2:30:30];</li> <li>Changes needed at the NIH [2:40:00];</li> <li>More.</li> </ul> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=220124-pod-covid2&amp;utm_content=220124-pod-covid2-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights

1. Space Out Vaccine Doses

If receiving a multi-dose vaccine, space out doses by at least eight weeks or longer to achieve a better and more enduring T-cell immune response, which provides long-lasting cellular memory. This strategy improves overall immune system response beyond just antibody levels.

2. Evaluate Boosters for Clinical Benefit

Consider boosters based on individual risk-versus-benefit analysis, primarily to reduce severe disease outcomes (e.g., for older, immunocompromised, or those with medical conditions). Avoid widespread boosting solely to reduce transmission, as this effect is often temporary and not a standard public health strategy.

3. Vaccinate to Mitigate Long COVID

Get vaccinated to reduce the risk of developing long COVID symptoms after infection, as adaptive immunity prevents the virus from spreading widely in the body and reduces inflammation. Vaccination may also help improve symptoms for those already experiencing long COVID by promoting more organized immunity.

4. Use High-Quality Masks for Protection

If concerned about exposure, wear high-quality masks such as N95s, KN95s, KF94s, FFP2s, double masks (cloth over surgical), or a cloth mask with a polypropylene filter. These masks effectively protect the individual, enabling ‘one-way masking’ where your mask protects you.

5. Adopt Pan-Viral Hygiene Practices

Implement a general public health hygiene strategy: wear a mask if you’ve been exposed to any virus, be cautious and maintain distance around vulnerable individuals, and stay home if you are sick. This approach is effective for all respiratory pathogens, not just COVID-19.

6. Seek Honest, Nuanced Information

Actively seek honest, non-tribal information about health topics, focusing on facts rather than fear-based messaging. Be humble and adaptable in your thinking, as scientific understanding and viral characteristics can change over time.

7. Assess Personal COVID Risk

Educate yourself on the facts about individual COVID risk, including hospitalization and death rates, especially considering age and comorbidities. This helps in making informed decisions and avoiding anxiety fueled by overestimated risks.

8. Recognize Natural Immunity’s Role

Acknowledge that natural immunity from prior infection provides robust protection, including broad T-cell and B-cell responses and diverse antibodies, which should be considered in health policies and personal risk assessments.

9. Use Sotrovimab Selectively for Omicron

If infected with Omicron and at high risk for severe disease, consider Sotrovimab (GSK/VIR biopharmaceutical product) as it is the only monoclonal antibody currently effective against this variant. Other monoclonal antibodies are primarily effective against the Delta variant.

10. Consider Fluvoxamine for High-Risk COVID

Be aware of fluvoxamine as a therapeutic option for high-risk COVID patients, as studies have shown it can dramatically reduce hospitalization and mortality, despite official recommendations sometimes lagging.

11. Explore Concentrated Convalescent Plasma

For severe COVID cases, be aware of concentrated convalescent plasma as a therapeutic option, which has shown a significant reduction in hospitalizations in well-done studies.

12. Prioritize Children’s Schooling & Normality

Advocate for policies that prioritize children’s well-being, including keeping schools open and returning to normal routines, recognizing the severe negative impacts of closures on mental health and learning.

13. Reflect on Personal Biases

Engage in self-reflection to understand your own agenda and biases when discussing health topics. Being transparent about these helps interpret information and foster more constructive dialogue.

14. End Tribalism in Discussions

Strive to end tribalism in health discussions by presenting data from multiple perspectives and allowing individuals to make their own informed decisions. Avoid automatic dismissal of differing opinions.

15. Engage Non-Judgmentally on Health

Approach conversations about health decisions, such as vaccination, with a non-judgmental attitude. Physicians, for example, should explain risks and benefits without shaming or mandating.

16. Question Authority & Incentives

Maintain a healthy skepticism towards concentrated power in public health and scientific funding, and question financial incentives within pharmaceutical companies and healthcare entities. This fosters scientific integrity and prevents groupthink.

17. Uphold Scientific Freedom

Advocate for scientific freedom, open debate, and transparency in data sharing, especially in public health. Resist pressures that silence dissenting scientific opinions or tie research funding to specific narratives.

18. Avoid Shame and Stigma

Refrain from shaming or stigmatizing individuals who contract an infection or make different health choices. This approach is counterproductive and damages public trust.

19. Understand Social Media’s Influence

Be aware of how social media can create and reinforce ‘hiveminds’ or groupthink, influencing beliefs and reactions without individual awareness. This understanding can help in critically evaluating information.

20. Hold Convictions Loosely

Cultivate a mindset of ‘strong convictions, loosely held,’ meaning be open to new evidence that could change your understanding or stance on a topic. This is crucial for nuanced thinking.

21. Advocate for Better Pandemic Response

Advocate for a more functional, data-driven, and rapid pandemic response system, including quick bedside clinical trials for therapeutics and a focus on diverse treatment options, to better prepare for future, potentially more severe, viruses.

22. Prioritize Key Research Funding

Advocate for public health funding bodies (like NIH) to prioritize research into critical gaps, such as natural immunity, virus transmission mechanisms, and mask efficacy, rather than disproportionately funding other areas or ignoring key questions.

23. Cultivate Empathy for Others

Develop empathy for individuals who hold differing views on health topics, even if you disagree with their scientific understanding. This can foster more productive dialogue and reduce societal division.

24. Broaden Public Health View

Recognize and address the broader public health threats facing society, such as suicide, homicide, drug overdoses, and motor vehicle accidents, rather than solely focusing on one disease.

25. Question Outdated Health Policies

Challenge health policies that are based on outdated data or variants, such as applying Beta/Delta-era rules to Omicron, and advocate for policies that reflect current scientific understanding and viral behavior.

26. Support In-Depth Content

Consider subscribing to the podcast’s membership program at peteratiyahmd.com/subscribe to access more in-depth, exclusive content and support ad-free, high-quality health and wellness information.

27. Listen to Previous Episode

For additional context and background on the subject matter, listen to the previous COVID-19 podcast with Drs. Marty Macri and Zubin Damania, released on January 3rd.