Straight talk with Michael Osterholm

Transcript

Eric (00:00):

Okay. Hello, this is Eric Topol and this is a rare privilege for me to interview my favorite epidemiologist, Dr. Michael Osterholm. He is the Regents Professor of the University of Minnesota. He's director of CIDRAP, which is certainly one of the leading entities around the world for public health. And, we've been friends for the last few years, which we'll we'll talk about. So, welcome Michael. Such a great privilege to have you today.

Michael (00:31):

Well, thank you, the honor, really is mine. As I have shared with you and others know very well--you have been a real mentor to me and many others during this pandemic. And, I could never repay you adequately for all that you've helped teach me throughout these last three years. It's been immeasurable.

Eric (00:49):

No, if you're too kind, I think it's much different. The opposite way. I've learned so much from you because this isn't my area, as you well know. I thought we'd start with, of course, right now things are relatively good for the pandemic in the United States and mostly around the world, with relatively less cases, less hospitalizations and deaths. But obviously still people are getting infected. And maybe you can tell us about the recent case that you went through that would be enlightening.

End of the Pandemic?

Michael (01:28):

Yeah, I think we're all trying to understand when the pandemic ends. And, as we've discussed many times before, we'll probably know that about a year after it ends, then we'll say, yep, that was the end of it. Don’t for a moment think that at the end means that there won't be cases. You know, for every infectious agent that we think of when causing a pandemic, they still come back, whether it be influenza, or potentially coronaviruses. They will, they will continue to circulate. It's a matter of how many cases occur, how many people die. And I think that's an important point. There isn't really a definition for when a pandemic ends. It's, I guess it's just when you feel like it's over. And clearly the world has come to that conclusion already. You don't need a, an epidemiologist or a politician to tell 'em that the pandemic's over that they feel that we're still seeing about 165 deaths a day in this country from Covid.

(02:24):

So it's hardly gone away completely. But we do have to acknowledge it. Most of those deaths are older individuals, people who have not been vaccinated recently with bivalent boosters. And in that regard, we could surely even reduce the illnesses further. I don't have any faith right now in the surveillance systems that have been set up to look at cases around the world. We've pretty much dismantled that. We are not testing people that we results in reports being made to public health agencies, whether in this country or anywhere else in the world. So I really look at two other things. One is deaths. And even they're realizing that still is a challenge in terms of how complete death reporting is due to covid. But then the other thing we're looking at, which has been really, you might say, public health revolution during the pandemic, and I say revolution cause it's really changed things.

(03:19):

And that is the issue of wastewater surveillance. And we've been able to ascertain in many areas of the world, in fact, with using wastewater surveillance, a much better sense of how much virus is in the community. And so, just in following with your very thoughtful comment about case numbers dropping, that's exactly what we're seeing in most locations in this country too. We, for example, here in the Minneapolis St. Paul area, have seen a dramatic decrease in wastewater activity in the last two months. So I think we're in a place right now where I can hope it'll only get better. On the other hand, you know, I have a lot of respect for this virus, and frankly, we all ought to have a lot of humility. We don't know if another variant will emerge that with, given how much immunity we have in our population will somehow break through that and cause increase in surgeon cases or whether this will become kind of the norm and we'll see less and less.

On Getting Covid

(04:16):

Now, you asked me about my case. Yeah. I have to say that, I speak about this with, with really some trepidation in the sense that I was not gonna get this. I had and very faithful throughout the course of the pandemic, where in my N 95 respirator when I went out and about, I had been fit tested. In addition, when we finally did socialize in our home, we had a, what became affectionately known as the Osterholm Home Rule. You could not have had known contact with someone of the, with Covid in the five previous days. You could have no symptoms yourself on the day of, and you had to test negative bilateral flow test within three to four hours of coming. And we would entertain small four, the six party, parties, and it was going wonderful.

(05:07):

And then on March 10th, the night of March 10th, a colleague from work came over with Fern and myself. Three of us had dinner. We went down our elevator in our building here, which were 31 stories up. No one else is in the elevator. And then we proceeded to go to a very small music venue where we wore N95s. We were some distance from any other people, and we were there for an hour and 45 minutes. And, literally two days later, almost 48 hours later, all three of us developed symptoms. None of us converted for another 24 hours. And then at that point, we all three tested lateral flow positive.. We all three took Paxlovid. I took it and was starting to feel better after that fifth day.

(05:59):

And then I kind of crashed and at that point, I got a second, , five day course of Paxlovid and started to feel better. And, I'm you know, was very happy to have this behind me. However, over the course of the last 10 days, I have really had significant fatigue. You know I'm not one that sleeps a lot But, I can tell you there are multiple ti