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Nicholas A. Christakis is the Sterling Professor of Social and Natural Science at Yale University, where he also directs the Human Nature Lab, and serves as Co-Director of the Yale Institute for Network Science. His most recent book is Apollo's Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live. https://www.amazon.com/Apollos-Arrow-Profound-Enduring-Coronavirus/dp/0316628212
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Now, Donald Trump is 74. He's overweight, needs cheeseburgers every day. When a guy like that catches COVID and is fine in four days, people get very dismissive of it, unfortunately. What did he receive? What kind of treatment did he receive? And how different is it than what the average person would receive if they got sick? So he faced a very significant risk of death, and I think he got lucky. So remember, his doctors put him on dexamethasone. So so far, we only have one proven drug that lowers your risk of death if you're seriously ill from COVID. And that's a very simple steroid called dexamethasone. And remdesivir has not been shown to lower mortality. It has been shown to lower your length of hospital stay, so there's some benefit to it, but it doesn't appear to lower your risk of death. What would be the difference between lowering your risk of hospital stay and lowering your risk of death? Why would they let you out of the hospital if you hadn't shown significant health improvements? And wouldn't significant health improvements signify that your body's recovering better? Yeah, it's a mystery, and it's confusing. And when the first remdesivir trial was published a few months ago, it didn't show a benefit for mortality, but it showed a trend. It looked like it would help, and it made sense. Like if it's lowering your hospital duration, probably it's good for you, and it'll also lower your risk of death. But then another trial came out, much bigger trial, as part of the, I think it was called the Solidarity Consortium, either the Solidarity or the Recovery. I can't remember right now, Consortium out of England, which showed that actually remdesivir had no benefit for mortality. Now, how can that be? Imagine that you have 100 people who are sick, and in the group that gets remdesivir, they only wind up spending an average of 10 days in the hospital, but 10 of the people die. And in the other study, the people that did not get remdesivir, 100 people get sick, and they spend an average of 12 days in the hospital, but again, 10 of them die. So the remdesivir has lowered the hospital duration from 12 to 10 days, but it hasn't affected the probability of people dying. That's entirely possible. So that is in fact what appears to have happened. And this was a study you said that was in England? Yes, it was a large study that was, I think the subjects were not just in England, it was organized by a group of English scientists, either the Solidarity or the Recovery Consortium, and I just don't remember right now the name of it. But I want to go back to your question about the president. So the president was given dexamethasone, and when that happened, I stated publicly that either the president was sicker than they were telling us. So he was sufficiently sick that they wanted to give him dexamethasone, because giving dexamethasone early in the course of the disease, before you're very sick, actually can harm you. So you don't want to give it to someone at the beginning of their disease. You need to wait until they're sufficiently sick, and then it helps you. So either he was sicker than they told us, and so they were lying to us, or he really needed the dexamethasone, in which case he faced a significant risk of death. So people in the trials that showed that the dexamethasone worked, 74-year-old overweight people, men, and men are at much greater risk of dying than women of this condition, who got the dexamethasone, they had about a 20% chance of death. So I think the president actually faced a 20% chance of death when he was at the hospital, which is a big risk of death. And I think he got lucky. He survived. He was also given this cocktail of artificial antibodies to the disease, which I think is another promising approach to treating this condition. We don't yet have the results of those randomized controlled trials, but we'll also know soon if those drugs help. So this was an experimental treatment that they gave him? Yes. And they gave him not the dexamethasone. That was a well-documented treatment. Right. But the antibody cocktail was apparently the CEO of the company of Regeneron was his golfing buddy or something. I'm not exactly sure. So whatever it was, it seemed to be very effective. And then immediately- No, I would conclude that. He went on a wild tweet storm. It seemed like he had a lot of energy. Well, the dexamethasone may have given him a steroid high. I wouldn't conclude that the antibody cocktail was necessarily effective. No, no, no. I didn't mean that. I meant the treatment, the overall treatment. Whatever they gave him when he was in the hospital, the response was for a 74-year-old guy to be back on the campaign trail with this rigorous campaign that he was doing four or five days later, pretty impressive. Yes. I did not expect that at all. And as I said, I think he got lucky. And I do think steroids can make you a little psychotic and a little manic, actually. And I think, I mean, you can't really know from a distance, but to me, he had, as a doctor, looking at him, I thought, this man has a little bit of a manic feel to him. But then they tapered his steroids and that went away. Just from the Twitter feed? Yeah. But isn't that how he always is? Well, I'm not an expert on Donald Trump's tweets, but if you just looked at some of the things, you're right. Maybe he was always that way. But if you look at some of the things he did, like, I think the little, having the secret service drive him around the hospital was a bit manic. That was like a very irresponsible thing to do. It exposed people to risk. It put his own health at risk. I mean, you and I, if you and I were in the hospital with COVID and we told our doctors, you know, I just want to go for a drive around the block right now and let me know. I mean, they would they would say, no, you know, that would not be an OK thing to do. He wanted to wave to people, right? Yes. Yeah, hilarious. The episodes of The Joe Rogan Experience are now free on Spotify. That's right. They're free from September 1st to December 1st. They're going to be available everywhere. But after December 1st, they will only be available on Spotify, but they will be free. That includes the video. The video will also be there. It'll also be free. That's all we're asking. Go download Spotify. Much love. Bye bye. Bye bye.