Editor’s note: This is the longest podcast produced to date by Modern Immortals. This is also a podcast containing some of the more unconventional, counter-mainstream views extended by our podcast guest, Dr. Gaeta, and at times, by our hosts. In the interest of honoring our audience, our communities, and clients, we have endeavored to extensively document evidence to support claims made in this podcast. We have endeavored to provide wide and deep grounding for our views from peer-reviewed literature. The links are extensive, and while we would like to provide commentary on each link, and have endeavored to do so, we are going to press at time of publication with just more than half of the links listed with some expository quotations on the links provided. In the interest of publishing the episode in a reasonablhy timely fashion, now nearly three weeks after our recording date, commentary on the remaining links may be added as needed post-publication.Opinions in this podcast have been formed through extensive research performed by both our hosts, and our guest, Dr. Gaeta, and as always, are subject to change as new information is available and integrated into an ever-evolving worldview. Our podcast hosts, Marco and Luke, do not always agree upon the meaning, significance, or importance of any given research finding. It is our habit and custom to “steelman” each other’s arguments, taking them in the strongest possible faith, offering the best faith version of the other ‘s position as we understand it. The result is a powerful, and personal dialogue between three clinicians that agree on some aspects of public health policy, and disagree about others, yet we are always careful to acknowledge each other’s positions, the solid ethical foundations that we bring to the conversation, and the great mutual respect to which we hold each other. . All clinicians hold positions towards any given topic are informed by our individual and collective desire to be in service to the strongest, healthiest, most vibrant expression of human potential. That is to say, though we all disagree on the exact way to get there, we all orient towards the best health outcomes for all. This podcast with Dr. Gaeta was recorded about three weeks prior to publishing. In the intervening period, the narrative around COVID-19 has already begun to shift.Just a few days ago, on January 20, 2021, the WHO released new guidance on the PCR test, stating that the PCR itself as a single diagnostic test, is inadequate and inaccurate enough to be used to determine an official “COVID-19 case.” New WHO guidance states that two PCR tests and the presence of symptoms are the new de rigeur definition of a COVID-19 case. This vindicates Dr. Gaeta’s views, showing his views are well-grounded in science. He was well-ahead of the curve. Marco Lam offers his take on this episode:I have a tremendous amount of respect for the amount of work and research that Luke and Michael have put into the making of this episode.I feel like the outlier on this particular episode as my larger medical community is highly pro-vaccine and supports the use of non-pharmaceutical interventions to lessen the spread of the illness.Where we are in agreement is that good science happens from asking good questions and having respectful, open dialogue. I’m not seeing this in our societal rush toward trying to get the train back on the tracks. The vaccine offers hope and that is important in itself. There is a crisis in trust of the government and for-profit corporations as a source of credible information and that is perhaps a symptom of a larger illness in our society.That said, the vaccine is not safe, we know that side effects can happen and can be serious. That said, catching COVID-19 is also not safe, and the illness can have serious long-term health consequences. I agree with Luke and Michael that the track record of this vaccine hasn’t been adequately researched. Though my current premise is the vaccine has better odds of safety than catching the virus and that the odds are in your favor of taking the vaccine for most people. Unfortunately, those most at risk are in the same category from both risk from the vaccine and from the viral pandemic. https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/reactogenicity.htmlI think that the science on vaccination and the pandemic will continue to evolve and grow. Earlier conclusions may swiftly become outdated. It is time for us all to pay attention and deeply examine our cognitive bias, including myself. I agree with Luke’s conclusion that our best practices are to strengthen our own metabolic fitness and the resilience of our immune systems. While I am fairly libertarian in my outlook in allowing individuals to pursue their own health care aims and beliefs, I believe in active and informed public health services taking interventions that benefit society as a whole. I believe effective NPI are useful.https://science.sciencemag.org/content/early/2020/12/15/science.abd9338I hope to keep learning with you all. I hope to keep questioning with you all. I hope you all stay healthy and well resourced.Blessings,MarcoNow onto offering research citations to some of the more counter-culture opinions offered in this episode:We cite more than thirty journal articles and publications that reflect data from around the world, in the current pandemic and in previous pandemics and infectious disease outbreaks: https://onlinelibrary.wiley.com/doi/abs/10.1111/eci.13484“While small benefits cannot be excluded, we do not find significant benefits on case growth of more restrictive NPIs. Similar reductions in case growth may be achievable with less restrictive interventions.”https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30208-X/fulltext“government actions such as border closures, full lockdowns, and a high rate of COVID-19 testing were not associated with statistically significant reductions in the number of critical cases or overall mortality”https://advance.sagepub.com/articles/preprint/Comment_on_Dehning_et_al_Science_15_May_2020_eabb9789_Inferring_change_points_in_the_spread_of_COVID-19_reveals_the_effectiveness_of_interventions_/12362645 “Official data from Germany’s RKI agency suggest strongly that the spread of the corona virus in Germany receded autonomously, before any interventions become effective. Several reasons for such an autonomous decline have been suggested. One is that differences in host susceptibility and behavior can result in herd immunity at a relatively low prevalence level. Accounting for individual variation in susceptibility or exposure to the coronavirus yields a maximum of 17% to 20% of the population that needs to be infected to reach herd immunity [11], an estimate that is empirically supported by the cohort of the Diamond Princess cruise ship [12].” https://arxiv.org/pdf/2005.02090.pdf“ The most notable feature of the results is that fatal infections are inferred to be in substantial decline before full lockdown. Sweden appears most likely to have peaked only one or two days later. The results also emphasise the fact that the infection trajectory is not simply a time shifted version of the death trajectory (assuming it was might lead to unwarranted delay in easing lockdown, for example). The difference in timing and shape of the inferred profile between the ONS and NHS data reflects the fact that the latter contain care home data. There is an argument for preferring hospital data for inferring community fatal infections, in that the care home epidemic is now known to have special features with at least some of the infection not coming from normal community transmission. In addition care home deaths are often attributed to COVID-19 without a test, especially since death certification guidelines were changed to encourage reporting of suspected, rather than confirmed COVID-19 deaths. The care home data therefore have some underreporting of Covid deaths, followed by over-reporting (the signal of this is visible in ONS data in the change in non-Covid pneumonia deaths being reported, relative to normal, for example). Taken together the results for England and Wales and Sweden raise the questions of firstly whether full lockdown was necessary to avoid health service overload, or whether more limited measures might have been effective (calling into question the implicit decision to heavily discount future life loss consequential on full lockdown in decision making – see Discussion), and secondly whether the several month duration of full lockdown was appropriate.”https://www.timesofisrael.com/the-end-of-exponential-growth-the-decline-in-the-spread-of-coronavirus/“Our analysis shows that this is a constant pattern across countries. Surprisingly, this pattern is common to countries that have taken a severe lockdown, including the paralysis of the economy, as well as to countries that implemented a far more lenient policy and have continued in ordinary life.The data indicates that the lockdown policy can be stopped within a few days and replaced by a policy of moderate social distancing.”https://www.medrxiv.org/content/10.1101/2020.05.01.20088260v2 https://www.medrxiv.org/content/10.1101/2020.04.24.20078717v1“This observational study, using a generalized phenomenological method based on official daily deaths records only, shows that full lockdown policies of France, Italy, Spain and United Kingdom haven’t had the expected effects in the evolution of the COVID-19 epidemic. Our results show a general decay trend in the growth rates and reproduction numbers two to three weeks before the full lockdown policies would be expected to have visible effects. Comparison of pre and post lockdown observations reveals a counter-intuitive slowdown in the decay of the epidemic after lockdown. Estimates of daily and total deaths numbers using pre-lockdown trends suggest that no lives were saved by this strategy, in comparison with pre-lockdown, less restrictive, social distancing policies. Comparison of the epidemic’s evolution between the fully locked down countries and neighboring countries applying social distancing measures only, confirms the absence of any effects of home containment.”https://www.medrxiv.org/content/10.1101/2020.09.26.20202267v1“Models that allow for heterogeneity favour build-up of herd immunity rather than 71 non-pharmaceutical interventions as the main factor underlying the early slowing and 72 reversal of the COVID-19 epidemic in Europe. This is consistent with observations that 73 epidemic curves in many countries reached a peak less than two months after the first 74 few severe cases appeared [8,9]. With this dataset it is not possible to distinguish the 75 relative contributions of heterogeneity of connectivity, heterogeneity of susceptibility, or 76 any other process that could have generated a smooth downward trajectory in Rt over 77 about one month in each of the 11 European countries studied. 78 Because the model is fitted to observed deaths, the estimates of cumulative numbers 79 infected and herd immunity threshold depend on the values pre-specified for infection 80 fatality ratios. Specifying an average infection fatality ratio of 0.3% gives an estimated 81 herd immunity threshold of 15%. Whatever value is specified for the infection fatality 82 ratio, a model that allows for heterogeneity has better fit to the data than the 83 homogeneity model and supports herd immunity as the main factor underlying the 84 reversal of the epidemic. 85 One objection that has been raised to estimates that herd immunity thresholds for 86 COVID-19 are less than 20% is that far higher infection rates have been reached in local 87 hotspots such as Manaus [10]. However country-level herd immunity thresholds as 88 estimated here are not likely to be homogeneous over every locality. In hotspots where 89 the basic reproduction number R0 is higher than the population average, the herd 90 immunity threshold and overshoot of this threshold will be correspondingly higher, with 91 or without heterogeneity.”https://www.nicholaslewis.org/did-lockdowns-really-save-3-million-covid-19-deaths-as-flaxman-et-al-claim/“First and foremost, the failure of Flaxman et al.’s model to consider other possible causes apart from NPI of the large reductions in COVID-19 transmission that have occurred makes it conclusions as to the overall effect of NPI unscientific and unsupportable. That is because the model is bound to find that NPI together account for the entire reduction in transmission that has evidently occurred.Secondly, their finding that almost all the large reductions in transmission that the model infers occurred were due to lockdowns, with other interventions having almost no effect, has been shown to be unsupportable, for two reasons:the prior distribution that they used for the strength of NPI effects is hugely biased towards finding that most interventions had essentially zero effect on transmission, with almost the entire reduction being caused by just one or two NPI.the relative strength of different interventions inferred by the model is extremely sensitive to the assumptions made regarding the average delay from infection to death, and to a lesser extent to whether self isolation and social distancing are taken to exert their full strength immediately upon implementation or are phased in over a few days.”https://www.bmj.com/content/371/bmj.m3588“We therefore conclude that the somewhat counterintuitive results that school closures lead to more deaths are a consequence of the addition of some interventions that suppress the first wave and failure to prioritise protection of the most vulnerable people.When the interventions are lifted, there is still a large population who are susceptible and a substantial number of people who are infected. This then leads to a second wave of infections that can result in more deaths, but later. Further lockdowns would lead to a repeating series of waves of infection unless herd immunity is achieved by vaccination, which is not considered in the model.A similar result is obtained in some of the scenarios involving general social distancing. For example, adding general social distancing to case isolation and household quarantine was also strongly associated with suppression of the infection during the intervention period, but then a second wave occurs that actually concerns a higher peak demand for ICU beds than for the equivalent scenario without general social distancing.”https://www.medrxiv.org/content/10.1101/2020.03.30.20047860v3“In this study, we applied cost-effectiveness analysis tools to distinguish between two different strategies aimed to slow down the virus spread. We show that a national lockdown (strategy 1) will result in a total of ~ 19,646 infected individuals and around 303 deaths over a period of 200 days. An alternative “testing, tracing, and isolation” approach (strategy 2) in which only individuals with a high exposure risk are isolated will result in a total of 38,761 infected individuals and 577.8 deaths. Overall, strategy 1 is expected to save ~274 more lives, but with a cost of $45.1 million to prevent one death case, compared to the more focused approach.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652751/“Epidemic theory dictates that a reduction in the force of infection by a pathogen is associated with an increase in the average age at which individuals are exposed. For those pathogens that cause more severe disease among hosts of an older age, interventions that limit transmission can paradoxically increase the burden of disease in a population.”https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3607803https://imgcdn.larepublica.co/cms/2020/05/21180548/JP-Morgan.pdfhttps://jamanetwork.com/journals/jama/fullarticle/2768086“Between March 1, 2020, and April 25, 2020, a total of 505 059 deaths were reported in the US; 87 001 (95% CI, 86 578-87 423) were excess deaths, of which 56 246 (65%) were attributed to COVID-19. In 14 states, more than 50% of excess deaths were attributed to underlying causes other than COVID-19; these included California (55% of excess deaths) and Texas (64% of excess deaths) (Table). The 5 states with the most COVID-19 deaths experienced large proportional increases in deaths due to nonrespiratory underlying causes, including diabetes (96%), heart diseases (89%), Alzheimer disease (64%), and cerebrovascular diseases (35%) (Figure). New York City experienced the largest increases in nonrespiratory deaths, notably those due to heart disease (398%) and diabetes (356%).”https://www.medrxiv.org/content/10.1101/2020.10.09.20210146v3“State mandatory isolations have caused economic damages and since these enforced isolations were suboptimal they involuntarily increased the risk of covid-19 disease-related damages (see additional deaths in Table 9) and led most locations to the point where future death minimizing strategies require negative isolation to healthy <60. Back in March 2020 for every location (see Table 9) there was a 100-day long total death minimizing alternative (with low ICU occupation) that becomes asymptotic with lower values than 1269 deaths per million (and much lower person potential years live lost) if the vaccination date was later than May 2020 (that is May 2020 and it didn’t happen), and simultaneously mandatory isolations did continue to and still produce economic losses on daily basis. Therefore, we conclude that economic damages overcame covid19 disease damages in all locations where governments kept enforcing mandatory isolation after June 2020. What went wrong? The SARS-CoV-2 epidemic required complex risk assessment and governments are not the best equipped to do it (insurance companies are). We propose for this virus (and future viruses) an isolation exemption insurance policy. This should be evaluated both as a revealing thought experiment and a concrete suggestion.” https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3665588“The lockdowns in most Western countries have thrown the world into the most severe recession since World War II and the most rapidly developing recession ever seen in mature market economies. They have also caused an erosion of fundamental rights and the separation of powers in large part of the world as both democratic and autocratic regimes have misused their emergency powers and ignored constitutional limits to policy-making (Bjørnskov and Voigt, 2020). It is therefore important to evaluate whether and to which extent the lockdowns have worked as officially intended: to suppress the spread of the SARS-CoV-2 virus and prevent deaths associated with it. Comparing weekly mortality in 24 European countries, the findings in this paper suggest that more severe lockdown policies have not been associated with lower mortality. In other words, the lockdowns have not worked as intended. “ https://www.nber.org/papers/w27719“One of the central policy questions regarding the COVID-19 pandemic is the question of which non-pharmeceutical interventions governments might use to influence the transmission of the disease. Our ability to identify empirically which NPI’s have what impact on disease transmission depends on there being enough independent variation in both NPI’s and disease transmission across locations as well as our having robust procedures for controlling for other observed and unobserved factors that might be influencing disease transmission. The facts that we document in this paper cast doubt on this premise. Our finding in Fact 1 that early declines in the transmission rate of COVID-19 were nearly universal worldwide suggest that the role of region-specific NPI’s implemented in this early phase of the pandemic is likely overstated. This finding instead suggests that some other factor(s) common across regions drove the early and rapid transmission rate declines. While all three factors mentioned in the introduction, 19 Details on these model extensions are provided in Appendix B. 15 voluntary social distancing, the network structure of human interactions, and the nature of the disease itself, are natural contenders, disentangling their relative roles is dicult. Our findings in Fact 2 and Fact 3 further raise doubt about the importance in NPI’s (lockdown policies in particular) in accounting for the evolution of COVID-19 transmission rates over time and across locations. Many of the regions in our sample that instated lockdown policies early on in their local epidemic, removed them later on in our estimation period, or have have not relied on mandated NPI’s much at all. Yet, effective reproduction numbers in all regions have continued to remain low relative to initial levels indicating that the removal of lockdown policies has had little effect on transmission rates.”https://www.bmj.com/content/370/bmj.m3543“Plagued by political turmoil over “Europe’s last dictatorship” and with a president in denial of covid-19, how has Belarus ended up with one of the lowest death rates on the continent?”https://www.medrxiv.org/content/10.1101/2020.11.01.20222315v1For adults living with children there is no evidence of an increased risk of severe COVID-19 outcomes. These findings have implications for determining the benefit-harm balance of children attending school in the COVID-19 pandemic.https://www.pandata.org/wp-content/uploads/2020/07/Exploring-inter-country-variation.pdf‘Consistent with observations that imposition and lifting of lockdown has not been observed to effect the rate of decay of the country reproduction rates significantly, our analysis suggests there is no basis for expecting lockdown stringency to be an explanatory variable. We will continue to assess this as the few remaining pre-peak countries’ epidemic curves mature over the next month or two. In this regard we note that, for lockdowns to be expected to “flatten the curve” significantly enough to reduce the burden on healthcare systems, the impact on the response variable in 5.2 would have to be significant. We will investigate a sensible threshold, but our sense is that a correlation of less than 50% would be wholly inadequate.”https://www.medrxiv.org/content/10.1101/2020.08.04.20168112v1#:~:text=The%20seroprevalence%20of%20COVID%2D19,care%20workers%20in%20Niger%20Statehttps://www.nejm.org/doi/full/10.1056/NEJMoa2029717https://www.frontiersin.org/articles/10.3389/fpubh.2020.604339/fullhttps://www.tandfonline.com/doi/abs/10.1080/00779954.2020.1844786?journalCode=rnzp20http://www.upmc-biosecurity.org/website/resources/publications/2006/2006-09-15-diseasemitigationcontrolpandemicflu.htmlhttps://www.medrxiv.org/content/10.1101/2020.12.25.20248853v1https://www.medrxiv.org/content/10.1101/2020.12.28.20248936v1https://www.aier.org/article/what-they-said-about-lockdowns-before-2020/amp/?__twitter_impression=trueMoving on to vaccines, we see a similar flood of data showing that vaccines can cause significant harm, including from “pathological priming,” where the vaccine causes the immune system to produce a bigger immune response, worsening symptoms, and causing other problems like autoimmunity.https://pubmed.ncbi.nlm.nih.gov/27269431/http://ipaknowledge.org/covid-19-and-sars-cov-2-research.php?fbclid=IwAR2aIHIjBsUOrMPNcQi7Vcfdh9W8S_Kx_geRLUiIRWzah4uV-_vY8WVZesshttps://pubmed.ncbi.nlm.nih.gov/32292901/https://www.sciencedirect.com/science/article/pii/S2589909020300186?via%3Dihub&fbclid=IwAR2_2GPnT1Xy0MHchMI6S0Ojm4f6Nzva18-ptO8gTK6vdmjeh3dDNNk0EPUhttps://pubmed.ncbi.nlm.nih.gov/17194199/We are already seeing side effects, including deaths, from the vaccines, as well as recalls on batches of certain vaccines. These are not products that are proven safe—they are experimental products. Use at your own risk.https://saahm.net/side-effects-of-covid-19-vaccines/https://www.courierpress.com/story/news/2021/01/11/moderna-side-effects-covid-19-vaccine-symptoms-shawn-skelton-viral-video-doctors/6623016002/https://www.theepochtimes.com/55-people-died-in-us-after-receiving-covid-19-vaccines-reporting-system_3659152.html?utm_source=newsnoe&utm_medium=email&utm_campaign=breaking-2021-01-16-3(note: Marco disputes the use of the Epoch times as a valid source)https://www.sfchronicle.com/health/article/California-calls-for-pause-in-use-of-huge-batch-15878735.phpThere are numerous ethical problems with the vaccines, including problems associated with insufficient informed consent:https://pubmed.ncbi.nlm.nih.gov/33113270/On mandatory vaccines, either mandated by employers, governments, or businesses such as airlines—these are a violation of our basic human rights, as outlined in the UN’s Universal Declaration of Bioethics and Human Rights:Article 6 – Consent1. Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice.2. Scientific research should only be carried out with the prior, free, express and informed consent of the person concerned. The information should be adequate, provided in a comprehensible form and should include modalities for withdrawal of consent. Consent may be withdrawn by the person concerned at any time and for any reason without any disadvantage or prejudice. Exceptions to this principle should be made only in accordance with ethical and legal standards adopted by States, consistent with the principles and provisions set out in this Declaration, in particular in Article 27, and international human rights law.3. In appropriate cases of research carried out on a group of persons or a community, additional agreement of the legal representatives of the group or community concerned may be sought. In no case should a collective community agreement or the consent of a community leader or other authority substitute for an individual’s informed consent.On the topic of natural immunity, several studies show that recovery from COVID-19 is associated with lasting immunity. The short story is, natural immunity trumps artificial immunity.https://www.technologyreview.com/2021/01/06/1015822/covid-19-immunity-likely-lasts-for-years/https://www.journalofinfection.com/article/S0163-4453(20)30781-7/abstracthttps://science.sciencemag.org/content/early/2021/01/06/science.abf4063On the inaccuracy of PCR tests, and their unsuitability as clinical diagnostics:https://www.sciencetimes.com/articles/27182/20200905/positive-covid-19-test-results-accurate.htmOn the importance of metabolic health, or lack thereof, as the primary driver of morbidity and mortality in COVID-19:https://onlinelibrary.wiley.com/doi/10.1111/obr.13128https://www.nature.com/articles/s41574-020-0364-6https://pubmed.ncbi.nlm.nih.gov/33320875/https://care.diabetesjournals.org/content/44/1/188The personal heatlh takeawaysThe best way to ensure your own personal health and longevity, and to ensure the most expeditious re-opening of society is two-fold: First, take responsibility for your own health by managing and improving your metabolic and immunehealth. If you don’t know how to do that, contact a licensed health care professional with experience in improving metabolic health through diet and lifestyle interventions. Secondly, If you display any symptoms, avoid close contact with people outside your household until you’re sure the symptoms are not transmissible. This holds for colds, seasonal flu, COVID-19, and any other communicable disease.Secondly, share this information, advocate for the use of solid-peer reviewed science, which shows that the public is best served by allowing individuals to manage their own healthcare decisions based on their own understanding of risk, thereby allowing economies to fully re-open, allowing individuals and businesses to thrive. Thanks for listening to our show!Special thanks to Dr. Michael Gaeta for his generous presence, wisdom, and deep knowledge of health and well-being. We’re honored to have him as a repeat guest on our show.In health,Marco & LukeEpisode notes compiled by Luke Terry, Marco Lam, and Michael Gaeta. Edited by Luke Terry. Special thanks to former NY Times science writer Alex Berenson, and the extended community of heterodox scientific thinkers, largely congregating on Twitter, for bringing many of these research threads to light.
