Latest / What the Hal?? 2.0 / WHAT THE HAL? PODCAST 2.0 – EPISODE 16: Exploring the New mRNA Flu Vaccine: A Paradigm Shift in Prevention

Transcript

WHAT THE HAL? PODCAST 2.0 – EPISODE 16: Exploring the New mRNA Flu Vaccine: A Paradigm Shift in Prevention · What the Hal?? 2.0

• 0:00
  We had a pretty rough flu season this year.
• 0:03
  You may have experienced it yourself, but there's hope on the horizon for better prevention strategies.
• 0:08
  I'm Hal Eisner with Hunter Lowrey.
• 0:10
  Elsa Ramon has a day off, and this is what the hell.
• 0:15
  Smart, fresh, and uplifting.
• 0:21
  We've got the stories that make you want to say, what the hell?
• 0:27
  For years, our flu vaccine has been kind of hit and miss, sort of.
• 0:32
  And scientists had to guess what flu strain might hit us that particular year.
• 0:37
  But now a new type of flu vaccine is nearing completion of clinical trials, and it has some familiar technology.
• 0:44
  Joining us is Dr.
• 0:45
  Steve Goldberg, Chief medical officer of Health Track, an overnight infectious disease prevention company.
• 0:52
  He's going to bring us up to date on this new innovation.
• 0:54
  So, first of all, good to see you, Dr.
• 0:56
  Goldberg.
• 0:57
  Thanks for joining us.
• 0:58
  Good to be with you, Hal.
• 0:59
  Good to be with you, Hunter.
• 1:01
  Before we get into what's new, let's talk about what's old.
• 1:05
  What problems are we facing with the current flu vaccines?
• 1:09
  It's a great question.
• 1:11
  The present flu vaccine has been out for almost 70 years.
• 1:16
  And the problem is it has wide variability in effectiveness.
• 1:21
  It is only effective anywhere from 10 to 60%.
• 1:26
  It's not 90% effective.
• 1:28
  And the flu is deadly for many people.
• 1:32
  In the United States, we have about 130,000 people get sick with the flu.
• 1:37
  And we have.
• 1:39
  Pardon me, we have 130,000 people get hospitalized with the flu, and sadly, we have about 5,000 deaths.
• 1:47
  And we offer a flu vaccine that's based on information from around the world six months before, we have our own episode.
• 1:58
  And a lot of times that match is not great.
• 2:01
  And the product that we make is not a terrific match for what's happening in our area from October till March.
• 2:10
  That's kind of what happened this year.
• 2:11
  Right.
• 2:11
  There was a little bit of a mess.
• 2:14
  There was a little bit of a miss.
• 2:16
  There was an Omicron variant that developed, and it developed after all the vaccine was distributed.
• 2:26
  And there wasn't a terrific match.
• 2:29
  There was some degree of match, but not perfect.
• 2:32
  So it was a rough flu season.
• 2:35
  You know, just for transparency, because we can hear and if you're watching on YouTube, you can see us.
• 2:42
  I am sniffling.
• 2:43
  Yes.
• 2:44
  And I have a cold.
• 2:45
  Yes.
• 2:45
  And after this, I'm going to get a bowl of chicken soup.
• 2:48
  Yes.
• 2:48
  And you know, it is what it is because we get sick and sometimes we just get these bugs that we kind of share with each other, and sometimes we get things that are much more serious.
• 2:59
  So for listeners who may only know MRNA from COVID 19 vaccines.
• 3:05
  Now you have this MRNA flu vaccine and it's different from the traditional flu shots people get each year.
• 3:14
  So in what way is it different and why is it in your mind significant?
• 3:19
  Well, let's talk about how the traditional flu vaccine is made.
• 3:23
  It's actually made in chicken egg.
• 3:25
  And what happens is for every dose of vaccine you need a single chicken egg.
• 3:31
  So it's a big, big project.
• 3:33
  And what happens is the virus is injected into the chicken and then it multiplies and then killed virus is taken and that's what is the component of the flu vaccine.
• 3:49
  And they have several different types based on the flu that's happening on the other side of the world.
• 3:58
  It's maybe 10 to 60% effective.
• 4:02
  But as we mentioned, lots of people sadly still get the flu, get hospitalized and die.
• 4:08
  So we want something better.
• 4:10
  What's the hope of mRNA?
• 4:12
  The hope of MRNA are a couple things.
• 4:14
  First, the preparation time is shorter.
• 4:18
  They talk about a hundred day goal.
• 4:21
  The second thing is that it's done in a lab, right?
• 4:25
  And it's thought that when you do it in a lab you can get a more accurate and sustained flu vaccine than you can when you're doing it in chicken eggs.
• 4:37
  The third thing is you can do it faster.
• 4:41
  And so that's all the hope.
• 4:44
  Then the other feature is that how does it work?
• 4:47
  What happens is you take some RNA from a virus and you inject it into the body, shallow but injected.
• 4:59
  And then what happened?
• 5:00
  The body sees it and literally makes proteins from the direction from that MRNA and then your body ramps up and is prepared to attack that.
• 5:11
  Now what happens?
• 5:12
  What's been injected degrades, but the infection fighting cells in your body, several types are all ramped up and ready to go at time of flu season.
• 5:23
  And the early data from MNRH based vaccines is that it's more effective.
• 5:29
  Two different trials were studied.
• 5:31
  The one that's advancing to the FDA is the Moderna vaccine for older individuals.
• 5:37
  And overall those that got it versus the traditional vaccine had 25% less flu episodes.
• 5:46
  So there's optimism.
• 5:47
  Now what happens next?
• 5:49
  An advisory committee recommended it to be advanced to the full committee of the FDA and that decision's waiting.
• 5:58
  Let's just clarify because I think earlier we said, you know, we have this new vaccine, we don't.
• 6:04
  It is still in trials.
• 6:06
  Third, what do they call it?
• 6:07
  Third series testing.
• 6:10
  Well, the, the, the third clinical trial was completed.
• 6:17
  It then has been presented to the FDA and it's Moderna's MRNA vaccine.
• 6:24
  And on June 18, the advisory committee voted 9 to 0 to advance it to the full committee.
• 6:32
  But it is not out yet.
• 6:34
  It is not approved by the fda, but it is advancing.
• 6:38
  How do these things go?
• 6:40
  Yeah, I was going to ask about timeline.
• 6:42
  Yeah.
• 6:44
  Could we have it for next year?
• 6:45
  Yeah, not likely.
• 6:48
  Not likely.
• 6:48
  And when it comes out, it won't replace other, it'll be an alternative offering.
• 6:55
  So in other words, you'll have a choice.
• 6:56
  You'll be able to say I want this or I want that.
• 6:59
  And oftentimes what we see is that we're being offered things like flu shots, pneumonia shots and other shots at the pharmacy.
• 7:06
  And you suspect that'll be a place where people will have access to this particular, particular thing once it becomes available.
• 7:13
  That's right, Hal, and there'll be a choice to make.
• 7:16
  So one of the findings from the clinical studies, the phase three study safety and efficacy, is that this new vaccine causes a higher rate of non serious side effects such as discomfort at the injection site, transient fever and
• 7:35
  chills, transient ill feeling, more so than the traditional flu vaccine.
• 7:40
  And that's likely because it's waking up more cells than the other.
• 7:44
  The good news is that the more serious side effects that could put you in the hospital just from getting vaccine are very rare.
• 7:53
  Very, very rare in both.
• 7:56
  So that's good news.
• 7:56
  So I think the message for people will be you might have a little bit more short term pain from, for long term gain and protection.
• 8:06
  Short term pain, long term gain.
• 8:08
  And so you know, you still have the sort of the battle out there of vaccine's good, vaccine's not good.
• 8:16
  But that's not a conversation necessarily for us to get into.
• 8:19
  I think that the conversation here is why is this better?
• 8:23
  What is it that makes this more effective, more meaningful, more significant than what we've done before and does it last longer or is it something that has to still change year by year depending on the flu strain?
• 8:39
  Those are all great questions, just great questions.
• 8:43
  So let's start right now.
• 8:46
  You need a six month lag to prepare your flu vaccine.
• 8:51
  So you get the information of what's happening on the other side of the world.
• 8:54
  In February, the fda, informed by the World Health Organization, locks down on the recipe.
• 9:02
  It's often three different virus types, so you've got to get that known in February in order to have the vaccine ready in October.
• 9:10
  Six months.
• 9:11
  The hope is that this MRNA process could be more of a hundred day process, so it'll be shorter.
• 9:18
  Second is when you do one vaccine by One egg.
• 9:23
  There's actually mutations that can occur within the egg while you're preparing the virus so that it might not be as effective.
• 9:32
  You don't have that when you're doing a laboratory preparation.
• 9:36
  The third thing is with the shorter window, you can see what's happening right before you go and launch out your vaccine in October, November.
• 9:47
  Hunter mentioned what happened last year.
• 9:49
  We had an omicron variant that happened during the season.
• 9:52
  Well, we might have gotten a view of that and be able to make that into the final preparation of an MRA offering.
• 10:00
  So those are all good reasons.
• 10:02
  And again, the safety, there's not any evidence that it's any less safe than the vaccine we've had for 70 years.
• 10:11
  Okay, let's get into safety, because a lot of people out there, the only other place they've heard about the MRNA vaccine is for the COVID virus.
• 10:22
  And that just was a little bit full of misinformation.
• 10:29
  So how can we allay people's fears of something they may not actually understand?
• 10:35
  Can you assist?
• 10:38
  Yeah, well, let's, let's go through the specifics that Moderna, that got supported by the advisory committee to the fda.
• 10:48
  Nine to zero.
• 10:49
  It's now going to the larger committee.
• 10:51
  What did the research studies say?
• 10:54
  Local reactions were higher.
• 10:57
  And we talked about that.
• 10:58
  Why?
• 10:59
  Because it's triggering more infection fighting cells than the traditional vaccine.
• 11:05
  Fatigue was higher, headache was higher, muscle ache was higher, but serious reactions were not higher.
• 11:15
  And in older adults, they had fewer and less severe reactions than younger adults.
• 11:21
  So that's all preliminary good news.
• 11:25
  Right.
• 11:26
  And so I understand people's concern about using a different method for vaccines.
• 11:32
  The other thing I want to emphasize is that when you're injecting this MRNA material in a, in a lipid soluble material that goes into your body, there's not DNA taking over your cells.
• 11:48
  It's staying confined as a local reaction.
• 11:51
  And then your body makes proteins that then wake up your own infection fighting cells and be ready when the flu season comes.
• 11:59
  That's all it is.
• 12:00
  And what's injected degrades.
• 12:04
  So how can we present this?
• 12:08
  I mean, you're probably not in a great position to do this, but I'm a victim of reading social media and even as of yesterday, I saw people posting stuff about the COVID vaccine saying that here we are, what,
• 12:27
  six, probably like five years after the vaccine was introduced and they're like, it will cause cancer.
• 12:35
  It will make your children mutate.
• 12:37
  It will, will everybody who gets the jab dies.
• 12:41
  I mean, I mean, that's a fact because it's like we're all going to die.
• 12:46
  But how is there any way that you can think of that we could clear up some of this misidentification, this misinformation that seems to be really causing people issues in protecting their health?
• 13:03
  It's very difficult and we're in a really challenging time right now where I think traditional scientific and medical authorities are under question.
• 13:16
  So that that gives people worry and fear.
• 13:19
  And I can understand that.
• 13:21
  What I do in preparing for conversations like this is I go to formal literature and publish papers which have certain standards of information that have to be presented in order to get recognized as a peer reviewed publication.
• 13:39
  So when I'm offering information, that's what I'm referencing.
• 13:43
  And there are five main points about the Mr.
• 13:45
  And a vaccine that we'll just emphasize.
• 13:49
  So when you're not doing it in an egg and you're doing it in a lab, you're not going to have risk of mutations that make the vaccine less effective.
• 13:59
  That's good.
• 14:00
  You're going to do faster manufacturing.
• 14:02
  Instead of six months, maybe they can get to a hundred days, but less.
• 14:08
  The third thing is you'll be able to precisely match the protein coats that are on the virus that's around the world.
• 14:19
  That is likely going to come here in a way with MRNA that you can't do when you're doing it within an egg.
• 14:27
  So we hope it's more effective than the 10 to 60% we're now experiencing.
• 14:33
  And then finally scaling ability.
• 14:36
  If you're able to do this and get this engine going, you're likely going to be able to engage this MRA technology for other types of infections such as bird flu for example.
• 14:48
  So that's the hope.
• 14:49
  And then based on the evidence that's been submitted to the FDA for this Moderna vaccine that was approved 9 to 0 by their advisory committee, the long term side effects were comparable to what you saw in a chicken
• 15:08
  egg manufactured vaccine which are very, very rare.
• 15:14
  Do you find sometimes that try to even debate what people are suggesting and whatever theories they may have gives you a lot of bruises on your skull as you're hitting your head against the wall?
• 15:29
  I mean, isn't it a battle to try to inform people publicly about infectious diseases and what's being done about it and to sort of suggest to them that the evidence shows that something may be good as opposed to
• 15:46
  whatever it is that people come up with as to reasons why it's not?
• 15:52
  Hal that's very difficult.
• 15:53
  You both are very distinguished Journalists and broadcasters.
• 15:58
  So you have a code of ethics that you operate by.
• 16:02
  For me, as a practicing physician and chief medical officer of infectious disease lab, what I do is I make comments based on peer review literature.
• 16:13
  And what happens for peer review literature is you have appropriately situated experts read the information and draw conclusions.
• 16:24
  And then I take that to inform my patients.
• 16:27
  That's what we're doing today, and that's the best we can do.
• 16:31
  I do it one person at a time.
• 16:33
  I'm having those conversations about measles.
• 16:36
  I'm having those conversations about whooping cough.
• 16:40
  It's something we do every day and we're glad to do it.
• 16:44
  And, you know, just, just, just.
• 16:46
  I'm sorry.
• 16:46
  No, I'm sorry.
• 16:47
  Just for the sake of perspective, I think my first doctor was a fellow named Fred Flintstone.
• 16:54
  And the reality is I go all the way back to the salt vaccine on a sugar cube in elementary school where we would get a little sugarcue, take the Salk vaccine and polio went, salk or Sabin?
• 17:08
  Salk.
• 17:09
  Dr.
• 17:10
  Salk.
• 17:10
  Right.
• 17:12
  A gift to mankind.
• 17:13
  An absolute gift to mankind.
• 17:18
  And you're right.
• 17:19
  I personally feel comfortable with vaccines.
• 17:23
  I check the primary research on their safety, and so I'm comfortable with appropriate recommendations nationally.
• 17:35
  And then when I have concerns, I go to specialty societies.
• 17:40
  So, for example, there's some debate in the Health and Human Services Immunization Advisory Committee on certain issues.
• 17:48
  And certain specialty societies have felt necessary to put out their own guidelines.
• 17:54
  So about a month or two ago, the American College of Ob GYN put out their own guidelines for pregnant women, specifically speaking to a range of issues.
• 18:05
  But where they differed from HHS was around COVID vaccine and pregnancy.
• 18:11
  And they recommended it.
• 18:12
  And then they had 14 societies sign off on that recommendation.
• 18:17
  So that's who I look to.
• 18:19
  And then if I have a pregnant patient asking me about COVID vaccine, I'm not giving my opinion.
• 18:25
  I'm giving it from an organization that's been around 70 years and their points of view have been supported by 14 different specialty societies.
• 18:33
  And since I've been around forever and always, I think that it's important to clarify.
• 18:40
  I was wrong.
• 18:41
  Hunter was right.
• 18:43
  It was Albert Saban's vaccine that was, I guess, on a sugar cube.
• 18:48
  Right.
• 18:49
  But Salk came up with the vaccine.
• 18:51
  Saban just made it easy to take.
• 18:53
  Salt made it in 55 and Saban in the early 60s.
• 18:57
  Thank you, Chad.
• 18:57
  CBT.
• 18:58
  But you know, I think it's important to, to make sure we fact check ourselves.
• 19:03
  So.
• 19:03
  But I do remember A test.
• 19:05
  To both of those gentlemen.
• 19:08
  Cheers.
• 19:09
  But I think the bottom line is that I remember this as a child, and it set a path for me of a comfort level in dealing with vaccines.
• 19:20
  And so I've never really had this issue with vaccines except to understand that they're there to, like, any kind of medicine I might get at the pharmacy, make me feel better.
• 19:30
  So, you know, just a different place we all come from in our own thinking about how we're.
• 19:36
  How we're dealing with our own bodies.
• 19:39
  I want to.
• 19:39
  I want to bring up another question that I had because I keep getting advisories about measles outbreaks.
• 19:46
  And that's another one that many of us didn't think twice about when we were kids.
• 19:51
  We just, bam, got vaccinated for this dread disease.
• 19:55
  But now we're seeing it breaking out out there.
• 20:00
  And as somebody who was vaccinated a number of years ago, how concerned should I be?
• 20:09
  How concerned should we be just, you know, getting on a plane or traveling or going on a cruise?
• 20:15
  I.
• 20:16
  Am I immune?
• 20:17
  Should we get more vaccines?
• 20:19
  I mean, should anybody get vaccinated?
• 20:21
  Is.
• 20:21
  Is measles overblown?
• 20:23
  Tell us, Dr.
• 20:24
  Goldberg.
• 20:25
  Those are great questions, Hunter.
• 20:27
  So we'll start this way.
• 20:31
  Measles before vaccination was an awfully difficult organism.
• 20:40
  Hundreds of thousands got ill, tens of thousands were hospitalized, and hundreds died every year.
• 20:49
  And the vaccine is highly effective.
• 20:52
  The reason that measles is so dangerous is because it spreads really easily.
• 20:59
  So if you are in a group of people and only one is vaccinated, everybody else who's not vaccinated is likely going to get sick.
• 21:12
  If someone with measles comes in every other person, it has very high rates of transmission.
• 21:18
  So that's what's dangerous.
• 21:20
  What has happened over time is a couple things have happened.
• 21:24
  One is not every parent is having their child get the necessary vaccinations before they enter school or are homeschooled.
• 21:36
  Most states do require it, which is fortunate, but there's been a drop.
• 21:40
  And so you need about 93% of a community to be vaccinated for it not to spread around.
• 21:49
  But in some communities and some areas where there's, let's say, vaccine hesitancy, there's a group of children that aren't vaccinated that create the opportunity for spread.
• 22:01
  And then there's a separate population which are adults.
• 22:05
  And adults have to get their own immunizations updated if they are in higher risk places, such as universities or certain travel to high risk environments.
• 22:20
  Most people, including those who only had one vaccine, have high likelihood that they're immune and low likelihood of getting infection on the assumption that you've gotten the vaccination.
• 22:33
  However, if there's any doubt, what most specialists recommend is not to get a lab test to see if you have immunity, just go get the vaccine.
• 22:43
  And that's what I'm recommending to my patients.
• 22:46
  No.
• 22:46
  No harm in.
• 22:47
  In getting it, even if you are immune, right?
• 22:49
  No, no.
• 22:51
  And for those of us who may have had a few years since we were vaccinated, like, I don't even remember when it was, should we just go ahead and do it?
• 23:01
  I mean, I do travel.
• 23:02
  I.
• 23:03
  I am not in a university or a school, but I get exposed to stuff.
• 23:10
  Frankly, it's a judgment call.
• 23:13
  And with what you're describing, if you're healthy, if you're not immunocompromised, you're not working at a university, you're not having contact with people who might not be immunized, you're not in a healthcare setting, then you're probably okay.
• 23:28
  That said, if you have any doubt, it's very easy to go to a chain or community pharmacy and get MMR boosters to know.
• 23:40
  Oh, hell, I think you're.
• 23:42
  I think you're muted, so I was.
• 23:44
  Just trying to see if you can read my lips.
• 23:46
  I.
• 23:48
  Sorry about that.
• 23:49
  I thought I had a side effect, and I went deaf.
• 23:52
  No, no, no, no, no.
• 23:53
  You know, I think a lot of people relate and connect things that they feel are bad to things that they worry may be bad.
• 24:05
  I was on my 24th cruise about a week or so ago to Alaska, and I'm going on my 25th cruise next month to the Caribbean.
• 24:14
  And I'm not afraid of ships.
• 24:17
  And I've never seen a major outbreak of some sort of a virus that has happened.
• 24:23
  We know it's happened, but.
• 24:25
  But it's never happened in my environment.
• 24:28
  And, you know, I thought, again, an airplane, same thing.
• 24:33
  You're.
• 24:33
  You're in a closed missile of people sniffling, coughing, and.
• 24:37
  Or either feeling good or feeling bad.
• 24:40
  We live in a.
• 24:41
  In a society where we're in community, and so it's not really avoidable.
• 24:46
  I mean, if we want to avoid it, I guess we have to put masks on all the time like we did before.
• 24:50
  Even.
• 24:51
  That's not 100%, you know, and even a vaccine isn't 100%, is it?
• 24:57
  Well, you're.
• 24:57
  You're raising lots of great questions, Hal.
• 25:00
  If you say to me, Steve, Dr.
• 25:01
  Goldberg, what is the one thing I can do to minimize my risk.
• 25:07
  Steve, I want to say to you this.
• 25:09
  What is the one thing I can.
• 25:11
  Sorry, what's the one thing I can do?
• 25:15
  Wash your hands, soap and water several times a day.
• 25:20
  That is by far the number one thing people can do.
• 25:24
  A mask can be helpful both to restrict if you're ill, spread to other and also do some protection of yourself.
• 25:34
  So those are two elements to consider.
• 25:36
  But number one, by far, really studied, really effective, is washing hands.
• 25:42
  I've got one.
• 25:43
  I've got one.
• 25:44
  Yeah.
• 25:44
  Yeah.
• 25:44
  So there's this new bugaboo which has me freaked out because they don't know how it's spreading.
• 25:51
  And I'm not even going to try to say the whole thing, but the spike nailed it.
• 25:57
  Cyclospora parasite, which has some very negative effects on our intestines, which I'm not going to get specific about.
• 26:08
  What do you know about that and where it is and what's going on with that?
• 26:13
  And what do we do?
• 26:15
  Okay, so cyclospora, or the condition cyclosporasis, is something that has been part of the US for almost 35 years, so not new.
• 26:31
  And it seems to peak during the certain time of the year, normally spring and summer.
• 26:37
  And it peaks then because people are consuming the common source of.
• 26:43
  Of this organism, which is a parasite, namely fruits and vegetables, particular ones including cilantro and raspberries and blackberries and components that go into a salad.
• 26:59
  And what happens is the parasites get in the irregular surfaces and you consume it and they embed themselves in your gut and cause and explosive diarrhea.
• 27:13
  And that's different from the other sources that can cause diarrhea.
• 27:18
  Norovirus, Salmonella, shigella, Campylobacter.
• 27:21
  And also it makes tracing real difficult because the waiting period can be seven days before you develop symptoms.
• 27:29
  So we have about 2,000 cases per year every year in the United States.
• 27:36
  Rarely does someone die.
• 27:38
  Rarely a certain percentage of people get hospitalized because they get dehydrated.
• 27:43
  So what's happening now?
• 27:45
  We have big outbreaks in New York, big outbreaks in Michigan, big outbreaks in Ohio, less elsewhere.
• 27:51
  The problem is we don't know the source.
• 27:55
  We don't know the source or sources.
• 27:58
  Most likely it is from vegetables and fruit that were grown and irrigated outside of the United States and then brought into the United States.
• 28:09
  And the water in their growth and preparation was contaminated.
• 28:14
  What happens is humans are the only known storage for this parasite, get the explosive diarrhea.
• 28:22
  But if you come to another person and Contact them hand to hand.
• 28:26
  You can't get them ill because the spores have to be out in the environment for a while to be able to implant in someone's gut.
• 28:34
  So someone has diarrhea.
• 28:36
  And the sewage is not great, the irrigation is not great.
• 28:39
  Some of the parasites get into the food prep and that becomes a new source of illness.
• 28:46
  What can you do?
• 28:47
  Well, I have a couple recommendations, some established, some judgments.
• 28:53
  So what's established?
• 28:54
  You gotta wash the fruits and vegetables, particularly ones I mentioned.
• 29:00
  Really?
• 29:00
  Well, that means not just running water, but forceful water.
• 29:04
  And get into the grooves and on the surface of the items.
• 29:08
  Also there's some suggestion.
• 29:09
  Soap?
• 29:10
  No, there's not evidence that soap helps.
• 29:12
  No evidence that bleach help.
• 29:14
  No evidence that oils help.
• 29:16
  No evidence that vinegar helps.
• 29:19
  People are trying different things.
• 29:21
  But forceful water, then some surface tension, either with a hand or a brush, just to do a final cleaning.
• 29:28
  Not to the point where you destroy the fruit.
• 29:31
  Now, the other recommendations I'm making are that in the past a couple international sources have been identified as sources of this infected fruit and vegetable.
• 29:45
  From Guatemala, for example, or from Mexico.
• 29:48
  As a general recommendation, I'm saying only consume us based prepared fruits and vegetables until we learn more.
• 29:58
  And then do the intense washing.
• 30:00
  And then if you're ill, right, by ill I mean you show yourself to have explosive diarrhea, or you're nauseous, or you're vomiting, or you have fever.
• 30:10
  If you gotta go get evaluated because this needs treatment and the treatment is highly effective.
• 30:16
  There's a particular antibiotic that works.
• 30:18
  If you're allergic to that, there's another one that works.
• 30:21
  And most people recover within two to three days.
• 30:24
  Good to know.
• 30:26
  You know, I'm curious about one more thing.
• 30:28
  Would you prescribe eating nothing but cheeseburgers until we know where this is coming from?
• 30:33
  I wouldn't, I wouldn't.
• 30:34
  Because again, we're talking about on average, as many cases as it is.
• 30:41
  Our run rate is about 2,000 cases per year.
• 30:45
  We have more this year.
• 30:47
  Hopefully we'll find out why, but it's still a relative small number.
• 30:52
  And fruits and vegetables are critical for your health and well being.
• 30:55
  So I think just doing some little cleaning, additional cleaning in the way that I described, and then going to a clinician if you're ill would be good.
• 31:04
  And by the way, when you go to someone, if you're ill, we'll do a test.
• 31:09
  And that's the type of testing our company Healthtrack does, where you take a swab and then they send it overnight to our lab in Louisville, and we result out the next day so the clinician knows exactly what's going
• 31:22
  on and what to treat you with.
• 31:24
  I just wondered, as we wrap this up, you know, looking down the road, way down the road, what do you see as the sort of future uses of mRNA?
• 31:36
  I think it's going to be a very successful platform for vaccination and disease prevention.
• 31:45
  I think it'll be faster, I think it'll be more specific.
• 31:51
  I think with time it will be lower cost.
• 31:54
  I think the safety's there and the effectiveness so far is much better.
• 31:59
  So I'm very optimistic.
• 32:01
  I see initial work around a flu vaccine with Moderna.
• 32:06
  I think Pfizer's working on other vaccines, combination vaccines, maybe flu and Covid.
• 32:12
  I see others working on bird flu, which is very important for animals and other.
• 32:20
  So I'm optimistic.
• 32:23
  That's good.
• 32:24
  Listen, let me ask you, do you have a website?
• 32:26
  Do you have any sources that people want to go look up and read some more?
• 32:31
  Yes, just go to healthtrack.com that's our company.
• 32:36
  Put in my name for search.
• 32:37
  Dr.
• 32:38
  Steve Goldberg.
• 32:39
  We offer commentary a lot on infectious disease topics, but also general health topics.
• 32:44
  And then if you have any questions, just email me at Stephen goldbergealthtrock and I'll get back to you personally.
• 32:53
  Well, my apologies for the sniffles and the coughs, and I'm gonna go get some chicken soup.
• 32:58
  Probably not a bad idea, huh, doc?
• 33:00
  And thank you so much for spending some time with us.
• 33:02
  Really appreciate it.
• 33:03
  It was great to be with you.
• 33:04
  Enjoy the conversation.
• 33:05
  Thank you, Dr.
• 33:06
  Goldberg.
• 33:07
  And that's what the how 2.0.
• 33:09
  I'm Hal Eisner, along with Elsa Ramon and Hunter Lowery.
• 33:13
  This podcast is produced by Hunter.
• 33:15
  Jamie Knapp is our technical director editor, and he handles all of the post production.
• 33:21
  Our original theme music is composed by Stuart Pearson.
• 33:24
  Earlier versions of the podcast were produced at the studios of Fox 11 in Los Angeles and are available through the link in our show Notes.
• 33:33
  This version of the podcast is available on YouTube and wherever you listen to podcasts.
• 33:39
  And what the Hell 2.0 is produced in Los Angeles, California.