20 Episode results for "Food And Drug Administration"
South Korean Shares Edge Higher On Monday.
"You're listening to the news office are on Africa Business Radio and South Korea she has rose just over one percents on Monday in line with Asian peers and this comes as the US drawn regulators station of the use of blood plasma from recovered patients as a Kobe and treatment lifted sentiment wrong you domestic cases sloat bought the Korean won on the benchmark bond yield weakened the benchmark Kospi closed on twenty five point two, four points at one point. One zero percent to two, thousand, three, hundred, twenty, nine, point, eight, three, five as net buyers of one hundred and ninety eight point six billion won worth of shares on the main board. The sub index from a cynical sector jumped two point nine percent following the authorization from the US Food and Drug Administration on Sunday and that wasn't at this time when Africa. Business Radio. You can't continue to listen live online at www Africa business radio DOT COM or. Honorable APP. I am ratio she gender. Thank you for listening.
Nigerian Drug Agency Engages Chinese, Indian Agents Against Importers Of Fake Medicines
"The Appellate podcast shares the stories of multifaceted Africans one episode at a time the podcast aims to uncover The Untold Stories of modern and Millennial Africans off base and various parts of the world. Each episode gives listeners an opportunity to learn and experience conversations that showcase who they are and they're Global perspectives in our own never change in World. Be sure to listen And subscribe to the absolute podcast on Spotify or wherever you listen to your favorite podcast. You can also follow at Affiliates podcast on all social media platforms, you're listening to the news at this hour on Africa Business Radio, the director-general of the national Agency for Food and Drug Administration and control nafdac off mode is announced agencies resonance to eliminate substandard and falsified medicines in the country through partnership with pre-shipment agents in China and India are they said the move? Parts of the agency's efforts to take the war against importation of illicit drugs to the source countries, you know, it said that 70% of the medicines used in Algeria imported while only 30% are produce locally stressing that attention must be paid on both imported and locally-made drugs by the agency to state that China in India. Now understand that they are responsible for making sure I brought up samples analyzed by them in their home countries are of quality. And that was the news at this time on Africa Business Radio. You can continue to listen life online at www off Africa business radio.com orva our mobile app and Rachel she didn't do. Thank you for listening.
US Gives Full Approval For Antiviral Remdesivir Drug
"The Appellate podcast shares the stories of multifaceted Africans one episode at a time the podcast aims to uncover The Untold Stories of modern and Millennial Africans off base and various parts of the world. Each episode gives listeners an opportunity to learn and experience conversations that showcase who they are and they're Global perspectives in our own never change in World. Be sure to listen And subscribe to the absolute podcast on Spotify or wherever you listen to your favorite podcast. You can also follow at Affiliates podcast on all social media platforms see on listening to the news at this hour on Africa Business Radio us Regulators have given full approval for the anti-viral drug when the receiver to treat covid-19 patients in hospitals the US Food and Drug Administration said vet salary the drugs brand named cause the recovery time on average by five days during clinical trials the World Health Organization last name. Exciting to see if you had little to no effect on patients survival that are being said. This was based on its own study for the drugs manufactured Gillett rejected the findings of the trial offer if it has been authorized for emergency use only in the U, S as in snake in the US it will cost $3,120 above our private insurance a $2,340 back government purchases for 5-day course, and that was the news this time when I figure Business Radio, you can continue to listen live online at w w w dot Africa business radioshack.com or our mobile app. I'm Rachel children do thank you for listening.
FDA Tightening Regulatory Requirements For Some Medical Devices
"Support for this podcast and the following message come from almond board of California almond farmers rely on healthy honeybees. So they funded more than a hundred research projects supporting be health more than any other crop group grow. What you know at almondsustainability dot org. The food and Drug administration is being forced to intensify. Scrutiny of medical implants. Now when you hear the word implants, it's easy to think of cosmetic surgery, but the word here includes a growing number of potentially lifesaving devices, the doctors place inside the patients, the problem is many of the devices have been breaking down like farm member station. WPN in Nashville reports on the effort to address that. There's no doubt that surgically implanted devices improve lives drug pumps, nerve stimulators, spinal rods. But the devices can also do serious damage like they have to Michel keel. It ruined my. Yes, it did. I'm sending near tears keel had. Problems with the leaky bladder. So a surgeon stitched a flexible mess strap insider pelvis, but the strap hardened and started cutting her insides the pain kept her from turning to her job in Michigan. As a hairdresser removing all the bits and pieces embedded in the scar tissue is required, multiple surgeries and resulted in chronic infections, kill can see why her doctor thought the high tech mesh would help. But she also now feels like she was a Guinea pig. We were the Chester's. There was no animal testing done. We were the animals for devices in which a failure could obviously be life. Threatening regulators have required some sort of human testing. But medical author Jeannie Linzer says the FDA now acknowledges that even some seemingly inert devices have caused major problems. So we have things like metal on metal hip, which outside the human body seemed to function just fine. They put them in little machines. They Rackham back and forth. They don't break. They put them inside people and something very different happens. Linzer just wrote a scathing book about the device industry and says she was dumbfounded to find out. How many devices never went through human testing like drugs? Do that's in part due to an expedited approval process known as five ten k it allows manufacturers to bypass many requirements by showing their product is very similar to something already in use. You just say your devices like an old device, and the device was never tested nor with your device in practice. Sometimes the basis for a whole family tree of devices turns out to be defective pelvic mashes a good example and a product for which the FDA has started requiring some human testing. But manufacturers have pushed back against calls to bring regulation of medical devices in line with medication Scott Whitaker of add them. It speaks for industry. Giants like striker Johnson and Johnson and mid Tron IQ testing should be as complete Hannah's thorough and his ethical and as appropriate as possible. But it doesn't all fit the same. And can't off it the same standard, not every surgery to treat the same condition goes exactly the same way every time the FDA declined to be interviewed for this story, but plans to make changes to the process over the next few months. The is pushing back on manufacturers basing any new device on one that's more than ten years old and regulators say they'll do a better job of watching. How devices do once they're on the market rather than relying on patients to report problems? Michael Metheny, a professor who tracks medical devices at Vanderbilt University approves of the FDA's incremental approach and calls thoughtful, he says he wouldn't want the changes to spark hysteria over device failures. It would really be unfortunate. If patients wouldn't consider any medical devices at all to be used in their bodies. But I do think being aware that there's nothing without risk is also important McCain notes, though that in some ways the risks are more profound than with medication if the FDA recalls pills. A patient can at least stop taking them immediately with a device, they're sort of stuck with it at least for a while. And that's if a surgeon can even safely remove it for NPR news. I'm Blake farmer in Nashville. The story is part of a reporting partnership between NPR Nashville, public radio and Kaiser health news. Support for this podcast and the following message. Come from Comcast business having the nation's largest gig speed network was just the start. Now, they're providing gig fueled apps and solutions that exceed expectations and help businesses perform Comcast business beyond fast.
House Committee Votes To Continue Ban On Genetically Modified Babies
"Today. A congressional committee voted to continue a federal ban on the creation of gene edited babies in the United States. This comes amid an intense debate about whether the ban is blocking valuable medical research and NPR health correspondent rob Stein is in the studio now to explain Hiram pay their Ari. I explained what the span is your sorry about four years ago, congress quietly imposed a ban that prohibits this ban that prohibits, the food and Drug administration from considering any proposals that involve using genetically modified human embryos to try to make babies. This is what prevents scientists United States from doing what that Chinese. Scientists, did you know making the world's first gene, edited babies and why did this come up today? So most scientists condemn what that Chinese scientists did. But some are unhappy with this band. And the reason is they say it's stifling. What could be really important medical research keen. Editing techniques like crisper could someday be shown to be safe way to prevent lots of genetic disorders, and there's another kind of genetic modification of human embryos that some scientists in the United States would like to. Assu right away. And that involves creating embryos with TNA from three different people, you know, these so-called three parent babies, which are also very controversial. Yes, they are. And the reason is that also involves making changes in DNA that can be passed down for generations, so it raises that prospect of designer babies, but many scientists think researchers should be allowed to pursue it as part of carefully designed studies just to see if it's safe because it could prevent devastating genetic disorders known as mighty Conrail disorders, and the British government is allowing that sort of thing right now. So if that's the background of the debate take us to what's actually happening in congress. Yes. So what happens last month subcommittee of the house of Representative dropped the band from a routine spending Bill and today that legislation came up for full debate on the hill, and it was a pretty emotional debate. Here's a Nita Lowey a democrat from New York, we have a moral obligation to allow advances in science so fewer parents will have to watch child by, but the ban ended up being reinstated after Lowy. And others acquiesce to the arguments of Republicans, like Jeff fort vary of Nebraska, the risks of harm a real, this was just the committee, what happens now does it go to the full house. Yes. Or the advocates for dropping the band say they are continuing to push for that. And they hope he does get pulled when the legislation live station finally hits the floor, but, you know, the chancellor party, probably pretty slim for them, succeeding at this point, that's NPR's rob Stein. Following the debate over gene, edited babies, thanks for your reporting. Rob. You bet. Kara.
Closing Bell Brief for Thursday, January 2nd
"Wall Street Journal listeners. Come from all walks of life and business and no matter what type of business urine eighty P is here to help you achieve what you're working king for with. HR talent time benefits and payroll informed by data and designed for people learn more at design don ADP DOT com. This is your closing bill brief for Thursday January second. I'm Charlie Turner at the Wall Street Journal. Stock stormed out of the gate for the New Year with the Dow Nasdaq and S&P. SNP all closing at fresh record highs on the first trading day of two thousand twenty. The Dow Jones Industrials Rose Three hundred thirty points to twenty eight thousand eight sixty eight Nasdaq composite. Is it gained one hundred nineteen the S. and P.. Five hundred twenty seven the markets jumped after China said it would take an additional step to reinvigorate its economy. The People's Bank of China. You said it would. Further loosen monetary policy by reducing the amount of reserves banks need to keep on hold at the central bank essentially freeing up cash for lending pharmaceutical cool companies started twenty twenty by raising the prices of hundreds of drugs however the average increase of five point eight percent was lower than a year earlier amid growing scrutiny from patients lawmakers and health plans according to an analysis visor led the way among the more than sixty drugmakers with price hikes increasing prices by over nine percent on more than forty products products. The drug industry traditionally sets prices for its therapies at the start of the year and again in the middle of the year the Food and Drug Administration says it will bar the use of fruit and admits flavors and cartridge e cigarettes in an effort to curb youth vaping but the FDA will still allow the flavors to be sold via tank vaping systems commonly found in. VAPE vape shops. The federal agency said manufacturers will have thirty days to stop making and selling closed cartridge e cigarettes that sort for more head to wsj.com or the W._S._J. APP.
Trump Goes Silent on Hydroxychloroquine
"Welcome to the point. Four April twenty third. I'm Lauren Ski. Co Author of the point. I'm here to cut through the political spin to bring you the news you need to know president. Donald Trump has spent a lot of time promoting hydroxy chloroquine as the corona virus tightened. Its grip on the United States. Beginning in mid March trump name dropped the drug nearly fifty times according to a CNN analysis of his public comments trump called it a quote game changer for Corona Virus. And that it shows quote tremendous promise but that came to a sudden. Halt trump has since shifted his rhetoric toward reopening the country. As of Thursday afternoon. He hasn't even mentioned the drug by name in more than a week. That shift in praise comes after evidence has increasingly mounted over the drugs potentially deadly side effects. One piece of evidence is a new study of hundreds of patients at the US. V A medical centers. They found current virus patients. Taking hydroxy chloroquine that same treatment touted by president trump. Were No less likely to need mechanical ventilation and actually had higher death rates. Compared to those who did not take the drug physicians have warned that will trump is enthusiastic about the drug or at least he was. It still needs to be studied to see if it works and if it is safe for the record there are currently no products approved by the US Food and Drug Administration to prevent or treat corona virus though research is underway on many drugs. Let's get to the point. President trump is now no longer calling hydroxy chloroquine a game changer. He's not mentioning it at all. And that is the point for April. Twenty third twenty twenty for more updates throughout the week including our Sunday night. Campaign Edition Subscribe to the point newsletter at CNN dot com slash. Point if you like this audio briefing. You can get every single weekday on Google or Amazon Echo or subscribe on Stitcher or apple podcasts or your favorite podcast app so you never miss an episode
Twitter Restricts Trump Jr. After He Shares Misleading Virus Video
"TWITTER GIVES DONALD TRUMP junior time out after sharing video directly refuting corona virus advice from top US medical experts. By Amanda Sites of the associated. In Chicago. Twitter has temporarily. President Donald Trump's son from tweeting on its site after he shared a video riddled with unsupported claims about the corona virus. Monday. Many Republicans reacted with outrage filling social media with cries of censorship after Donald Trump junior's account was put on time out for sharing the video which was viewed millions of times online in a matter of hours reaching the president himself before facebook twitter and Youtube bandit. These social media platforms have zero tolerance policies on posts that pedal potentially harmful untruths about the corona virus, conservative media, outlets, pundits, and personalities promoted the video across facebook and twitter on Monday. It features pro trump doctors telling Americans they do not need to wear masks to prevent corona virus while also pitching hydroxy chloroquine anti-malaria drug. The president has previously touted himself as a sure fire way to treat corona virus. The video directly refutes advice from trump's own medical experts whoever urged people to slow the viruses spread by wearing masks and cautioned against using hydroxy chloroquine to treat corona virus. The US Food and Drug Administration recently withdrew and order that enabled hydroxy chloroquine to be used as an emergency treatment for covid nineteen. Trump's son took to twitter Monday night to share the misleading video with his five million followers calling it. A must watch because it spread misinformation about treating the corona. Twitter required trump junior take down the video and put his account on a twelve hour timeout. A twitter spokesman confirmed Tuesday. Trump junior's profile is still visible, but he cannot tweet re tweet or like other posts during that time. The president meanwhile, only re tweeted posted the video, which has since been taken down his account remains live. Versions of the video are still circulating widely on platforms like Instagram, twitter and facebook racking up millions of views, facebook and twitter said, they have removed several versions and are working to take down others. Youtube also said, it has removed the video from its site.
Pixel vs Nexus with UrAvgConsumer
"At Novartis. They're exploring the boundaries of science in pursuit of transformative medicines, and that requires intense collaboration. Keep breakthrough often happens when experts of different fields combined know-how with innovative technologies like crisper teams at Novartis. Are Designing, one time treatments that address the root causes of disease to hear more about how Novartis is reimagining medicine with cell, and gene therapy stay tuned for the show. Greetings mobile accomplishes I am bone. This is part of our special run for the verge cast where we talked to other reviewers about all the hardware that's coming out this season and this week I'm very excited. We have got aura he's your average consumer on Youtube. Drivers consumer and we are looking at a review that I've been teaching for a while it's the nexus five from two, thousand thirteen. The reason I wanted to talk about the next five is we just saw the announcement for the Google Pixel five and I think they're really comparable devices low cost new kind of wireless network coming into a very interesting phone market. We talked a lot about the differences between the phone markets back then and how they are. Now, we also talked about what it's like to be reviewer who works primarily on Youtube like gender does I'm really jealous of the fact. That he has all these different formats that he can make. You know I've got blog posts I've got reviews on the website, and then I make some videos whereas he just makes youtube videos. He can do a lot of really interesting things. We also looked at some of our very, very early youtube videos. They're kind of embarrassing. I'm just GONNA. Say That mine is ten times more embarrassing than Jenner's was because mine made everybody who uses android on it hate me for three years I'll tell the whole story in the show had a really great conversation with I. Really Think you're GONNA enjoy it. Thanks so much for joining us. You are the average Sumer on Youtube and I don't believe this, but it may be that some people are audience haven't senior videos or heard of you. Can you talk a little bit channel it what you do I? Sure. So I, of course, have a tech channel also on Youtube at call it your average consumer because I want the videos to be easily digestible for the average consumer. Tech for the everyday person walkaway knowing whether or not something is what they want to buy or something they should stay away from it's more fun. But also like more useful thing than maybe some of the stuff that I do. Hand reviews go. We need to that later So I had you here I've been telling people that we're going to be talking about a product they weren't expecting, and if you looked at the title of the Podcast, you'll see that we're talking about the next five review. which is ridiculous because that was six or seven years ago along. Yeah. But I thought it was interesting because we just got the announcement official finally after all the leaks announcement of the Pixel five and the Pixel for a five G. and I don't know do you have a review unit yet to you? Do you? You know you don't. Fortunately now, since we can't talk about that review till later I wanted to talk about The next is five because I think it's really like a parallel device to the pixel five it was really cheap. It was the first next on a new wireless standard and like just a bunch of stuff. But before we get there, we should actually just talk about the pixel five stuff. Did you did you watch Google's infomercial? Would you think it was good? I mean honestly what I would expect from one of their presentations it it felt right in line but you know the pixel five itself out like what I saw in certain aspects. I mean looks pretty good on paper for a Pixel device and I'm very happy that the front of it at least looks up today bright just like the screen and every. Elizabeth Twenty Twenty device on pretty happy about that. Yeah. The back man that's what do you how do you feel about fingerprint sensors on the back I was initially it was like but then I kind of miss it. I don't know how I feel about it. I've missed fingerprint sensors since they've. Vaporized by it's weird because it feels like a step backwards we're we're not used to seeing features go away and when something else comes along, see that go away in favor of the older writer you know we we haven't really seen that yet. So it feels weird. I finally starting to get used to face unlock and that's gone like I do we know if there's even like an unsecure like a not very secure version of the face in law they might pull it android hat not secure version of face unlock since the Galaxy Nexus, which was. Twenty to twelve or twenty thirteen way long ago but they you know it might still be there but I guess you could use that but I would never i. don't know if you do that but you're right it's weird to have a phone where they pull stuff. So the the processor is technically I think even slower than staff eight, fifty five. If you just do a benchmark on it, maybe that doesn't matter who knows we'll see but they don't have the pick. It doesn't have the Pixel Neuro core image processor goes back to the fingerprint sensor There's a lot of stuff that's like. Yeah, it is surprising steps backwards. Yeah. But I mean it is supposed to be a mid range phone So you review everything watched your note twenty trust stuff that you've done and you also reviewed like the mid. Range Funds. Approaching needing to make a video about something that's like in the mid range. That's explicitly not like the superfly except that everyone wants to know about the cool new tech stuff. Do you approach those kinds of things differently than you do the flagships or is it just you just need to tell people? You know if it's good or not or what? So for me mid range and looking at those. Can I complete all the tasks that I'm used to doing on those devices? That's the best. That's more of the criteria they're like can I get regular stuff done for flagships? It's like okay I know I can get regular stuff done. What more does does this product bring to the table right and that's kind of The way I look at them I. Think when you do it like when you look at it that way it makes it makes it a little bit easier and went up device has a mid range device has a little something extra. That's like a much bigger bonus whereas like you get the job done and it's got a couple of cool features to. Does one thing. Yeah I guess for the Pixel probably be the camera again has got to be right I mean they they actually talked about improving video this year, which I was not expecting I didn't expect either I was actually pretty impressed with the portrait mode and nightside combination. That's a lot of a lot of work for a that process assuming this. is coming up with the cameras. So there's a surprising to see that kind of evolution there with even back processor. Well, tell you what we will review it. When it when we get, but we should actually talk about the nexus five. So okay, this was a came out in two thousand thirteen, the Google Nexus five is now official. The algae may devices a five inch ten, eighty P display supports Lt e. and runs on the new android four point four Kit Kat besides a few design tweaks new integrates SMS into hangouts upgrades Google now and add search to dialer essentially turning into the yellow pages the next you remember about the next five it's weird I feel like Google loved that phone. I I assume many years that was the form they used as their product images for any kind of software. Dan, that's an extra five th on. Whether it's hangouts or I don't know whatever software they came out with. The next five, even after multiple phones came out on. In particular that phone it was interesting to me because it was was it four hundred bucks? It's three, fifty I think three fifty wild right here that price nowadays, and you're thinking like you know super low tier phone but it wasn't we saw L. T. e. come to it actually took a look back at my review and it is interesting to see that the camera. Wasn't really like a big thing for the next this linebacking today watching and playing games are a pleasure on this device as the screen is much better than it was with the next four although there is a drawback, hinders the experience and that's the speaker. The speaker is very easy to block depending on how you hold the device and can lead to some completely muffled audio. Cleaning. Muffles out. Okay. So what's funny to me about that? I mean we should get into the camera two minute but the fact that you pointed out that you can muffle the speaker every single phone. We had to put it on the note twenty-year-old tra- why do they keep making sustain? It is the weirdest thing you would. You would think and they watch these reviews. It's they know that this is a message that not only are people experiencing, but we're talking about. It, it just doesn't matter I. Guess It's maybe it's easier for them to make it that way but you would think that's a problem that got solved years ago. Well, so they did solve it for a while it was thing where you would get front facing speakers on phones and that was the thing and everyone was like oh finally, and then it turns out nobody cares I guess except for us and? We need more we need bigger screens. Yeah. I what who introduced those kinds? I, think HTC was really big on what was it the boom boom speak they had the boom sound. So there was a a windows phone that had a slight up speaker that was front facing and it was like it was meant to replace a Bluetooth speaker and then they had boom sound on the htc one, which was a direct competitor to this next two seven. The one seven technically right we should. We should talk that phone was hot HTC. Till. Frontal. Stereo speakers with Bilton amplifiers sharper reach. The new HTC one. Okay. So besides the speaker other any other little things that bother you on the people just keep doing it in phones like fix this one little thing I'm tired of it it's been years. Discover the speakers like a big one for me. Definitely. Actually a pretty good question. One thing that they always do be. It's face moving actually on the on the selfie camera. I don't mind if it's there and I'm happy to turn it on and actually use it. But even the default you think you've turned it off especially in like Samsung. Phones it smooths no matter what and it always looks a little bit fake to me. I don't know I really persnickety about cameras. I. Keep using the word. persnickety. No I I completely understand that sentiment it always just looks so process you know it makes you you're in baby mode. It's it's a weird. It's weird thing to see when we look at cells in the mirror every day, and then we'll see this completely different image and it looks like we did some kind of photoshop to. Fix Our face up. You know yeah I can completely understand that I'm not a huge fan of those either whenever there's an opportunity to turn it off. That's like one of the first things I do yeah. Well, I mean also I can fix it an editor I know most people don't really like throw it into fallen photo editor but. They've gotten so good now. So easy. Now, Google photos is actually really great. Now, they just updated it that I if I want to smooth my face up, I can always get it done after the fact that an editor you know. But maybe maybe as cameras snobs are the wrong ones stat. Really. Maybe the average person who've. Has a blemished don't WanNA show maybe. Yeah. Maybe they appreciate it a little bit more but. Reviewing phone ring phones. It's tough because you look at a bunch of android phones and like a bunch of them are usually have the same processor. You know they're a bunch of stuff is really say me and like you can talk about sophomore differences but usually the big thing that's different between each phone is the camera and so you end up spending way more time than you expect on the camera when really it's not the most important thing on the phone, right? Right. So we played your clip forgot to play my clip, but I gotta I got set up are. There now saying the the we know they're gonNA announce an exercise, leave everything Google makes leaks right and so they call me upward having an event of like cool. We're GONNA bring four people we're live blogging where do the verge thing where we show up with a huge crew and do a big live law and then go to a big hands on it'll be awesome like no, no no, we're going to a really small event for just like maybe fifteen journalists and you only get one person that can come and that's it. It's not going to be livestream. It's just really quiet. No that sucks do you gotta bring somebody like well, look like there's this guy that got put in charge of android not that long ago and you know he just wants he wants to have a really chill event says his name is Dr Chai okay, and so he just wants religious event and So okay fine. But I pushed and pushed I pushed I finally got them to let me bring a video director. So it's me and this Guy Christian christian-moslem. So we show up, they announced the phone we ask some questions everything's fine. Okay. Go do a hands on where at I know some Google office in San Francisco or something here's what happened. It was just like fifteen people in the room is. Quiet just utterly quiet super echo and everyone was like doing their thing and working. So he turns the camera and I start talking and everyone looks at me. Oh Oh this is awkward and there is an eight megapixel camera with optical image stabilization. So that should help a better shots that has a hd are plus which does a better hd shots. We'll see how it goes. Usually android cameras aren't that impressive Man So. This whole video is like maybe a minute and a half tops and I was so nervous to talk to loudly in that room I talked really really quietly and didn't really make my points really well. But here's the thing because there weren't other camera people there. There's like maybe one other person. This is one of the only videos on the entire Internet for a few days over the next five and it was just me like whispering to the camera. Style and not actually testing it yet, not actually putting it through its paces because I had to do this really fast because I wanted to get it up because we were going to be the first of course, and then I say this thing about the about Andrea Cameras, right? Yeah. We'll see how it goes. Usually android cameras aren't that impressive. So back in the day, it was this phone. I. Think it was s three was yes. Four ACC was just getting good. But what I meant to say was next cameras because we're next cameras. Any good before the next five extra the pixel they were not right. They were not that good. They were fine but they were not like the central focus of thing it wasn't. It wasn't point. Yeah. But the result of this video being the only thing that people could watch about the next six people were desperate to get next content was our slash android on on reddit hated me for about three years just I was the guy who hated android for years and I found android central. Blanking enter. Thank you. Yeah I. Get it. You're in the moment you're just trying to get something out there. Yeah. A little stumble of words and to Saul takes. Around and the vessels on the side of the screen are very, very thin. So it's actually relatively comfortable. The hold the hand despite the massive screen we're GONNA have a lot more with the next five soon. But for now, it's just a quick look. Okay. So we finally review the phone like what did you think of the phone like as a phone? Did you think there's any good I like to actually I? I. Liked it. It was back in days pretty snappy next devices were you know smooth as you have a pretty smooth experience I think the only thing I had the bright red version which was super. Read it. It was like orangey red exactly is more of an orange is right in the middle you know you. Can See where a little bit on the back with the material that was made out of but for the most part I kind of liked it. You know there was always plenty of pride back in the day is running stop android like you know geared you're getting the full experience here. Yeah. It was nice to have as interesting to see just how things have changed since then. Yeah. So what are the dramas when it first releases? The camera was actually really bad I was right Everyone flipped out user terrible, and then six weeks. Later Google put out a software update that kind of fixed. The Camera Google has released the android four point four point one update that brings dramatic improvements. The next is five camera including faster focusing better low light and less shutter lag. Tested Ourselves Kim away rather impressed by the time of the read one came out. The camera was actually pretty decent, and now when we're reviewing I was saying before now when we were. The everyone pays attention way more to the camera but back, then when we're like, Hey, this cameras bad it was like, oh, wait people care Google's like, oh, the camera needs to be good. No. It's fine. Now, they all their eggs in that. Bad. That wasn't ask. Yeah right now it's now camera or nothing. I mean I love that phone. It was it was my phone for like that entire year like twenty fourteen I just kept going back to it. Was the one that that stayed in your pocket. Yeah it was fast enough. I. Mean I broke like three of them. I kept breaking the screen on it for some reason that was like that screen was really fragile for whatever reason that would break my heart if I luckily, I haven't broken a screen just through normal use yet really guard I probably shouldn't have said that out. Next thing you know next phone fixed five, it's going to happen. But yeah, that's never happened to me that Kinda. Sucks. It sucks but it was only three and fifty bucks I guess, Right But I mean lots of people walk around broken phones all the time you know must be like, do you put a case on your phone? Absolutely do yeah I don't. I'm crazy. Brave as well. I don't know. I don't leave the house still right now. Yeah. I. Still couldn't do you stub your toe. Or something and then phone out your hand I. Guess. Maybe that's people don't care that much about camera bumps, right? Because there's always a case on it anyway. All right. One more thing before we take a break I played my embarrassing video. I, think it's only fair that we play. What are your early videos is this okay. Yeah. A year that this this video gets me. This is your average consumer. And today have video for you guys because all maximum seven one of the comparison between the beat mixers. The SOLEUS US and. I don't have the studio I can't compare those. But I do hadn't have to be. Sounded like someone had a gun to my head and told me to make the video. Like a hostage negotiation. Other they've got. They've got be traffic. I'm. The next it's five, they're gonNA kill me. It's rough to watch that one. Because just like there I'm completely void of energy. There's you no. Looking back at it, there's just so little effort is just just me just just talking and it's funny because I forgot that a comment Dow's like my third fourth video I think. And I was so small back then that a single comment could drive me to make an entire video. Yeah. Yeah. So that's kind of how video happened and looking back out of even the way it's edited I thought I was fancy I had a regular camera. A webcam fired up I I tried to put the I. Put the Webcam footage over my normal cameras footage and you can still see the sides of my of my hd camera. Four by three on the Webcam. Yeah. Horrible editing low energy. Had the beginning on the other hand when you're getting started on something like Youtube like you had the headphones you had right like I didn't have this other one but like you work with what you've got. You do your best. He talk to the camera you try something. Like it if I'm. I'm trying to learn some more cameras skills. I'm definitely not a youtuber but every single time I make video I try and do one thing like one new thing camera technique or trying to be more have higher energy or whatever. Like I work on one thing for each video like this video I'm going to get better I, don't try and like be perfect all at once and so the fact that you were trying to switch between your Webcam and st can like you should give yourself more credit man that's great. Yeah. Yeah. I mean all that has led to. What I know now just practicing, it's always good to I like your strategy just. Give one thing ago every single time just get better and better and better. A great place to take a break and we should actually talk about what it's like to make tech youtube videos. Now that you know we know what we're doing. Right, now, scientists at Novartis are exploring new ways to treat intractable diseases after all medical breakthroughs can sometimes have unexpected beginnings take crisper. For example, when biologists for started analyzing the DNA of bacteria, they noticed something strange in the genomic sequences scientists three, half a tendency of ignoring things to do not understand or giving them really complicated nate's like Christopher they were. Amazed to discover what crisper actually does and that led to a Revolutionary Cure for yogurt but the story doesn't end there crisper technology. It turns out led to a potential turning point in treating disease to learn more about that stay tuned for the in-depth post show and for more information on how Novartis's reimagining medicine, checkout, Novartis Dot, com slash. Cell and gene today. We're back you know what I'm sure that you get asked this all the time. But your big youtuber you gotta you gotTa three million subscribers. How did you get your start? Did you jump? I'm assuming you didn't jump full-time right away. So what was your progression from I wanna make some techy two videos to your average consumer now today. Okay. So for me, it pretty much started I think my senior year of college. I was watching a lot of tech videos. smartphones refresh is following pretty heavily I think channels like phone dog. Noah Techno Buffalo knows my man hey, was going on everybody I'm doing from Dot Com. This is Google Nexus one it award. This is the best android phone you can buy right now at least in the United States, I've watched these guys and I just love it. I was learning so much. I always had a love for technology, but it's not something I really had I was able to use an. have get my hands on all the time. So I'm those all that was soaking it in through you to, and after some time I felt like you know what I bought a couple of android devices as one day I think I can do this too I think it could make some videos but I remember having to go back and watch those videos here what they were talking about and having to research. I have no idea what this processor means or what that thing does I'm going to go research I learned but what I wanted to do my view, all right I want it to be super easy I don't want anyone watching my videos to have to go do extra research like I did right. So Kyra I'll call it your average consumer 'cause that's why I'm going to be talking to just regular videos like you walk away knowing it's fast. It does this it does that not super SPEC heavy you'll just know your experience and I just started making terrible hills as you as you saw her and. I was driven by commenters who said Hey we want to see this. We want to see that. Helped me to keep going and just from there became became you know but that's that's how I got my star just wanting to do the same thing I saw so many other people doing and I fell in love with and just do it on an easier level. One of the things I love about your videos is you never take for granted that people know what a thing is or that the people don't WanNa see it. So I don't know like just like the thing that really struck be you. Know wireless decks on note Tony Ultra. I'M GONNA. Turn on decks and what's cool is that it works with meany smart TV's. As you can see, I've got LG TV that I set it up with before and you know Samsung algae they're not exactly buddies we're gonNA start this hit allow. Here's what it is. Here's how it works. This is really cool and I'm like you know what? That is really cool and I didn't even talk about it because like decks decks was on the twentieth. So everybody knows that and that's not true at all like you actually do need to show the thing even if it's old hat to me or you, it actually is really cool and you should show and I love that you always always do that on every new thing. Thank you. Yeah. I think it's so easy for us to be a little jaded. that's clearly gimmick and we've seen that before an even though things might come off as gimmick for us for someone who doesn't who's not in the world they just like my phone can do this I had no idea i. just needed to send a text message on the Internet, but there's so much more power there sometimes that people don't know about yeah. Well, and it's also need to always treat it as well. You should you buy this thing or not because of this one feature, it's like you buy the thing around if it's good but if you do get it, you should know about this one cool feature. It's like a nice thing that's extra. Not. Drive. Your purchasing decision but not every feature needs to do that right? Exactly. Okay. So the other thing that a low budget channel that I'm actually kind of jealous of is most I. do Kansan videos the reviews and If I want to do like video say I'll make a processor video that's like I have a deep thought about the future of computers but I've got job. So that's about all I have time for, but you have just a ton of different formats that you make. You've got some really cool like hall and boxing's you've got these day in the life videos that I love here. You've got the reviews you've got your home tours. How do you decide wake up in the morning? You WanNa, make a video. You got a new thing in your hand. How do you decide what what format choose when you're making a video because you can do so much more than just a hands on an interview For me I think it all depends on obviously the product So sometimes, if it's a product that I think it s something I think a lot of people will be interested in feel WanNa know like the nitty gritty you know. So a real during the live four flagship devices listen you'll know exactly what you're getting out of this it makes sense and if it's something that they might not know about I'll try and do something a little bit. More creative. Maybe you know just something that may not draw attention just based on the name of the product itself but like let's say it's a lesser-known Prada I'll try to spend. It s something like interesting video in Djelic video format and try to piece it in their right. Just people can get there is on an NBA exposed to something you. You know. So if it's like I don't know a list of tech that I didn't expect to love. This nice time for people to just see. Okay. So there are these products out there that I probably wouldn't pay attention to and you know it kind of fits in like that. But yeah, we tried so many different things. We know what the out our audience likes. You know what they really engage with and. You know this is a matter of finding what products you know. Kind of fit that those formats in. Staples, but sometimes, we try to go out of the box without too. So the other thing that you do like, Your House your family congratulations. Thank you thank you like their characters in the video like I feel like. I'm looking at you on on our chat on looking at like watch videos I. Watch you do a bunch on boxing's right behind where you are, what's it like making the place where you live like a character in your videos. So that's actually something that been I guess pretty intentional. Act Because I had we have a studio as well, but we have studios in like an apartment. Like a separate apartment. Wanted to have like that kind of Homey vibe they're unlike the idea of being guy next door like the guy he can just come up to ask him about tag break casual and when he wants to feel like. jettas this stuff guy who he just stands front of the camera and spits everything. Now let you into my world. That's why do the real day in the life I try to I try to have things in my home are trying to have a home setting. So people can kind of view themselves in the situations or the way I present the videos around and having having friends and family involved too. It just makes it all the better because not only can I be more of myself in front of the camera, but you know the ads And it also adds a layer of like getting other people's opinions in as well. So there's just like so many good benefits such just having family and friends, and even just like a setting that feels welcoming. Yeah. No I love that. That's totally true anymore that but my apartment's too small. I'm classic. Okay. Sorry. We were supposed to be talking with the next five. I totally took us away. So, we've talked about how like you to change the next five came out in this really weird context Google is making its own hardware yet, and I feel like this is like twenty, thirteen, two, thousand, fourteen, the smartphone world still felt like it was wide open. Samsung hadn't taken over HTC was still really popular Nokia they're still making windows phones. I kind of miss those days a little bit. Very different world. If like I said, it was a lot more open. There was so much variety and everyone was coming in with this one feature or this one thing vac kind of separated them from the rest and. Low Bit quite a bit different now. Well, it's like everyone sort of figured out what the core stuff is and they're they're competing on sort of the same thing but. We were talking about the HEC one boom. Sound right. So you when you were going out there, you could go EC had this thing that was all metal front facing speakers, and then it had this wacky four megapixel camera. It was like the ultra pixels because they figured out that you have big pixels you can bring in more light and like this is this is the one as well the camera quality actually it was. Yeah die in theories on great. And then there was leukemia ten, twenty, nine twenty before that you remember the their windows phones and then they had just massive. Big sensors with the Luma. Ten twenty. You will see things you never seen an entirely new. All high resolution forty, one megapixel back side illuminated sensor the forty one mega. Kind of thing that we are maybe entering another round hopefully of weird experiments and not just everybody competing on who can have the best low light performance absolutely you keeping up on like I, guess it's folding phones right thing. Immediately thinking what is it the algae wing and this is the wing. Yeah. I know looking at the pictures it looks weird and. But I'll. Great Job Oh man what do you think of that thing? A thing is wild I haven't seen it in person yet. I have so many questions in terms of how it is to actually use on a day-to-day basis just flipping opening closed is incredibly nice. It's also way thinner and lighter than you would expect from something with two screens in weird flipping hinge like this I think is the most out bird design we've seen so far. Yeah. By folding phones we get it makes sense but flipping twisty whatever yeah I know it's crazy so. We are starting to see experience because I don't want to smartphones have plateaued kind of plateaued in terms of just features an youth new things that will. Come to them. So now this experiment of adding extra screens or expanding screens, it's a, it's really taking over the other thing that was different in that area and we check with the next five is Google had this strategy where they didn't make the phones themselves. They went to like different manufacturers over here and make us a phone and they did it so that they could just make a new version of android and like show off with how Or could work whatever. But now we have this pixel strategy. How do you think that's going? I know it's it was interesting because back in the day who they have within the next five LG was G. I I remember every time a pixel came out a next came out I. I was always waiting for my favorite manufacturer to get the nod. HTC. Come back on the next us. I think I like that. has taken over I think it means that there's More control and what we're not seeing a second vice somewhere out there that looks exactly like but with different software. Yeah I don't know if people remember this the next this was always basically based on another phone that the company already made and so you knew that this was just like the Google version of whatever the other was it like the g three for the next five I, can't remember and remember. As possible ninety five G. Three. Yeah. What did he call those versions of Android I? Mean those phones always had just like a stock version of android Google play edition yes. The play this and. Came like right around that time, and so you could get the stock version a back back in the day we we thought of it as a stock version. It was technically still like it was the Google version it wasn't pure stock Android, but you could get something without touch was on it because. Touch was was sway too much back then. It was so much stuff that was like the my least favorite out say then having that option was so cool. But Digress. I do like that Google has taken it on themselves. Have they made the best choices in terms of like design, all that MOS. Absolute each person to decide but I still like it being in house you know I feel like it's it gives them more control. They choose to exercise. You know really listening to feedback in implementing that you know but I do like the strategy I feel like we've seen. Microsoft. Really good job with that with their hardware on the surface the laptop stuff. Laptops. Just seeing them. All right. We're GONNA take this in-house start making our own things and you know we've seen pretty good success. Yeah for them. So I like the idea as a matter of like execute. Well so I'd like I agree with you I like the because. Google gets to make what a definitely wants to make. Right. It's not. This, year the next. This is not so good because it. You know they they based on the wrong phone this year, right? The next six was hallway phone had all sorts of bugs. What Google makes Google's responsible for right. There's nobody else to blame, but it also means that there's nobody else to blame, right? Yeah. I love Google don't get me wrong best al I love the Pixel devices but one thing I feel like we see manufacturers kind of learn and change things up a bit. I feel like the pixels learning curve has been. Not, the BASS. Just just from the hardware perspective is just. Having been wowed by hardware in a while right. So this is my take on it as they're really conservative right now. So actually the pixel five is a perfect example of this. They went back to fingerprint sensor, but everybody else Samsung has been doing screen figure fingerprint one plus has been doing in screen fingerprint sensors. It's like it's a whole thing. Google didn't. So part of it is cost savings but part of it their explanation for. Well, the one on the back is a thousand percent reliable and it's faster and they're not wrong like I do still have a little bit of a lag sometimes even on like a super fast hot Samsung phone hitting that fingerprint sensor under the screen, but it's not exciting. Is the TIKTOK they're exactly I honestly, I'm not with you mentioning that I'm I remember liking having a fingerprint sensor in the back and it's just so how how our opinions can change over time because the way the market goes, but I really enjoyed having a fingerprint sensor the because you could just pick up your phone and the second you pick it up you're. Thinking directly go onto the sensor and your phone is unlocked pretty quick and easy experience honestly. Also weird season ticket step back. So with the next five, they came into that thrifty price point done it with the Pixel for the the next four and so it was they were a little bit cheaper everybody. Also, all phones were cheaper. But they were they were cheaper than everybody else. There wasn't a lot of competition at that price point at that quality. So the next five, one of the reasons I loved it is it was cheap and everybody else but equality. But now with the Pixel Five, there's a lot more competition this year right then they had with xs five there's the there's one plus eight out there. That's relatively cheap April can sometimes be that same price, the Samsung Twenty, F, e. Got The faster processor Scott like three cameras on it. There's an iphone eleven that's the same price and the iphone twelve is going to be who knows probably around that same price. What do you think the landscape that they're putting this mid range Pixel five in? Its competitive. It's competitive right now and feel like they went down to weight class but that way classes kinda stack to you know it's not just like bringing down the price you're not competing with Fox's anymore. There's a whole group of phones in that area now. And it's GonNa. Be a tough battle because in the phone department, there are some really big names out there like Samson. Apple. So it's it's not GonNa be any easier I direction but it would have been cooler to see things like to see those flags of specs or. Sort of flagship specs at that price point. Seeing snapdragon age sixty, five or something in there rather than the seven sixty five being able to have those things and kind of call like, Hey, boo, just slashing prices. That's that's a more interesting story you know but I mean it's still and it had like one twenty hurts you know just just those features that we expect from the flagship is if they were able to bring that down then we're. We're able to compete. That's actually like the central conflict of the pixels who pays attention to the pixel like really truly who knows what the Pixel Tech nerds right people that are like really into phones attack an android or like Oh. Yeah. I know about the Pixel I know what that means I know people know that Google makes a phone or whatever. But like the people that are really paying attention are the people that know the difference would might care about the difference between a ninety one, hundred, twenty screen so they're making a phone for the masses but the. Only people paying attention to them are people that are in attack, and that's a really hard thing for them to deal with and people in that category that that market is looking. So heavily those numbers yeah under super informed exactly and even if the numbers tell the entire story or they don't, you know exactly take the experience that audience is suber driven by those numbers like insanely. So it does make it a lot tougher because people will just look at it on paper and say, Hey, this I mean, this oneplus near over here has forty cents megapixel camera thirty megapixel. Really really tough well, lucky for everybody There are Youtube Channel Take consumer that will tell the people about the specs and about the numbers. So the understanding but also talk about the actual experience of the thing if it's any good and the average get Super Schwab, where can people find you if they wanNA look for you youtube back actually anywhere you can find me can also media just type in your average consumer and Alibaba. Well. Appreciate you coming on the PODCAST and I'll be waiting for your up five view. Sounds good to see her. Thanks so much for coming on the show like you said, you can find him on Youtube. He's at your average consumer that is you are AV g consumer. I on twitter at backlogged, and actually if you wouldn't mind tweeted me or even shoot me an email theater at the dot com, let me know you think of these Tuesday episodes or anything like that change. Are there any products definitely want us to talk about really curious to get your feedback next week we have a new guest. I'm very excited to say we're going to have Marquez Brownlee you known as MK PhD. So tune in for that. Gene. Therapy is really confirmational today crisper for breakfast brought to you by Novartis. This is not the future anymore. This is the protest, a global health care company that's reimagining medicine just the tip of the iceberg. Crisper it does sound a lot like a breakfast cereal but what is it really? Think about it as a pair of programmable molecular scissors cut anywhere. We target Susan. Stevenson heads up the cell gene therapy initiative at the Novartis Institutes for Biomedical Research. So how did crisper get focused? When crisper was observed by researchers in the early two thousands it was heralded as a miracle cure for yoga. That's right. Yogurt is basically made from bacteria which can get viruses just like you and I can't food scientists discovered this strange repetitive DNA sequence in the genome of certain strains of bacteria that are used in dairy production turns out. It was actually an immune system enabling the bacteria to fight off. Viruses by cutting their DNA into bits. So the researchers turned crisper into a technology using it to vaccinate yogurt and cheese cultures against infection. One giant step for the dairy industry not to Earth shattering for anyone else until scientists outside of the dairy world started asking Paul from cutting denial viruses can also do something else Dominic Hefner is the director of Genomic Science and Novartis Institutes for Biomedical. Research scientists are now using crisper on human cells in labs around the world in the hands of the scientists weakest parts of the Crisp Machinery to cut DNA in desire places to alter the genetic code of cells. Team is using crisper to study the roots of the. Other groups are designing crisper based technologies to treat disease currently the most promising applications Paul, so-called diseases. So diseases which are really cause by era in the genome. In other words, Crisper is ideal for treating diseases caused by a mutation in a single gene diseases like Huntington's Disease Parkinson's disease muscular dystrophy that the. miatas inherited retinopathy many others crisper. It turns out may enable researchers to carefully snip, DNA, and fix broken cells at the genetic level. Susan. Stevenson and her colleagues at Novartis are developing a crisper based therapy for sickle cell disease. That's genetic condition that affects the shape and function of the bodies red blood cells leading to pain crises in significantly reducing life expectancy. The Food and Drug Administration has approved plans for a clinical trial of the experimental therapy retake the patient's own cells we. Delivered, the components of the crisper system into the stem cells, and then we re infused those gene modified stem cells back into the patient. The idea is that the repaired cells will then flourish and fill the patient's bloodstream with healthy blood cells unlike traditional medicines, this treatment targets the root cause of the disease at the molecular level Crisper is just one of the technologies powering cell gene therapy and exciting new approach to treating disease. These treatments are designed to be given just once so There can result in potentially lifelong cure just a single treatment for the first time. Scientists really have a tool in the hands that allows to dream and think of potentially being able to really correct the underlying causes of disease. So, despite its humble origins in your breakfast bowl, this revolutionary technology has huge potential and for Dominic Heppner crisper is more than just another tool in the geneticists toolbox it represents a huge leap forward in shared scientific knowledge story of crisper actually shows how silent thinking hampers scientific progress I mean keep breaks often happens when experts of different fields combine know-how and only when gifted bacteriologist and Mammalian cells biologists started work side by side. The true potential of this discovery was realized for more information on how Novartis has reimagining medicine, Goto Novartis Dot Com Slash Cell and gene.
Why Healthcare Policy Needs To Focus On Prevention with Dr. Anand Parekh
"Coming up on this week's episode of the Doctors Pharmacy policy-makers need to help Americans The healthy choice the easy choice Hey everybody it's Dr Mark Hyman so whenever I talk to my patients about going gluten free the first complaint is giving up pasta now. I Love Pasta Ula Pasta. We all have pasta Austat but going gluten free and even eating grain free and low carb doesn't have to mean missing pasta thanks to something called wonder under noodles from thrive market now wonder noodles are also known as Shiva Taki noodles and had been used for centuries in Asian cooking. They're made from a route called Cognac route. Cognac Yam and they contain glucose mannion which is actually a very powerful soluble fiber. It's been proven to lower blood sugar her to lower cholesterol to actually help with weight loss. And also feed all the good bugs in your gut that helps keep your mic rebound healthy and you healthy and because wonder noodles. Noodles are made from this fiber. They're extremely low calorie. I think there's actually no calories in them and they're very low carb because there's no carbs in them it's all fiber so will thrive market wondering does come in multiple forms or spaghetti. There's Fettuccini my favorite Angel Hair Pasta. They take on whatever flavor you want so honestly they can use any dish and one of my favorite ways to prepare. them is with coconut curry sauce with grilled veggies. I just so delicious really. And you don't feel like you're missing out on the Pasta and the noodles. And with thrive market you can get wonder noodles delivered right to your doorstep so that your pantry is always fully stocked so not only does thrive market offer twenty five to fifty percent off all of my favorite brands but they also give back for every membership purchase. They give a membership to a family in need and they make it easy to find the right membership for you and your family you can choose. WHO's from a one month three month or twelve month plan? I go with the twelve month because an only as up to five dollars a month and I save hundreds on my grocery bill throughout the year and right. Now thrive thrive is offering all doctors pharmacy listeners. A great deal. You'll get up to twenty dollars in shopping credit when you sign up to spend on all your own favourite natural food body and household items and any time you spend more than forty nine dollars you get free. Carbon neutral shipping. All you have to do is head. Over to thrive market DOT COM Simon. That's thrive market dot com forward slash. Hyman I think you're gonNA love them as much as I do. I'm proud to have them as a sponsor and be an investor in their company. All right. Let's get back to the episode. Welcome New Doctors Pharmacy. I'm Dr Mark Hyman this pharmacy with an F. F. A. R. I.. macy Y plays for conversations that matter and conversation. I think will matter if you care about your health. The health of our country and trying to find solutions to our chronic disease epidemic. That's crippling everyone in this society and one way or another whether it's someone you love or yourself or economy or just all the crazy crises of healthy we have in this world today. That we really find are are mostly unnecessary because we can prevent them. And that's why I've invited doctor a non Perak. WHO's an extraordinary physician? He's the chief medical adviser for the bipartisan policy. Does he center. which is a group of policy makers physician scientists come together to solve difficult problems around health in the country? It's pretty extraordinary and many other issues. He's provided added credible support to our nation through his work in the government he's Basically been focused on work that he did to his decade gate of service at the US Department of Health Human Services He was the Deputy Assistant Secretary for health. From two thousand to two thousand fifteen. He developed and implemented national initiatives on prevention prevention wellness and care management at the BBC now. He's focused in areas of aging prevention of Global Health He's really an important figure in our country and trying to think differently about about how we solve our big chronic health issues. He's a board certified internal medicine doctor. He's a fellow of the American College of Physicians. He's an adjunct professor of Health Management and policy at the University of Michigan School of Public Health off and Adjunct Professor Assistant Professor of medicine at Johns Hopkins. He's spoken widely extensively and written a lot about topics on health including his new book. Prevention mentioned first policymaking for a healthy America published by Johns Hopkins Press which is an amazing book. I read it. It's a little dense but is full of the solutions that we need to solve our chronic disease crisis. All right. Welcome Dr. Thank you for having great to be on the podcast with you. So we met a number of years ago. When I came to Washington I was human health and Human Services advocating for lifestyle interventions for chronic disease as treatment and I went around and met with many leaders in healthcare at at the time the head of the Senate committee? Congress Secretary Sibelius Nancy into Pearl and the White House trying to advocate for a simple idea which inches we could take these patients crock disease and use aggressive lifestyle interventions in groups to help them transform their health and get better and everybody was one hundred percent on board and nobody wanted to vote against it but ended up on the cutting room floor in the affordable. Care Act because There was the backroom horse trading. I think that happened but everybody. He was on board the idea because they re realized that we really have this global crisis and in America were leading in that global crisis. We have the best trained doctors in the world. We have the best hospitals we have the best technology we have the most cutting edge treatments and drugs for a whole multitude problems patients from all over the world to get healthcare here but on the other hand our own citizens are pretty unhealthy. In fact we have pretty crappy life expectancy. I think we're forty third of the world yet. We spend more than twice ever any other nation on healthcare. We have services aren't guaranteed everybody we have uneven quality of care we have health disparities And we're lagging behind almost every other country in health metrics including life expectancy. How come it's a great question A lot of I think important reasons for that. I think you're absolutely right. There are significant disparities in the United States. And I think that's one of the reasons why why we're different. Just take income if you compare life expectancy of the of the top one percent wealthiest Americans and you compare it to the one percent poorest Americans. There's a fourteen year. Life expectancy difference for men in a ten year. Life expectancy different for women even so income matters take race though. Infant mortality has has gone down in this country. We are behind many of our peer nations and one reason for for that is is disparities. Based on race and ethnicity African American populations American Indian populations have significantly higher infant mortality rates than other subgroups. So race is also important. Our system also Dr High Minute Health system is different in the sense that you know we only have about ninety percent of Americans Americans with health insurance. Most of our pure countries have ninety nine to one hundred percent so a lot of differences. That way I think the final difference I would know. It is Lately there's been a lot of research on how much we spend in this country. I'm healthcare versus social services. Compare we're paying for the wrong end of that equation. That's right that's right. They you know we spend nearly eighteen percent of our GDP as you know in in the United States on healthcare Compared to many other almost one and five dollars of our entire economy I mean three point six trillion dollars and we are headed to four five six trillion dollars in in the near term. And if you compare air that to our pure countries many well developed countries. That's almost twice as much on the social services side so that what does that mean that. Means investments in housing and nutrition and transportation education and income supports We spend probably a little bit less than our peer countries or or about that much. But if you look the ratio so social social services to health care where at about one to one whereas most of the countries That we compare with their close to two to one on racial matters because there's been research even domestically that looks at the fifty states in our country and those states that have a higher social service to help your services ratio. They have better outcomes. They have less Crohn's disease risk factors. They do better with chronic diseases. Lower mortality rates. So it's really that ratio of social services to help your services as a country we were to take care of people before they get sick and you wait till they get an absolute so whether it's Children's and child care whether it's it's it's seniors and in home supports and home delivered meals whether it's paid family leave for working Americans The Social Service report art supports in those countries we have them here But the ratio of social services to healthcare service report a service spending. That is really. What's what's different friendliness? And I imagine what's not captured in that is an. We're spending twice as much on healthcare because we're not taking care of those people early is also another invisible costs which is productivity. Absolutely because if you have a population that's healthy. They're more productive more engaged with communities and families when you have our population which is super sick you lose all this productivity value in the economy so the costs are probably even more absolutely and and that's not to take into account even from a national security perspective. Uh Our our military these the number one reason for for new recruits to enter the military. The number one reason that they're not allowed to join his is because of obesity obesity and and and high high body weight so all of these issues whether it's economic military national security are standing there. were all connect back back to the need to focus more upstream. Yeah I mean even you know in General Jackie and I I knew him. He was been commander in Iraq war and he said seventy percent of the recruits from the military rejected because they're unfit to fight Kids in school. Academic performance is terrible in America. We should have very academic performance. Where thirty first in math and reading in the world and be at Phnom is better than us? You know. It's like a very poor developing country does better than us. What's going on and it's really speaking to the food? We're feeding our kids to school lunches to the amount of toxic food environment that we have. We're all exposed to this driving these choices. And it's pretty much unregulated in this country absolutely and I would say that this is the right time to be talking about this very subject because this is the first time we're experiencing in one hundred years in our nation's history since World War One where in this country we are now experiencing three consecutive years of life expectancy declines and that's because of the OPIOID epidemic the obesity crisis as well as what's what's considered the plateauing and the decline of debts from cardiovascular disease as well as cancer the CDC estimates that every year there two hundred and fifty thousand potentially preventable deaths. That's in the United States. So that's just taking the five leading causes of death heart disease stroke cancer chronic lower respiratory disease and unintentional injury if if the states that had the highest mortality rates did as well as estates in this country that that that that had the lowest mortality rates we would save two hundred. I'm fifty thousand Americans every single year. And so I think the time a timing of this conversation is really true is really important. And you know it's interesting if you take a map you can go on the CDC and these maps of obesity diabetes and life expectancy they completely superimpose in terms of the states with the highest rates. It's of these problems and the worst or the South East. Yeah yeah southern cooking. I guess where there's more obesity there's more disease and you know when I graduate medical school probably you did too. That was not a single state that had an obesity rate over twenty percents and now there's not a single state that has an obesity rate under twenty percent in many have forty and many more encroaching on forty so when you think about forty percent. Obesity rates seventy percent overweight. I mean the tar countries and unfortunately enforcing many of the states That that that you cited you know have that ratio of a pretty low spending on social services who's been and and they also have high uninsured rates as well so they're finding themselves spending a lot of money on the healthcare side of the equation for things that are that are preventable if if we tried to tackle them up and you know you you were in key positions in government trying to think about these problems and create policies to help overcome some of these challenges challenges and and that's not an easy job because there's so many competing forces that are at odds trying to solve the problem. We don't want to have a nanny any state you write about in your book. Danny stay idea that you know I'm like well what's wrong with Nannies. What do they do? Their job is to protect our children. Should we protect our children. I mean think about it. There was a foreign nation that it was doing to our children. We're doing to them. We would go to war to protect our kids right absolutely and yet we just kind of let it go. How how you break through that? Ah Challenge Changing those policy. I thought a lot about this while writing the book you know we all agree. That prevention is important. But but why has it not been the policymakers elevated. Why haven't they elevated this issue at the top and came up with a couple a couple of reasons That'd be happy to share. I you know I think the first is an you touched on this lot of policy makers are reactive in. General and prevention requires a proactive approach. And the reason they're reactive is is whether you're an executive branch or your member of Congress. They're oftentimes so many emergencies. Either real or or or imagined or crises or political controversies diversities that. oftentimes you spend a lot of time reacting to the fire. Absolutely as opposed to thinking about proactive policies to improve health and then Prevention oftentimes takes time as well. So you have to have that. Patients and oftentimes results are at least from a public. Health perspective are often invisible when when things are working and and and health is being protected and so I think the first reason is that The mindset of policymakers needs to shift from being reactive to proactive. Think the second reason is it could very well be. The policymakers are just not as eh tuned to the evidence base whether it's lifestyle medicine weather. It's prevention whether it's a social determined to help understanding the evidence now that has been generated unrated about the effects of all of these other modalities I think is critical. And when you don't know the evidence Then then you tend to think well that might be a slush fund. You know those those dollars in prevention might be a slush fund. You know why should we support it there others as you said who who who may think of prevention Shen as you're right part of the nanny state prevention is is about individual responsibility and the government shouldn't be involved so I think those are a couple of reasons but then I think it goes beyond that prevention and public health that require resources and right now in this country. If you look at our national health expenditure accounts only about three percent of our our dollars go to public health. Only five percent go to primary and secondary prevention and so even though we're on a tight fiscal the climate. We're always going to be in a tight fiscal. Climate finding opportunities through our discretionary budgets are mandatory budgets. CBO doesn't always help with their tenure Budget aged window in terms of scoring so just to clarify for people congressional budget. Office's the watchdog that's right it looks over the cost of things for the government policies and laws and and they score policies based on their impact over ten year period but the benefits of prevention might be over twenty year periods. So Cost Center instead of Uh Cross savings absolutely absolutely and and I think that's a very important point And I think so there needs to be more focus on on Finding the will really the political will to expand resources using discretionary about two swells are mandatory budgets in through Medicare and Medicaid. Because that's really how we scale things so I think that that's that's also critical point. I think after hyman another reason. Why policymakers haven't gravitated towards is prevention? Is We have a three point. Six trillion dollar healthcare system and frankly D- can't make make as much money on prevention as as you can on on treatment so the incentives they are in the system are not as much there now value based on the government yet from people running healthcare absolutely now value-based healthier transformation with the focus on payment based on outcomes as both a volume should change that over time. But that's that's that's going to be a long haul so we're just to clarify for people people the way. Typically doctors get paid and hospitals get paid is like widgets the mortgage stuff you do. The more you get paid more angioplasties you do the more surgeries you do. Marcona squeeze you the more visits. You do the more money you make. That's right and it doesn't care if the product is good or not it's like imagine you know paying for a car but it didn't work like you're not paying for the outcome value. Base care is a new way of thinking that's incentivizing healthcare systems and doctors to be accountable for the outcomes of their patients health. So keeping them healthy if now somebody bounces back to the hospital the Dr Dos but makes money in the future of the hospital won't make be making money by keeping people out of the hospital hospital and that's a very different paradigm shift or not quite there. You absolutely absolutely. We're about a decade in into this but still of the vast majority of healthcare payments are still currently paid based on The services provided and a fee per service. So so we're not. We're not quite there and I think the last reason why You know this hasn't really You know in gotten the attention of policymakers is really think if you look at the general public but we haven't galvanized the American public And whether that's They don't realize the power of prevention or or We haven't realized or or where we haven't communicated needed to them the importance of sound policies to support the healthy choice rate policy-makers need to help Americans Make the healthy choice is the easy choice. And so I think galvanizing the public Lobbying firms or interest groups going to members every single day in the halls Alza Congress preaching prevention but you do need a grassroots movement. You do need the American public the hey I'm doing everything. I can every day for my family to eat well to exercise to avoid Substances to stop smoking to drink alcohol in moderation. I'm doing everything I can. But but if they're not community supports if they're not policy supports if there aren't policy systems environmental change helping me and my family. Yeah it's going to be very very difficult tickled to do and I think that's a critical message in this book. I think it's pretty important because if you don't actually provide an environment that allows people make healthy choices. You know no it. It's hard to do the right thing and I think one of the biggest challenges in this conversation is the sort of dichotomy between the idea of personal responsibility and so the nanny state you know the environment we live. And how do we change the toxic environment and I think you know most of the messaging I'm from most professional associations much of our government policy and certainly the food industry is that it's your fault. You're overweight is it's your fault you're sick. It's a personal choice. Just like smoking's a personal choice and and they talk about moderation. There's no good mad calories that thousand calories of Broccoli thousand calories hours of soda there's focus on exercise as the solution there's folks about moderation. It's really interesting and it and it's a a culture that's really focused focused on personal responsibility but ignores the fact that you actually can't be responsible in a toxic environment if you can't go in your neighborhood in by a vegetable and you have to take two hours of buses for you know by a care at that's a problem and if and if we don't address the environment we live in. We're going to get people to make his. I remember eating study where they looked at people who are overweight and diabetic. Who lived in very low socioeconomic neighborhoods? They moved to his slightly better neighborhood and their blood. Sugar went down and their weight went down without any other interventions. Just giving them a better zip code amazing so basically the ZIP code we have is determined. Terminate our genetic code when it comes to our health and we don't really seem to acknowledge that in our policies we said it's all about choice and I think one of the areas I wanted to talk about. This is the whole snap APP debate. Now the bipartisan policy. Center right about it in your book prevention. I did a very important report card leading nutrition that outlined some of the challenges is with our food stamp or snap program supplemental nutritional assistance. which is I don't know what should be call that because it's simple mental food assistance? It's not nutrition I would call most of it go. Seventy eighty five percent of it is junk food ten percent of it is soda and And it's very clear that people who you know compared to an income eligible person who's not on snap is less healthy And they drink more soda and they have more health consequences so you know people will go well. We can't really limit people's choice when it comes to sort of they have to buy that. It's going to stigmatize them You know and and and you're right. The policy makers are are influenced by big food. I mean Soda Companies Coca Cola. I think twenty percent of their US income from food stamps Walmart of the seven hundred fifty billion dollars the farm bill for food stamps about one hundred and thirty eight billion goes to so they don't want this to change and and it's it's a real challenge and you're you're right. I mean I remember walking into Senator Harkin's office is a really great center longer senator but I said you know he said well what what organization are you from. And I'm like well none just representing the science and the policy and my patients and I wanNA get science into policy goes well that would make too much sense you know and I think I think so when you've got all this evidence that this is true you know as doctors and scientists at this is really the problem but the policies really are are being heavily influenced is by lobby money yet. How do you how do you deal with that? And sort of break this cycle of blaming the victim and not changing the environment and not helping people make better choices. Yeah so now that terrific and thank you for raising this topic to the snap program. Previously the Food Stamp Program. The purpose of the bipartisan Policy Center was is really put the end back and snap exactly your point that nutrition and diet quality ought to be a key factor that program. The program has been around for for several decades now. Forty million Americans rely on the snap program Every year It has substantially reduced food insecurity in this country important and food. Insecurity does have indirect health benefits for children for new mothers for seniors as well But with our obesity genyk environment airman and in the last several decades The program has not evolved to ensure that diet quality nutrition is paramount as well. And you're absolutely right. The the number one Consumption of of of snap benefits of snap enroll ease Soda Products Now. That's not too different than than the rest of the population. We're so does is number two. It does beg the question that are we doing the best job that we can to incentivize the consumption of healthy food would and disincentivize the consumption of unhealthy food. And what our task force you know. There were Republicans and Democrats on there and we ask yourself some pretty tough tough questions. It's Snap is an important program food insecurity for sure. But how do you improve nutrition when we looked at sugar sweetened beverages decker Hammond his. You know there is no nutritional attritional quality nutritional impact in in so it on sugar sweetened beverages And yet it's harmful i. It's absolutely yeah. I know it was a tremendous harm as a leading cause of obesity diabetes. And what we saw in the retail community in fact during the period when when and snap enroll es were purchasing Their food sugar sweetened beverage and soda. Were really the ones that are very bring marketed to them You know and I think we all found we hit on that for a little bit because people don't realize that when the first of the month cons people get their benefit cards. That's when these stores that are in these poor neighborhoods highly. Advertise this war marketing. Yeah yeah in in in better neighborhoods. That are more affluent. They don't advertise absolutely they're they're literally targeting already targeting. It's terrible. Yeah Yeah and that adds to see issues about health equity as to help disparities as well And so the task force recommended. It was a difficult recommendation but that sugar sweetened beverages ought to be excluded and that doesn't mean that individuals can't purchase these things out of their own pocket but from a health perspective In Taxpayer refunded program. We ought to be again incentivizing healthy Food and disincentivising unopened. In fact there was a follow up. Study from. Tufts University versity Harvard School of Public Health. That actually looked at the mix of both incentives and disincentives over time an excellent simulation and found that you could you could prevent a a substantial amount of heart disease and diabetes and save healthcare costs billions of dollars billions of dollars and there is a the vendee grams between snapping for example Medicaid. Overlap in such a way that that this could have significant impacts on State Medicaid Medicaid program. So I think there's a lot there we wanted to. You know we really wanted to to to elevate this issue that yes. The snap program is important but if it can involve to elevate nutrition Than than we can really do something for the public. You know you've got the hunger groups completely opposed to this. You know yet are focused on food insecurity and hunger like you. Can't you can't restrict that it's going to stigmatize these people people you know. They should have the same opportunity. Purchase everybody else but you know you can purchase a two liter bottle soda. But you can't purchase a rotisserie chicken on stamps so there are restrictions. You can't buy cigarettes. You can buy alcohol you. I can't cook food. There's a lot of the restrictions absolutely other programs. We have in the government like Wick and women infants and children in school lunches. They have nutrition guidelines ensure quality nutrition. But we don't have that and there's so many groups of posing any gains. Yeah so how do you see happening. It just seems like a hopeless. Yeah yeah well. We'll talk about that a little bit in the book at that you know we released recommendations and and there there there were a lot of people are cheering because on both sides there were folks said. Leave it alone. Don't touch it. We want to focus on food insecurity on the other side or folk saying hey well you know we questioned the fiscal integrity of the program and and so we again had had both sides involved. That's that's what we do at the bipartisan Policy Center and said you know for looking at from a health perspective improving on the current program is the is is the way to go and that's been our message to lawmakers and policymakers as well You know the farm bill passed Recently about every several years these issues shoes get get resurfaced. So I think we have to keep on You know Ensuring that there was a drumbeat to ensure that the N. in snap the nutrition in part becomes a paramount principle in this part of what you talk about the social determinants of health. You know we've talked on the show before but you know people understand that the environment I mean you you live is a bigger determine of your health outcomes than anything else absolutely even in your diet or exercise or and those things are not addressed in healthcare. We sort of ignore them you know. Yeah and so you talk about you know healthcare without walls. What does that look like? What do we have to think about differently? In in how to address these things. Yeah healthcare slowly moving in this direction but they are And and probably there are better place address social needs and there's an important distinction I think between social needs and social help social determinants of Health for housing. Let's say a building affordable housing addressing. A social need is modifying the home to re- to reduce falls for example for nutrition social determines the health ensuring during the healthy food financing initiatives. You can increase the availability of healthier food. Farmers Market you know social needs is entering a home delivered meal for Transportation Social Terminus Chairman's health is improving community infrastructure through land users owning policy for social needs. It's ensuring that there's ridesharing available so people can make their point. Women so healthcare is getting into the business of social needs because they see it connected to the value proposition of improving outcomes and potentially reducing preventable health. And I think that's that's all fine but but their healthcare is not going to take care of the broader social himself. We still need focus and resources on education an and income and housing nutrition and transportation. Because you're exactly right. Those have profound implications on the health of the population and are also connected to a lot of the behavioral risk factors driving so it seems to me. I'm biased because I'm focused on food but it seems to me that you know the food food food system. If we had to pick one thing to target would be the biggest thing and because that's affecting the chronic disease burden the majority of I think chronic disease are causing part by diets. Million people die every year around the world from Diet related. I think that's an underestimate because when you add in the the additional causes such as diabetes and in heart disease and yeah it's it's like in the forty fifty million range and so when you when you when you have that level of impact. It seems like we can't address all these issues unless we fix the food system. Yeah and and that the forces that are opposing that are quite big. You know just the farm bill known as a half a billion dollars of lobbying on it yes for that and the majority of food stamp so how do we how do we. You've been in government you've been in these these conversations you've you you're not just talking about it from a think tank. You've actually been there. What's your perspective on? How you move the needle I mean? Do you have to wait for newness. Ration- do we have to wait till the community of Activists rises up like abolition changes. Our government I mean what what are we to do to see change because it's discouraging for people to sort sort of feel like they can do anything about this. Yeah given the political winds in this country change Pretty regularly. I think it's important Dr Hyman that we take incremental progress whenever we can. But you're absolutely right. You're premise that I took a base hit. I think I think I think you have to educate policymakers. That's what part of this book is You know we should go for the whole you know. It shouldn't be that that we're just going for basis we go for the home run But it's also important when there are are incremental opportunities to take them. I agree one hundred percent with your premise I I call sort of obesity the public L. Challenge of of our century. I mean that it is the critical challenge. Cancer will soon in this country. The leading cause of death for Americans and and it will surpass heart disease and the reason for that is really Poor poor diet so people don't understand this but obesity is linked to cancer not just learning at least a dozen cancers are now very well the establishment management the link between obesity and cancer is now a pretty well developed in some most common cancers breast colon all the big ones. Yeah Yeah so I. I think that that that we need to you know so when I talk about sort of incremental progress so for example right now you know try to look at things sort of glass glass half full from a policy perspective. Look at the Food and Drug Administration. There's an important in the next several months A new change to the nutrition. Facts label able I in that all foods will need to have information about added sugars And that's that's pretty important fact. There was a recent study done that if in fact this has done over the next You know two decades There would be substantial reductions in both diabetes diabetes and cardiovascular that's and significant healthcare cost savings now if if the industry actually then reformulated their foods given that now this is transparent on the label There would be even more a doubling of an impact over twenty years. I think it would go from thirty billion dollars in healthcare cost savings to sixty billion and from one million cases this is of heart disease and diabetes two million. So these are these are substantial pieces assault of voluntary sodium production. So it's voluntary. This started Arctic. Look without a society Obama Administration. You're only sixteen but this current administration is moving forward with voluntary sodium targets in one hundred fifty different food groups and if indeed Manufacturers are able to meet these targets within two years we can Reduce the average consumption sodium in this country. Which is about thirty four hundred milligrams to three thousand within ten years we can get the twenty three hundred milligrams and that could save substantial? Daniel lives down the road in terms of heart disease and reduced healthcare cost so I think there are some things that don't get a lot of attention. I think that are important. There are then more challenging things things Sugar sweetened beverages and taxation of that and the politics of that portion size which I think is is a really important issue also over the last several decades. The portions of scared at that we get are so large. Deborah Cohen researcher at rand has done some important worked on portion sizes and has shown that that that as portions have increased our consumption increased Of course as well. And she's actually advocated for standardizing portion size. Just like we did with alcohol so I if you have a certain amount of alcohol. There's a standard size standard size of portions CNN's you could reduce consumption there. Particularly for unhealthy foodstuffs takes away the whole idea personal choices sort of like mandating different portions. Dan Buettner who wrote the Book Blue Zones Create Initiative and I think it was in some Midwest state and and essentially got community interventions. That were invisible so everybody's sweatshops shot the place to ten inch plates. What was it the checkout counters? The gross changed a healthy options candy. Yes they build walking past. They basically created initiatives that were just to friction lists about people make better choices that mainly huge difference in healthcare costs and health outcomes stuff that we think of as the the nanny state. But it's actually south it's proven to be effective and I would say that it it doesn't it. I would probably say that. It doesn't actually take away individual choice so people are certainly you can go back for seconds. Yeah absolutely but I think it's shown that that that when when the healthy choice easy choice or that people Change their practices. And I think that information take menu labeling now which which is common and that policy change giving people the information. I think the behavioral economics peanut. You're talking about those things. I think incremental ways forward in those areas I think are important my favorite studies where they up to people and give them both cereal. One bowl constantly refilled from the bottom and the other one was a fixed amount of cereal and the ones that had the constantly feeling so I just kept eating it like it was like a trick bowl I actually love I gotta think thank you know. I'M A serial killer hate zero. I think it's one of the worst invention Saudi seventy five percent. Sugar top about added sugar. Oh my God. That's huge absolutely okay. So let's so as a policymaker man that was a policy think tank advocate. You mentioned a lot of these initiative everything can make a difference but I just keep pushing back against the idea of you know how. How's it going to be a citizen sort of get their congressmen to go? Because they don't we'll have millions of dollars to lobby right. I when I went to Washington I pay my own ticket at hotel. Washington's not cheap food on their like who are you where are you from. And what are you doing unlike because they never seen a individual being advocate and so but there are ways right there are ways to get involved and I think there's a food policy action network. Is I think a group that scores your congressmen and senators on their voting on food and AG policies so there ways to affect it. But it's tough because you know you've got for example on the snap Subject you probably wear this when there's a hearing about snap to try to improve the nutrition quality and snap and talk talk about the Soda Reduction. Maybe you were hearing. There were many of the committee members committee who basically said it's all about personal responsibility responsibility more exercise. That's the real problem is not about the food and when you look at who is funding their campaigns it was soda companies tunes tunes to the tune of collectively millions of dollars. Yep How do you fight that. Yeah Yeah Well I. I think it's first and foremost helping Americans understand That there are things that the guy that government and policymakers can do to support them in these areas is that that it's not just about personal responsibility and so some of it is sort of education and empowerment there Some of it is also the doctor patient relationship as you know Dr Khomeinism trusted one I think You know ensuring that healthcare professionals can be that voice as well to support Support Patients On some of this is educating policy makers as well and policy makers You know on their own understand the importance of preventing so in my in my book for example example there five sort of key. Takeaways for policymakers at the end in terms of what they can do to support Americans you know the first for example Apple To make prevention the number one priority for this or any administration Coming in the health and Human Services Secretary saying thank you know there's a lot of mission essential functions but prevention will be the number one priority all of our agencies whether it's senators disease control and prevention or the FDA or the National Institutes of health. You know figure out. How prevention elevates at the top number two healthcare professionals in value based healthcare transformation commissioning? We're now going to measure you and hold you accountable. Not just for how. Well you manage diabetes heart disease but how will you prevent them in the first place. We're I can hold you accountable. Not for how. How much you screen? Just screen for tobacco's to the test for blood sugar but actually reduce it and and what that will do is force the healthcare community to build the clinical community linkages to help support individuals so that sort of second takeaway a third takeaway is. These are all in the book. These are correct the overarching takeaways. For policymakers which I think that can be helpful to to Americans out there. The third is in this country. If you're a drug a pill or or device there's a pathway in this country for that that intervention To be scaled. There's a food and Drug Administration that that assesses safety and efficacy and once. FDA approved that intervention cms Medicare Medicaid decides whether it's reasonable and necessary for payment for coverage and then a lot of private payers follow. What Medicare ties to interrupt you there? The recent study that was published published showing that stents and bypass angioplasties. Don't work for the majority of patients to get them is not a new story. I read this. This article in different iterations in the past and keeps getting repeated in the research gets more robust and yet Medicare and Medicaid pay for these services because there are device and they're it's sort of the end but they won't pay for stuff that works absolutely lifestyle program that can reverse diabetes right right on on the treatment side so but if you're an evidence based program and either prevention or treatment lifestyle focus to your point. There is no pathway in this country. Like there is if you're a drug or a device vice and yet there are so many evidence based programs like the one you just mentioned the lifestyle treatment or prevention programs whether it's falls prevention across the sea self management programs uh-huh there there's so many programs out there where thousands are benefiting benefits in my book. I actually call for a parallel path just like you have. FDA looking at the safety and efficacy of drugs or devices whether it's CDC or the administrator admission aging Congress ought to give them a regulatory authority story to review a lot of these evidence based community treatment or prevention programs and if they meet the bar then cms would would have to consider them as being reasonable and essays for payment. Just like they do for Cleveland Clinic. We've got our program called functioning for life for people with chronic disease. Change their lifestyle. We changed our diet. We actually to social support. Help them change their behavior. We're seeing extraordinary results. I mean we're worsening diabetes heart failure all kinds of stuff weight loss. Obviously and and yet. It's not really reimbursed. That's right and we're saving saving so much money and we're not getting paid for what we do. We get paid thirty cents on the dollar and reluctant who make one hundred bucks on a patient. And we see them or less you know and it doesn't even cover our costs of running our center. But we're providing so much value in the system. Yeah yeah which is benefiting Medicare Medicaid and also private insurers so the whole system is sort of rig right not incentivized to do the right thing. Yeah right yeah absolutely. And so. And there's there's no money to study it. I was like oh I'd love to get you know I mean there's literally billions of dollars spent on research and right country and almost nothing's been nutrition or lifestyle reset and that's right and therefore a parallel well. Pathway Cook could help infuse resources in you know to to research as well as ensure that there's not a double standard for a lot of these interventions That that are focused on lifestyle or occur outside the clinical clinical arena. Remember that and others to other to others. The fourth is look we have about about a four trillion dollar budget fed government. This is prevention public health. It's too important to underfund this and there needs to be bipartisan. Support to finance Evidence based prevention and public health interventions. So it could be community based prevention programs. Rams I talk about several things that we did health and Human Services from from the Recovery Act of your house and nine there are opportunities finance the public health infrastructure which is significantly underfunded underfunded in this country a public emergency funds so the next baller or the Zeka we face. We're not waiting on Congress to fight for for months at a time before their their resources but targeted targeted investments to lift up prevention and Public Health That that seems to be that has to be a national priority and I think in terms of bipartisanship Hoti crack that not. There was an important commission on evidence. Based policymaking that Senator Patty Murray Murray and former Speaker Paul Ryan actually let a couple years ago and talked talked about sort of evidence the importance of evidence based policymaking in that same vein. There ought to be bipartisanship around those priorities in the prevention and public health. Space that we actually need to invest more visit because the truth is you know. Food Industry in Pharma are not investing in research around this. That's right that's right and that leads me. The sort of the fifth breath point. Which is we need Dr More Research? I mean we. We had the We have Evidence based right now but we need more research into prevention of the nationals Soussan News on health estimates at nineteen percent of their budget every year goes to prevention. Now one could ask. Is that the right number or not. I don't know another really true. Nineteen percent prevention nineteen percent. Now there was another study that I recently saw that. If you look at the National Cancer Institute only five percent of their budget it goes to prevention so whatever. The number is I would think I think that these are all sort of low well that well let's just to find prevention because he's a mammogram. Prevention is a colonoscopy prevention Russian. No it's early detection. Yeah yeah true. Provision really dealing with the causes the upstream causes right. You talk about your right right right and so I would argue and I argue in the book that that there ought to be a much more focused research Emphasis on prevention. That looks at and not just sort of the biology of illnesses but also the importance of behavioral change as well as policy as well as other areas and so and that will also so actually helped Congressional Budget Office irrespective. What happens with the ten year budget window? The more research the more evidence there will policy makers so I think in all five of these Zacharias Number one leadership prioritizing prevention number two healthcare professionals focusing on prevention not just management number three a parallel pathway for lifestyle interventions in evidence based community prevention interventions number for public health resources in number five prevention research. All of these. They're all heavy lifts Dr Hammond but but I think that I wouldn't be writing a book if if these weren't absolutely important for policymakers on both sides of the aisle to understand the importance of these and I think if there's movement on the policy side the American public will we'll see this Also as away to support themselves as they try to make Sort of the healthy choice. But but the American public is is clamoring for assistance. The behavioral change is is difficult given the environment which you have so beautifully described and and I think the best way to counter that that that environment is through policy policy change and empowered American. Speaking out yeah one of the things you mentioned your book in addition to these points is so targeting things at work but aren't paid for so digital regional health for example. You mentioned Mata help. I helped advise when they were starting out right right and I and I said to them. Look the diabetes. Prevention was a good start but is based on a little bit antiquated equated. Nutritional data about low fat diets carbonized for diabetics. But it worked because and I met people who are in the program and well the work because we came to groups because we had had to write everything we eat because we exercise together. And you know it wasn't so much the food although healthier wasn't the healthiest and and there's been and more sort of advanced versions of that that have developed. Yeah that our digital for example a health you probably heard about where they literally taken poorly control. Pretty overweight poor diabetics sixty percent sixty percent reversal now in traditional medicine. It's like zero zero right. Yeah unless you get a gastric ashby bypass and they had sixty percent. Reversal had ninety percent or more off of insulin or very low insulin doses. They had twelve percent weight. weight-loss which is an amount studies at five everybody's dancing around happiness excited for five percent loss and they did it through a digital platform arm where they were coaches and support those remote monitoring for key tones for Wade from blood sugar and publish the data using a Ketogenic Ganic intervention. which is the opposite of the EPA which is basically high fat and yet this is not reimbursed? And it's the amount of savings in these patients just astronomical call. So how do we sort of get because this sort of goes back to the conversation earlier about prevention and treatment so prevention is important. It's a population based intervention. Yeah you know not all the people you're GONNA do. The intervention are going to get the problem and there was not everybody gets a colonoscopy colon. Cancer right yeah but everybody who's already sick yet. Needs the intervention of lifestyle intervention because its lifestyle is treatment not only prevents right right right but that's not reimbursed and yet it's probably the biggest bang for the buck in terms of our health care system. In how how do we. How do we get our government to start a understand that and maybe you talked about your funding more research? That proves the model right right. Well I think it's all they bob also having pathways again as you said there's no real pathway Medicare Medicaid. Don't really know what to do with a lot of these interventions that are not sort of the traditional medical model You know nine hundred. Sixty five Medicare was I Created it was essentially paid for the treatment of disease. He's using You know routine medical services. So it hasn't really caught up with today's Day and age and what we know about the importance of life installment medicine either with prevention or treatment So I think some of this is is research some of our new pathways in the government regulatory pathways ways Some of this is educating the public. it's really gonNA take all of the above to change the status quo because there are a lot of opportunities out there that are not being realized right so so you are. You're in the middle of it all and you feel like there was movement when you were there that people were were trying to actually shift the policies in ways that actually were effective or was it sort of spinning wheels. Yeah no I think governments broken. It's not going to do anything. What's the point? But yet you have a different view. There are lots of lots of things that I saw with the affordable care actors State Clinical Preventive Services. One part of that was now high value clinical preventive services There ought to be no cautioning for them that makes sense from a value based Insurance Zayn perspective and that should increase the likelihood that Americans receive high value based clinical preventive services. So meaning if people I need to get screened for disease or a PAP test mammogram right. They shouldn't have to pay for it and the private insurance shouldn't get co-pay and Medicare shooting at McDonalds after cancer screenings or or or counseling interventions inventions for tobacco alcohol immunizations. These things Can improve health reconnected. Nutrition in proportion reimbursed for a while. Right right right well. I think we saw a waste. Go in in some areas but but that's one example where we're trying to make it easier for people To access important clinical preventive services serves in terms of community preventive services. I know that that'd be is prevention program. Maybe as antiquated sort of Nutrition aspect of the intensive lifestyle piece there. But they're You know the team at Medicare Medicare just getting the Diabetes Prevention Program through took a lot of work required the authorities of a newly created center at Medicare Medicaid called CMO which is a center for Medicare Medicaid innovation there. There was a test essentially of the Diabetes Prevention Program and it was found to save money and reduce costs. That's the only way got expanded. Sure but that's why I call for a parallel pathway. Otherwise you're reliant. On on on the government has the fund is not coming from industry right. Yeah exactly exactly exactly. So so. I think the government You know and the reason why the government so important is the private sector is critical. But there's only so much from scale scale perspective that philanthropy or nonprofit organizations can do the needs are for millions and we're only reaching thousands and the only way to scale from thousands to millions There there could be other ways but but government there's a role for government and I think that's part of the premise of the book as well In in the community base stuff is important. Because when you think about word disease happens or health happens it doesn't happen in the hospital or the clinic you know. Eighty percent of our health is determined by where we live by our diet and lifestyle and our genes things that have nothing to do with what you get when you go to the hospital she. The doctrine yet eighty percent of our funding for what happens with its veteran hospital so clearly backwards. Yeah absolutely we talked about the importance for example nutrition counseling but you get the best nutrition counseling but then somebody walks clinical setting they see fast food establishments and they see no farmers markets. They're no meals on wheels programs. Now would you expect them. To so the whole idea of clinical community linkages is to reinforce what happens all the important efforts on the clinical side to reinforce him the community site. Otherwise they're not gonNA stick so one example. A couple years ago I was out in the south side of Chicago and and I visited a a program called Community Rx and essentially in this community are axes community is medicine. Exactly the the the the community are they the program Graham mapped out social service providers and community based organizations around the city and then they took that information linked to the electronic health record and and and linked at two particular conditions and diagnoses so at the same time whenever a patient came to community health center. They always got a healthy healthy Rx script based on their diagnosis matching them up with appropriate community services in the community. So what they learned in the clinical setting was was was then than they received Essentially referrals to get supports in the community. Reinforce learned the Clinton and that just sort of one example of how we need to build old. These clinical community couldn't clinic. We started program because I'm very strong advocate of getting out of the hospital. And it's there when you need it. I mean I had had heart rhythm problem this year and I had to have an ablation. I'm like thank God but most the problems in these communities are not going on in the hospital. It can't be solved there So he went in very underserved African-amer community in Cleveland. You're Cleveland Clinic and we start. Community Program in a community center wasn't in hospitals and their the help center and no it wasn't even hospital just a community center and we developed a group program. I arranged for them to get meals. Yeah sort of fresh rush. Whole food meals got the right nutrients just as a temporary solution? See what would happen. If people had the support in their neighborhood there was nowhere to get get food and within like six weeks. It's a ten week program we're GONNA have a follow on for a year. They're dramatic changes. I mean Apple's lost twenty pounds owns in five weeks. They had dramatic blood sugar. Their blood pressure as stroke couldn't really talk or lift. Anything now is talking and actually was able to carry things with her arm. I mean it was. I was shocked and and it was so simple and we taught them to cook get cooking classes together. We went shopping. They learn about food. You know we had Cox with the nutritionist and the health coaches and it was really powerful because they wanted to change. They just didn't know what or how and nobody showed him and nobody told him. And it's an I and I think those kinds of things are where we need to be thinking of. This is not going to be solved in the hospital. We still need acute care medicine for sure. Yeah but the problems we have aren't solved in the hospital. Yeah absolutely absolutely agree. I give you another example gazing health system in central Pennsylvania. Your podcast skull. The Doctors Pharmacy. They opened up their first food pharmacy. A couple of years ago and they did a a really good job matching the acuity of the individual with the intensity of the intervention so they took poorly controlled diabetic patients who screened positive for Food Insecurity Security and the intervention there was not just diabetes self management training in counseling. They actually provided for food. Who Two meals a day for ten meals a week for the whole family family? All right and what they found in their pilot was average hemoglobin agency which indicator of of of severity diabetes thought from nine point six percent seven point five percent and why why that matters is is every one percent drop reduces mortality from diabetes and complications by twenty percent and saves eight thousand dollars in healthcare costs. And what what's it's also important to realize. Is that two point. Drop out seem like a lot but if a drug gets a half a point drop. It's a raging success right there. You got four times as good as drug. That's right that's right. It's a Louis. So there's evidence based so why doesn't Medicare now pay for food firm. Susan pay for food for everybody. Yeah well I think we need to move in that direction again. It's the medical model model that has been the focus of policy makers for so long and as we build this evidence base and in some areas it's substantial now that that different quote unquote types types of interventions can actually do more than the traditional interventions that medical intervention more than medical interventions. That's where we need to focus because that's where we'll deliver Ah Not just the best improvements in health but also the most significant healthcare cost savings. So if you were an autocrat and you were in charge of American policy and you were the Putin of healthcare. You're not a bad good analogy but you could actually take a wand and make the changes that you see are going to make the most difference Prince. What would they be mentioned the five things already it because those things are are realistic? But if you really had things are gonna GonNa have the biggest impact. What would you do well not just in terms of healthcare across our whole society in terms of making the changes that need to have laser focused on the risk factors driving chronic diseases in this country as well social determines health and their organizations out there like trust for America's health who issued recommendations In in in this area but but I I think it's really a package. Dr Hyman of policy changes so on the chronic disease risk factor side of the equation whether it's tobacco oh poor diet physical activity alcohol their series of policy interventions their smoke free laws are raising Pricing on tobacco reducing alcohol outlet density increasing nutrition physical activity access in schools reducing the availability of unhealthy foods in different ways. They're a package of policy. Changes There and then on the social terminal the health side whether it's housing affordable housing housing first Whether it's education universal pre kindergarten whether it's income paid family leave You know earned income tax credit their series of interventions that go beyond the four walls of the clinical CEO but tackle both the social determinants the health as well as the lifestyles the risk factors driving Crohn's disease and in this country as you know half of adults have chronic diseases Shaft Awesome. Yeah sixty percent now. Half of that half have multiple chronic conditions which was really my focus at health and human services and virtually all the three point six trillion dollars that we spend in this country. Go there so as you're like focused on on on the risk factors driving Crohn's disease and the interplay that the social determines have an policies. They're so a lot of this again is outside the four walls of clinical setting agree. I I would I would add in there and I think you know going upstream conversation. Is You know what is driving this social terms. What is driving the disease for the most part I would say it's our food system and you have to change change the way we grow food? What food we grow? How is supported all those upstream things? It's like we're just still yeah down in the weeds if you don't actually change the food environment. Yeah Yeah if you look at the subsidies going to their agricultural sector the marketing by the food industry There are a lot of forces That Whether they admit it or not make it harder. Make it harder to four Americans out there To make the healthy choice easy choice and I don't think we want to demonize parts of but we want to work with all sectors of our society to see how we can all push health for and I think that's the best best interest. Well what you know we. We came down hard on tobacco because we were clear about. It's dangerous but now. Ob City and food is overtaken tobacco as leading cause of death. So you you know. I think we have to start to really think about that honestly. I think the industry does as well for the sake of their own future and their bottom line. They need need to understand which products of theirs are leading to ill health and and and And change their practice and culture as well So you know I think there are there are some You know in the industry who taken positive steps but but I and I think when that happens we need to applaud laud them but I think you're absolutely right as a whole I think it's important where it's not possible to see that voluntary steps? I think governments German scholar role. It's got a really important role because ultimately that's why we have government still You know I always say health and education. Those are the two most important porn things you know. Health provides the foundation education provides the accelerator You know as we pursue our goals in life and and if anywhere where where government needs lean lean forward. It's gotta be in those types of I agree. I think that's great. Well thank you for your work. A thank you for working for us in the government for so long trying to do the right thing and now with the bipartisan policy commission. which is I think? One of the most important organizations out there bring parties from all sides together to solve difficult problems across government. And I think you know what I think. Is You need a big lobby arm. Yeah you need like one hundred million dollars. Lobbying fun to be out there telling stories in ways that get lawmakers maker to pay attention so thank you so much for your work and for your book. Prevention I policy making for a healthier America. It's a real contribution to our thinking about. How do we do the right thing? Because if we keep going the way we're going we're screwed so thank you and check out the book on Amazon where we get books Bookstore Barnes and nobles and Check out the work of the bipartisan Policy Center. I love their stuff. It's a little nerdy. I'm a little geeky. I love that stuff you might to and If you love this podcast please share your friends and family and social media. Believe a common. We'd love to hear from you. Subscribe every area podcasts. And we'll see you next time on the doctors pharmacy. Thank you thank you very leadership dot com thank. You wanted Dr Mark Hyman so two quick things number one. Thanks so much for listening to this. This week's podcast. It really means a lot to me if you love the podcast. I really appreciate you sharing with your friends and family second. I WanNa tell you about a brand brand new newsletter. I started called marks picks every week. I'M GONNA send out a list of a few things I've been using. Take my own health. The next level is can be books. PODCAST research that I found supplement recommendations recipes or even gadgets. I use those and if you'd like to get access to this free weekly list all you have to do is visit Dr Hyman dot com for slash picks. That's Dr Hyman Dot Com for slash picks. I'll only the email you once a week. I promise I'll never send you anything else besides my own recommendations so just go to Dr High Dot COM for sized picks. That's P I C K S Saina a free today. Hi Everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only this podcast. This is not a substitute for professional care by Dr or other Qualified Medical Professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice services looking for helping journey seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner you can visit IFM dot. Org and search. They're fine a practitioner database. It's important that you have someone in your corner who's trained. WHO's a licensed healthcare practitioner and can help you make changes especially when it comes to your health?
EU Extends Ban on Travel From U.S.
"Facts allow you to make decisions in unpredictable times. Get the facts you need from the Wall Street Journal from PRE CORONA UPDATES to daily deep dives and our podcasts videos WSJ is a trusted source in uncertain times visit wsj.com. Here midday brief for Tuesday June thirtieth I'm Jay are willing for the Wall Street Journal Americans will continue to be banned from entering the European Union for non essential travel today. The E. You said that will start allowing travel from up to fifteen countries, though not the US. The move was expected given the recent surge in US Corona virus infections. The Food and Drug Administration today outlined its conditions for approving a covid nineteen vaccine. The agency says any vaccine must first. First be proven safe in clinical study, and at least fifty percent more effective than placebo companies, producing the vaccine will also have to conduct, follow up safety studies and the Supreme Court today struck down Montana law that ban state aid to parochial schools and a five four decision. The court ruled that states can't exclude religious institutions from programs that benefit nonsectarian private schools. We've more details on these stories and other news of the day at wsj.com and the WSJ APP.
How COVID-19 Shines A Light On Our Broken Food System with Dr. Dariush Mozaffarian
"Coming up on this episode of the Doctors Pharmacy. Our policies are not in line help or support people to eat healthy food. We have almost three and four. American adults are overweight or obese and about half of American adults have diabetes or prediabetes. Welcome to the Doctors Pharmacy. I'm Dr Mark Hyman and this is special episode focused on cove in nineteen. And I'm so lucky to have my friend and colleague Dr Dash Safari known as as friends to as Dari. Who's an extraordinary doctor? He's one of the few guys out there in academic medicine who really understands. That food is medicine and talks about it nonstop other than me. Which is pretty awesome. And he's a cardiologist. He's the Dean and John Mayer professor of at the tops. Friedman School of Nutrition Science and policy. He's professor of medicine at Tufts Medical School. He's one of the top nutrition researchers in the world and their goal at Tufts Freeman school is to produce trust the science future leaders and real world. Impact is not just an academic center. It's about focusing on policy and change in the world and there is no in medicine and academia. I know who's on more it to advance nutrition in policy frontier to speak out about the things that matter than than Dari and he has authored more than four hundred scientific publications which is unbelievable. I'd read most of them. I've quoted most of them. Well not really probably most but I read a lot of them. Have you read my bug? He's like a key feature in the book. There on how we focus on issues of obesity diabetes heart disease and evidence based policy approaches to really reduce this burden of chronic disease in the United States and globally. He's all over the place he's on visory grows in the US and caning governments the American Heart Association. The World Health Organization the United Nations and he's been featured in New York Times Wall Street Journal. Npr Time magazine and he was named as one of the world's most influential scientific minds. And I think of all the people out there talking about food and health and chronic disease food Pasi changes. There's no with more depth with more humidity and more brilliant addressing this than Dr Modifying so welcome to the Doctors Pharmacy. Wow Mark thank you so much and with that interaction we've set up the listeners for disappointment You're my hero. You're my hero. Your intellectual and hero and I learned so much from you and we want to talk today about what seems to be unrelated to Cova Nineteen which is an infectious disease but it's diet and chronic disease and you wrote an article with the former secretary of agriculture. Dan Glickman that was posted on. Cnn entitled Can Diet Flatten the curve for covert nineteen and it's sort of like How does that even make sense? So we've heard all about these ideas of fighting. The curb was social dissing handwashing washing and contact tracing an isolation testing but your article presented a very different view about how we can use food and nutrition and specific nutrients to actually help us address. This pandemic so. Can you tell us why you wrote this article and why this is more important than ever to address these issues? Yeah I think markets really clear that that to those of US following this crisis that cove nineteen has really laid bare these incredible challenges. These incredible disparities is incredible unreasonable aspects of our food system. Are there so many ways that that covered nineteen influenced student? Nutrition and nutrition Kobe. Nineteen back up at at all. Just go through quickly and we can go about each of them so you know. One is immunity the actual immune response to Cova and then you actually the blunting of the excessive inflammatory response to cove. We can talk about nutrition and actually the immune response to is is hunger and food insecurity which of course 'cause incredible human suffering with this economic shutdown lost wages at schools being closed but also we know from long clinical experience malnourishment further predispose people to infection. So that's the site and that doesn't mean and that doesn't mean skinny and wasted away could be that your nutrient deficient which is really common in America. Absolutely absolutely. There's one call hidden hunger. People look like they're getting food but there's hidden hunger because they're not getting the right the right nutrients and what's paradoxical is the most obese are often the most nutrient deficient when you look at their numbers. Right it's kind of interesting. Yeah and then. These other aspects of Kobe crucial to to you know of just quickly mention our third. The incredible intersections supply chains and food. Waste and getting food to people we. We don't really have a national food system even global food system. We have this fractured supply chain. That's now becomes you know very very dire And then I think one of the one of the most important things for really thinking about covert long term. Because this is going to be with us for for some time. Many ears is the incredible relationship between for Metabolic Health Diabetes Hypertension Heart Disease Obesity and poor outcomes with Cova. The the latest analysis from New York which has had the most cases in in the United States showed that with each of those conditions diabetes hypertension of city. There is about two or three full higher risk two to three times higher risk of hospitals. And if you put those three things together lots of people have diabetes hypertension and obesity. There be sixteen fold higher risk of hospitalization. And so it's very it's very plausible. And we're modeling this now. It's very plausible. That you know. If we had a metabolic healthy population job it would be much much less severe. And so you know thinking about nutrition and immune response malnourishment and hunger and food insecurity disparities very high rates and african-americans very likely related to nutrition in a major way the challenges to food systems and supply chains food waste and then metabolic health. You know these are all things that that you and I and others who study food at about that that food nutrition or a dire challenge and an incredible opportunity to improve the health of the population but Kobe. Nineteenth really liked taking a you know a knife and slice down dessert that was hiding immediate objects and so you know if five years from now we're back to where we were a couple years ago and there's no improvement in our food system quality of the food the way we get it to people in science that we have to address questions. I would be just devastated. I would be so disappointed that we haven't realized the opportunity here to fix the food system. So filming in the straight. What you're saying is that if you have chronic diseases and multiple chronic diseases that your risk of being hospitalized sixteen times higher that if you're metabolical unhealthy more likely to get sick because your immune system isn't working and then only twelve percent of us are actually healthy so that means if we actually had a healthy population that was eating a diet that created metabolic health instead of the opposite. Which we're doing now that this may just be a bad flu and we wouldn't have full hospitals in a society that shutdown and trillions of dollars in economic losses. All the evidence supports that you know. Of course we can't do a randomized trial and wave a wand and make everybody know about healthy to test that but all the evidence suggests that you know as you said. I'm based on national data. Only twelve percent of adults in this country are metabolic Healthy that's just taking things like waste. Your Conference Blood Glucose blood pressure cholesterol. It just measure those things. Only twelve percent of adults or metabolic be healthy and most of those people in their twenties right. You haven't yet really had a lifetime of for die in for lifestyle. And so the vast vast majority of American adults over forty are metabolic late unhealthy and given these associations you know as I mentioned even just one of these risk factors. You're doubling or tripling the risk of hospitals ation and you start piling up together In terms of risk of death is in so few debts especially under age. Seventy unless there's at least one of these other conditions. Yeah and so. It's very plausible. That if we had a very healthy population you know. Instead of a twelve percent medically healthy. We had twelve percent metabolic the unhealthy. What if nine of were metaphor healthy then in nineteen would be a far far less severe disease? Many many fewer hospitalizations fewer deaths. We wouldn't be shutting down the economy we wouldn't have. These hospitals overloaded our healthcare providers but insulted dangerous petit and working chefs on an and. What's really important here is that we can actually fix this now in real time. And so you know. It doesn't take years and years and years to reverse diabetes or to reverse hypertension or Reverse for metabolic health. Yeah does take years and years to change. Wait for many people but metabolic health. Whatever your weight. We can pretty rapidly improving. Edibala cal over months sometimes even shorter. But so yeah so the country. In addition to the things that we're doing social distancing and testing we should be launching a national campaign to improve the way we move and eat to improve our metabolic health to both protect ourselves and to protect our nation and globally to protect ourselves. This is this is what you're saying is pretty radical is that is it yes. We may take a long time to lose all the weight. We need to lose. But they're very short order. We by changing the food. That goes in putting in good stuff and bad stuff which you've written about and you know thous- particles that we could quickly revert to a more normal metabolic health reduce inflammation improve our immunity. And we see this. I seen this great example for people to understand is when someone who's very very overweight gastric bypass within weeks. Their diabetes goes away. There's still very overweight. But their metabolic health changes because they're eating a very different diet and that that's the key to remember that your metabolic health really quickly reverted so on a macro level. We sort of painted a picture of the poor quality diet we have leading to obesity and metabolic health. Which would make a massive difference if we changed. But you also were talking about what happens on the micro level on the micronutrient level. And that's really fascinating to me and I just shared the Arctic with you. I read this morning. That was done in China. Where in China has some of the most wide disparities selenium levels in the soil so in some provinces almost no selenium and other provinces there's abundance selenium in the soil and so the populations some are very efficient and some somewhere adequately nursery selenium and in this one study this one micronutrient right in the populations that had the highest levels. They had three times better curates for Kobe. Nineteen then the lowest levels in the population of the lowest level is selenium died five times as much as the ones with the highest levels. And that's just one nutrient so you were talking today about what you're trying to develop a study to look at a collection of nutrients that together could bolster the immunity of our population. And you're trying to get this study going so tell us about what is nutrients. How does it work? And what are you trying to find out through looking at the study? All great questions first and foremost ocean right. I think I am foremost. I've always been a guy who believes in foods food diet patterns from all the cardiovascular literature there's been a failed nutrient supplement after failed nutrient supplement. A single supplement. Doesn't really make a big difference. It's really about your overall food. And there are some exceptions. I think a mega threes Mega three fatty acids particular. There's after we did only some studies you know for for benefits mixed mixed findings. But on average for complex chronic diseases like cardiovascular disease and You know cancers and other conditions supplements don't seem to replace foods and so so i. I raise that because I come at this. As a skeptic I come at this as an automatic skeptic that individual nutrients could make a difference You know yet. As soon as Cobain head I started reading and consulted with colleagues experts in nutrition immunology nutrition infectious diseases. We have some of the world's way bang nutritional immunology. That's a wrestler. Yeah we we have. We have a incredible expert. Doctors Sabine at absues. Former president of the American Society for attrition the former head of research at tops Very very Much had a career study tricia technology and so together and recruiting other experts. We started looking at the evidence. And there's actually very compelling evidence from cell models animal experiments and even human studies about single nutrient supplements and infections on and specifically recovered. There's lots of research that suggested that some of the very same proteins that the Cobra virus uses for its own entry and replication. That have been another viruses. Like SARS is nutrients have specific benefit for for activity against those proteins. And so now I think there's maybe eight or ten nutrients that are potentially promising that could have an effect and I would put those accidents or three camps One camp is direct potential effects against Kobe protein. So those proteins that are needed for the virus to enter the cell and there's proteins replication and reproduction exotic For example Zinc has it inhibits. I'm looking at my notes here. To get the terminology exactly crack inhibits the army dependent Arman race. Which is needed for bio replication dancing with SARS? The SARS are a race and that's our home race to cope in nineteen and and now that means that the virus basically hijacked your genetic material and uses that little assembly line produce replicate itself and that interrupts that assembly line production is what you're saying exactly and another nutrient is a Christian person a and all fines to the ace two receptor of SARS which which with sorry advisor the receptor which SARS uses to get into into the cell and so and high level computer modeling as just recently identified. I attend as one of the top candidates were blocking Hobart entry into the south so it was a one camp and all I can go through those insurance. One camp is actually direct effects against specific effects against Cohen. A second camp is just generally improving pathogen killing and so we know again from animal experiments in humans. If you're deficient in these nutrients actually clinically deficient in these nutrients zinc selenium You know some of the b-vitamins some other vitamins. The immune system doesn't function as well and in animal experiments. And even some human trials if you give these vitamins you improve. T. Cell Function T. cells are are crucial fighting viruses. You improve saw option. And you get you boost. Immune responses general immune-boosting response and then the third category of these about eight or ten nutrients which to me. I think is actually the most interesting. Cogan is some of these nutrients help fight pathogens that are invading the lungs but also importantly dramatically ramp down prevent soften the excessive inflammatory response that the death with code because kills us because not because the virus itself. But because there's this this overwhelming excessive inflammatory response in the lungs called cited kind storm where you get way too high levels of inflammation the body's trying too hard to fight a code which may explain why people with inflammatory conditions like diabetes hypertension and obesity are at risk for hospitalization and death. Because they're more likely to get this kind storm and many of these nutrients have really clear experimental benefits against reducing cited kind storm zinc in particular Quercetin IGGY CG which is from from Green Tea EG CG for example multiple diverse models of lung injury if you injure the lungs in many different ways including violent faction in animal models it blunts that excessive response in animals. He'll better and live longer. So so if you put all these nutrients together. I can't tell you for sure that they would have efficacy against covy. We don't we don't know but compared to some other things it's at least there's at least as much evidence to test leads and and compared to let's say chloroquine hydroxy Lawless side effects. A lot in the side effects are very very safe and so we're really interested in doing a rigorous randomized trial to testes and one of my frustrations what really keeps me up at night. Right now is research takes time. It takes nine to put together the protocol the human subjects approval and get funding. And we're GONNA go to Major Federal Foundation funders and get try to get. This trial started as soon as possible. But we could complete this trial in a few months. if we have a sufficient funding and and I can tell you where we can talk more about. This is good nutrients and yeah well. It's fascinating it's fascinating because what you're saying is based on science. It's so out of the purview. But we normally think about and people go there worth the evidence but it's like it's there it's not something you normally pay attention to sort of been the aside mirror and if you think just selenium study if there was a drug that could reduce mortality. Fivefold Headline News. But I mean this is just one Dragon. Use The synergistically. They work synergistically with multiple different mechanisms. So so I guess what I'm having for dinner. I'm having a couple of Brazil. Nuts don't have more than two or three because they get too much selenium. I'm going to have chicken liver for the vitamin A. I'm GonNa have always tres and pumpkin seeds for the zinc. I'M GONNA have courson containing onions and eventually spinach and I'm going to have I'm GonNa have mushrooms and Herring Vitamin D. And I'm I'm going to top it off with some green tea at the end and I think it's by mute system. That's a pretty tough for most people to take out. I'll taste day together so I think you know in terms of specific nutrients we looked at. We looked at several. I forgot I'm GonNa make a curry because of the turmeric that you mentioned so some some of the promising nutrients that that we thinker less specific decoded but interesting but but not at the top of our list are are know vitamin C. VITAMIN IN D. Two merick selenium and the b-vitamins Are All nutrients which could have some efficacy in beneficial benefits for the immune system. They don't have the specific evidence for you know. Halfway Specific Nineteen Selenium study. Just you just mentioned is kind of one of the first. There are interesting vitamin A. Also they're all interesting. I think the ones that we have put together that we think are off. Candidates are Zinc Carson vitamin E and E G. Cg and actually think it's the combination putting before together now would have benefit. I'm really testing the combination because they all have subtle mild small effects. These aren't drugs this is and I'm sure you're up here. You're getting a lot of big Pharma wanting to fund these studies right but if we if we test the combination we think together they'll work synergistically in a complimentary way and again there so safe. The chats three. You're saying this is not something a user an ICU. But this is the general population could help us be more resilient in the face of Kobe. Nineteen well we think the best population would be people who are just us This could work for prevention. This could work in the sickest sickest patients in the ICU. That seems less likely. So I think based on mechanisms when you're first leg nosed these es nutrients could help reduce the progression reduce the severity reduced. The days of illness prevent you from getting to the hospital. If you're in the hospital already prevent you from needing a mechanical ventilator. So that's the population we're GONNA target. And I want to emphasize that I am not recommending taking these things because we don't know yet if activity against against my immune boosting dinner of chicken livers inherent right helped. Say the problem with that because there's a lot of nutrients that are in food and if you eat them regularly you're going to up your levels of these nutrients and it's not that hard. I mean vitamin D is a little hard yacky. Harry and a Lotta Pechiney Mushrooms. Or you have to go in the Sun half-naked for twenty minutes between ten and two south of Atlanta but they are take a supplement but for most of these you actually can get them from your food and I think food is always the strategy and that's really why now for two reasons. It seems like it. You're saying one you want to improve your diet. Because you want your metabolic health in terms of insulin. Resistance and the inflammation goes along with being overweight and chronic diseases. But you also want to up level your nutrient density the micro nutrients in your food by choosing smartly the foods that contain these nutrients. So you kind of have a double strategy for addressing your metabolic and nutritional health to make yourself more more strong in terms of preventing and maybe even recovering from in nineteen and. You're also going to be helping society at large by taking care of yourself by reducing the burden on our hospitals and healthcare systems and helping people to open up the economy. That's maybe why some of these European populations are struggling. I mean look at Sweden. I mean there are generally much healthier population they want to help us populations in the world and they have an open society but they're not seeing the same rates as we are and I'm wondering if maybe that's partly because of their general health. What do you think well we for sure again from clear evidence the United States? That if you don't have these conditions you have far far lower risk of hospitalizations and deaths and so I actually think that you know. Probably the regions of the world where per infected person. We're GONNA see the fewest deaths are going to be the you know rural low income regions of the world. So there's our door doorbell live live live on gassing the beauties of working at home my cat walk through the scene. I'm sure my children won't will run by on but I think that you know. It's very plausible. That in you know rural sub Saharan Africa Rural Asia. You know rural regions where there's a lot of poverty there's going to be huge rates of infection. I mean very rapid rates of infection by the percentage of people are going to be ostracized and dead among infected. I think is going to be going to be quite low and this is why getting to your point about food. Food is so important for this. Double Benefit This is why we need policy fix. This is why as you covered your book. You know. Our our policies are not in line to help or support people to eat healthy food. We have almost three and four. American adults are overweight or obese And about half of American adults have diabetes or prediabetes. When you start you know saying that a healthy population is the small minority of the population right and should it? Not Okay Right. It's it should be. That people with disease are the minority and we generate healthy. You've completely flip that on its head and we have a tiny tiny Population is actually healthy and everybody else has disease and most of that disease all of it. Most diseases is strongly rated. Yes so so we wrote you wrote in your CNN article that before Cova. Nineteen that poor diet kills five hundred and thirty thousand Americans every year about fifteen hundred deaths every day before over nineteen yeah so cove nineteen is is is tragic and these fifty thousand deaths. You're already in. The United States are tragic and and we need to be doing everything we can to reduce this and at the same time before cove in nineteen around forty thousand. Americans were dying every month directly from Diet related diseases that we estimated that would not have happened at Diet and so and we. Weren't you know going up in arms and saying this is that we have to stop this. This is causing catastrophe. But it was it was it's causing you know Billions of dollars. Tens of billions of dollars in provincial. Health care costs which burdens are American businesses which burdens are federal governments and state state government budgets. On it's causing incredible disparities big differences between the haves and have nots in our society and it's causing a lot of suffering and it's overwhelming healthcare system. So so here's where I think you know I and moving beyond the today to think about the rest of twenty thousand eight twenty twenty one next administration. We really need to take this learning from Cova that that we do not have healthy population. And when you don't have the healthy population in crisis strikes it shuts down the economy and people and business upper. We need to take that knowledge and fix the food system. And there's you know concrete things we can do. So we we. We in medicine have a phrase. It's called acute on chronic. Someone is a smoker as emphysema. They get pneumonia. They're not going to do so great. And if you're a healthy guy and you get a little ammonia. It's called walking pneumonia. It's like having a bad cold and that's exactly what's happening now. Cove is the acute on chronic disease. Obesity pandemic we have and and it may seem like why are we talking about chronic z? We have a big infectious pandemic. Let's just focus on that but now you're saying is more important than ever to address and before it's interesting ironic. You reported created a report on the fiftieth anniversary of the White House. Conference on food health and nutrition that you publish with your team from Tufts and colleagues Harvard. Which laid out in early in March where red for this. All took up was like perfect. Timing a series of strategies to really address this chronic disease pandemic the underlying failures in our food policies and the food system and it was. It was really brilliantly done and address a lot of things we talked about my book Including things like leveraging the power of the USDA programs to improve nutrition utilizing economic incentives to get people to eat healthier food and incentivize not so great food protecting our children from you know avaricious marketing and advertising. I think we if we if we were foreign nation. We're doing to our kids. We're doing what we'd go to war to protect them but we just let it happen. And then you even focused on healthcare and health professionals. How do we get healthcare to focus on food medicine? How do we train our doctors and healthcare providers to understand nutrition and incentivize better nutrition knowledge and treatment of chronic disease? And then how do we address Agriculture Sustainability? And these. These are all intersecting ideas. Not any one of them is going to fix the problem and you sort of identified eleven different key sectors addressed within these five things so so can you talk about given now say you were hired by the next president to be the foods are what are you going to be your key strategies so that we can improve the overall health of our population and we make ourselves more prepared for the next pandemic from infection. And how do we address? The health disparities. The economic challenges the climate environmental challenges all these intersecting issues which offers silos and you're a big system's thinker and often people are in silos within Congress or within medicine or academia. But somehow you've got to go wait a minute. Let me go thirty thousand feet and see how all these things connected. And how do we solve all them by working on them in a coherent way? Well you know the the Inspiration for that report. Was that nine hundred sixty nine. There is a White House conference on food food nutrition and health. That was focused on the big problem of the day which was true calorie malnutrition true hunger. I mean there were operations in the United States. Where you'd see kids with the tiny arms and distended bellies that you now see. And you know sort of famine-stricken nations elsewhere. There is true lack of food and in many places in this country And it was dire and so John Mayer who went on to become president of tops and found our school and I hold John Mayer Professorship quite humble to do that. John Mayer worked with President. Nixon a Republican organizes conference. They brought together all the stakeholders and they put together. about Sixteen hundred recommendations to fix the BOOT system thinking about sheer hunger. Only six hundred. Yeah I say that because there wasn't fixed right but they looked two years later. Fourteen hundred of them have been implemented and so that conference dramatically changed in. Osita way the way we approach hunger in this country so led to expansion standardization of school lunch expansion and standardization of the food stamps program it led to Wick. There was no program for mothers with infants and led to the creation of Wick. Which is the program that one and two babies in our country are born on wick which is errol program gives healthy foods to MOMS with with babies on the lead team nutrition axe labeling it led to other consumer protection that FDA it was quite instrumental in changing our policy and essentially eliminating caloric unger. We have another kind of hunger now. People have healthy food. It eliminated that sort of severe orrick. Malnutrition the country country And so you know. Fifty years later we said that was the last time there was a high level role attention on our food system. We have new problems right. We have diabetes. Obesity hypertension incredible disparities diet related cancers. All the new things we're learning about diet and brain health food allergies auto immunity inflammatory diseases health. We are facing a very very different food crisis. Now than fifty years ago the military you know More than half of young. Americans can't enroll military because they off by and number one. Medical reason is overweight or obesity and so a large group of retired admirals and Generals Mission Readiness. More than seven hundred. Fifty retired admirals and generals had said that that childhood obesity is a national security crisis or not ery so so this was just said piggyback on that and then Orleans. She continues in that report. The most striking statistic I saw was that the evacuation from Afghanistan and Iraq. There were seventy two percent more evacuations related to A. B. C. D. related problems than for war injuries which was just mind blowing to me. This is not even the people trying to get people already in the military who are struggling with overweight and obesity in poor health. Well I'm GONNA divert away from report and come back but a line. Art Refers Occcupation Health was very interested in first responders in helping policemen and firemen and improving their health and understanding what was causing their risks. Which you know again in this era's more important never and so he started studying. What was chilling police And Fire fighters on the job on the job and to his great surprise the number one cause of their of their on the job deaths where heart attacks and other you know a challenge is not getting shot or getting killed in the fire and then he started looking at well. What's so different about? Firemen and policemen found that higher rates are attack their age than than the average American adults and the number one number one factor lecture. They're just horrible. Diet because of working shifts working cars working overnight. You know the sort of the pervert. You know the the The the the donuts are donuts. Writer that's so he. He sort of shifted his focus to seeing how we can improve the nutrition police and firefighter so so it is it. Is this this quiet overwhelming disaster that you know? Our fighting forces policemen firefighters. Children are all getting killed. Mowed down by metabolic diseases. And where we sort of shrug. Because it's happened over. Decades and and humans are evolved were evolved biologically to respond to acute risk. This is GonNa kill me today. We're not biologically evolved to understand in the same way risks. That might kill us over months to years because you know back in the day when we were out on the Savannah right we about that that Sabertooth Tiger right in front of us. Not something that was going to happen. You know a year later and so something like Kobe. A true crisis at we think. Oh my God I could die. Changes everything and yet diabetes. Obesity HYPERTENSION CANCERS. Autoimmune diseases allergies chronic. Kidney disease you know all these things that are diet related that are still killing our operation and incredible numbers on. We were sort of assuming as normal so so so I think get to go back to to the report. I think there are three big picture principles that that. I'd like to highlight that I think are report highlights One is that there are concrete. Solutions are very real very concrete solutions that we can fix this to you know. Many of these are win win so this is not like tobacco where we're just trying to get rid of it an entire industry. We want to help the food industry from farmers to manufacturers restaurants to producers to retailers. We WANT TO HELP THEM. Healthier more sustainable more affordable food to people. So they can do. It can be win win and three. This can happen quickly. This is not a five year plan. We could change things within a few years if we implemented that the right policies and as you said there's about you know there's no single black magic bullet. It's one of those hanging fruit. I mean you know. We had a great conversation. They talking about the dietary guidelines for America and the dietary guidelines are interesting because they're designed for a healthy population and you just said that only twelve percent of us are healthy so it doesn't apply to most of us it is amazing you know. The dietary guidelines are incredibly positive process. I'm not somebody to bash. The doctor guidelines are one of the great things the government does which is get scientists together review the guidelines carefully put on islands. Every five years. There are problems in the process. So one of the biggest problems is that the scientific report at the scientists right then goes to the federal government and they change it. You know without exactly knowing how to put out the guidelines and usually it's ninety percent solar but but some big things are changed probably because of industry influence so there are problems but the other problem that you mentioned that or really the lost opportunity. Is that the Nitra guidelines by definition by law. I think are for generally healthy population and so they they specifically say these Dietrich islands are not to treat any disease or to help give anybody specific dietary guidance. If you have any specific disease you should see your doctor. You know that music. Ninety percent of Americans die Drei. Islands don't apply to them because they diseases right. And that's a challenge but so the low hanging fruit. Well I think that You know there are. There are several. It's not it's not one. I think. One is to engage and leverage the power expertise and finances of the healthcare system for food and nutrition. So so the number one cause of poor health in our country poor nutrition is ignored by healthcare system. And so we have to take this massive system that we've created our doctors. Our healthcare system is a lot of wonderful things about it. We have to take this massive system that we've created and use. Its resources our to help improve through nutritious food as medicine and and you know things like healthy produce prescription programs. We go to the doctor if you're food insecure and have diabetes or hypertension or some of these other conditions and you get a prescription to to pay for summer all healthy as one example. That's that's a clear low hanging fruit to get food as medicine into healthcare. Another one I think is to better use better leverage the investment of snap the The the the program formerly known as food stamps about one in seven Americans were on snap before Kobe hit. And you know it's it's going to go up for isn't it one in four kids and I don't know the exact statistic art with Burr. More kids in so maybe one on four kids. Yeah there's there's a large number of children on south. There's large number of elderly on snappers larger military active duty military staffers people in the military whose families are on snap. Because they don't have enough money for food and so it's not just for you know it's not just a hand. This is families. Elderly veterans active duty military. Who really need a helping hand to snap is a wonderful program powerful program to get money to people who need money to buy food and and and that's crucial and we need to strengthen There's a lot of people who say what's in Costumer at seventy billion dollars a year. It costs too much about had it spending. You know what I say is instead of cutting its funding. Let's let's use it to lower healthcare costs and then it will pay for itself and so we use it to lower healthcare costs by incentivizing disincentivising certain kinds of foods so that people still have have choice. They cancelled choose what they want to eat. But we're actually leveraging snap to make people to make people healthier for the farmers market you get double your money if you use food stamps at your farmers market yeah we. We did a national simulation model in very rigorous modeling science to say. What would happen if you did something which we call snap plus no snap plus would be if you bought fruits vegetables nuts or rains fish or other seafood healthy plant oils beans a whole range of produce? You'd get thirty cents more on your dollar you'd get a dollar thirty per dollar snap benefit on and at the same time to help to help paper that and also disincentivize healthy foods unhealthy foods if you bought you know soda or other sugary beverages or junk food or you know highly processed cheered needs you get thirty percents less on your dollar you get seventy cents on the dollar and you know that you know upfront you have a choice of you know what you. WanNa get and you can get a little more or a little less on your dollar that snap plus program would immediately be cost savings. That actually wouldn't add anything to the SNAP. Budget billions of dollars right would save tens of billions of dollars in healthcare costs. You know that the government and others are paying. So it's just kind of a natural thing knows would offset of snap right. So you're saying he got it wouldn't fully offset the cost but it would. It would still in the day were were giving to everybody including children and so it would take a long time to see returns on healthcare investment for children but it would it would save tens and tens of billions of dollars in healthcare spending without increasing costs of snap at all and so it would certainly be lead to lower government spending so. I think those are two clear things that could be done. I think I think to other things mentioned. No one is to really help. Spur and catalyze the ongoing revolution in in innovation and entrepreneurship so businesses everywhere from farm to retail to personalized medicine to packaged foods are rapidly trying to innovate because customers are demanding different foods. They want food that I think is going to make them healthier. That's sustainably sourced. That's good for environments. That comes from sustainable labor or fair Labor practices and so companies are scrambling figure this out too hot or get healthier affordable food to people and right now you know it's just the market is determining what works and what doesn't and so that means that companies that are really trying to innovate and do the right thing if their product costs a little more because they're making it healthier if it doesn't taste quite as good because they've needed healthier they're at a disadvantage and so an that's insane right with those companies should be should be at an advantage we we need a national program to spur innovation in in in business to help reward through tax policy and other policies help reward. Us companies. That are trying to do the right thing and then I guess I would give two more two more things already. A fourth item. I think is to really expand federal nutrition research You know as the as a percentage of overall research federal nutrition research has been pretty flat for for forty years and while Diet related illness has skyrocketed. And so you know we should be really prioritizing at national health at USDA at the Department of Defense at the Va at the FDA. All these places the at NASA all these places that actually already nutrition research. We should be really prioritizing amplifying or meeting that research I love research. Yeah we need. We need strong. Wouldn't have been great if over the last ten years. We had multiple well-funded studies on you treatments and immune system. Yeah and so. When Kobe hit we had already stockpile that you know army metareum of evidence and so as soon as go hit we could leverage this file release that stockpile and and you know enthoven and and not have this crisis right. I'm so so we. We really need to much much better. Understand you know food in the microbiome and winks to health personalization all the phenolics and flab animals You know that are in veteran foods. Anything research questions supply chains disparities. Yes I think that fourth thing is we really need a major new investments in federal nutritional. You talking about the national suit of nutrition right. Yeah that's one option. We we've been reviewing options funded by the rock were found nation. And we've come up with several options and we're going to release that report the summer. What are the options could be a new institute at the National Institutes of Health? There's twenty seven institutes and centers at the National Health and ratchet. They're actually asking the wrong name. It should be called the national institutes of diseases. Because it's not. There's no health in their. This'll be the first one that focuses on health. Most of them are deceased focused. There's one on heart disease one king answer. I mean there's an institute on complementary medicine it's fairly small but there are some Y- okay but Trish in so you know what Dan Dan? Glickman who your friend and former agriculture secretary said he reviewed the NIH national health strategic plan and nutrition was off. Sorry food was mentioned in there only once and it was in the context of the Food and Drug Administration. So that's likes really sad that that was that was last year and this year's plan that was that was released actually is which is an advance mostly around precision nutrition Understanding induced personalized nutrition. Which is Great? Yeah so that's in advance so we go. We Wanna go gradually good. I didn't know about that but you know they were fun. We don't WanNa take away from the existing institutes. We don't want to say okay. We're going to create a new national soon attrition and take away some funding somewhere else. We want to be added. It right has realized this is a national priority. And take this on. It just seems so. Have you started? Because if food is the biggest driver of disease in America. How do we have no institute? Organization within the government focused on studying. It's just it's like a what well you know. Mark Mark you hit me on the head. Let's let our healthcare system doesn't address the leading cause of health are the nationalities of health. Doesn't have a institute focused on the leading cause of Corell and the number one cause of death and disability in this country is diet related diseases and venable health spending and why active duty military recruits starry white otherwise qualified military coots can't get into you forces on and on number one cause of death for first responders is dying and all make sense the the front of my book. The opening quotas from Wendell. Berry says we have a food. Industry either pays no attention to health and the health care industry. That pays no attention to food. I think that's not a optimist by nature after all the doom bloom on optimus mark. And I think your book really lays out some of these options options really well that that the healthcare industry is now starting to pay attention to food. Is You know waking up to this and the food industry starting to pay attention to nutrition so these worlds are starting to converge. Happening too slowly. I don't WanNa wait fifty years the fixed. That's right now. Ten Yeah Health. Health care is is getting groups like Kaiser Permanente John Hancock insurance others are starting to incentivize and care about healthy. Eating and food companies are starting to try to create more nutritious products. And so you know it has to take on this crazy complicated system and help spur it. In catalyze leverage it nurture it faster. I'm which brings me to the fifth. You know kind of low hanging fruit You know that that that I think we could do in the next administration Would be to create a national organizing. You know office to organize all of these federal food and nutrition policies and programs. I'm after September eleventh. There was which was a devastating crisis to our country There was recognition that the all of the national intelligence agencies did work separately but that it wasn't coordinated and so you know the FBI and the CIA and always other groups were talking to each other and that was limiting our ability to respond quickly and effectively to intelligence prices so the office of the Director of national intelligence is created Odeon. I which is a cabinet level office reports to the Office of the President and coordinates Oliver National Intelligence and brings that coordinated single message and information to the president to Congress that the heads of agencies and freights coordinated actions with the unbelievable fragmentation of our food system in our nutrition response that Kobe has really laid bare. It's time I think for a similar office around food nutrition policy. You know we would call it. The opposite of national director of ood nutrition we Owen Defen- very similar to the Odeon. I would be a cabinet level position for the first time ever would say we're spending well over a hundred billion dollars a year in the federal government on fishing shoes. Let's coordinate it. Let's bring it together so now I mean the mad if you count in the healthcare costs like you know eighty percent of the trillion dollar one point of care we're talking about trillions of dollars that the federal government alone with the states because the states paper for Medicaid but government alone Hayes hundred sixty billion dollars a year for direct medical care for type two diabetes alone so suggest type two diabetes which is mostly preventable condition. If you can can eat well and treatable condition is one hundred and sixty nine years absolutely so well over five hundred billion a year you count healthcare spending on. We should coordinate it so that you know what's going on in the Centers for Medicare and Medicaid Services. And what's going on in school lunch and what's going on and snap or what's going on with and what's going on food labelling and once going health claims and what's going on in the Department of Defense Research around performance and recovery from injury and what's going on. Va around the our military veterans. All this were all this programming which is disjointed and disconnected all the USDA INCREDIBLE USDA agricultural research and policy to help stimulate farmers and rural development right US massive programs to develop rural development USDA. Actually the farm bill is the biggest single supporter of conservation. People criticized the FARMVILLE. But it's the single biggest conservation program. The APP to help coordinate all of that and so I think a new National Coordinating Office is actually not high in the sky. It's it's actually really an idea whose time has come while. Hope you're talking that into the ear of the candidates because this is. This is the moment to to make that happen. And drawing the connections helping people see the intersection of chronic disease pandemic we have our environmental crises climate change now security academic performance on social inequities health disparities. I mean these are not separate issues. And what's amazing to me is. These are not hard problems to solve. It's not rocket science. It's not going to have to come up for the cure for Alzheimer's or something really hard. This is this is something we know about. You've been writing about three decades. Your colleagues and everybody at Tufts and Harvard have been shouting from the rooftops. The problem is nobody's really been listening and I think now it's time for them to really listen and it seems like there's a real openness. Listen this is that moment in history where there's a crack in the door and I think we can walk through and and tell a different story and actually help transform our our national foods policies and agriculture policies across all these sectors. You talked about encourage you to check out this report I mean it's it's fantastic. You can just google it. The report of the Fiftieth Anniversary of the White House conference on food nutrition and Health. That was put out in. March as this condemning started and and it really lays out Kind of unwittingly the solution for what we have right now literally. It was implemented tomorrow. I think we'd all be better off. Thank you so much for having me and for letting us discuss these issues you know. This is kind of a principal. Functional Medicine Right. Functional medicine isn't for patients isn't some Hokey pokey magic. It's just that when somebody comes in with hypertension and diabetes and joint pain and obesity. You don't treat each of those a separate problems and and get one dry for you say well. What's underlying functional of all of this and let's go to the root and try to fix the root of the problem well. This is functional medicine for our country and for our food system. We haven't even talked about regenerative agriculture. You briefly mentioned kid learning in school. You know productivity of the workforce on it incredible disparities and injustice across different segments of the population. So much of this is related to our food and nutrition system and we have to stop trying to put our fingers in the dike. One at a time to fix this time and say we have a systems problem and it's not rocket science not brain surgery. It's pretty basic stuff that we can do and it's win win. It's win win for industry. It's win win for farmers it's win win for pretty much. Everybody so I think it's the time has come through that door so I've asked you all the easy question. I WanNa ask you a hard question. You say win win but you know. What are the obstacles other than lack of education awareness to actually make this happen? Who are the people or the organizations are companies that are going to be resisting the change because I think there will be and how? How do we work around that? How do we? How do we work around that? It depends on the approach right if the approach is only Punitive if the approaches which some countries are doing like Chile Mexico. Some of these new food system programs They say look. We think there's too much salts and sugar and You know saturated fat in the food supply. So we're going to penalize companies through warning labels or other things if they have those and we're gonNA restrict marketing and that's it. That's the only approach food industry is going to be kind of annoyed. Her going to say you know all you're doing is is hitting us for the negatives in our products what if we have a fermented product if we add fruits in product. What if we increase for grains what if we tried to have more healthy oils? You're not getting credit for that. So so I think that if you take a punitive approach there's GonNa to be some big time opposition from publicly traded companies that have stockholders the shareholders. Excuse me there You know All too and and financial responsibilities. I think if you if you take a a win win. Approach that look. We're going to use sticks and carrots. We're GONNA help companies that are doing the right thing we're GONNA help you shift your portfolio. We're reward farms. That are doing the right thing you know of. Course there's there's some products that are GonNa you losers right so some single you know. Single products may not be around much longer or they may not be sold that much or they may cost more. But you don't food. Companies are diverse in bait console. Lots of things restaurants or diverse inconsolable beans farmers in overtime. Lots of things. So we don't have a monolithic system with one product like tobacco that we have to get rid of so so. I think that the real oppositions going to be fear of loss right so nobody wants to lose what they have now so whether it's fear of loss in research that research agency say well the new research agency focus on nutrition. Lose it on now. A Food Company says look. I don't WANNA lose. Twenty percent of my portfolio. A farmer says I don't want to lose their. It's fear of loss right so there's no I don't think there's anybody entrenched with a line in the sand that I'm going to grow you know You know corn and I want that horn to go to corn Syrup in soda and that's it no matter what and I don't I don't care what you say to me. That's what I WANNA do now. I don't think there's many people that are going to say that. I think that people say. Oh Yeah biking grew corn in that. Corrigan go in make whole grain whole corn corn meal. That can be healthy and impaired with vegetables and be part of a healthy meal and I get actually a little bit more because my crop tastes better in his nutritionally. Soundness grown regenerative agriculture and I can get a little more profit because customers pay for that because it lowers. Yeah it can be win win. I think the report is really brilliant because threads the needle on that really tough question of. How do you bring everybody along on the team? Even the reluctant wants that's that's the brilliance of this report. It's not it's not blow up the world and start again. It's like how do we make smart choices in the policies? So that being get alignment on every side of the aisle on all sides of business on consumers everyb-. I don't think there's anybody in any business in any seat of government or any any one of our citizens who wakes up and says you know what I want to create a system that makes people sick and fat and kids not people learn and people depressed and in make our national security worse and causes destruction of our agricultural environment. There's nobody that says that or once that as a human being and so I believe we appeal to human beings who are behind these companies and behind these policies that that most of them will be able to be a few but most of them will be able to brought along. And I think it's you know we've been in Washington and I think you've been lot in Washington probably more than I have. And what's really striking is that there's a really general lack of education awareness about these issues. Like the level. Of of being informed of policymakers so low on their hearing a lot of information from the food industry from big lobbyists. But there's not a lot of lobbyists for the good guys right. We run down to Washington and we like we pay our own way like run around. And it's like but it's it's it's farm. Who Between. Well you know these are complicated issues right. It's a complicated system. You know living in Boston almost twenty years. I'll see it's wicked complicated with a really bad Boston accent. Wicked complicated Wicked complicated system right and and so you ask me. What's the low hanging fruit? I couldn't give you and second sound bite are complicated issues here. So so getting that complicated message to the public policy makers when they're so busy they're so overwhelmed. They have so much they're doing you know they're they're they're thinking every possible issue under the sun and getting people to see these interlinkages any solutions challenging and so I think that you know. Communication is a huge huge part of this It's not the solution righteous. Just talking about it doesn't fix things but communication through what we're doing through other avenues is crucial. And you know there's no. There has been historically no funding for that right. Nobody's paying public health experts and physicians and scientists to communicate where people pay us to teach into new research and people pay clinicians to see patients scientists to do research. Nobody pays us to actually go out and spend our time you know and I don't need to get paid extra. I just mean the staff instructors to do that. Communication Jocelyn Murnian don't exist and so I actually think that you know an effort building around the themes in our White House report building around the themes in your book. I think effort to bring some you know interested people together to create a coalition of of people in some funding to bring this message out and to Tell People. There are actually solutions. That help us right now. I think would be really wonderful. Well we're on the way we you and I are collaborating on the food fixed campaign which was a nonprofit advocacy group exactly designed to do this bringing together. A coalition of all the stakeholders across all sectors involved in the food system and science and health care and agriculture to really have a coordinated strategy and bring these ideas into the two thousand keep people in Washington who make decisions at the White House and Congress and agencies that can make a difference and I think this is really never happened before. I'm super excited about some anybody. Listening is excited about this. Anybody wants to get behind it whether you have money or you have relationships that can make a difference or connections or just ideas. We'd love to hear so I'm so excited that this is going to be. Even though this is a horrific time this is going to be a little window of opportunity for us to actually make a big difference so I just what you've done what you're doing. You're my hero in all this and I vote for you for the head of that office in the cabinet. That's going to be in charge of whether you want the job or not. I'm quite happy at the Friedman School of nutrition science cars. Well thank you so much being on the doctors pharmacy. I really appreciate your time. And you're busy and if you've been listening to this podcast and you love what you heard. Please leave a comment. We'd love to hear from you. Share with your friends and Family. Social Media. Subscriber every podcast. And we'll see you next time on the docket. Everybody's soccer hyman. Thanks for tuning into the doctor's pharmacy. I hope you're loving this podcast. One of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from and I'm WanNa tell you about something else. I'm doing which is called marks picks. It's my weekly newsletter and in it. I share my favorite stuff from foods supplements to gadgets tools to enhance. Your health. Is All the cool stuff that I use. And then my team uses to optimize our health and I love you to sign up for the weekly newsletter. Only Senate you once a week on Fridays. Nothing else a promise. And all you do is go to Dr Hyman DOT COM forward slash picks to sign up. That's Dr Hyman DOT COM four sized picks Pi C. K S and sign up for the newsletter and. I'll share with you my favorite stuff that I used to enhance my health and get healthier and better and live younger longer. Now back to this week's episode. Hi Everyone I hope you enjoyed this week's episode just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for helping your journey seek out a qualified medical practitioner if you're looking for a functional medicine practitioner you can visit IFM dot. Org and search. They're fine a practitioner database. It's important that you have someone in your corner who's trained. Who's a licensed healthcare practitioner and can help you make changes especially when it comes to your health?
Episode 126: The FDA's chaotic week, Trump's effect on science, and Musk's big reveal
"Welcome to this week's episode of the read out. Loud but weekly biotech podcast from stat I'm Damian Gardai social distancing from the borough of Queens. I'm an importer scene still isolating in Cambridge Massachusetts and Rebecca Robbins off today. It's Thursday August twenty seven, and here's what we're going to talk about this week I it has been a chaotic week at the FDA between accusatory. Trump tweet and a controversial press conference. We'll break down what happened next. Our colleague left faster joins us to discuss trump's war on the FDA and what it means for the agency's future, and finally this podcast has long missed Elon Musk angle. We are fixing that this week with an in depth look inside Musk's brain science tech startup first a word from our sponsor. RNA Therapeutics treat the root cause of disease rather than the symptoms by silencing the expression of the genes that make disease causing proteins. L. Nylon has pioneered RNA Therapeutics by translating the Nobel Prize winning discovery of RN. into an innovative new class of medicines, which we believe has limitless possibilities learn more del nylon com slash stat news. That's ail ny L. A., M., dot com forward slash stat news. Damian it's been a tumultuous week at the FDA and like so many DC dramas these days it started with trump tweet. That's right. So on Saturday morning, a lot of us woke up to see that the president had accused the Food and Drug Administration of delaying the development of Crow Virus Vaccines and drugs for political reasons I won't do an impression of the president at the tweet read the deep state or whoever over at the FDA is making it very difficult for drug companies to get people in order to test the vaccines and therapeutics. Are. Hoping. To delay the answer until after November third must focus on speed and saving lives exclamation point. Yeah you know. So I was so looking forward to. Sing weekend away from work. But of course, this tweet drops like a bomb on Saturday morning. So a bunch of us. It's dad had to scurry and get a story about it get reaction from the industry. Now obviously, there's no evidence to support trump's nation and the industry people that we spoke to you over the weekend were quick to condemn trump's tweet and you. Know, and they also raised a lot of concerns about the FDA's independence. You know it's really important that decisions that are made at the FDA regarding covid nineteen treatments. You know whether those be drugs or vaccines are based on science and the data and not about politics and I think actually that reaction just sticking to Saturday alone before things escalated is kind of interesting in illustrates. How the FDA has a different relationship with the industry, it regulates I think a lot of other regulators in the united. States when you talk to people at biotech companies and specifically biotech investors, they rely on what they would call a strong FDA because that establishes a gold standard by which they can base their business their investments etcetera the idea of a super lenient cutting the red tape food and drug. Administration. Is Not really something desired by by at least most of the. People that we talked to who actually regulated by the FDA I think that might be different for you know I. I don't cover for example, the beef industry but I assume they have their gripes with the USDA but at least in drug world, there's there's kind of idiosyncratic relationship and of course. Damian. This all comes at a time when drug makers are rushing to develop covid nineteen vaccines, right so this would be alarming I think to people just in general, but it's it's ratchet up. The pressure in that, there is at least in my lifetime really never been more attention paid to the drug development process and the FDA's role in it. So as this is all swirling around in that tweet that we mentioned Donald Trump tagged Steven Hahn, the head of the FDA who is at Steve FDA on twitter and that kind of I think shine the light on on what's going on in and around there the FDA has insisted that it will uphold the agency standards for. Vaccines and drug approvals for Covid nineteen, and I think notably earlier this week Peter Marks, who is the vaccine regulator told Reuters that he would resign if he were asked to approve a vaccine that hadn't demonstrated the safety and efficacy that would normally be required, and so that was our crazy Saturday and I don't know about you Damian but you know try to go to bed at a reasonable hour. But of course, at about eleven twenty, two PM on Saturday night trump's press secretary. Puts out another tweet in which she teased a news conference that was going to be held on Sunday evening at which trump would announce a quote major therapeutic breakthrough on the the China virus and joining trump at that announcement would be h secretary Alex as our and FDA Commissioner Steven Hahn Right. So that led all of this to bleed into Sunday, and when eventually that press conference came about the announcement was related to convalescent plasma, which is blood plasma, take it from people. Who have recovered from covid nineteen that would then be infused into people who are sick with the disease with the hope of treating them and more accurately with the hope of them not dying. So the announcement which was supposed to be a breakthrough is not exactly a breakthrough. It was the announcement that there would be an emergency use authorization for plasma, which you know we we can get into this later may not really change much about the availability of that treatment, but there's a prologue. To this, which is that a lot of big name scientists at Nih and elsewhere had expressed concern that there might not be enough evidence supporting convalescent plasma to justify an emergency use authorization. Yeah. Your trump touted the benefit of plasma Then we heard that the NIH had opposed this emergency use authorization, and now here we have the FDA announcing the very same thing and raising questions whether or not the FDA, the agency had bowed to trump's pressure. So there's the debate over whether this. Authorization was justified by the data You know reasonable parties can disagree where things got problematic. However was how the White House but especially how Steven Hahn characterized the benefit we've seen from this in a large clinical trial that that we report on a couple of weeks ago. Here's what Hans said at the podium on Sunday thirty five percents. Improvement in survival is a pretty substantial clinical benefit. What that means is if the data continue to pan out one hundred people who are sick. With covid nineteen, thirty five would have been saved because of the administration of Plasma Yeah and I think that just sort of ratcheted this whole thing up to like eleven because what Han said there at the White, house on Sunday evening was just plain wrong. I don't WanNa get deep into the weeds here but the actual benefit of lesson plasma is far less perhaps may be three or or five people out of one hundred would have been saved by this kind of treatment based on the data that they. Actually. You know made the decision on you know and as I said on twitter over the weekend and Kinda reiterated in a column that a colleague Matt Harper, and I wrote You know I've spent twenty years as a journalist listening to writing about biotech CEOS who oftentimes make nonsensical inflated claims about the benefit of their drugs and it was really weird disconcerting to hear the FDA commissioner do the exact same thing like you said, Damian haunt could've made a case for granting Andy Way to plasma you know without. The data you know. So it just kind of ratcheted this whole thing up higher, right. So in the days that followed Stephen went on what I guess is not an apology tour, but but he he walked back that statement he acknowledged that he should have been more nuanced in his description of the data and he eventually got around to disputing this notion that his employees are part of deep state operation to sink President Trump which I'm sure they appreciate it however late might be but to a lot of people who were paying attention externally, it was very much too little too late I mean it's it's if you do your misstatement on live possibly. Global. Television. As the world is awaiting a treatment for this horrible disease, and then you do your walk back of in a series of interviews with wire services and other media. You know the first thing is probably gonNA speak the loudest and resonate the most with with people who are paying attention. So the big picture implications to all this is whether trump's assault on the FDA and Hans Response to date will do lasting damage to the agencies all important reputation with the American public our stat colleague left Faster Ross story this week on that very topic and he joins us now to talk about it. Love welcome back to the podcast. Thank you guys what a week. So, there's long been this trope that the FDA is an organization that exists sort of outside of American politics and I think we know that's never been one hundred percent true. But what makes the trump White House's relationship to the agency different from administrations past? Yeah. The FDA, it's not an independent agency and it's not technically in a political agency. It's run by a political appointee other top officials within the agency are political appointees but there is a longstanding culture at the FDA of trying to make decisions in advance policies based on science and based on data and I think what's most different? About trump administration's approach to the FDA is really this overt belief on the part of president trump and many of his senior as that. The FDA essentially serves them their hopes and desires on things as specific as emergency use authorizations for specific drugs that those things should take place at the direct whims of the administration in some cases regardless of whether there's data to support those decisions. So we've seen this over the course of the past several months with the emergency use authorization for hydroxy chloroquine. We saw it in the rollout of the BLOOD PLASMA UA we've even seen it with a couple of. Top trump aides pushing for FDA to sanction the use of Leandra, which is a totally unproven plant extract as Cova Cure, and all of these things have been cast as breakthrough. So this isn't the first time at the broader attitude and the broader tone with which the trump administration speaks about. The FDA is just a completely different animal and it has longtime agency insiders who are currently there who used to work there scientists on the outside, a lot of people in Bio Pharma just very, very alarmed. So love furthering this point your reporting suggests that FDA staff, we're kind of already alarmed by some. Of the recent appointments at the agency, tell us about these new people who are working at the FDA so I want to highlight to recent hires. The most prominent is that of Emily Miller as the assistant commissioner for Media Affairs. So essentially, the FDA's top spokeswoman, she's filling a role that is traditionally non-political traditionally filled by a non-political civil servant, but she's a political appointee, which is itself odd. What's more odd she is a former reporter for one America News Network. If you're not familiar, it's a far right cable channel openly allied with. President. Trump that frankly very frequently espouses complete conspiracy theories. She has long track record as a Republican operative and is a conservative media personality. She's written a couple things that I think have really alarmed folks at the FDA, who of course want their spokeswoman to have roots in medicine and science or just at least in. Presenting government data in good faith So some of her works include a book called Emily gets her gun Bama wants to take yours. It's about gun rights and her struggles to buy a firearm in DC. She's written a couple of Washington Times columns here are the headlines Apart in the language in one of them Maryland's bathroom bill benefits. Few transgenders puts all girls at risk from pedophile 's I should actually say pardon the language in both because the second is new obamacare ads make young women look like sluts so This is a very unorthodox appointment at FDA to say the least and it has people at the agency concerned about how the data that they're agency analyzes and presents uses to make decisions is being spun essentially to the general public. We saw that, of course on Sunday with Stephen Hans dubious claims about the blood plasma mortality reductions and Emily Miller, subsequent defense of him one other higher I'd like to highlight is that of David Gort gorter. Who has worked at FDA previously, but is coming off a stint at the heartland institute, which is a conservative think-tank. He's written that The FDA essentially is in need of a mass firing and it's funny because he's worked at the agency since I believe June but the heartland institute only trumpeted his appointment there in the wake of all this controversy and in a press release, you know how? Great Gertler is how great it is that he works at Fda they called the agencies sclerotic and they. said that the FDA essentially has come to serve as a barrier to Americans accessing the most up-to-date biotechnology. So there are folks coming into the agency who clearly have some extremely controversial views, many of which are just out of step with how a lot of the career scientists at FDA view their role and their job, and it's really shaken people up. Because as I say, you know is very, very atypical. So at the center of all, this is the aforementioned FDA, Commissioner Steven Hahn, who has been on the job for for less than a year, you and are calling Nicholas Forego wrote a story about his approach to leadership at the agency. How is he different from his predecessors I? Think the two big differences are one. He is not a political person. He is not someone who has kind of come up through the system, of DC, and worked at various federal agencies and worked in government even at all. Before at any level, he's a career cancer doctor and beyond that beyond his status. As a political outsider without these kind of deep deep roots routes in connections, he does not have a lot of experience around him. The senior leadership at FDA for the most part is very green. There has been a lot of major departures since for Commissioner Scott Gottlieb left in early twenty nineteen. So there's a view of Han within the agency that I think people view him as a good guy as a qualified scientists, but they also just don't see him as having the capability forcefully push back. Against these attacks from President Trump, and as we saw on Sunday, he's even been willing to play into them directly in kind of further the political messaging of the trump administration and you know the trump administration's effort to essentially. Use the FDA as a as a campaign tool just a couple of months out from the president's reelection. So all the stuff is foreground to something that really scares the public health world you know, and that's the possibility that trump will compel the FDA to approve a covid nineteen vaccine that is either unsafe ineffective or both now have you spoken to lots of people in and? Around the FDA, how realistic do they think that possibility is people at FDA view it as a distinct possibility that there would be an emergency use authorization for code vaccine before the election and the FDA's even convening a vaccine advisory. Committee on October twenty second about two weeks before the election. That's GonNa look at some data that's going to discuss many of the underdevelopment vaccines. I don't know that. Anyone will view a recommendation they issue as as finding there's no guarantee that anything will come of that meeting. And it's also an open question even if there is an easy way before election day whether that will be a causal link or whether there will just be a decision made that the data is there at won't be You know as a result of interference from president trump at of course, it's a it's a very, very deep fear and president trump has repeatedly hinted at a forthcoming vaccine approval. And it's also worth noting I think that a lot of people closest to trump mark meadows, his chief of Staff Peter Navarro, one of his top trade advisors they've just taken these openly antagonistic and very public anti FDA stances where they support the president's deep state rhetoric than they talk about things not wanting to get bogged down in bureaucracy. So you know there is an overt push on the part of. The trump administration to make the if FDA move faster on all fronts. There's a degree to which I think people see that as appropriate were on a pandemic one, hundred, seventy, five, thousand, or so Americans have died. But yeah, the the fear of a politicized vaccine approval has only I think grown stronger as a result of the last two weeks of total FDA chaos lead. Thanks for joining us. Thanks for having me. Is a neuro science technology company founded by Elon Musk that is attempting to fuse human brains with computers. It's also a company grappling with chaotic internal culture where a rush to meet some ambitious project timelines has conflicted with the sluggish pace of science earlier this week stats Aaron Rodwin Rebecca Robbins published the story that offers the first revealing look inside the pretty secretive work going on at neural link Aaron Join Today to talk about it Aaron Welcome back to the PODCAST. Thanks for having me. So most people know that Elon Musk has made his career building, electric cars and rockets, but perhaps fewer no neural link can you explain to us what the brain machine interfaces are designed to do? So. There is a whole history of brain machine interfaces largely used to help people with spinal cord injuries and policies and other forms of brain injury walk and regain some mobility. For example, There are certain things that help them operate you know mechanical prosthesis. So you can be able to pick up a Coffee Cup by thinking about picking up a Coffee Cup with your mind an Elon Musk with neural link is also trying to create a brain machine interface that would help. People with prowse same type of injuries but Elon Musk has ambitions that are much farther ranging than just helping people with disabilities and injuries to regain mobility and I imagine we'll get into some of those shortly. So in the course of your reporting spoke to former neural employee's and some independent experts. So what did they tell you about the company? So I was not entirely surprised to learn that never links company culture sounds a lot like the company culture out a lot of Elon. Musk's other startups which includes spacex and Tesla where there's a rush and a real sense that you know engineering will kind of solve everything that if the you have a project that is starting to become really really difficult that you abandon it and start a new project and basically it's just you know throw a lot of things at the wall see what sticks and like let's get this done and while that's worked really well for SPACEX and for Tesla it's a little. Less clear whether or not that will work in the case of a company that target is the human brain. So just over a year ago in July twenty, nineteen yuan organized the flashy invented San. Francisco where he said that human testing of new links brain machine interface in people with paralysis would start at the end of twenty twenty is the company on track to meet that goal. Yeah. That's a really great question. So one of the things that I was saying at the beginning. I'm sure we'll get into some of the other ambitions that Elon Musk has an and some of those ambitions include things like I. Think he's tweeted about perhaps on Friday revealing the quote Unquote Matrix in the Matrix, which is a cool Sifi reference for all the signers nerds out there. But basically saying that he's going to use this technology to reveal the nature. Of, Our Reality Aka, the red pill to end all red pills and it's a little less clear whether that is actually going to happen on Friday or not. It appears at least from the interviews that I conducted that that they are not quite on track to do that because they are not on track to test their product in humans yet and in order to. Deliver the Red end-all, red pills I think that you would probably have to migrate from testing your early devices in rats, which I believe they've done to primates which I also believe that they've done into humans but from the interviews that I conducted, they are nowhere near ready to start. Testing in humans, of course, the interviews that we conducted our with employees. So who knows perhaps they've. Progressed by leaps and bounds and some of the employees were at the company I think the jury is is pretty out on exactly what's going to happen on Friday but from what I could dig up testing in humans is not something that's on track for Friday. So Erin beyond a red pilling people what are neuro links other concrete ambitions Yay. So the first one that we talked about is helping people with paralysis and other forms of brain injury to regain some mobility and the idea would be putting a device inside the brain that. is able to allow people to control computers, prostheses, and other forms of assistance with their thoughts. So Aaron as you mentioned before, this is all kind of in the foreground of a big announcement expected Friday, August twenty eighth, and we're recording this the Thursday before. So we don't know what neuro link is going to reveal to the world about its research, and as you mentioned before, you know it's kind of anyone's guess what neuro link is going to announce but you know having spoken to independent scientists working in the same field who were watching. From. Afar what's their impression of the company and what do they think is coming on Friday. Yes. The majority of experts that we talked to I'd say they're kind of split into two camps. There are the experts who are brain machine interface experts who've been studying and looking at things like brain gate as I mentioned at the beginning for years and years, and those kinds of technologies like brain gate have out for decades. So their impression of link and what is going to present on Friday they come to this with a lot of skepticism understandably. So because they're like, okay, you know you're working on something that we've been working on for decades and then the other camp of. Experts that I talked to people who say, for example, you know what norling is doing is amazing. They are working on something super super hard, and there for the first time perhaps bringing all of this hard academic work to a semi public stage where lay people can potentially learn about it That said the majority of people that we spoke to think that what Elon Musk and erling might present on Friday is probably going to be focused around showing some of the research that he's done in primates and showing for example, that the technology that he constructed can be used, which includes this pretty fancy cool. Robot called a sewing machine robot which implants the electrodes into people's brains at once. They think he's going to basically unveil a demonstration of the electrodes recording brain activity and potentially seeing primate, for example, control video screen with brain using neural links technology. So I'm sure you'll be watching elands presentation and maybe he'll be popping that red pill. Thanks for joining us. Yeah. Thanks for having me. I am looking forward to it. That does it for another episode of the read out. Loud. Thank you to heison tip another and crystal milner who produced this week's episode. Alex Hogan. Is Our senior producer and Rick Burke is our executive producer and we love to hear from you tell us about what you like about this week's episode what you didn't like and whether or not Damian should get a brain machine implant. You can do all that by sending us an email at read out loud at Stat News Dot Com. We really appreciate the feedback, and if you like what we do, leave a review or rating on Apple podcasts or whichever platform you used to get your podcasts. See you next week.
At $2.1 Million, New Gene Therapy Is The Most Expensive Drug Ever
"Support for NPR and the following message come from Panera bread. Ed Pinera breakfast to go. No longer means to settle. Try their new maple glazed bacon. Scrambled, egg and cheese breakfast rap, and new Madda, gas carbon Ila cold brew Panera, food as it should be the food and Drug administration approved a new form of therapy today for a devastating genetic disease. It is providing hope for babies born with this rare but often fatal disorder. But as NPR health correspondent, rob Steiner reports at more than two million dollars. The treatment is the most expensive drug ever approved. When Donovan Weisgarber was born, he seemed perfectly healthy, but within weeks, his mom, Laura says it became clear something was wrong terribly. Wrong, it was when he is Abou one month old was, when we started to notice some symptoms, he started getting really fussy stop squirming, and got weaker and weaker turns out. Donovan had a genetic disorder spinal muscular atrophy. It was destroying the nerves that control his muscles many babies don't live beyond their second birthday. It's the most common genetic cause of death among infants. We were devastated obvious. Yeah. You know, obviously, you're devastated. Let's definitely the worst time of our lives. But then doctors told Laura and her husband Matthew about something new. They might be able to replace the defective. Gene killing Donovan with a new type of gene therapy, so they agreed to let doctors infused on of, and with genetically modified viruses, carrying healthy genes into his body. Donovan slowly started to improve and three years later. Donovan still needs a wheelchair in a feeding tube. But otherwise, is doing great. His mom says, and he loves going outside his family. He goes to preschool, so, yeah, he gets to do a lot of normal things. So it's just I mean it's amazing. Using and Donovan isn't alone. This gene therapy has been saving other babies with spinal muscular atrophy. David linen is the president of a vexes, the company that makes what's now called soul gems Ma first of all one hundred percent of the kids survived, and this is a population where ninety two percent of the kids would expect to have died or beyond permanent. Ventilation by the time they're twenty months old. But then we also saw additional things a lot of these kids could swallow seventy five percent of these kids were able to sit. And we actually had a few kids we're able to stand and walk independently based on these results Lennon's says the company is justified in setting the price at two point one two five million dollars for each child, which would make it the most expensive drug ever approved and that price tag is making a lot of jaws drop. You know it's absolutely stunning. Peter Bach studies health policy at Memorial Sloan cancer center in New York. It's just alarming that we have gotten to a point where, you know, any tree. That is a product of this collective scientific enterprise, that has grown out of the human genome project. That was publicly funded has now been captured by a single drug company and is now going to turn around and charge, potentially millions says, it's just the most extreme example of how drug prices are draining resources from society. We have been slowly, subjected to price increases the same way, the frog and the boiling water. Is slowly boil to death now. Linen acknowledges the price might team shocking, but he argues it's worth it. The only existing treatment for spinal muscular, atrophy clus, hundreds of thousands of dollars a year. And this will hopefully be a one time lifesaving treatment that will last a lifetime. What we're talking about it, and we have to remember as we're talking about a lifetime of benefit being condensed down into a one time treatment, we're not used to thinking about this that way, we're used to a system of chronic medication where we spread costs out over years, if not decades drug companies need to be able to recoup the cost of developing life-saving, cutting edge treatments. Limit says if they're going to be encouraged to find new breakthroughs Donovan's, parents didn't have to pay because their son was part of a research study. But they think the treatment is worth the price giving someone alive someone that would have died in infancy early childhood the opportunity to live into adulthood. I mean I don't know. I think that's valuable I think it's. Valuable investment rob Stein. NPR news.
Morning Brief for Wednesday, March 6th
"Discover Milan Italy with WSJ magazine and into Garay. Join WSJ magazine editors for behind the scenes access in Milan. As you meet the city's most influential taste makers dine at top restaurants. Visit the private villas of lake coamo and much more book. This once in a lifetime trip at Indy. Gory dot com slash WSJ magazine or call six four six seven eight zero eight three eight three. I'm Anne Marie for totally in the newsroom at the Wall Street Journal, the resignation of Scott Gottlieb, the head of the food and Drug administration leaves the future of some of his initiatives. In question Gottlieb who worked to crack down on cigarette makers has also proposed a ban on menthol cigarettes. He also took steps during his tenure to speed up the approval process for generic drugs. Gottlieb's expected to leave his post within the next month. Two new studies say US consumers have been the hardest hit by trade tariffs. Researchers say importers pass costs onto consumers who bore an added sixty nine billion dollars in costs last year. Wednesday brings the latest international trade data for the month of December amid ongoing trade tensions between the US and China will also see the Federal Reserve's beige book on Wednesday, including anecdotes from small businesses across each of the Fed's twelve districts, plus we'll have earnings reports from dollar tree Abercrombie and Fitch NB Jay's wholesale among others. Retailer and jeans maker diesel has filed for bankruptcy. The company hopes to reemerge from chapter eleven quickly with fewer stores and a revamped business plan diesel launched in the US in nineteen ninety five. It was founded overseas in nineteen seventy eight for more details. Head to wsJcom or the w s j app.
Closing Bell Brief for Thursday, November 15th
"Technology today has never been smarter. But smart only matters when you put it to good use together, we can build a smarter future for all of us. Let's put smart to work. Find out how at IBM dot com slash smart. I'm Charlie Turner in the news room at the Wall Street Journal, stocks rallied to close higher in volatile trading Thursday. The Dow snapped a four day losing streak. The Dow Jones industrials rose two hundred eight points to twenty five thousand to eighty nine. The NASDAQ gained a hundred twenty two the S and P five hundred rose twenty eight the markets were boosted by a big jump in tech stocks which helped offset losses among shares of retailers. There were also renewed hopes the US and China can strike a compromise. On trade, the financial times reported that US trade rep Robert lighthizer has said the next round of tariffs on Chinese imports has been put on hold the food and Drug administration said Thursday, it would seek a nationwide ban on menthol cigarettes. They account for nearly a third of the roughly two hundred fifty billion cigarettes sold annually in the US more. Than a dozen municipalities of adopted bans on menthols, but cigarette makers have so far avoided federal restrictions. Facebook CEO, Mark Zuckerberg and the company's board took issue on Thursday. With a report suggesting the social media giant deliberately played down. The impact of Russian interference on the platform on a call with reporters. Mr. Zuckerberg repeated his admission that Facebook had been slow to spot Russian activity and recognized that significance, but he described as untrue an article in the New York Times, saying top executives at Facebook overlooked warning signs and a time sought to conceal the scope of the problem from lawmakers and the public for more details had to wsJcom or the WSJ app.
NPR News: 03-20-2020 10AM ET
"Live from NPR news in Washington. I'm Korva Coleman the. Us stock market opened modestly higher. This morning as the Senate consider bill to patch some of the economic damage done by the corona virus. Npr's Scott horsely reports. The Dow Jones industrial average jumped more than two hundred points in the first few minutes of trading stocks are building on Thursdays modest bounce after a sharp selloff earlier in the week. All the major indexes rose at the opening bell with the Dow and S. and P. Five hundred gaining about one percent and the Nasdaq climbing about two percent. Forecaster said the. Us economy will suffer a sharp contraction in the coming months as Americans are urged. Hunker down to avoid spreading the corona virus here in Washington lawmakers are considering direct payments to many Americans Milan with aid for struggling businesses to help them whether the storm the Federal Reserve is also acting aggressively to keep credit flowing. Scott horsely NPR news Washington the Commissioner of the Food and Drug Administration says that the trump administration is working to help develop a vaccine to treat Kovic Nineteen but Dr Steven. Hahn warns that any vaccine is at least a year away. Testing remains a key point to help detect the spread of the corona virus but many areas in. Us still don't have enough kits Hans Book to NPR's morning edition about why other countries are able to test thousands of people quickly. I don't want to speculate on what the test that they've done are and how they performed. What I can tell you is that. We've been focused on making sure the most reliable accurate and reproducible tests are available to the American people researchers at Johns Hopkins University have been tracking the outbreak. They report more than fourteen. Thousand Corona virus cases have been diagnosed in the US and two hundred five people have died. Meanwhile some hospitals in New York state are suspending most testing. Because they still don't have enough supplies in May areas kids will only used for healthcare workers and the very sick north country. Public Radio's Brian Man. Reports New York has the largest number of covert nineteen cases of any state in the US but testing supplies remain critically low albany medical in Saint Peter's Health announced the cutback in tests last night in the state capital saying they'll focus on screening healthcare workers and the very ill adirondack health. And New York's World North will save their supply of cove in nineteen test kits for people sick enough to be hospitalized. Even people with Corona virus symptoms are being told to go home without testing to quarantine themselves the lack of community wide. Testing means officials have limited information. About how fast this virus spreading Brian? Men. Npr News New York. The State Department says it is temporarily suspending routine visa services and all US embassies and consulate all routine. Immigrant and non immigrant appointments are now canceled. This comes a day after the State Department told all Americans abroad to return home or get ready to remain outside the US for an indefinite period of time on Wall Street. The DOW IS UP ONE. Hundred. Fourteen points this is NPR. The Olympic torch has arrived today in Japan ahead of this summer's Olympic Games but there are growing worries over whether these can open in Tokyo as scheduled on July twenty fourth. Because of the world pandemic organizers insist. They will go forward despite calls for the Olympic Games to be postponed or even cancelled most K. Through twelve students in the US are now out of school to slow. The spread of the corona virus but school leaders are scrambling to make sure millions of children can still get the free school meals. They depend upon. Npr's Corey Turner has more. Ask anyone who's been working in the school food world if they've ever seen a challenge like this and you'll get an answer like this not my lifetime. Lisa Davis is senior vice president of the no kid hungry campaign. We know what to do in a natural disaster. There is a playbook for that but this is unprecedented right now. Most closed districts are adapting the playbook they use in the summer. They're packing up lunch and often breakfast for the next day and handing out these grab and go meals at schools where poverty is most concentrated. Some districts are even using school busses instead of picking up kids. They're dropping food and doing quick check. Ins Corey Turner. Npr news the national weather. Service says a significant storm is impacting the central. Us heavy snow and strong winds are making for dangerous travel from the Rockies to the northern plains farther south severe thunderstorms are expected. Heavy rain could fall on the southern plains to the Mississippi Valley. I'm Korva Coleman. Npr news from Washington.
U.S. Asks Vaccine Makers to Hold Authorization Filings Until They Have Enough Doses to Distribute
"Brought to you by lucky charms, magical mission, enjoy a new addition to family time with lucky the leprechauns interactive adventure where you'll be jumping, running and singing to restore magic in the eight charm lands available on your Smart Speaker just say open lucky charms, magical mission or search for it wherever you listen to podcasts. US, government asks vaccine makers to hold filing for authorization until they have enough doses to distribute by Alice Park as the Covid nineteen pandemic enters its tenth month. The pressure to develop an effective vaccine or vaccines continues to mount speaking at the Johns Hopkins University and University of Washington back seen symposium online Dr Months of S- Alaui scientific head of Operation Warp speed the government organization funding and supporting development and distribution of Covid nineteen vaccines provided the latest updates on when a vaccine and how many doses might be available in coming months perhaps most. Strikingly slowly said that the government has told vaccine manufacturers not to seek authorization of their drugs from the food and Drug Administration or FDA until they have enough doses to provide to a desperate public we have recommended to companies that if they achieve efficacy demonstration while no vaccine doses are available at industrial scale of several million doses to at least immunize relevant fraction of the population. Then they should refrain consider refraining from filing an emergency use authorization because the populations would have a major disappointment over expectation of the availability of the vaccine he said. Emergency use authorization or e you a is an accelerated review and authorization process by the FDA that would allow vaccine makers to distribute vaccines that are safe and effective, but not fully approved by the agency. Sloughing also supported the FDA in its recent conflict with the White House over stringent guidelines proposed by the Agency for evaluating data from vaccine studies which include A. Recommendation. That all vaccine trial volunteers befallen for two months for any potential side effects vaccine makers supported the guidelines but after initially rejecting them arguing, they would delay availability of the vaccines. The White House has accepted them. At this point meeting demand would not be a problem if the EU a were given to the two vaccines made by Moderna adviser that are currently. Furthest along in testing the companies began late stage testing for these vaccine candidates in the summer and Slough said, the manufacturers have been manufacturing doses at large scale in parallel to testing the government began stockpiling doses of these unapproved promising vaccines in the single digit millions in September and will continue to do so in October, he said and both Madeira and Pfizer will. Likely have twenty to thirty million doses produced by November and December. This year two of the other most promising vaccines in development are from Astra Zeneca and J. and J. Both of which are quickly enrolling participants in late stage studies outside of the US and may deliver first hints of safety and effectiveness by late October or early November however if those results prove. Of these companies would likely have to consider waiting until their manufacturing capabilities have increased before requesting e you a from the FDA at that time, there will be very few doses of vaccine decision was made to approve them said slowly. So we are working hard to accelerate manufacturing and stockpiling and will likely have a few tens of millions of doses from January onward. He noted that there are now twenty five manufacturing sites across the US dedicated to manufacturing covid nineteen vaccine candidates half focusing on the virus. Based parts of the vaccine that would train and activate the immune system and half charged with producing the vials and other sterile equipment needed to construct a vaccine delivery system. We feel comfortable that within the next month or month and a half, we will have one or two vaccines that will have a read on efficacy and for which there will be enough vaccine doses in November and December to immunize with two doses. Thirty million people I in December and then another fifty million in. January says slowly.
NPR News: 08-24-2020 10AM ET
"Live from NPR news I'm Korva Coleman stocks opened higher this morning building on a rally that pushed the S. and P. Five hundred index into record territory last week. NPR Scott Horsley reports the Dow Jones industrials jumped more than one hundred fifty points in early trading. Stock Traders welcome news that the food and Drug Administration has granted emergency authorization to treat more covid nineteen patients with plasma from people who've recovered from the disease president trump touted the FDA's move on the eve of the Republican. National Convention tens of thousands of people have already been treated with convalescent plasma the world, health. Organization. Says, results so far have been inconclusive. The rate of new corona virus infections in the US has fallen by about a third in the last three weeks. Oil and gas platforms in the Gulf of Mexico are being evacuated as a hurricane and tropical storm make their way towards the Louisiana stocks in Europe and Asia were also up overnight Scott horsely NPR news Washington Tropical Storm Marco is expected to make landfall later today in Louisiana followed by tropical storm lure, which may become a hurricane before it makes landfall close. To the same place in about forty eight hours, some government buildings are closed today in Kenosha Wisconsin. After a night of unrest demonstrators filled the streets of the city south of Milwaukee after a police officer shot a black man in the back the incident was videoed reporter Kim. Shine of CBS affiliate W. DJ says Wisconsin Governor. Tony. Identified the man as Jacob. Blake. The video you you pretty much see the man identified as Jacob walking away from officers and then one eventually as Jacob is trying to get into his suv one of the officers seems to be pulling on his shirt and then you hear seven gunshots and and why that actually happened we still don't know police haven't said Blake is hospitalized in Milwaukee in serious condition postmaster general. Louis to joy will testify today before the House Oversight Committee the joys under scrutiny for recent changes to postal operations that have raised concerns about mail in voting in November NPR Susan Davis has more Democrats called for joy to appear to explain the decision making behind the removal of certain sorting machines and mailboxes. As, well, as changes to overtime pay for carriers that coincided with reports of male delays, Democrats alleged that the trump administration is meddling with postal operations citing the president's repeated attacks on mail voting, which he believes will hurt his reelection chances despite no evidence of that to joy already testified under oath before the Senate last week that he has never spoken to the president about postal operations he also testified that the postal service is capable of handling mail in ballots this November, but advise people vote early to ensure they are delivered on time Susan, Davis NPR news Washington on Wall Street. The Dow Jones Industrial Average is up one hundred, sixty, two points. The Nasdaq is up nearly sixty nine points. You're listening to NPR news. Two of the largest wildfires in recorded California history are burning out of control in that state started last week, and each has burned about five hundred, forty square miles the L. and U. Lightning complex is burden north of the San. Francisco Bay area the S. C., you lightning complex fire using central California west of Sacramento hundreds of thousands of people remain under evacuation orders in California due to the wildfires. NPR's Lawrence summer reports because of the pandemic many evacuees are being sent to hotels. Instead of shelters evacuation centers can be crowded places during natural disasters but concerns about the corona virus are changing that the Red Cross says it's spreading out cots and tables and requiring that masks be worn by everyone. To, maintain that distancing almost half of the evacuees who contacted the Red Cross are being sent to hotels in northern. California. Those most vulnerable to the corona virus are being prioritized. Local officials want to make sure that the pandemic doesn't stop anyone from evacuating who should be lauren summer NPR news. The Republican National Convention has gaveled into session this morning in Charlotte North Carolina, a few hundred delegates are meeting to conduct party business but the big event of the day will happen when the state delegates place President Trump's name in nomination. Again, as the party's presidential candidate president trump is scheduled to be in North Carolina today but it is unclear if he will be present during the roll call of states. Again Wall. Street the Dow is now up one, hundred, seventy, six points. I'm KORVA COLEMAN NPR news.
NPR News: 04-22-2020 4AM ET
"Live from NPR news in Washington. I'm Shay Stevens the. Us House is poised to take up a new wave of corona virus relief funding totaling nearly half a trillion dollars. Npr's Claudia Griselda says. The measure could end up on president. Trump's desk later this week. The Senate approved the plan to replenish popular small business. Loan program that recently ran out of money house speaker. Nancy Pelosi called the bills additional new funding for hospitals and testing a great victory. The House could send the measure to the president on Thursday. Senate Majority Leader Mitch. Mcconnell says Congress may not take up another relief bill until it returns next month. Npr's cloudy grew. Sal is reporting. The Food and Drug Administration has green-lighting the first home kit to collect samples for corona virus testing but NPR's Richard Harris reports that the test requires a doctor's order the FDA previously made it easier to collect samples for corona virus testing by approving the use of swabs that collect from the front of the nose as opposed to deep in the nose and throat. Now they've taken that one step. Further people will be able to collect their own samples at home with medical grade swabs and mail them to Labcorp which is producing these test kits. The FDA says this is as safe and accurate as collecting a sample. In a doctor's office. Labcorp a major medical laboratory says it will make the service available in most states in the next few weeks. The FDA approval for collection is only for this one particular product right now Richard Harris. Npr News as rock-bottom crude prices panic oil markets energy regulators in Texas are considering ways to try to prop up the industry from Austin K. UT's motza shell. Reports at any production cuts would be contingent upon cooperation from other oil producing states and countries. It's been almost fifty years since Texas oil and gas. Regulators used their authority to limit the amount of oil companies can pump from the ground but state regulator Ryan sitting proposed a twenty percent cut to production for large companies to reduce oil supply and stabilize. Prices we are seeing a level of demand destruction and a level of wheel industry downturn than the happened over a course of years now happening over a course days ultimately. The vote was pushed back to next week before then. Texas officials will talk with counterparts in Oklahoma North Dakota and Canada if Texas regulators move ahead with cuts to production they want commitments from other states and countries to do the same for NPR news. I'm Mozambique Shell. In Austin and trump administration is ordering Chevron to wind down its operations and Venezuela by December with only limited operations there until then it's part of the US let campaign to pressure Venezuela's embattled leader to give up power Chevron is the only major US oil companies still doing business in Venezuela where it's invested in oil fields that are valued at more than two billion dollars this is NPR news a Louisiana Pastor accused defying. A state wide ban on large gatherings has been arrested again as w arcade Paul Braun reports. The church leader is now charged with aggravated assault over an alleged encounter with a protester. Police say pastor. Tony Spell nearly backed a bus over a man protesting in front of Life Tabernacle Church central Louisiana on Sunday after posting bond. A defiant spell told a crowd gathered at the jail that the state's restrictions aimed at slowing the spread of the corona virus by late his rights to assemble and worship freely. He said he has no plans to cancel. Services or start preaching online for more than a month spell services have drawn crowds of angry protesters and hundreds of congregants more than five hundred people showed up on Easter Sunday. But attendance is said to be down in recent days after it was widely reported that a member of the church died from covert nineteen for NPR news. I'm Paul Braun in Baton Rouge. Scientists say the global travel restrictions are prompting some changes to the Earth's environment making it cleaner and wilder air. Pollution is reportedly down thirty percent in the northeastern United States and down nearly fifty percent in Rome. Researchers say that sea turtles are nesting better and the absence of human interference and that more wild animals including coyotes pumas and goats being cited in urban areas on Asian stock market shares closed mixed today lower in Tokyo. Us futures are up around one percent and pre trading. I'm Shay Stevens. Npr News in Washington.