In this episode, I am speaking with Dr. Tim Spector – a professor of genetic epidemiology, genetics and microbiome expert, researcher, and one of the top 1% of most cited scientists in the world. We will talk about the latest updates on COVID and what that means to you.
In this podcast, Dr. Spector and I will discuss:
- How Dr. Spector’s ZOE app has allowed him to accumulate one of the world’s best data sets on COVID.
- Is the recent lockdown in the UK grounded in good data, or was it a mistake?
- The danger of removing context and perspective from the C19 conversation.
- How the politicians and media are exploiting fearand causing unfounded levels of hysteria.
- The truth about population immunity and antibodies. (And why it’s taboo to talk about this basic science and logic).
- Spector’s top advice for how to think differently about what’s happening right now.
- How to become a ‘citizen scientist’ and take charge of your own health.
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Transcript
Ari: Hey there. This is Ari. Welcome back to the Energy Blueprint Podcast. With me now for the second time is actually one of my personal favorite guests. His name is Dr. Tim Spector. He is a professor of genetic epidemiology and Director of the Twins UK Registry at Kings College, London, and has recently been elected to the prestigious fellowship of the Academy of Medical Sciences.
He has published over 800 research articles and is ranked as being in the top 1% of the world’s most-cited scientists. Like I said, I’m very excited to have him on for the second time. What’s really interesting right now is, one of the things we talked about in the previous podcast, which was on the interface of genetics and nutrition, is Dr. Spector’s work with something called the Zoe app.
The Z-O-E app is involved in his research around the interface of genetics and nutrition. What’s fascinating is he has now repurposed, or I guess that’s too strong of a word. In addition to using it for that other purpose, he’s using it also now to collect a mountain of data on COVID-19. We’re going to be talking about that and his insights into COVID-19. Welcome to the show again Dr. Spector. Such a pleasure to have you.
Dr. Spector: Thanks for having me back, Ari. It’s a pleasure.
How the ZOE app has helped making an extensive COVID rapport
Ari: Yes. I guess to give people the overview, very briefly, of the Zoe app and how you’re now using it to collect data on COVID-19, and what kinds of data have you accumulated over the last several months?
Dr. Spector: Well, it’s an interesting story. For the last couple of years I, as one of the co-founders of Zoe, we’ve been working by doing real-time trials of people and we’ve looked at thousands of people, mainly twins coming through my hospital here in London and a few in Boston. Basically, giving them identical meals and looking at their personalized responses to those foods, linking that with a microbiome, glucose monitors, and lipids, and giving people an app that tells them their personalized scores.
Since we last met that’s now gone live in the US and people can actually sign up on joinzoe.com for that if they’re interested. What was interesting is we would– This is in March and it was the same on the East Coast of the US, everything got shut down and we were told, “You’ve got to go home. You’ve got to cancel the studies.” I was looking at a very rather bleak six months, nothing happening. Cycling home from work, the idea came. I said, “Why don’t we repurpose the app that we’ve been developing with Zoe for something that could be used in COVID?”
I spoke with the CEO, Jonathan, of the company and he asked the team and they said absolutely. The whole team basically was at least 40 people, spent the next four days, day and night, getting this app ready when we were just really in the peak of that first wave in London. It proved to be an amazing success and within 24-hours we had a million downloads and we now have over 4.4 million people. We launched it a week later in the U.S. and a month later in Sweden. It’s been an incredible journey really because the team did what normally takes six months in about four days.
Yes, they were bugs and it fell apart a few times but people loved the idea. In those early phases in the epidemic when really no one was allowed to go anywhere, you weren’t allowed to speak to your doctor, you weren’t allowed to go to the emergency room, no one was getting tested and we had suddenly, a vehicle that people could interact with, this app that was interested in them. They were saying, what symptoms have you got? Where do you live?
Then we started to create this whole list of symptoms, where people lived and build up this amazing radar tracking device of the epidemic as it rose and rapidly fell and the rest is so history as we’re now in the second wave and then rose again. We discovered all kinds of incredible things that we can only do because of this technology. The fact that we had so many people who were trusting us with their personal data and interacting with us in a way that I don’t think has been done on this scale before with millions of people logging every day, saying how they feel and telling you whether they’re a healthcare worker or whether they dieted or all of the things about them.
The key impacts we’ve had really were very early on, we able to give an estimate of how many people were infected when the government really had no clue, they were just counting deaths and people admitted into the emergency rooms and intensive care. Then also we picked up very early one of the first signs of COVID that wasn’t on the official list, which was this amazing loss of smell and taste. That I think probably had the biggest impact on the world because it was adopted around the world as a key symptom of COVID and it turns out its 10 times more predictive of COVID than fever or cough.
Then we went onto do the same in looking at older people aged over 70, and it turns out that confusion and delirium is another predictive sign. That was cool. We’ve done a lot of work also on lung COVID which we can probably discuss more of later, but we were pretty much the first to really point out that in the population, as opposed to in the hospital, a lot of people were taking a long time to recover and they weren’t just crazy.
These are real cases because we documented them when they were well and then they turned sick and then they stayed sick. Whereas most of the other groups like the Facebook groups, Excel people, anyone can join and you join a few months later and it’s not the same as doing it in real-time tracking. It’s been a super exciting journey and there are all kinds of stories I could tell you, but the government tried to shut us down, my institution wouldn’t speak to me for a while because they thought we were doing something against the government.
We had scares about fraud and hacking but now, the government loves us, they’ve given us funding, our reports go every day to number 10 Downing Street and people really use our data to make decisions about all kinds of things from hospital risks to locking down areas, to closing pubs, all kind of stuff. It’s been an amazing journey and hard work, but super exciting to see science put into such real-time effect.
Ari: Absolutely. It’s worth maybe emphasizing this and maybe you can quantify this better than I can, but you have a degree of data or millions of people’s data that is I think greater, or at least as great as what the government of the UK has. Is that accurate to say, or how would you phrase that?
Dr. Spector: Well, our data is unique because no one else is collecting daily data on so many people. There are two other surveys of the state of the epidemic in the UK. One is by the office of National Statistics, which is a bit like the CDC, and every two weeks they’re surveying about 20,000 households. There’s swab testing them, and that they get an idea of what’s going on.
There’s another study that’s every month is sending out swab kits to random people by post. They are the two other surveys and ours was the largest up to about a month ago, but the government wanted one has really boosted its numbers because essentially, we have between one and one and a half million people everyday reporting how they feel and if they get sick, we send them a swab test.
You’re essentially doing a sample of a million people on a fairly regular basis and the percentage that turn positive, we have results for. We now have 200 million people’s daily records and so it’s a unique result. No one else has anything approaching that or has ever done anything like that in the past. We’re serving the unknown and it’s– We didn’t realize we’d last a week, let alone nearly a year now.
Ari: Wow.
Dr. Spector: It’s kind of exciting. We’re trying to think of other things we can do with the app as we go along. We’ve done a few surveys on the way we can discuss like we did a big diet survey during the lockdown both in the US and the UK which was fascinating and we’re thinking of now doing a mental health survey as well because the other cost of COVID.
How the actual data differs from governmental reporting
Ari: Yes. I want to talk more about that. You have this mountain of data that gives you layers of insight, as you said, that are different or beyond what other surveys have. The UK recently went into lockdowns and you had some insights into what was happening with the curves in the UK that were a bit different than what the government was saying at the time as far as what justified going into lockdown again. Can you describe what the differences are from your data set versus what they were presenting?
Dr. Spector: Yes. This all happened about two weeks ago in the UK. There was a government leak that they were going to go to lockdown because we’d previously had this so-called tiered system where depending on how many cases there were– It’s like by state. If one state had very few cases, they had light restrictions and if they had a lot of cases, they had quite severe restrictions and they closed restaurants and cafes and pubs, et cetera. What we saw was that a month before there were really high levels particularly in the North of the country and in Scotland. They started to fill up the hospitals and people got worried.
The government at that point their advisors were saying, “Well, we’ve done some modeling and it looks like these increases in the North are going to get even worse. They’re going to wipe out the capacity of the hospital ICUs and it’s going to be a disaster.” They also took another survey which was about a week before ours. Ours reports daily, theirs only does once every two weeks. They reported that the R-value had gone up dramatically from 1.1 to 1.6.
This means that the doubling time of the virus was about nine days. At the same time, we were seeing the doubling time was actually 28 days. Our estimates didn’t agree, we didn’t agree on the modeling and what we saw with our data was by the time they’d made the decision, and I think they’d made it a few days before because in government, these things, you can’t just turn the tap on and off very quickly so they obviously had a plan.
They said, “Well, if you don’t act now all hell’s going to break loose and people will die.” They were forced into this corner by some of their advisors, but if they’d come to me I would’ve said, “Well, our data doesn’t show that. It shows that actually, these peaks in Scotland and the North of England had already peaked and were starting to come down.” It had run its course as it does quite naturally and was going to settle down. Basically, if they’d held their nerve, they wouldn’t have had to shut the country down which effectively meant crippling the economy in places like many in the South where they had few cases anyway.
Suddenly, they’d lost business, unemployment, and mental health problems that could’ve been avoided. I understood the dilemma they were in because the first wave they were accused of not shutting down early enough because they got the modeling wrong then and so I guess they couldn’t politically afford to take that risk. It’s always easier to be the expert or the politician that in a way, increases the risk, and then it’s been seen to be safe than the other way around. As we can discuss, that may not be the best overview for the country.
Ari: Actually, I heard Michael Levitt. Nobel laureate, Michael Levitt, who’s– I think he’s a physicist and expertise and mathematics in particular. He’s done a lot of modeling around this and one of the things he said around modeling related to numbers is, in every other discipline, where these models are done, there is a penalty for being wrong no matter which side of the equation you err on.
If you guess too high or too low, there’s a similar price to be paid, but when it comes to infectious disease epidemiology, we have this attitude that if you’re 20% under in your estimate, meaning you guessed that it would be less bad than it actually turns out to be, that’s a really horrific thing, but if you model that it’s 20 fold or 50 fold greater than it actually turns out to be, that’s okay and we all feel that it’s perfectly okay to err on the side of caution. Why do you think, and I’m assuming you think this, but why do you think that that is misguided? Is there a penalty to be paid for being too cautious and locking down too quickly?
Dr. Spector: Yes, we’re only really discovering this now, because we’re seeing the other side of the coin, we’re seeing deaths from heart disease going up, we’re seeing less people coming to their family doctors and going into emergency rooms than would normally happen. We’re seeing cancellations of operations because people are scared because part of the process of getting compliance of a population is also to make sure that you emphasize the downsides of the virus and you don’t mention any of the other downsides of it.
We’re seeing suicides going up, we’re seeing depression going up, a lot of loneliness, people in care homes are not being able to see their relatives. At the moment, the net risk-benefit is looking pretty shaky that this extra benefit on deaths you may get through lockdowns, particularly national ones where people can’t meet each other at all doesn’t really merit that side of it. Very few people take this global view. They just tend to look at the one disease we’re on about and of course, there’s only been one disease in the news for the last nine months and everyone’s an expert on it.
We forget like in the US, everyone has now fixated with this dashboard, where you see how many deaths in the country, how many deaths in the state today. No one really says, “How many people died of car crashes?” Which would be 10 times, 20 times the number that could have been avoided if you banned cars. There’s no context about this risk. That’s my beef with this, is we’re not putting it into the context of the true cost. I’m not trying to underplay the fact that this virus has suddenly taken lives.
We’ve got the whole long COVID, long haul has problems which we’ve written definitive papers on, but when it comes to deciding these guidelines, I don’t think the experts are taking a broad enough view when they’re advising the government and the government isn’t taking a risk approach that works in both directions because they say, if cancer deaths go up or a heart disease goes up, that’ll be in a year’s time and it’s not going to be now, whereas the newspapers, the media who are also to blame are going to put that on the screen now, and they’re going to see this peak of deaths going up and that’s all the voters will look at.
It is a complex problem and I can understand the government’s and politicians’ dilemma in this because they feel they’re between a rock and a hard place, but they’re there because we’re not openly discussing this as other countries are doing. I’m talking we as in the US and the UK, with a similar culture, about discussing death and other things that are a bit backward compared to other countries. You go to Scandinavia, they discussed the fact that deaths are mainly in the age of over 85, these people would likely die within two years anyway. It says a matter-of-fact thing, rather than saying, that’s terrible, you can’t say that. You’re evil.
Ari: I think in the US that feeling is probably even more amplified than in the UK, to even broach that topic here of years of life loss, which is commonly done in public health, is you’re a psychopath if you speak in those terms, but that’s just science, you have to speak in those terms, you have to be willing to talk about whatever the facts are.
Dr. Spector: Yes, and I think an epidemiologist should be a scientist who does take the big picture, who does focus outside their little area of expertise and at the moment, most of the experts are very much infectious disease epidemiologists and they’re modelers and they are basically used to producing the worst-case models. Everything is about that and they just don’t have that expertise necessarily or tradition of providing this full picture that incorporates something as simple as GDP and each percentage change in GDP costs X many lives lost.
You’ve got the 85-year-olds plus who is going to die a little bit earlier, but there are lots of estimates now there that many of us will lose a year of our lives younger, because of the economic downside of this that has a direct correlation between a country’s economic prowess and its healthcare and its deaths. That’s the big picture. It is a debate, I think we all ought to realize and be grown-up about it.
It’s not about all one or the other, it’s about trying to find that right middle ground that is acceptable and it’s not right to just say, “Those deaths are going to happen next year, therefore, I don’t care about them.” Or, those extra cancers and heart disease and people being given the wrong diagnosis or suffering at home, or committing suicide. They’re real.
The consequences of lockdowns
Ari: There was a report that came out, maybe a month or two ago in the US saying one quarter, 25% of young adults contemplated suicide in the last six months. These are I think, the kinds of effects that these public policies have not considered deeply.
It’s like we’ve had– We’re dealing with a new infectious disease, so we brought infectious disease epidemiologist to the forefront to guide government policy, but the problem is those people who understand infectious disease epidemiology and are modeling that, they’re not figuring into those models, for the most part, all of these other deaths from the causes you described, what are the consequences on mental health and on deaths from other causes. That seems to be– It’s almost shocking that the world could work that way, in a way where public policy could be dictated in a way that doesn’t consider total harm minimization, don’t you think?
Dr. Spector: No, I agree with you, but at the same time, you’ve only got to look at the media and it’s hard to change public opinion because in the UK most of the public is still committed to some harsh measures to bring the virus down, not all of them but I think still the majority.
They fear it and they’re being told that they can eliminate it. Therefore, it’s just a question of turning those screws even tighter and you’ll get rid of it because they’re not being told the truth, that actually you won’t be able to get rid of it completely, we’ve got to live with it and you have to start making these decisions both as individuals and as nations about relative risk and benefit in a way that we wouldn’t discuss driving a car. If you said to America, “Okay, death rates are far too high in Arizona. We’re going to just for a month stop those because the emergency room’s a bit too full.”
Ari: Death rates from car accidents?
Dr. Spector: Yes.
Ari: Yes, exactly.
Dr. Spector: [crosstalk] in young people.
Ari: Then say, “Okay, nobody drives cars for the next two months.”
Dr. Spector: Yes, “We’re going to get it right down, and then we’ll be fine again.” That wouldn’t work. It’s useful to have these other examples of what people would accept. We have these debates but there are very few parts of the mainstream media that are prepared to actually put all these things in context because they’re worried about seeming to be heartless or not with their readers who are worried and anxious and they don’t want to be told, “Hey–” Or they risk being told they’re lunatics who believe this is all a hoax.
The media’s critical role in how we perceive the current COVID situation
Ari: There’s also I think probably a psychological aspect of the newspapers are seeing their numbers as far as readership goes off the charts with the more fear-mongering they do because the human brain is wired to pay much more attention to something that’s activating those fear centers in the brain than something that’s saying, “It’s not really as deadly as was feared previously. It’s not killing us all.”
As you said in the UK it’s the 15th leading cause of death. That’s the kind of context that’s important for people to understand. Those kinds of headlines don’t go a long way to attracting a lot of readerships. I think there’s probably a self-serving element of the media just trying to get more eyes on their articles and get more virality. They’ve probably seen the data that the more fear-mongering they do, the more readership they get I would imagine.
Dr. Spector: We see that in our press stories we put out. It’s quite obvious what gets picked up by the media and what doesn’t and generally, when we show rises in the cases we get more hits, hotspots. People love to see which regions are going up. There’s no story in, “No cases reported today in this particular area.” They like new symptoms and these big medical stories.
Talking about the other side of it, people aren’t as interested in it because their perception of risk is still much more about the risk of COVID whatever their age and disproportionately and it’s very hard to– Having many people frightened, it’s very hard to draw back from that and actually have a more meaningful conversation. They say, “You told us this one thing, we should hide and do all these things.” Now you’re saying, “Actually it’s more important.” That was a problem with the messaging in many countries in the US and the UK.
It flipped flopped around and there wasn’t really a consistent message. It was all or nothing. We got rid of the virus and now we haven’t and it’s come back and we got to do this or saying, “Hang on a minute, everyone. Let’s just talk risk, let’s just talk about getting a plan that we can put in place for six months that allows most of our lives to carry on and we do the stuff without tough regulations that can minimize the harm done by this until these vaccines come onboard.” It hasn’t happened in many countries.
Ari: You said something a minute ago that I think is really important and I want to come back to it. You said many people in the population, most of the population now believes that these measures like lockdowns or you didn’t mention masks specifically, but we can assume we can lump that in, are going to suppress the virus essentially into non-existence.
This is really an interesting phenomenon to me and I’ll tell you my perception of it, I’m curious to what extent you agree, but in the beginning, we had two weeks to flatten the curve and the whole idea was, slow the spread such that you avoid acute hospital overwhelm, you avoid excess deaths that would occur as a result of overloading the hospitals and people not being able to get treated. The models and I remember hearing lots of high-level epidemiologists talking about this at the time saying that by flattening the curve, you are not changing the total area under the curve, you’re not changing the total number of people infected, you’re just essentially changing the timeline in which those total number of infections occur.
In other words, measures to slow the spread do not ultimately change the total number of people infected, and yet, after that period, slowly over the course of months, what happened in the minds of the general public seems to be that lockdowns and social distancing and wearing masks no longer were understood as a measure to slow the rate of spread and avoid hospital overwhelm, but became conflated with essentially stopping the virus and making it go away. If the virus hasn’t gone away yet, that means we just haven’t locked down tight enough and we haven’t done enough mask-wearing, and so on. I’m curious if you agree with my perceptions, or how would you explain that?
Dr. Spector: I agree absolutely and it was exactly the same message in the UK as in the US. It was all that flattening the curve and helping the medical staff and this huge support in that first wave. That’s just changed. No one’s really focusing on the hospitals. A lot of the hospitals in areas that are locked down are pretty much empty and it is kind of weird how that has in a way been hijacked by this eliminate the virus group.
It could be the fact that some countries in Asia have managed to pretty much do that and it’s just the Americas and Europe that’s failed massively and is struggling, but I think you’re right, that if people return to that original message, then it would help people understand that, that’s all you’re trying to do. Means you’re still going to get on with your life, there’ll still be risks, we can all get it, we can get it twice but hopefully, it’s going to be a minor risk, rather than a major one and something that we’re prepared to carry on life, just like we carry on driving a car on a freeway. The risks are quite high at night, but you do it.
Ari: To that point of grounding this in context, I would love for you to talk about what you see as the proper context to understand this. I’ve heard you make a statement in your recent interview on UnHerd talking about COVID in the UK, it’s still only the 15th cause of death nationally and you said, “Every time you see these figures, about COVID cases and deaths, we should really be presenting the fact that about 40,000 people will be dying in November in any normal year.”
You said, “Don’t get too obsessed about this because risks for most people are relatively small.” Also, I want to mention in Sweden, Sweden has been viciously smeared and attacked for a lot of the last eight months up until the last few where they’ve had almost no deaths, but they were getting really attacked for having a high mortality rate from COVID. You see these sort of articles, “Sweden is irresponsible and they’re trying to kill their whole population and so many people are dying, they’ve had one of the highest death rates of COVID in the world.”
When you look at all-cause mortality rates, Sweden is on track for a perfectly normal year of all-cause mortality and in fact, I heard Dr. Sebastian Rushworth who’s a Swedish doctor say they’re on track for one of the least deadly years in their history. How can we make sense of the media talking about these shockingly high case numbers and everybody’s dying and this country has this high mortality rate and so many people have died and yet simultaneously, you could have placed on the track for relatively normal years or normal months in terms of all-cause mortality? How can those two things co-exist?
Dr. Spector: Again, it’s by not putting the deaths into context. I think in the US as in the UK, if every time they said how many deaths there were this week, they put it into the context of how many deaths there were last year due to flu or any cause and you’d be able to put it into perspective. I think that’s what we need. We just need the idea you can’t just pluck these figures out of the air because people have got no context. They just see it going up or down.
Most of the population is not sufficiently geared up mathematically to actually assess real risk. We’re all worried about when we go in the sea– People are worried about shark attacks in ways that we’re just not worried about it going for a ride in a car. We’re very poor at making our own judgments on risk.
Ari: Just to add one thing to that too because I actually know the stats on sharks. I’m a surfer, so I happen to know stats on shark attacks. I’ve been afraid of sharks since I was a little kid, so I spent some time digging into those numbers.
Dr. Spector: You’re the expert on that.
Ari: The risk of getting into a car accident and dying in a car on your way to go surf is– I think it’s a 1,000 fold or 10,000 fold higher than the risk of dying from getting eaten by a shark while you’re surfing, while you’re in the water. To that point of the human brain not being very good about assessing risks accurately.
Dr. Spector: A couple of years ago, I was caught in a helicopter accident in a remote part of Georgia whilst heli-skiing and luckily survived unscathed, and it was, “Oh, you’re crazy. I’d never go on a helicopter. They’re incredibly dangerous.” You’re in a helicopter for a very short time. It was equivalent to– I worked it out, doing something like 100 hours on a car on a freeway, which many people might do in terms of the risk of death. We see these rare unusual events as much riskier than the day-to-day things that we’re always encountering.
That’s why COVID death or shark attack or a lightning strike or whatever it is, or deadly jellyfish are always seen way out of proportion. We have to combat that with just lots of figures that people can understand and not in a complicated way. Maybe the way around this is from now on we say mandate every newspaper, USA Today, to assess how many people died in Florida today. Isn’t that great? People get used to the fact that there will be I don’t know, 50,000 deaths in Florida or whatever on a Tuesday and it’s no big deal and the same number of people die as people get born and that’s a lot.
It’s a conveyor belt we’re on and how many people die of guns or alcohol or those things. Just get some better perspective that common things are the most common causes of death and a small change in that, a small change in improvement in car safety or distance or drink driving can make a huge difference to population stats as opposed to [unintelligible 00:40:00] events.
The real stats on excess mortality
Ari: Yes. I love the idea to mandate things in that way. I’ve had this experience of talking to people who are saying in the U.S. for example, there are 700 to 1,000 people dying per day of COVID and when you think of it in those terms, it sounds like this rolling tidal wave of doom. This deadly thing that’s sweeping through the population, killing 1,000 people per day, and eventually, it’s going to sweep through my part of the population and kill a huge chunk of people with me.
Invariably, what I’ve found is when you actually tell those people, “Do you know how many people normally die every week in the United States?” And they go, “No.” You sat, “It’s like 55,000 to 60,000 people die every week in the United States.” You’re talking about a variation on– For the last few months what we’ve had in the United States, a variation on normal mortality rates that’s within about 10% or 12% of the normal number of people that would be dying every week.
When you think of it in those terms it’s like oh, it’s 10% above normal for the last few months. It sounds very different than, “Oh, 1,000 people are dying per day.” In the media, there are cases exploding. 100,000 new cases per day. Hospitals are filling up. All these kinds of articles in the media make us perceive that there’s 300%, 400% more people dying every day than would normally be dying and the actual number is more like 10%. Is that accurate? How would you put the context of the U.K. or Europe into that?
Dr. Spector: Yes. When you look at Europe, what seemed to be happening was that the first wave did cause an excess of deaths across most of the badly affected countries more than you would expect because at that time of year, generally, March, April, you’ve gone over the flu season and you’re into generally a lower mortality.
You’ve got excess mortality there which I think was about 20% or 30% on those times. What’s happened since then is that although cases have kept going up, the relative mortality hasn’t really changed much.
Seasonally now we’re getting into winter, you get more deaths generally this time of year. It’s usually double that in the summer from natural causes and for some reason people just die more in the cold than they do in the heat. We’re not seeing really any excess deaths in Europe for the time of year in most countries. Until we’re done with the whole year you won’t really know what it’s about.
We keep quite good records in the UK and I think it was in 2015 there were 22,000 deaths from flu in that winter. We’re now 50,000 deaths from COVID. It gives you some idea relatively and they were probably undercounting the flu because now everyone’s overcounting COVID. Everyone’s doing testing whereas people weren’t being tested necessarily with flu back then.
Yes, there are some excesses but it’s nothing like the number of people– Your chance of dying from a heart attack is still infinitely greater if you’re under 85 than it is from COVID. It’s getting this whole idea of proportion back in there that we lack and as I said, the whole thing goes into terrorism, you know? Everyone’s worried about getting killed under a terrorist attack. You’re more likely to be abducted by Martians really than being killed by terror. Even the very worst 9/11 disaster, you put that over 10 years, it’s still a ridiculously small percentage of people.
Five times more people died fleeing from other potential terror attacks and in car crashes than actually died in the actual terrorist event. Again, terrorism feeds on our inability to properly calculate risk. It’s not just COVID, it is a general human weakness we’ve all got and it’s exploited by some people. Fear is exploited and terrorism is a perfect example of how one shoe bomber with a crummy device can make countries like the US spend 30 billion on Homeland Security, with a trivial risk that may have never happened about someone blowing up a plane with a bit of liquid in their shoe.
How fear can be exploited to control the population
Ari: You mentioned how fear can be exploited a minute ago. How do you think fear is being exploited right now?
Dr. Spector: Well, I think it’s being exploited by– For good reasons, in a way of people trying to get them to comply with regulations. It’s natural if you want to get a population to suddenly change their behavior. You’ve either got to rely on their goodwill and explain it all, which takes a bit longer, or you do a rather simple message to say, “COVID kills stay at home. Save lives.” I can understand in a way why they did that at the beginning. I think we didn’t really know what COVID was capable of, or what it could mutate to, or whatever, and it probably was appropriate to scare people with the unknown.
Now, we know much more about it, I think we should be going back to the carrot, rather than the stick and we should be moving more to inform people about the virus and not just using the fear card. If you don’t what you’re told, then there’s going to be body bags as far as the eye can see and it’ll be your fault which is not realistic because of the other side of the coin, because no one is saying, “Because you’re putting this fear in, you’re creating body bags for people with mental health problems and undiagnosed cancers.”
I don’t think fear should be used on either side of those things. It should be a much more logical, reasoned argument. Everyone needs to be an armchair epidemiologist and understand a bit more. No one knew what the word meant and suddenly, everyone’s everyone wants to be one now.
Ari: That must feel odd for you as someone who is one of the most respected epidemiologists in the world, one of the most-cited scientists in the world with all of this formal training in epidemiology to see the whole world all of a suddenly become armchair epidemiologists.
Dr. Spector: Well, people get an idea of what your job is now and yes, they never did before. They just say, “You know what? Whatever, I’ll just call you genetics, or I’ll just call you a research doctor or something. I don’t really understand.”
Herd immunity – why it matters
Ari: I want to talk to you about population immunity, herd immunity. I’m hesitant to even use this word, herd immunity because it’s become so misunderstood and so misrepresented but population immunity, I’m curious if you have any insights from Zoe data, or if you have any thoughts in general on the plausibility of higher levels of population immunity than are currently thought or estimated by the blood antibody titers of IgG and IgM antibodies. What role do you think, if any, that has played in keeping the virus at relatively low levels in, for example, the UK, Sweden, many other countries?
Dr. Spector: Yes. Great questions. Well, as a sub-study of the [unintelligible] Project, you may remember I’ve been running this twin project for the last 25 years. We have about 10,000 twins and during the height of or just after the worst of the epidemic, about the end of April, we got a team together from the hospital in London and visited these 400 twins and got antibody tests on them and very accurate levels. We worked out how many people in the south around London had been affected. It was about 12% had high titers antibody and a bit more if you were more relaxed about what that antibody response was.
We know from the other studies that after 12 weeks, half the people tend to lose their antibodies. If you took a back-of-an-envelope calculation, you might say that it’s likely that the people with strong antibodies three months afterward still represent just a percentage of the people who are infected and those may be the same again, who were infected, who either had short term antibodies or had this other T-cell response that you find, which is virtually impossible to measure in large numbers, because it’s so hard to do but is understood by immunologists.
In a place like London, which is like New York in terms of its exposure, it’s quite likely that something like 25% of people was exposed in the first wave to the epidemic and we believe, although, again, this is a taboo subject, that you’re not allowed to talk about immunity but those people had some relative immunity about having a second infection.
The number of people that report second infections is very small. It’s not zero, but it’s small and the number of people who had a proven second infection with a different virus, it wasn’t just the same one they kept secreting is less than 100, I think in the world.
It’s a rare event to get re-infected. I think, I personally can assume that most people within six months, still have some immunity against the virus. Now, nobody mentions that in the UK, and I’ve not seen much of it in the US because they think the population if they knew this, would run around going crazy, and just say, “Hey, I’m immune and which very initially, people thought they would get a passport with a stamp on it from the CDC saying, “I’m immune, now I can go to Acapulco and enjoy myself.”
That didn’t seem to be the case because of the disappearing antibodies and this whole uncertainty about how much it actually protects you. I think what’s really interesting is with the virus coming in, suddenly, immunity is coming back into our mindset because they said, “Hang on, the point of a virus is to raise an antibody, if you’re raising antibody you’re immune, but hang on, but if I have natural ones and suddenly I’m not immune? That doesn’t make sense.
We’ve got a stupid story of our prime minister, Boris Johnson, who as you know, was critically ill in my hospital here and still has antibodies, someone else in his staff tested positive. He’s now in quarantine for two weeks and he boasted that he had antibodies. He’s got antibodies, what’s he worried about? That would be the same as if he was given a vaccine. Suddenly, this madness, which was created to make people– Keep them fearful of the virus, whilst being slightly disingenuous with the truth, I think has emerged.
They’re starting to clash with these ideas. You can’t save the world with a vaccine that produces antibodies and tell people, “Well, you got antibodies, but we don’t think you’re immune from the virus.” This is really going to be the next month that people are going to cotton on to this fact and say, “Hang on a bit. This doesn’t make any sense. I got antibodies, I should be able to see my sick mother. I shouldn’t be shielded from her.” All these kinds of things are going to be a comeback in reality.
Coming back to maybe London– I deviated from my London survey. We think about 25% of Londoners probably had the virus and are likely immune. When we look at the charts of the second wave in London, it really didn’t take off. It never went beyond a linear increase and unlike other areas of the country, which did go exponential and took off, it’s only been creeping up in London, despite you’ve got massive city, 10 million people, most people still working. A lot in September, we had people in restaurants, and whatever.
One place, it would take off would be London so I think it’s played a really big role in driving down the numbers of the virus because it couldn’t just easily hop from one person to another because of this exposure, and that also should have similar impacts for other places like New York that got hit first time around. It’s much more likely to hit places that didn’t get hit the first time around and that’s– When you look at the map of the US, that’s exactly what we’re seeing as well.
Ari: Yes. Thank you for having the courage to say that. As you mentioned earlier, it’s taboo to even broach this topic and, but it’s just logical speculation and that’s what makes [crosstalk].
Dr. Spector: It’s not all or nothing. It means, I had COVID back in April, mildly three weeks, it may have worn off now my immunity or my antibodies were never very high, but I presume you had a T-cell response as well. I would say if I met someone with COVID, I have a risk of getting it, but it’s probably much less than if I hadn’t had COVID before, and it’s people are getting used to this idea that it’s not about all or nothing, It is just mitigating risk, the things that we do every day, anyway.
Ari: Yes. There’s a couple of interesting data points that one’s more anecdotal, but I’m curious if you know about them. In New York City there are some communities like the Orthodox Jewish community, which lives in very tight quarters and they have big gatherings and frequently, and there were some stories that came out all the way back in maybe May or June saying that those many of those people in those communities were saying, “I’ve had COVID, everybody that I know has had COVID or has either had it or been exposed to it.”
Living in the same household as someone else has had it and I think it’s reasonable in a scenario like that, where they’re saying literally everybody we know has had it or been exposed that population immunity seems to be very plausible, at least in pockets like that. In Japan, there was a very interesting study similar to the way you’re collecting data with this Zoe app, except they did it with antibodies. I don’t know if you saw this study, but they took about 1800 people and they followed them for several months and they did antibody tests each week, I think something like every seven days or so during that span of time.
They found at the start that the antibody titers or the antibody– The percentage of the pocket, that group that had antibodies was about four or 5% at baseline. Over the course of the several month’s studies it went up to 45% had antibodies and then went back down to something like 10%, meaning because of what you said before, this disappeared– That a large chunk of people loses their antibodies, any particular time point where we go into a sample of the population and measure how much of that population has antibodies is very likely, sounds to me very likely, greatly underestimating the total number of people who have actually been infected and based on the Japanese data, it may be upwards of 45% of the population may have been exposed. Do you think that’s reasonable speculation or logical speculation with, some data points?
Dr. Spector: Yes, and I think we’re underestimating the number of people who were exposed in the first wave because this is a very clever virus. It just, it beats us and when we didn’t know anything about it, we were so dumb, it just went everywhere and I think a lot of people who thought they were lucky and didn’t get were just resistant.
It’s not like it didn’t touch them, they just had the right immune system, plenty of couples where one guy was totally ill and his wife had absolutely nothing and they’re coughing all over each other. It’s impossible they didn’t have the virus. Some of those will have antibodies, but others won’t. They just had a really good T-cell response.
I think we will have built up a fair bit of natural immunity. The question is not that, but how long will it last? That’s the million-dollar question, of course with the vaccines. Are we going to have a monthly injection of this stuff or is it going to last several years, and we can get rid of it and the same about our own immunity, which definitely wanes and it also can be very different. We’re starting to look at this in the twins, and there’s definitely a genetic effect on how our immune system copes and how long it lasts. I think this amazing– We’re realizing as humans, we are much more different than we think we are.
A new approach to COVID19
Ari: Well, Dr. Spector, I have a long list of other things I would love to talk to you about for the next three hours, but I want to be respectful of your time. The last thing I want to ask you is just, you’ve compiled your own data, as we’ve talked about, you’re taking this broad approach to thinking about this in complex systems based way rather than in a myopic, COVID is the only cause of human suffering and death sort of way.
You’re thinking about things in terms of total harm minimization, which I really appreciate. I wish a lot more people were doing. My last question to you is basically, if you have any thoughts, either for the general population or for public health authorities and other experts out there, but if you have any general thoughts or one key takeaway that you’d like to leave people with about how to think differently about what’s going on right now. What would you say?
Dr. Spector: It’s such a complex problem, but I guess it’s realizing that the virus has a natural course and it comes in waves and comes and goes, and it has its own agenda. We have to realize that I think we’ve just got to work with that agenda to try and minimize the impact it has on us until it goes away. We’ve got to work out how as humans, we fit into that, that cycle of this brilliantly constructed machine that replicates inside us all and feeds off our human stupidities. I think it’s just realizing that we’re just one part of this whole puzzle.
Humans themselves cannot do it all. We’ve got to accept nature will run its course to an extent, but every little bit we do, social distancing behavior, mask, washing your hands, they all have a slight impact on how much damage it’s going to do and how long it’s going to be around. That’s my overall message that we can all play a part, but realizing how powerful nature is as well.
Ari: Beautiful. Thank you much, Dr. Spector. One last thing, which is just where can people learn more from you, find out more about your work. The last time we did this, we talked about the Zoe app. I know you had a large influx of people from my audience signing up for the Zoe app, I heard lots of very excited people who were happy to receive their kit, and so on. I don’t know if you’re still doing that, but I wanted to just give you the floor to let people know if they can work with Zoe app in any way or I don’t know if it’s a [crosstalk] thing.
Dr. Spector: If you live in the US, all you got to do is go on the website, joinzoe.com and you can see the product and start getting your kit this week and get into personalized nutrition and become a citizen scientist. You can follow me on Twitter, Tim Spector, or Instagram, which is more for the diet, nutritional stuff. Twitter, at the moment, is all pretty much COVID and you can also look at my books on the gut microbiome and diet. Diet Myth is the one I’m making on the microbiome and my new book Spoon-Fed is about the food industry and personalized nutrition and both are now available in the US.
Ari: Beautiful I know we have another interview coming up in a couple of months when Spoon-Fed comes out and I look forward to that very much. Thank you Dr. Spector and thank you for the work that you’re doing, thank you for having the courage to speak out and challenge some of the prevailing common mainstream media narratives. I really appreciate the work you’re doing. Thank you so much.
Dr. Spector: My pleasure. Goodnight.
Show Notes
How the ZOE app has helped making an extensive COVID rapport (01:32)
How the actual data differs from governmental reporting (11:16)
The media’s critical role in how we perceive the current COVID situation (27:00)
The real stats on excess mortality (39:57)
How fear can be exploited to control the population (45:32)
Herd immunity – why it matters (48:17)
A new approach to COVID19 (1:00:50)
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