“One of the greatest gifts that you can give your children is the confidence that they can show up as who they are.“
Dr. Vivek H. Murthy served as the 19th Surgeon General of the United States from December 2014 to April 2017. As America’s Doctor, he called the nation’s attention to critical public health issues including the opioid epidemic, e-cigaretes and emotional health and wellbeing. Prior to serving in government, he conducted research on vaccine development and clinical trial participation and founded several organizations focused on HIV/AIDS education, rural health, physician advocacy and clinical trial optimization.
He is the author of Together: The Healing Power of Human Connection in a Sometimes Lonely World. After being sworn in, Dr. Murthy embarked on a listening tour to see what was affecting communities across the United States. He found that, regardless of occupation, location or economic status, there was an crisis of loneliness that was not being formally addressed. Anywhere from 22-50% of people suffer from loneliness, far more than the number of people currently living with diabetes.
Loneliness is more than just a “bad feeling.” It affects performance and puts people at higher risk for heart disease, depression and anxiety. It affects our ability to have healthy dialogue with one another. If you take this sense of inadequacy to your interactions with other people, the feeling compounds, as you’re preventing real, honest interaction.
On top of this, society isn’t set up to prevent disease. Proper nutrition, good rest, physical activity and social connection are the deciding factors in good long-term health, but our current system addresses problems after the fact.
LISTEN AND SUBSCRIBE
SPEAKER
Dr. Vivek Murthy
19th Surgeon General of the United States
MODERATOR
Anthony Scaramucci
Founder & Managing Partner
SkyBridge
EPISODE TRANSCRIPT
Joe Eletto: (00:07)
Hello everyone, welcome back to SALT Talks. My name is Joe Eletto and I'm the production manager of SALT, a global thought leadership forum and networking platform encompassing finance, technology, and politics. SALT Talks is a series of digital interviews with the world's foremost investors, creators and thinkers. Just as we do at our global SALT events, we aim to both empower big, important, ideas and provide our audience a window into the minds of subject matter experts. We are excited today to welcome Dr. Vivek Murthy to SALT Talks.
Joe Eletto: (00:39)
Dr. Murthy served as the 19th surgeon general of the United States from December 2014 to April 2017. As America's doctor, he called the nation's attention to critical public health issues including the opioid epidemic, e-cigarettes and emotional health and wellbeing. As the vice admiral of the United States' Public Health Service Commissioned Corps, he oversaw a uniformed service of 6600 offices dedicated to safeguarding the health of the nation. Prior to serving in government, he conducted research on vaccine development and clinical trial participation and founded several organizations focused on HIV/AIDS education, rural health, physician advocacy and clinical trial optimization.
Joe Eletto: (01:27)
He received his bachelors degree from Harvard and his MDE and MBA degrees from Yale. He completed his internal medicine residency at Brigham and Women's Hospital and Harvard Medical School, where he later joined the faculty. If you have any questions for Dr. Murthy during today's talk, please enter them in the Q&A box at the bottom of your Zoom screen, and now I'll turn it over to Anthony Scaramucci, the founder and managing partner of SkyBridge Capital, as well as the chairman of SALT, to conduct today's interview.
Anthony Scaramucci: (01:57)
Doctor, it's great to have you on, it's a big honor for us. I sort of start these interviews the same way, my traditional question, there's something about you that we cannot learn on Wikipedia or from your professional service, public service, et cetera, so tell us something about yourself that led you to where you are today that we cannot learn on Wikipedia.
Dr. Vivek Murthy: (02:24)
Well, there are a couple of things I'd mention. The first and foremost thing that led me here that isn't on my resume in any way, shape, or form, are my parents and my sister. I was brought up in an immigrant family, my parents traveled to the United States from India many years ago, and I was raised in Miami, Florida. We didn't have a whole lot in the way of resources or connections when we came here. There were a long time, things were pretty tight, had to be careful how much we spent in the grocery store, had to be mindful of how we lived our life. And I tell you, as a kid it was scary at times, I'll tell you that, but what I gained from my parents over those years were a core set of values that really have stuck with me throughout my life.
Dr. Vivek Murthy: (03:10)
A value for hard work, a value for people and community and investing in others, and a value for service, giving back to those who have helped you and even those who haven't, recognizing you could be in tough circumstances one day yourself. My parents did that not by giving me a book and telling me, "Memorize these three lessons and live by them", but they taught those lessons to me by living their life that way, and so they are the most important reason that I'm here today, and that's what I want to share with you today.
Anthony Scaramucci: (03:42)
Well, that's an amazing tribute to your parents doctor, are they still alive?
Dr. Vivek Murthy: (03:46)
Yeah, I'm grateful they're still with me. In fact, they're probably about 20 feet away from me right now, because during this quarantine my wife and my two small kids and I have been in Miami, which is where I grew up and my parents still are, so we've been living the extended family life and it's been chaotic but wonderful.
Anthony Scaramucci: (04:03)
Good for you. All right, so make sure you tell your mom that I live two miles from my mom and I've been doing her grocery shopping for the last six months, okay, I just want to make sure your mom knows that, I want to win some points with her before we continue the interview.
Dr. Vivek Murthy: (04:19)
She'll say you're a good son.
Anthony Scaramucci: (04:21)
Well, I hope so, I'm trying. I haven't been perfect but I've certainly tried. Earlier in the summer I purchased a book titled Together: The Healing Power of the Human Condition in a Sometimes Lonely World, and I got to tell you it's an amazing book. Very, very thoughtful book and I think you are making the connection which all of us need to make about the body and the mind, and how we handle stress and connect with each other, and how it helps us physiologically as well as our mental health. And so kudos to you, and obviously the book was very well timed, given the fact that all of us are in some level of home confinement. And I'm just wondering about, when you decided to write that book, why you decided to pick that genre, which I think is a fascinating genre, and what could we tell somebody here on this SALT Talk if that could tease them to get them go out and buy the book? Which I'm strongly recommending that they do.
Dr. Vivek Murthy: (05:27)
Well, thank you, Anthony. This is anything the book I thought I would write, to be honest with you. It's not the topic I thought I would focus on before I was surgeon general, but what happened to me, Anthony, is I began my time as surgeon general on a listening tour, traveling around the country asking people how I could help, and trying to understand a bit about what was going on in their lives. And what I heard were some stories that wouldn't surprise you.
Dr. Vivek Murthy: (05:51)
Stories of opioid addiction, of alcohol use disorders, I heard stories about violence in communities, about parents who were worried about their kids being depressed and anxious. I heard a lot of stories like that, but I also heard these stories I didn't expect, which were throughout so many of these tales of chronic disease, were these threads of loneliness where people would often say to me, not, "Hi, I'm Vivek, I'm lonely" or, "Hi, I'm Anthony, I'm lonely". They would say things like this, they would say, "I feel like I have to deal with all these difficulties and burdens on my own" or, "I feel if I disappear tomorrow, nobody would even care" or, "I feel invisible".
Dr. Vivek Murthy: (06:30)
And hearing that again and again, anything just from people who were old or living alone, but also from college students on college campuses, from members of congress, from CDOs, from people across the country, I realized there was something deeper happening here. And as I delved more into the subject, I realized that there was a lot of research on loneliness that told us it was more than just a bad feeling, but that it increased our risk for heart disease, for premature death, as well as for depression and anxiety. But it also affects our performance in school and in the workplace, and our ability to dialogue with each other.
Dr. Vivek Murthy: (07:05)
So if you're looking at the world today, if you pick up a newspaper, or if you go online to any news site and you scan through the topics that are being reported on, I guarantee you that you will find subjects that ultimately are driven in some way by loneliness and disconnection, whether that's political polarization, or challenges that our kids facing in school, or the litany of chronic illnesses that we're struggling with. So I know it's not a typical subject for a surgeon general to talk about, it's not tobacco, it's not physical activity, it's not the opioid crisis, all of which I've worked on, but it is, I think, a root cause issue that we have to address if we want to build stronger, healthier lives and a stronger, healthier society.
Anthony Scaramucci: (07:49)
So in addition doc, to the loneliness factor, what are some of the other things that you're worried about in terms of the public health. We'll get to the pandemic in a second, I'm more talking about the ethereal aspects of our health and our mental wellbeing, and what did you learn on that listening tour that you went on?
Dr. Vivek Murthy: (08:10)
Well, what I learned is that a lot of people are worried about their health and they're worried about the health of their families, and it's coming from a few different perspectives. One is, people are worried that if they get sick, they won't be able to get good care, either because they can't afford it, because they don't have insurance, or because the health care system itself is not built for them. And I would hear this particularly from minority groups who felt like we had real trust issues with the system, but I also heard from many people who were worried that the fundamental building blocks of health itself were often missing.
Dr. Vivek Murthy: (08:44)
When I think now about what is it that contributes to so much of the illness that I saw as a doctor over those years, it's a few fundamental building blocks. It's the food we eat, it's whether or not we get good rest, it's physical activity, do we get it or not? And it's social connection in our life as well. And if you think about it, as a doctor who went to medical school and residency and then worked for many years, I didn't learn a whole lot at all about how to optimize those building blocks in people's lives. I learned how to treat illness once it came about, but I think there are many people in this country who recognize that they'd much rather prevent a case of diabetes than get it and then deal with it.
Dr. Vivek Murthy: (09:24)
The challenge is, society doesn't seem to be set up to really do that for us, so if we want to truly build, Anthony, a healthier, stronger society, what we've got to do is focus on these four building blocks and ask ourselves, "How do we not only inform people about how to live a healthy life, but how do we actually enable them to do that? How do we make healthy food actually cheaper and more accessible? How do we make physical activity more part of our lives at work and school and in our neighborhoods? And how do we facilitate and strengthen social connection at a time where work and other priorities have overtaken our relationships?" And even though we all value people, we often find that our relationships and those we love are pushed increasingly to the side as second, third, and fourth order priorities.
Anthony Scaramucci: (10:10)
You mentioned something that you call the social recession. Tell us what that means, the social recession.
Dr. Vivek Murthy: (10:19)
Well, I was thinking about that in the context of what's happening right now, because in the context of... even before COVID 19 arrived on the scene, we were struggling with very high levels of loneliness. If you look at the United States and data from 2018, this is actually the more conservative data, I don't mean that politically, I mean that methodologically; those numbers put loneliness at about 22% of adults in the population who are struggling with loneliness. The real numbers are undoubtedly higher, but there are many surveys that have actually put that number closer to 50%, and some surveys, including a survey from Cigna, which have shown that the numbers are actually trending the wrong way, that they're increasing. To just put this in context, even if you take the lower number, 22% of adults struggle with loneliness, that's more than the number of adults who have diabetes, it's more than the number of adults who smoke.
Dr. Vivek Murthy: (11:09)
So we were struggling with a lot of loneliness before, and then comes COVID 19, and all of a sudden, at a time of extraordinary stress and uncertainty, a time by the way, when we typically reach out to people to help them deal with that stress, we find ourselves having to physically separate from one another and we can't connect the way we were used to. And that I think, for many people, has deepened their loneliness, so when I think about a social recession, I think about a period of time marked by deepening disconnection and loneliness. And if you understand the health, economic and political consequences of loneliness and you recognize the consequences of social recession, the price that we will pay, is just as important and comparable, I believe, to the economic headwinds that we're facing as a result of this pandemic.
Anthony Scaramucci: (11:55)
One last question before we get into the pandemic, because I think we would both agree to this, that loneliness, people are afraid to admit that they're lonely. They have a self-consciousness about it, makes them feel like it's something that reflects poorly on them if they're not surrounded by people, and we also get that from social media, there's pressure on us from social media, we see people... trust me, my kids are always taking the picture stuff with the best lighting and they're trying to frame it out. In the immortal words of my daughter Amelia, "It's either real life or social media, I choose social media". Unfortunately, I think there's a lot of truth in that. So what ends up happening is, if we feel lonely, we can't admit to it, and so therefore there's a bit of a stigma. So how do we break that down? What do you suggest people do?
Dr. Vivek Murthy: (12:49)
Well, that stigma's real, and I'll tell you that. Not only did I hear that in the people's stories around the country, but I've felt it myself, because I am someone who's also struggled with loneliness a lot over my life, particularly when I was a child in elementary school where the scariest part of the day for me was lunchtime, going into that cafeteria wondering if I was going to be alone. And at that time, I thought I was the only one who was experiencing that, and that's the real challenge with loneliness, is we look around us and we think, "I'm the only one who's struggling here, everyone else seems to have wonderful lives, especially if you look at their social media feeds". But the reality is actually quite different, we know now, based on real data, that people are in fact, all around us, struggling with loneliness.
Dr. Vivek Murthy: (13:29)
But there's another reason actually that we don't admit it, because in our society, we tend to live in an extroverted society where engaging and socializing, especially in large gatherings, has a premium to it. It says that we're popular, we're desirable, we're attractive, we're interesting. So I think the real challenge here, is how to admit to being alone in a society that always values being surrounded by others. And so when I think about what's driving loneliness today, whether it's for young people like Amelia, or whether it's for people of our generation or people older than us, I think there are a few key factors you have to recognize. One is, we're more mobile than we ever used to be, which is great, but it often means that we move away from communities that we've grown up with and come to know.
Dr. Vivek Murthy: (14:17)
The second factor is our technology. Technology I think is an extraordinary tool, I say that as somebody who built a technology company, who is a big fan of what tech can do for us, but I think how we use it is what makes the difference between whether we deepen our connections or dilute our connections. And I think the way in which we use social media now is predominantly geared toward ultimately hurting our social connection, because we spend so much time in front of screens we crowd out our time with people in person, and we also bring technology into our interactions, such that it distracts us when we're talking to other people.
Dr. Vivek Murthy: (14:52)
But for young people in particular, and I think about my kids a lot in this context and worry about their future, I think that social media also undermines their self esteem, because it's constantly telling them that they're not enough. You're looking at other people's perfect lives thinking you're not good enough, you're not popular enough, you're not thin enough, you're not buff enough, you're not whatever it is. And so when you constantly feel like you're not enough, you approach...
Anthony Scaramucci: (15:17)
Just so you know doc, Joe Eletto met every one of those criteria, he's thin enough, he's buff enough. I just want to make sure, there's three of us on this call, but Joe has made the criteria. But keep going document, I just wanted to make sure you knew that.
Dr. Vivek Murthy: (15:32)
Well sadly, not all of us can be Joe, but as we continue to work toward that, I think many people in society now, young people in particular, just walk around feeling like they're inadequate. And if you take that sense of inadequacy to your interactions with other people, what you find yourself doing instead of focusing on being yourself and just truly being present and listening to them, you're constantly thinking about how you're coming across, you're constantly trying to orchestrate and work the conversation and say the rights things so the other person thinks of you in a positive way, and when we're not ourself, we don't connect as deeply and as strongly.
Dr. Vivek Murthy: (16:07)
So if we think about all this together, we realize that loneliness didn't come about yesterday, it didn't start with this pandemic, it's been brewing for a long time. And if we want to address it, we've got to start with recognizing that all of us at some point in our lives have struggled with it and there's nothing to be ashamed of. And this is the last point I'll make about this thing, Anthony, in terms of why people shouldn't be ashamed of it, because let me ask you this; are you ashamed of being hungry, or thirsty? None of us are, we know that everybody feels hungry or thirsty at some point. We should think about loneliness as the same type of thing. It's a signal that our body sends us when we're lacking something we need for survival. It's something we've evolved to do, because when we were hunter gatherers thousands of years ago, our survival depended on being in trusted relationships, and when we were separated from our tribe it increased our vigilance, it pushed our focus inward because we were worried about safety, and it increased our overall stress level.
Dr. Vivek Murthy: (17:02)
If you transport that to 2020, Anthony, to the modern day, what you find is that our circumstances are different but our nervous systems are the same. And so we can think about loneliness not only as a signal that tells us we need more connection, but also as a source of stress, which in the short term can be beneficial, it can motivate us to pick up the phone or call a friend or get in the car and go and visit a relative, but in the long term, that stress has powerful and negative effects on our body, leading to physical and mental illness.
Anthony Scaramucci: (17:32)
Well I think it's very well said and I think we have to continue to have this conversation, because a lot of our illnesses of the mind are just that, they're illnesses. If I told you I had clogged arteries, god forbid, you'd put me on some medicine or exercise or whatever. Something wrong with my knee, we would take care of it. But when we have issues related to our mind, we are trapped somehow, we feel like there's a social stigma there which really doesn't need to be, so I really do appreciate all you're doing to make a difference in that area, because hopefully it'll lead people just to relax a little and be themselves and enjoy the authenticity of who they are. There were some in the White House, when I was there doc, that wanted me to care a little more about what other people thought of me, but what can I say? We did our time training at the Scaramucci house, just let me to be who I am. What can I tell you?
Dr. Vivek Murthy: (18:28)
Well listen, I'll just say, last thing on that, you said something really important there, which is being ourselves is not always easy in the modern world. And one of the greatest gifts that you can give your children, is to give them the confidence that they can show up as who they are, and that what matters most is not the approval of other people, but it's whether or not they're living up to their highest version of who they can be. Are they living up to their values? Look, I wrote this book, not because I wanted people to be depressed about how common loneliness was, but I wanted two things to happen; one is for people to recognize that they weren't alone, if they were lonely. But the second thing is, I wanted them to recognize that our social connections, our relationships with one another, are one of the most powerful resources we have for healing, for strengthening ourselves, for enhancing how we show up in the world, whether it's at school or work.
Dr. Vivek Murthy: (19:18)
And if I told you, Anthony, that I had a pill that could dramatically reduce your risk of heart disease and mental illness and that could boost your performance and could even enable you to dialogue better with people on the other side of the aisle and everything, I'd do really well if I sold that drug. People would be snapping it right up. The truth is, we have that power within us in the form of relationships, and what I want, and my fervent hope for not just the United States but for the entire world, is that we can recognize once again, that if we put people at the center of our lives, if we truly prioritize people in terms of where we spend our time, attention and energy, if we design our curricula in schools and our workplaces in ways that strengthen human connection, then we can not only come out healthier and stronger, but we can help people and or children will be much more fulfilled and happy than many of them are right now.
Anthony Scaramucci: (20:12)
Well, I think it's very well said, I'm glad that you took another moment to re-emphasize that for everybody. We get a lot of young people on this call, doc, and so I hope you guys are listening out there. Let me switch gears and talk a little about the pandemic, and then I'm going to turn it over to Joe because we've got a ton of questions piling up in the queue. I want to talk specifically about the disease for a second, about COVID 19. There's a lot of misconceptions about this disease; we were treating it differently in March and April than we're treating it today, so tell our listeners a little about that if you don't mind, and then tell us a little about these long haulers. What's your opinion there? And what is the long term prospects for them, frankly, in terms of their quality of life?
Dr. Vivek Murthy: (21:03)
It's a great question Anthony, this has been such a journey of discovery, a painful journey of discovery as we learn more about COVID 19 and have understood not just how it's affecting us here in the US, but have seen what's happening in other countries, and my hope is that we continue to learn from what's happening outside of our borders. But where we are right now is that we have, unfortunately in the United States, reached a very difficult point where we've lost over 200,000 lives, we have nearly 7 million people who are infected with COVID 19, and those are almost certainly dramatic underestimates in terms of the real numbers. We know what hurst the most though, Anthony, is that it didn't have to be this way, is that we had opportunities and still do have opportunities to curb the spread of COVID 19. Is there a scenario where we could have prevented anyone from getting sick or dying? I don't think so. I think this was inevitably going to effect some people's lives. But what has happened is it has spread on such a scale that I think it has caused so much more damage and fear and anxiety, and has led to economic pain in terms of prolonged shutdowns, and educational, terrible impacts in terms of school closures that didn't necessarily have to be as prolonged as they were. It is not too late though, to change that.
Dr. Vivek Murthy: (22:23)
I do think we know enough about how this virus spreads to put in place measures that can reduce spread, for example, we know now that masks are actually quite effective. Unfortunately, there's a lot of misinformation out there about masks, unfortunately we're not hearing consistent messages from our leaders in the country as well, which is unfortunate. But we do know that masks work, we know that distancing works, and the fact that we still have a lot of COVID does not mean that we can never resume our way of life. We can. There are safe ways for us to educate our kids and to resume certain types of work, we just have to have that coordination and the courage to have a clear plan and actually implement it. So all this to say that COVID is still an unfolding story, and my hope, despite the challenges we've had, is that we will muster a more science driven and effective approach, and that we'll communicate honestly and openly with people along the way.
Dr. Vivek Murthy: (23:20)
One of the things we have learned though, about COVID, which is really interesting and unfortunate, is that there are some people who have symptoms for a prolonged period of time. These are colloquially sometimes referred to as long haulers, so people whose symptoms don't go away in the first couple of weeks, but actually may last for many, many months. And those could be symptoms of fatigue, they could be general aches and pains, it could be a mental fog that some of them have described that they experience. We don't know enough to really know how commonly this occurs, or if it ultimately will peter out at some point, or if it will be something that will be with people for years. It's still something we have to understand.
Dr. Vivek Murthy: (23:59)
And that's why as we go through pandemics like this, investing in science and discovery and collaboration is so important. If we had learned from what was happening in Europe and Asia and actually implemented those lessons when COVID got to the US, we actually would have been much better off in terms of protecting our schools, in terms of protecting workplaces and ultimately, protecting people's lives.
Anthony Scaramucci: (24:23)
So you mentioned this brain fog, I just want to take one more question on this, there was an article this week, I think it was in the Wall Street Journal, talking about the blood vessels and the heart, and that there's some issues there. Is that permanent damage do you think, doc? Or is it something that we don't know.
Dr. Vivek Murthy: (24:44)
Unfortunately, we don't know, and there are two cardiovascular complications I think, that we have seen. One is myocarditis, which is an inflammation of the heart muscle itself. Interestingly, and somewhat disturbingly, that's something we've seen in young people as well, including in young athletes. There was an article published in the Journal of the American Medical Association of Cardiology recently, which it was a small study looking at a population of student athletes and found that both symptomatic and asymptomatic people who didn't have any symptoms, people who had COVID 19, that they both seemed to have evidence of inflammation of their heart. Now, is this consequential? Is it going to cause long term problems? We don't exactly know.
Dr. Vivek Murthy: (25:26)
But the other challenge that we found on a cardiovascular level is that many people with COVID 19 seem to develop blood clots in the hospital. These are people who tend to be severely ill, those clots have been noticed even when they've been on blood thinners. So what is it about COVID 19, the inflammation it creates, it seems to generate what's called a prothrombotic state, a state where we're prone to developing clots, again, is also unclear. But one thing is clear, the more we learn about COVID, the more we learn about how many organ systems are actually affected.
Dr. Vivek Murthy: (25:58)
In the beginning, we thought this was just about the lungs and then we realized that actually it can hit the nervous system, it can hit the cardiovascular system and it can affect your kidneys. And one by one, we started to realize, this virus is a lot more complicated. That's why it's important to be cautious, it's why we don't want to just say, "Okay, let's just let this virus run like wildfire through the population". Because not only will we lose many lives, and we've already seen that, but we will have many people who survive the virus but may have complications that they may live with for months and possibly for years.
Anthony Scaramucci: (26:32)
Well, I think it's a brilliant exposition of what is going on. We've got a ton of questions and we'd like to keep this thing tight, so I've got to turn it over to the very buff and in shape Joe Eletto. Go ahead Joseph.
Joe Eletto: (26:45)
Only because the gyms opened three weeks ago, but I had my mask on the entire time, I promise.
Anthony Scaramucci: (26:50)
By the way Joe, as an aside, I have to start complementing John Darsie otherwise we could have a [crosstalk 00:26:58]. Yeah I got to tell you, I got to boost, after what... this is our other co-host doc, after what you said about loneliness and stuff like that, I got to go pick this guy up. When I leave this call I'm going to FaceTime him and send him love, but go ahead Joe.
Joe Eletto: (27:13)
Good for you.
Anthony Scaramucci: (27:14)
Yeah, I got to do that now. I feel guilty about all my tweaking of him.
Joe Eletto: (27:20)
So turning back to social media just briefly, I want to ask; social media companies are under intense scrutiny for misinformation, and I went back through your tweets and you wrote out, "If social media companies can't police misinformation, they should shut down their platforms". I thought that's fantastic and I wanted you to elaborate on that, and considering the amount of people who makes important decisions based on what they read, potentially in an echo chamber, on their social media feeds, why aren't we approaching social media regulation as a public health issue?
Dr. Vivek Murthy: (27:59)
Yeah, well Joe, the reason that I believe this is so important is because so much of that misinformation people are getting is coming through social media, and it has real consequences. This is not a laughing matter, this is the kind of thing that makes people decide not to take vaccines that could save their lives and protect their children. This is the kind of misinformation that sends people to take medications that are unproven and they actually cause harm, but they're misled to think somehow they would be helpful, and we've seen that with COVID 19. And so the real question is, whose responsibility is it? And what I think is problematic is when social media companies say, "My job is just to create the platform, it's up to people to use it the way they do". That sounds good and fine, and that might even be in accordance with the letter of the law, but there's a higher responsibility that we all have to each other to create and build products and services that ultimately advance humanity and don't cause harm.
Dr. Vivek Murthy: (29:01)
And I think that in the vein of taking responsibility, I think that social media technology companies have a responsibility to police themselves, and if they can't police the harmful effects and mitigate the harmful effects that they are having on the population at large, then we have to seriously ask, "Is it okay for them to continue to function in the way that they're functioning?" We wouldn't do this, you wouldn't, for example, put a drug out onto the market and say, "It seems to help people, it's killing a whole lot of people, but it seems to help a few people so maybe we should just keep it up there and it's up to everyone to make up their own minds about whether they want to use it or not, and figure out whether the data's real or not". We wouldn't do that, because that doesn't make sense. Because we know it's actually exceedingly difficult to figure out whether a medication is safe or effective on their own. They need trusted sources to look at the data, to parse the science et cetera.
Dr. Vivek Murthy: (29:55)
Similarly, it's very hard these days for people to figure out on social media what's true and what's not. Things are so often not labeled, if they are labeled as false it's well after the fact, and the bar that many of these organizations have for taking action is often way, way too high. So that's where my concern comes from, I'm not thinking about anything other than, first and foremost, what is going to help protect the health and wellbeing of people around the country? And right now, social media has not made a good case that it's on the side of helping reduce pain, suffering and improve health.
Joe Eletto: (30:29)
Yeah, and continuing on from there, I mean talking about the forthcoming vaccine which hopefully we'll have some information on the efficacy of it by the end of the year, maybe next year, and do widespread distribution by the summer at best, is what Dr. Fauci is advising us. But relating to social media so we don't have to dive into any rhetoric coming from the White House, what are people going to do? We're reading things online that vaccines aren't safe, or maybe COVID will be not as rigorous, the vaccine for COVID won't be as rigorous. Governor Cuomo just came out today saying that New York state is going to have its own review process for a vaccine, so all of these conflicting messages don't really instill confidence in someone who might even be looking at a vaccine for the first time in their life. So I'm curious to see what your take is on how you would solve for that.
Dr. Vivek Murthy: (31:23)
It's the right question Joe, because it's on everyone's minds and especially as these clinical trials for the vaccines advance I think we're all hoping that we'll get a good vaccine trial result soon, and one that can hopefully deliver a safe and effective vaccine into our hands so we can start saving lives. That's the hope and everyone should be in favor of that. The challenge, and this is a bit of an unprecedented challenge that we're dealing with, Joe, is not that there are some people who don't believe in vaccines, that's been true for many years, but it's always been a very small percentage of the population. It seems a lot bigger than it is, but it's actually quite small.
Dr. Vivek Murthy: (31:59)
The part of the challenge that's unprecedented is, we've never been in a situation where there was so much distrust of what was coming out of the FDA and the administration, because in Republican and Democratic administrations in the past, when we had major outbreaks or pandemics, both Republican and Democratic presidents often came together around the science and they spoke with one voice, in terms of scientists and political leaders all speaking to what people needed to do, and they had a process that had integrity when it came to evaluating a vaccine. And that's really essential and I think they did that because they knew what was at stake. It wasn't just a current vaccine and illness, but they knew that if you compromised faith in a vaccine, that it would impact you for years to come, for future vaccines as well.
Dr. Vivek Murthy: (32:45)
And what we've unfortunately run into is a situation where because of, I think, a division, if you will, between what scientists are saying and what political leadership is saying, on a variety of things, not just vaccines but on masks, on hydroxychloroquine, on a range of other issues related to COVID, people are starting to wonder who's really telling the truth. And if the administration says the scientists are telling us that we should trust this vaccine, is that actually what the scientists are saying? I think that unfortunately for all those reasons you see what the Kaiser Family Foundation demonstrated a few weeks ago in its full, which is that 54% of Americans say that if a vaccine was available today for COVID 19, they would not take it. I mean, that is staggering, if you think about it. Because this is a pandemic that's turned all our lives upside down, we should all want a vaccine, but that speaks to how deep the mistrust is.
Dr. Vivek Murthy: (33:35)
So if we want to correct that, if we want to instill faith, we've got to do a couple of things; number one, the FDA has to lay out clear standards for what constitutes effectiveness and safety, and the second thing they have to do is ensure that we will hear from independent scientists on the advisory board as well as from the staff scientists at FDA, hear directly from them about what their take on the data is. And third, they've got to make the data actually available to the public so that scientists and the community can look at it, can assess it, can opine on it. Without those bars being met, it's going to be very hard for people to trust an administration that has repeatedly, unfortunately, shown a callous disregard for science.
Joe Eletto: (34:18)
And I want to, just as we're winding down, talk about the next three months going into 2021, what a potential post COVID world is going to look like. We've just hit a staggering milestone of 200,000 people who have passed as a result of COVID 19 and complications thereof, there are some projections that will take us now up to 400,000; what does the rest of the year look like? What does the [inaudible 00:34:45] start of the new year look like? And what sort of mitigation efforts would a Biden presidency bring in to restore faith in the FDA, restore faith in the NIH, the CDC, and how do we reeducate the American population about what the facts are behind COVID 19 and the science below it?
Dr. Vivek Murthy: (35:07)
This is a difficult time and the projections show that unless we take a different tack here to get this virus under control, we may lose up to another 178,000 lives by January 1st. This is according to the University of Washington Institute for Health Metrics and Evaluation. Those are staggering numbers, but I do think that we can do things differently, and overall, as sobering as the numbers are, I actually am optimistic that we can overcome COVID 19, because we actually know what to do. We have extraordinary scientists. We have learned a tremendous amount. We have amazing civil servants who are standing at the ready. What we just need is coordinated, clear leadership to help execute and to make the plans that are necessary. So I think what a Biden administration would hopefully do is, to number one recognize that you've got to step in here with strong leadership. And what does strong leadership do? Well, strong leaders lead by example. Ultimately they step up and fill gaps, they take a responsibility and they deliver results, and that's going to be more important now than ever.
Dr. Vivek Murthy: (36:13)
I think the second thing that a new administration would have to do is to rebuild trust, and the way that you rebuild trust is to ensure that you are letting science guide your decisions, but that you're also communicating openly and honestly with the public about where we are, where we need to go, and how we're going to get there. Part of that is allowing scientists to speak directly to the public, and you don't avoid letting scientists talk to the public unless you're worried about what they're going to say or not planning to follow their guidance. But again, we've got to speak with one voice.
Dr. Vivek Murthy: (36:46)
And I'd say the third thing that a new administration would need to do, which I know vice president Biden has spoken extensively about, is to lay out clear plans on our priority issues. Those being; how do we distribute a vaccine fairly and quickly? How do we ensure that we close the gap on testing where we still have shortages? How do we put forward, not just a plan, but the resources to open our schools? How do we provide the economic support for people who are hurting so they won't have to find ways to go back to work while putting themselves at risk, and they can in fact prioritize their health? And ultimately, how do we put forward clear guidance for families, for workplaces, for states and for schools, so people know what to do to keep themselves and their community safe?
Dr. Vivek Murthy: (37:28)
All of this is going to require good, strong partnerships. It's going to require federal government that's willing to step up and work closely with states and communities and organizations. It doesn't mean the federal government has to do everything, but what it means is that the federal government needs to have the courage to lead and not step back and allow others to take responsibility when things fall through. Because that is the definition of a leader, you step up to fill the gaps. Look, ultimately I think we can do this. The reason I think we can do this is because we have overcome great challenges in the past, we have dealt with major outbreaks, we have distributed vaccines to millions and millions in the population, we have done extraordinary things in public health. Have we done something at this scale and addressed a situation that was this urgent in the last century? No. So this will take actually America coming together in an extraordinary way.
Dr. Vivek Murthy: (38:19)
I lastly want to say this, which is as important as everything I've mentioned is, in terms of what government should do and what states should do; there is no way that we will overcome COVID 19 if as individuals we also don't step up to not only do the right thing in terms of safety, but to support one another. One thing that's giving me heart and hope during this time has been to see how many people have been stepping up in communities to support their neighbors, to look out for their family and friends and loved ones, to support strangers; I walk around my neighborhood in Miami and I see these signs that neighbors have put out thanking nurses and doctors and grocery store workers for putting themselves on the line so that others can be safe and taken care of.
Dr. Vivek Murthy: (39:01)
And there's something deep within each of us, a spirit of common concern and decency and compassion that I saw when I was surgeon general, as I had the privilege to visit communities across the country. That is ultimately what will sustain us during these difficult times, and I want us to recognize that, because it can be easy to feel like you're powerless during a time like this because you can't create a vaccine, you can't make the medicine, but I want us to know that the compassion, kindness and love that we wield, that we have inside of us as part of our birthright, that that is one of the most powerful medicines we have. I say that as somebody who has written many prescriptions for medicines over the years, but there's nothing more powerful than what love and compassion can do to help us heal and to make us strong during difficult times.
Joe Eletto: (39:47)
That's fantastic. It almost feels like the problem that we're living through, however terrible, could actually be a solution to the discord we're having between political parties, between people now, and coming out of this, we could see something of a coming together and a solving of that. But I want to thank you so much for coming on SALT Talks, Anthony, do you have any final words?
Anthony Scaramucci: (40:08)
Oh, doc, I appreciate it. I brought my mask for everybody, you see that, so I'm wearing it in your honor sir, okay. And I just hope that people will listen because this will save people's lives, and if you love your parents and they have comorbidities, you want to wear the mask. Now of course, you guys can't hear me through the mask, but I'm making the point visually, so let's keep it together and I really appreciate your time today...
Dr. Vivek Murthy: (40:35)
Of course, great to be with you Anthony.
Anthony Scaramucci: (40:37)
And hope to see you live at one of our events once when we can get back up and running.
Dr. Vivek Murthy: (40:42)
Thanks Anthony.
Anthony Scaramucci: (40:43)
Thank you.
Dr. Vivek Murthy: (40:43)
It's good to be with you and Joe, great to be with you and the team as well.