The Peter Attia Drive

In this episode, infectious disease and pandemic preparedness expert, Amesh Adalja, M.D., puts the current pandemic into context against previous coronaviruses as well as past influenza pandemics. Amesh also provides his interpretation of the evolving metrics which have contributed to big variations in modeling predictions, whether this will be a seasonally recurring virus, and perhaps most importantly—how we can be better prepared for the inevitable future novel virus. Finally, Amesh explains where he sees positive trends which give him reasons for optimism.

We discuss:

• Amesh's background in infectious disease [2:40];
• When did the virus actually reach the US? And when did Amesh realize it would pose a real threat to the US? [4:00];
• Comparing and contrasting COVID-19 to previous pandemics like the Asian flu of 1958 and the Spanish flu of 1918 [8:00];
• Will COVID-19 be a recurring seasonal virus every year? [14:00];
• Will a future vaccine be specific to this COVID-19 or will it also cover previous coronaviruses as well? [15:15];
• What does Amesh think might be the true case fatality rate of SARS-CoV-2? [16:15];
• Why did early models over predict infections and deaths by order of millions? [18:30];
• Role of government—How does Amesh view the role of local versus central government in dealing with a future pandemic? [21:50];
• What went wrong with testing and how could we have utilized it more effectively? [25:15];
• Future pandemic preparedness—why Amesh is cautiously optimistic [27:30];
• Should there be different policies and restrictions for places like New York City compared to less populated and less affected places across the US? [30:15];
• Why mass gatherings might be disproportionately driving the spread of the virus [32:30];
• Learning from HKU1, a lesser-known novel coronavirus from 2005 [34:00];
• Thoughts on Sweden's herd immunity approach [36:10];
• The efficacy of masks being worn in public and what role they will play as restrictions are slowly lifted [37:20];
• What are some positive trends and signs of optimism? [39:15]; and
• More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ameshadalja Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

In this episode, psychiatrist Paul Conti, M.D. discusses the impact of the fear and uncertainty surrounding the COVID-19 pandemic and the resulting stress, anxiety, and trauma it may impart on the population. Paul examines how this situation has highlighted the challenges we face at the societal level as well as the individual level, and stresses the importance of seeking absolute truth above personal truth and taking action as individuals as a means to combat many of these pervasive problems. We discuss:

• Paul's personal experience with a presumptive case of COVID-19 [2:15];
• Through the lens of trauma, Paul's overall take on the lasting effects of this pandemic on society [4:30];
• The imperative to unite as a species given the isolating and suspicious nature of an invisible enemy [8:15];
• The indigent population and the affluent population—The commonalities and differences in how both populations have been affected [16:15];
• The prevailing feeling of demoralization spanning the population [25:30];
• Health care workers—What lingering psychological effects might they suffer from this? [35:00];
• Could this pandemic be a catalyst for changing the way people think about science, truth, and logic? [46:30];
• How our inability to deal with uncertainty exacerbates the problem, and the need for humility [58:00];
• What has been Paul's recipe for self care during this time? [1:06:45];
• The forthcoming challenge of reintegrating back into the world when the quarantines lift [1:14:45];
• An urgent need for change which must come through individuals seeking absolute truth and taking action [1:19:15]; and
• More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/paulconti2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

In this episode, Peter sits down with his daughter to answer questions from her and other kids about COVID-19.

We discuss:

• What is a virus? [1:45];
• How did this version of coronavirus (SARS-CoV-2) start? [4:30];
• How does COVID-19 compare to SARS and MERS (previous coronaviruses)? [6:00];
• Will COVID-19 come back again after we resolve the current issue? [7:15];
• When will kids go back to school? [7:45];
• How has the US surpassed China in total cases, and how could we have been better prepared for this? [8:30];
• Should have we started to quarantine sooner than we actually did? [11:45];
• What about herd immunity? Would it be easier if we all just got the virus so we could be immune? [13:45];
• Which age groups are the least and most at risk for getting a deadly version of the virus? [15:00];
• Why do we have to wipe down packages that are delivered to our homes? [16:30];
• How a lack of preparation and discipline led to this troubling situation [18:45];
• Is China to blame for all of this? [24:15];
• What did Olivia think when her parents pulled her out of school before it was mandated? [26:30];
• What's been the hardest part of this for Olivia? [27:50];
• What does Olivia appreciate now that she probably didn't appreciate in the past? [28:50];
• How are Olivia's zone 2 workouts going? [30:00]; and
• More

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/covid-19-for-kids Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

In this episode, originally recorded to be the 100th episode of The Drive, Peter discusses topics that he has changed his mind about since starting the podcast as a result of preparing for interviews as well as from the actual conversations. Peter also reviews some of his favorite moments from the first 99 episodes, shares what books he's currently reading, and much more. Initially scheduled to be released as episode 100, this was delayed due to recent podcasts covering COVID-19.

We discuss:

• Definition of "strong convictions loosely held," and the value in trying to shoot down your own hypotheses [2:20];
• Metformin—How Peter's strong convictions have changed since 2018 [8:00];
• Getting a dog—Why Peter caved and how it's going so far [15:45];
• Rapamycin—How Peter's feelings have evolved, and the questions still needing to be answered [20:45];
• Archery, the joy of pursuing mastery, and the importance of stillness [26:50];
• Zone 2 training—Why Peter has made it a big component of his exercise regimen [37:30];
• Deadlifts—Why Peter now believes it's extremely beneficial to longevity when done properly [41:45];
• Read any good books lately? [50:00];
• Baby aspirin for preventing blood clotting—Why Peter no longer takes it, and a few alternative options [53:15];
• Generic drugs—How and why Peter's mind has shifted on generic drugs [55:45];
• Omega-3 fatty acids, EPA and DHA—How Peter's long-held views have changed [58:15];
• How Peter got better at saying "no" [1:02:30];
• Does Peter have any favorite episodes of The Drive? [1:07:15]; and
• More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/strong-convictions-loosely-held Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

In this episode, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and author of Deadliest Enemy: Our War Against Killer Germs, provides an overview on the COVID-19 pandemic in regards to what has happened to date, what we've learned about how the disease spreads, and his optimism and pessimism about what potentially lies ahead. Michael gives his take on the true case fatality rate, why it differs around the world, and which underlying conditions, such as obesity, impact risk of severe illness and death. We also discuss the outlook regarding vaccines, repurposed drugs/antivirals for treatment, and Michael's growing concern about supply chain limitations with respect to drugs, vaccines, n95 masks, and testing kits. We discuss:

• Recapping the brief history of COVID-19 and what potentially lies ahead [2:15];
• Some positive news about immunity and reinfection [10:45];
• Case fatality rate—The challenge in finding the true rate, difference by country, and the impact of age, underlying conditions, and obesity [13:00];
• What has to be true for less than 100,000 Americans to die from COVID-19? [24:30];
• How do we best protect healthcare workers? [29:45];
• Concerns about testing capability—Reagent shortfall and a supply chain problem [39:30];
• Vaccines and antivirals—The outlook, timing, and challenges [47:45];
• Long term health of survivors of COVID-19 [56:45];
• The impact of comorbidities—Diabetes, obesity, and immunosuppressed patients [59:30];
• Understanding R0 and how the disease spreads [1:01:30];
• The challenge of forecasting with so many unknown [1:08:00];
• What explains the difference in cases and fatalities in different parts of the world? [1:14:30];
• Repurposed drugs/antivirals being considered for treatment options—any optimism? [1:16:45];
• A parting message from Michael about what lies ahead [1:18:30]; and
• More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/michaelosterholm Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

Ryan Holiday, bestselling author and author of Daily Stoic, discusses practical ways to find stillness and apply the insights of stoic philosophy in the midst of COVID-19 chaos. Ryan discusses the importance of taking back a feeling of control, the benefits of structure and routine, and the idea of being prepared for anything. We discuss:

• Using times of adversity to evaluate and reflect how you've set up and prioritized your life [2:30];
• What insights might the famous stoics provide amidst this COVID-19 pandemic? [8:15];
• The possible consequences of the socially isolating nature of a pandemic (and why we need good leaders) [13:00];
• Stoicism—what it means and how to apply it [18:45];
• Lessons taken from the life of Winston Churchill—stillness, structure, routine, hobbies, empathy, forward thinking, and more [23:30];
• Alive time vs. dead time—taking control of your time and making it count [38:45];
• Auditing how the world (and its leaders) are handling the COVID-19 pandemic through the lens of stoic philosophy [44:15];
• Asserting control and using routine to find stillness in an environment not conducive for it [52:15];
• Why you should find a way to exercise, especially now [58:30];
• How to find purpose during this time—goal setting, having a project to work on, and the benefits of keeping a journal [1:02:00];
• What is Ryan most optimistic about and what is he most concerned about over the next few months? [1:08:45];
• How can you follow Ryan's work and messages about stoicism and stillness? [1:17:45].
• And more.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/ryanholiday2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

In this episode, Sam Harris, neuroscientist, author, and host of the Making Sense Podcast, joins Peter to discuss this unprecedented coronavirus (COVID-19) crisis. The discussion includes the important distinction between COVID-19 and influenza, the impact on the economy, the dire situation in New York, and the challenge of creating a safe and effective vaccine. Additionally, Sam brings insights from his extensive meditation practice to help those struggling with stress, anxiety, and fear in this extraordinary situation. We discuss:

• A time unlike any other—why many people don't seem to fully grasp the magnitude of this situation [2:00];
• Why comparing COVID-19 to influenza is a bad analogy [10:45]
• The impact on the economy of measures like shelter-in-place—Is the "cure" worse than the disease? [16:45];
• Why are some places, like New York, getting hit so much worse? [24:45];
• The trickle down effect of an overrun healthcare system on non-COVID-19 related health issues [34:45];
• How to calm our minds and manage our emotions during this craziness [38:00];
• Talking to kids about this situation without burdening them with undue stress [50:15];
• Insights from meditation practice—Recognize and unhook yourself from a heightened emotional state [52:00];
• How to make the most of a situation where you let your emotions get the best of you [59:15];
• What are some potential positive things that Sam hopes could be learned from this crisis and applied to the future? [1:09:30];
• The unfortunate politics being layered on top of this crisis [1:15:30];
• The challenge of creating a safe and effective vaccine for COVID-19 [1:20:00]; and
• More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/samharris2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

In this episode, Dr. Peter Hotez M.D., Ph.D., Dean for the National School of Tropical Medicine Baylor College of Medicine, returns to continue the conversation on COVID-19. Dr. Hotez informs us on how we can gauge the number of infected people, behaviors to reduce the probability of becoming infected, and the inconsistency of hospitalizations among young adults between different countries. Dr. Hotez underscores the continued uncertainty in many virus-related developments, but ends with some points of optimism. Disclaimer: This is information accurate as of March 19, 2020, when it was recorded.

We discuss:

• • How to gauge true number of infected people [5:45]
  • Reducing the probability of getting infected [22:45]
  • Inconsistency by country in infected young people [27:15]
  • Conferred immunity, seasonality, and repurposed therapeutics [30:30]
  • Vaccine development [39:30]
  • Practical behaviors to reduce risk of transmission [46:00]
  • Mental Health resource and funding [51:00]
  • Points of optimism [56:00]; and
  • More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/peterhotez-2 Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.

Today's episode of The Qualys is from podcast #47 – Matthew Walker, Ph.D., on sleep – Part I of III: Dangers of poor sleep, Alzheimer's risk, mental health, memory consolidation, and more.

The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for "qualifying round," which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., "fast"), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive.

Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now.

Learn more: https://peterattiamd.com/podcast/qualys/

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In this episode, Dr. Peter Hotez M.D., Ph.D., Dean for the National School of Tropical Medicine Baylor College of Medicine, shares his expertise on viral disease and how it applies specifically to the coronavirus disease (COVID-19) and the virus that causes it (SARS-CoV-2). Dr. Hotez informs us about the current state of disease progression, which has many unknowns, but has thus far been greatly determined by the delayed response time and lack of testing. Moreover, we discuss what we can do on a country, state, community, and individual level in order to collectively slow transmission of the disease. He shares with us a potential hope in convalescent plasma therapy and underscores the need for US federal involvement - particularly in the creation of a specialty task force to address areas of concern and unknowns.

Disclaimer: This is information accurate as of March 13, 2020, when it was recorded. We discuss:

• The disease and the virus: transmissibility and lethality [04:30];
• Disease transmission: US playing catch-up [12:00];
• Convalescent plasma coronavirus therapy [16:00];
• Remdesivir drug treatment and vaccination challenges [19:45];
• Disease mechanism and reported pathology [27:45];
• Most concerning geographic regions in the US [39:00];
• Risk reduction [46:30]; and
• More.

Learn more: https://peterattiamd.com/ Show notes page for this episode: https://peterattiamd.com/peterhotez Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on Facebook | Twitter | Instagram.