meals to people hit by crises and natural disasters around the world. that's it for today. have a great week and we will see you next fox news sunday. ♪ ♪ ♪ ♪ >> hello america this is life, liberty and event. i'm mark levin with two great guests tonight. doctor david katz, one of the first really point out a strategy that he felt would work best and doctor. [inaudible] first some background. you are the founding doctor at the research center, i don't

even know what all of that means but it sounds very impressive. i want the audience to know you're not one of these doctors we yank off the street. you have a bachelors degree from dartmouth and md from albert einstein college of medicine, masters of public health from yale school of public health, but that's not why i asked you to show up. i asked you to show up because you are a seminal piece in the new york times called is our fight against coronavirus worse than the disease. this is over a month ago. in part you said, and i want you to expand on this if you don't mind, help the country figure out how to get out of the situation. as we battle of coronavirus pandemic and heads of state declare we are at war with this contagion, we are have the same dichotomy that applies. open war with all the fallout

or something more surgical. the united states and much of the world so far have gone in for the former. i right now with a sense of urgency to make sure we consider the surgical approach while there's still time. and so now we know we have 22 million people, 22 million people since you wrote this who applied for unemployment insurance and thousands of businesses are going under and are shuttered. the clustering of complications among the elderly and chronically ill but not children, only very rare deaths in children suggest we could achieve social distancing, saving lives and not overwhelming our system by protecting the medically frail and those over the age of 60 and particularly over 70 and 80 from exposure. this is what you wrote over a month ago. it's now being repeated by others a month later. some are talking about it as a way of opening the economy again. first of all how did you come to the so early.

what was it in your brain that was triggered that said wait a minute this is too broad, we need to focus. >> marked my first well thank you for having me on. i think it's a native aptitude to see the big picture for 30 years i've been a clinician taking care of patients. i've also worked in public health. my focus has been on doing everything possible to add life to years. so, i'm trained in epidemiology, i understand potential for an infection like this to hurt people, to kill people, also trained in social security and unemployment and upheaval can translate into health

devastation. so at the very beginning of all this i was drawn to global data looking at data coming out of china and south korea, and it was apparent in the pattern, again that's what i'm trying to do is look at those pattern that there were these massive risk differentials that were people with very high risk of coronavirus and potential death and a much greater segment of the population that was at massively lower risk and if that was true then a one-size-fits-all strategy, essentially let's keep everybody away from everybody else and shut everything down had potential to hurt more people then it helped and it wasn't the only option. i used a military analogy of a surgical scrub rather than the open carnage of war and all the mayhem that can ensue so

essentially i was advocating a closer look at the risk groups. you mentioned in your introduction that we had many millions of people in the united states now laid off and businesses shuttered and going under we have about 30,000 deaths. if one of those people is a member of your family, the total number doesn't matter to you. this is a tragedy, a crisis we all need to respect that and take it very seriously. this infection can kill people but the fact that a thousand times more people are being affected by societal and economic disruption, that matters to. i was just looking at all the ways this can hurt people and all the ways we can prevent it.

it doesn't just mean preventing infection. it also means minimizing the fallout of social disruption. >> doctor, it seems so rational what you wrote and what you said now over a month later, it seems to be something that's embraced by a growing percentage of the population on how we get out of the situation were in which is becoming a situation of economic carnage. the unemployment rates we are seeing are rates of the great depression, the federal government is spending massive amounts of money, going deeply in debt and the money moves very quickly and they have to pass more and more. you're concerned about this but let's put things in context now. i'm curious to know what you think about this. heart disease kills 650,000 people every year. cancer called 600,000 people, accidents cal kill 170,000 people. lung disease 160,000 people.

stroke 146,000 people. alzheimer's 121,000 people. diabetes 84000 people. the flu and pneumonia associated 56000 people, suicide almost 50000 people. we've seen these numbers, these so-called models and data over the last six to eight weeks they have fluctuated wildly. millions might die then hundreds of thousands might dine out less than 60000 might die in the arguments that are being made by the public health officials that are advising all of us is well that's because of mitigation. that's not just because of mitigation, it's because the models and data will wrong. >> the models and data were certainly wrong because frankly we never have enough data and that's really important. those numbers you cite are

important and i'll circle back to the big picture again, but to be clear as we have this conversation i'm about to leave the next day for a stent as a physician volunteer at one of our beleaguered new york city hospitals, and that is a reality. i've been citing all those other numbers. i'm an expert at health promotion, i want people to know that poor diet kills half million people in the united states i want people to respect that and do something about it. i want people to know heart disease is almost completely preventable and that doesn't need to happen either. we need to respect those numbers. there is still a difference about an acute pandemic and that is its acuity. this fact that you get this concentration of cases of severe infection in one place at a time so it's not made up that we have overrun hospitals

and icus in new york, it's not made up that i've been asked to volunteer my clinical services, that doesn't usually happen, both of these things can be true at the same time so we absolutely can respect that a contagion like this, a pandemic like this imposes acute demands on the medical system and we have to be responsive to that. we have to try to mitigate spread among the vulnerable those most likely to need a hospital bed or icu bed. one of the things that seem to be fairly unique about coronavirus is the intensity of care it can required to get to recovery. people eventually do get out of intensive care but they spend the month on a ventilator. huge demand on the medical system. that's part is real but so are all those other numbers that are routinely neglected and frankly one of the reasons we may be vulnerable to a certain

mortality total is that we were fairly neglectful of the prior state and all those other things that were making us sick and killing us before also make us vulnerable so there is a big story to tell but if we circle back to the data issue because yes the projections are wrong, you really can't project what's going to happen if you don't have good data. there's been a major deficit in the data we need in order to generate good policy. for example mark, we've talked about the case fatality rate and that's the number of people who die from coronavirus divided by the total number infected. we don't have that denominator. we need it. we need to climb the data pyramid and know the total number of people exposed to this pathogen.

from that group we need to know who's developed immunities and made antibodies and then we can stack the tears of the pyramid. out of that group who was even sick enough to bother seeking medical attention because many people never do. many people have asymptomatic infection we need to know those numbers. out of that group how many need hospital or icu. out of that group how many die. if we do that and also ascertain the spread in various risk factors, age, sex, prior health, diabetes, although some were in a whole new place and we can start say wait a minute. >> wouldn't have to take a break and we come back i'll ask you this, we have 22 million people now unemployed and how many businesses that have gone under and not coming back. that number could get much, much worse in the next ten,

20, 30 days. so while i'm all for testing and testing everyone in getting all the exact data, what we do now? we'll be right back. to make america's tomorrow brighter.

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mark: welcome back. doctor katz, when i gather information we had better

information surely then we did a month ago, what do we do now? we have an economy in deep trouble, a lot of people are saying including me it's time to reopen it, we can do it in a responsible and thoughtful way, what do you say? >> yes, i don't disagree, and if there is a difference between the difference of a few days, when i say we need data, we don't need to do millions of tests, we need to do presented of random sampling. a small population representative of the state or u.s. i don't think anybody's going to argue this far into the crisis that the three days are going to be what make the difference for the economy, for unemployment, for people's health. i think hearing hey, this is what were doing for the next three days, gathering this data and were going to pivot the vertical interdiction. working a phase people back to life, back to the world as we know it. we could do that already. we already know all the people

at greater risk are people with heart disease and underlying conditions. there are low risk populations that can go back to the world. the more data we have on risks specific to america so were not borrowing data for iceland or germany, we say here in the u.s. these are the list of that we are seeing. the cdc does these random samplings all the time so get the data and then use the data to inform policy and say now week can rely on it on whose at lower risk and can go back to the world. one of the things we haven't talked about mark and it's really important is we've got to go back to the world if we want the world back before there's a vaccine which is 18 months away or two years away. we don't know. i just hope we can have it in 18 months but it could be much

longer. the only other way to get back to a world as we knew it is to develop herd immunity which is to admit that actually those of us with low risk infection actually need to get this and get over it to make antibodies. all of this should be data informed. anything we do now i argued yes we could pivot, phase people back to the world, that could start right away but we also ought to continue data as we go because ultimately i am a human, i want to make sure that the toll of this, every way that this can hurt people is minimized and the more we know the more we are forearm to descend against the way this can hurt people. >> let me underscore your point about herd immunity. i'd like to elaborate on that. exactly what is herd immunity. it's in your article and why is that very, very important for society? what is that all about. >> one of the things we are hearing about in the news is

singapore did so well now they're starting to have a resurgence in cases where south korea the same. if you lock everybody away from everybody else and kind of wait until everybody gets better, if the virus is still out there we don't have antibodies will just get it later. if all you do is flatten the curve, you don't prevent severe cases you just change the dates. we don't want to do that. how do you prevent that. we only have two options. one is a vaccine, scientists are doing the best they can but it's many months away. the other is herd immunity. the other is when people are prone to the milder versions of this infection get it, get over it. let's say i do that and you don't. i represent a roadblock on your behalf when it comes to coronavirus. if i have antibodies i can't get it, i can't give it to you so does doesn't matter if

you're vulnerable. paired when enough of us have made antibodies at the population level, there are enough dead ends that the virus just can't get through the population. it finds it harder to get through a host where it can survive and it dies out. that's herd immunity. the numbers of this that need to have antibodies vary with the properties of the given contagion and were learning what the properties are. that also needs to come from data, but it looks to me like that is the best way to get to a place where grandparents can once again hug their grandchildren, and i had 80-year-old parents. my mother doesn't want to get coronavirus and die, she also doesn't want to die of something else before ever again being able to hold hug her grandchildren because she still waiting for a vaccine. herd immunity gives us a much more possible way to get back to life in the world we know.

mark: so what you're saying, just to sum up from a pedestrian point of view we know the vulnerable populations, focus on them. we also know the vulnerable communities. in your article you're saying okay, fo focus on those particular area but the sooner the better we can get the rest of the population that is not statistically vulnerable but in fact gets us the virus, they become immune and then we spread basically that population throughout the rest of the population this is the quickest way to get rid of this virus or at least tamp it way down. >> we agree almost completely, the only thing i would append to that is that we know a lot of what we need but we don't know all of it and so we absolutely need to combine any policy actions with the continued effort to collect more data so we can be more

refined about it because again, the goal should be total harm minimization. the virus can hurt people, unemployment can hurt people, a people can hurt people. we want to minimize all of those across the economy, the better we know the better we can do that. we already have a lot of temptation about these risk differentials. facing people back into the world looks to me, as it did a month ago, the best way to minimize the total harm of this. mark: so there's a bagel place near me. our government here, virginia would say that's non- essential. while it's essential to that guy and his family was a south korean immigrant me tell you how he does business. he has a table in front of his door, you come up to the table, you'd never go inside

the store, you yell out what you want, he makes it, he wraps it in aluminum foil, you put your money in a bowl, he puts it on the table you're 6 feet away and you take your food. we don't need a lot of data to figure that out. i agree with you. but that said that's what makes america strong. a small business guy or gal they know they don't want to catch the stuff at least we should take some input from them and see what they do because all the answers are not centralized decision. i want to thank you very much. starting five weeks ago all the way up to today you've contributed enormously to public health and public knowledge in this country. >> we'll be right back. be surer before you begin an aspirin regimen.

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live from america's news headquarters, i'm ashley strohmeyer. president trump saying he will use the defense production act to increase output up to 10 million a month. governor cuomo says things are improving in new york with the number of deaths in the coronavirus fell to 507 down 33 from friday. he said it shows social

distancing practices are working. police report 13 are dead plus a shooter in the province of nova scotia. please say it all began last night when they entered a call for firearms violence and into this morning it ended with the suspect dead as well as a canadian. [inaudible] back to life, liberty and levin. for all your headlines log on to foxnews.com. >> welcome back america. we have a tremendous guest doctor john chloroquine. you are codirector of the research innovation center at health research and policy and of statistics. you are one of the most cited medical researchers ever come up professor of statistics at stanford university, you are a member of the u.s. national academy of medicine.

in research that you conducted, and others posted on april 8, you concluded that quote, based on the data until april 4 for the whole covid-19 fatality season to date, the risk of dying from the coronavirus is equivalent to the risk of driving 915 miles per hour ca by car. day. i have been saying and i look at your research that the numbers that were thrown around early on models that were not really made available, data which i didn't comprehend, maybe because it's not very solid, these huge numbers of millions of americans were going to die and hundreds of thousands are going to die, i could never find a real basis for these numbers and the media kept pushing on the monitors and the screen, every day, every

day and then wait a minute we don't have reliable data. tell me what was in your mind when you wrote this piece and tell me what you like. >> thank you for the kind invitation and an opportunity to answer these tough questions. i'm a question who's working with data and i'm also trained in infectious diseases so it was natural that when the covid-19 pandemic evolved, it became a top priority for me to understand what was going on. much like many other scientists i started looking at what information do we have available and how solid was that evidence that is guiding decisions that have monumental impact on saving lives and also potentially harming lives because the consequences of some of the measures. it became very obvious to me that the evidence that we had in the early phases of the pandemic was utterly unreliable. we had to base our decision on whatever we have, and i think

we did the right thing to act decisively and urgently. many of the numbers that were circulating were based on how many patients we were seeing who got tested and how many of those died. it was possible that there was just a tip of the iceberg, that many more could have been infected and actually there never documented because there never tested so the denominator might've been much larger. the original figures that were circulating and the ones that were circulating suggest that 3.4% of those people who we diagnose, we give them a label of covid-19.

we are making astronomical predictions about tens of millions of people dying around the world, 50 million people, 2.5 million people in the u.s. which of course would be a catastrophe that we have never witnessed before. however, that's not true. it is completely off. it is an astronomical air. over the last several weeks we have started accumulating data that show that indeed there is an iceberg, and we were just seeing the tip of the iceberg. there are far more people who are infected with this virus. the vast majority of them don't even realize they have been infected. they are asymptomatic, they have no symptoms or they have very mild symptoms that they would not even bother to do anything about. the best data that we have now suggests that it's not one out of 30 or one out of a hundred people that get infected, it's probably in the range of one and a thousand. we also know that there's some type of people who are at much higher risk than others, most

of the population has minimal risk in the range of dying while you're driving from home to work and back. however, very elderly individuals, people who have severe underlying diseases, in the hospital in particular or in nursing homes, there are studies and people that are very high risk and these settings and people we need to protect fiercely and do the best and save lives, however the original expectation that will be seen tens of millions of dying individuals, that's not happening. spiet mark: am a constitutional lawyer not a doctor there's a big gap between the two. you're saying well under a thousand, one tenth of 1% of the population that actually has the virus will pass away as a result of the virus or in connection to the virus? >> so this is also a good

question because for the data that we have a little bit more mature and detailed information like italy that has already gone through the peak of their epidemic wave, we realize that 99% of people who die with this virus have other reasons as well today. on average, they have close to three other reasons to die. they are 80 years old with other morbidities and there is quite some debate on whether these people would have died anyhow if not immediately perhaps in a few days or a few weeks or a few months. in our country, we see a fairly similar picture. we see that people who are disadvantaged, poor people creating even further inequality in the population through covid-19 seem to be very hard hit. we see that the age death is a

little bit lower than european countries in the range of 73 or 74 years old, and we see again lots of comorbidities and people who die with covid-19. it's very hard to say how many of these people would have died anyhow and how much is a direct contribution of the virus. these data are evolving, but if anything, they suggest that the burden of disease as we call it, the number of years lost, how many years of life are being lost is much less than even what the number of deaths we suggest. this is not to minimize the problem, it is a serious problem and we need to deal with that, and we need to protect these vulnerable individuals were actually among those who our society probably has not helped in the past so we need to do everything to protect them, but in the big picture the risk is much, much lower compared to what we saw before. >> i think you and a handful of other experts, doctor

katz of yale and so forth and your team have developed a growing consensus among experts and certainly among the people, take care of the vulnerable but let the rest of us go free. we have lives to live, we will be careful, we can mitigate, we will figure this out, but we are 22 million people who are unemployed. 22million. god knows where it's going to be next week and the week after that. we have some politician saying we are not going to open up our economies and our states until we have a vaccine or were not going to open up the economies in our state until every single case is resolved. i want to turn back to you when we come back, not about the politics, but is that even rational? we'll be right back. it may lead to a world of possibilities. entresto is a heart failure medicine prescribed by most cardiologists.

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you ever wish you weren't a motaur? sure. sometimes i wish i had legs like you. yeah, like a regular person. no. still half bike/half man, just the opposite.

oh, so the legs on the bottom and motorcycle on the top? yeah. yeah, i could see that. for those who were born to ride, there's progressive. mark: doctor ioannidis welcome

back. i'm interested about this medication issue. i can understand out of the gate all hands on deck and so forth and so on to appoint, advised that doctor fauci and others were giving, but i'm looking at it today and you've got a lot more data today and you all have the ability to really drill down on this data. my question to you is this. it has been said by doctor fauci and others that thanks to mitigation we been able to drop the numbers from 2.2 million potentially 240,000, 200,000 to 60000. i've been suggesting that might be partly true but it's also partly true that your numbers were never right. what is your response to that. >> i think it's very early to tell how effective are mitigation efforts have been. we have seen success stories in countries that follow different approaches to the

pandemic. some of them more restrictive than others a bit more liberal and less restrictive in terms of how fiercely they adopted social distancing and lockdown measures. i think we have to be very cautious but it is unavoidable that we should try to reopen our world and i think we should do that pretty soon as we see the epidemic wav waves receding and the number of hospital beds required are going down rather than up, number of new cases is going down and deaths doesn't seem to be skyrocketing. if anything at stabilizing and going down as well. we cannot really keep our society lockdown forever. we seek tremendous consequences not just on the economy, the economy when it is melting down society is destroyed and lives are killed. i think that if you consider the burden of increased suicide, the burden of increased cardiovascular disease and cancer that you get from economic meltdown,

the fact that people don't get the medical care that they need for every other disease, people are not going to the hospital because they're afraid, you have severe consequences and far more lives that might be lost compared to what coronavirus itself might do so, we need to start dialing back and we need to do that cautiously. now we have data, we have data on seroprevalence, how common it is, how active the epidemic wave has been and how that is evolving over time as we are dialing back some of the measures that we have taken. several countries have started doing that, austria, denmark, even italy that was so severely hit has started reopening some of their shops and businesses. i'm not saying it's going to be easy, we have to be very watchful, we have to be very careful, nobody knows which one of the measures that we took had a major impact or no impact at all or perhaps was even harmful.

as we dial back and we remove some of these measures we have to watch very carefully, but i think that optimism is warranted that we will do well. elective surgery, i've never understood what that means. mark: sometimes if you don't have elective surgery the outcome can be disastrous. elective surgery we said, when i can have electiv elective surgery so maybe someone needs a heart procedure or other critical procedure and they're not getting it. we have any data yet on the health fallout from the almost myopic focus on this virus and the panic panoply of other virus and diseases that have claim second-tier. >> we have seen some evidence this could become a disaster. people who have a heart attack or stroke need to go to the hospital to get care and if there afraid and they do not

show up, then we will have far more deaths compared to what coronavirus might be doing at the moment. also, many of the procedures that are essential for handling medical conditions of different kind have been postponed, kind of said with an open horizon, and we know that for many of them the timing on when you have the procedure and when you have medical care could be influential in having the best possible outcome. i think that we should encourage people to take care for medical conditions that are not related to covid-19, and we should refocus our health system in trying to take care of these people because they are the majority of the health risk and health burden. at the same time we should give a strong message to individuals who have symptoms that are suggested of covid-19, not to go to the hospital unless they are very sick. the one situation where covid-19 does create disaster is when you have people who

have flocked to the hospitals massively with minor symptoms that would not have the need to have hospital care, then you have the hospital environment being infected, you have physicians and nurses being affected, they infect other people, and then you have what we call a nosocomial infection, it spreads within the hospital and is killing vulnerable people at the hospital. not patients with covid-19 but others that did not have covid-19 and then they get infected. this we need to avoid, but at the same time we need to make sure that we offer the best care to americans and to citizens all over the world who do not get the best medical care because of the fear and panic of covid-19. >> all right. we'll be right back. it kills weeds, prevents crabgrass and feeds so grass can thrive, guaranteed. get everything you need for spring at scotts.com order today.

mark: welcome back doctor ioannidis. first question is this. i looked at the official government form that they're giving the hospital and the doctors to fill out and how to cold them. at the very end i said, it said when in doubt put coronavirus. if you don't know but they seem to have the symptom put

coronavirus. then you have this happening thousands of times a day, different hospitals and so forth, at least a hundred times a day, are you concerned about that number is not so hard one way or another. >> i think there is a serious concern that the number of deaths is overestimated because of that practice. of course we would have to wait until that epidemic wave passes and we have the ability to scrutinize very carefully these deaths and the circumstances that happened and what other diseases these people have and what other reason they had to die. i think it's fine to document that there is suspicion of covid-19 infection, but this by no means documents that these people died to specifically and only because of covid-19. mark: do you think it's a service to the public, and i mean this in all honesty, when you look on a television screen there is a monitor and we have these constant

numbers, like it's some kind of hockey game or something, the number of people confirmed that have the virus and then the number of deaths when in fact we don't know how many people have this virus at all, and the death number is also in doubt one way or another. do you think that's helpful for the public mindset? >> i think it is helpful to have data, provid provided those data are reliable and we need to provide reliable data to the public in order to think carefully about what is at stake, what we are doing, where we are heading and what we should do next. i think it's important to add the proper caveat to every piece of evidence that we disseminate to the public. for example the number of cases is vastly underestimated based on evidence that we have currently we know that we need to increase this number by 20 fold or 100 fold in different locations. we also know that possibly the number of deaths is

overestimated and we need to convey that message to the public. we need to avoid fear. knowledge would help us diminish fear, it would help us think rationally, it would help us move to the next step and hopefully get over this ordeal. mark: all right, so the next step, open the economy to the extent we can or not? >> i think it's unavoidable that we should try to reopen our world. we need to save lives by reopening our world, because as we said, we will have major consequences on a number of fronts that affect severely our health. this cannot be done overnight. it has to be done with gradual steps. there are lots of measures we can try to dial back in terms of reopening schools, opening some businesses, gradually allowing people a bit more mobility and allowing them to meet in small numbers. obviously i would never recommend that we start having full attendance at baseball

games and soccer matches or the meeting of the american heart association with 50000 people attending. that is not something that is on the table, but there is so much that we can do, and we can do pretty fast with continued speed back on how is the epidemic involving while we are doing this. we have more cases, fewer cases? how is our hospital capacity in different locations? are we at full capacity or having empty hospitals? as you realize you have to have some precautions taken at a national level and others that may need to be fine-tuned at a local level because different places in the country, much like different places around the world are hit to a different extent and they have different hospital bed capacity and different circumstances. mark: doctor, i want to thank you for all your research. you have contributed to the public's knowledge and i think no matter how we will get there. doctor john ioannidis, you are my friend.

we'll be rightd. back. so try making it smaller, and you'll be surprised at how easily starting small can lead to something big. start stopping with nicorette.