♪ 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 i have two great guests tonight, doctor david katz, one of the first to point out the strategy he thought would work best and doctor ioannidis will be our second guest. before we get to doctor ioannidis let's talk to doctor katz. first some background. you're the founding director of the research center, and mv mpa facp m, sa cp lmn, i don't

even know what that means but it sounds very impressive. i just want the audience to know you're not one of these doctors we yank off the streets here. you have a bachelors degree from dartmouth, an md from albert i'm seeing college of medicine and a masters from yale school of public health, but that's not why i asked you to show up today. i asked you to show up because you wrote really a seminal piece in the new york times dcalled is our fight against coronavirus worse than the disease. this was over a month ago. indo part you said, and i want you to expand on this if you don't mind, and help the tountry figure out how to get out of the situation. as we battle the coronavirus pandemic and heads of statete declare that we are at war with this contagion, you wrote the same dichotomy applies. the united states and much of the world have gone in for the

former. we have to make sure we consider the surgical approach while there is still time. now we know we have 22 million people since you wrote this who applied for unemployment insurance and thousands of businesses are going under and are shuttered. you said the clustering of complications from covert 19 among the elderly and chronically ill, but not children, only rare death in children suggests we could achieve the social distancing save lives and not overwhelm our medical system by protecting the medically frail and those over age 60 and 70 and 80 from exposure. this is what you wrote over a month ago. this is now something that is being repeated by others a month later. first of all, how did you come to this so early. what was it in your brain that

was triggered and said wait a minute this is too broad and we need to focus. >> first of all, thank you for having me on. i think it's the native aptitude to see the big picture and nothing more than that. for 30 years i've been a clinician taking care patients, i've also worked in public health, and my focus has been on doing everything possible to add life to years. that obligates a view of the big picture, the forest through the trees if you will so i am trained in epidemiology and i know the potential for an infection like this to hurt people and kill people. also trained in the deterrence of social upheaval and how that can translate into health

devastation so at the very beginning of all this, i was drawn to global data and looking at data coming out of china and south korea and it was apparent in the patterns, that's what i'm trying to do, that there were these massive risks, people at very high risk with severe infection from coronavirus and potential death and there appeared to be a much greater segmentnt of the population that was at massively low risk and if that was true then a one-size-fits-all strategy, essentially let's keep everybody away from everybody else, shutut everything down had potential to hurt more people than it helped and it wasn't the only option. again i use the military analogy of a a surgical strike versus the open carnage of war and collateral damage in all the mayhem that can ensue. essentially i was advocating a

closer look at the risk. who is at risk for severe infection. you just mentioned in your introduction that we have many millions of people in the united states now laid off and businesses shuttered and businesses going under, and 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. it's a tragedy, a crisis we all need to respect that and take it very seriously. this can kill people, but the fact that a thousand times as many people are being affected by economic upheaval and societal disruption, that matters two. i was just looking at what are all the ways this can hurt people and what are all the ways we can prevent that bad and that good and that doesn't just mean preventing and

infection, it also means minimizing the fallout of social destruction. >> it seems so rational what you wrote then, now over a month later and it seems to be something that's embraced by a growing percentage of the population on how we get out of the situation we are in which is becoming a situation of economic carnage, quite frankly. the unemployment rates we are seeing are those of the great depression. the federal government is spending massive amounts of money going deeply in debt and the money just moves very quickly and they need to pass more and more.nt you're concerned about that, but let's put things in context now. i'd be curious to know what you think about this. heart disease every year kills 650,000 people. cancer kills 600,000 people. accidents of all kind kill 170,000 people. chronic lower respiratory

disease, 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 see these numbers, these so-called models in the data, they have fluctuated wildly, millions might die, hundreds of thousands might die, now they're saying 60000, give or take maybe less than 60000 and the argument that's being made by the officials, the public health officials that are advising all of us is because of mitigation. that's not just because of mitigation, is it because the models in the data were wrong. >> the models and data were certainly wrong because frankly we never had enough and that's really important in all circle back to them in the

big picture, but to be clear, as we have this conversation, i'm about to leave the next day for a stint as a physician volunteer at one of the beleaguered hospitals. that is a reality. i've been citing all those other numbers. i'm in the expert in disease prevention. i want people to know that poor diet kill half million people in the united states every year. i want people to respect that and do something about that. i want people to know that heart disease is almost completely preventable and as you say kills 650,000 people, 800 people a day. we need to respect those numbers two. there is still something different about r an acute pandemic and it's the acuity, these cases of severe infection in a time that's not made up that we have overrun

hospitals and 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. we have to accept that a contagion like this imposes acute demand on the medical system and we have to be responsive to that. we have to try to mitigate spread among the vulnerable, the people most likely to wind up needing a hospital bed, one of the things that seems to be fairly unique about coronavirus is the intensity of care it can required to get to recovery. people who eventually do get out ofofov intensive care spenda month on a ventilator. a huge demand on the medical system. that parts real but so are all those other numbers that i hide in plain sight and are routinely neglected and frankly one of the reasons we may be vulnerable to a certain mortality poll from

coronavirus in the united states is that we wereta fairly neglectful of the prior state of health, all these other things that were making us sick and killing us before also make us more acutely vulnerable. there's a big story to tell there. but if we circle back to the t data issue because yes, the projections are wrong, you really can't project what's going to happen if you don't have good intelligence or good data. there has been a major major deficit in the data we need in order to generate good policy. for example we talked about the fatality rate, the number of people who died from coronavirus relative to the denominator, the total number of people who are infected in the first place. we don't have that denominator. we need it. i madeto a recent statement that we need to know the total number of people who have been exposed those who have been affected with or without symptoms, whose developed

antibodies and wh how can we stack those pyramids out of that group, who was sick enough to even bother seeking medical attention because it looks like many people have symptoms.ic if we do that and also ascertain the various risk factors, age, sex, prior health data, diabetes, all the sudden we are in a whole new place and we can start say wait a minute. mark: organ have to take a break here and when we come back doctor, i will ask you this, wek have 22 million people now who are unemployed and god knows how many businesses that have gone under and are not coming back. that number could get much, much worse in the next ten, 20, 30 days. and so i'm all for testing and

testing everyone in getting the exact data, what do we do? we'll be right back. triple acti. it kills weeds, prevents crabgrass triple acti. and feeds so grass can thrive, guaranteed. get everything you need for spring at scotts.com order today. working day in, day out.e. at&t is here. providing support with advanced services for first responders. and connected temporary hospitals, mobile testing sites and emergency management centers. because until their job is done, it is essential that we all have their backs.

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and no credit check on the first two lines. get a $50 prepaid card when you switch. it's the most reliable wireless network. and it could save you hundreds. xfinity mobile. 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. at papa john's, we want you to know that from our 450-degree oven, to box, to you, it's our policy that your pizza is never touched once it comes out of the oven. and we're taking extra steps, like no contact delivery, to ensure it.

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witpeople at higher riskng, must take extra precautions. you are at higher risk if you are over 65, or if you have an underlying medical condition. please visit coronavirus.gov for more information. live from america's news headquarters, the death toll from the coronavirus is getting close to 41000 people here in the u.s. president trump says more than 4 million americans have been tested for coronavirus so far. that's more than ten other countries combined. andrew romo reports things are getting better in new york. the number of deaths fell to 507 down 33 on friday. they show social distancing practices are working. 17 people are now reported

dead in canada reported a suspected gunman in the country's worst mass shooting ever. the rampage started last night and ended this morning three towns away. investigators have not determined a motive yet. the data includes a 23-year-old veteran of the canadian force. she leaves behind two children. now back to life, liberty and levin.om mark: welcome back america, we have a tremendous guest doctor john ioannidis. welcome. you are codirector of the research innovation center at stanford university. the professor of medicine of health reach search and policy, and you are one of the most cited medical researchers ever, professor of statistics at stanford university, member of the u.s. national academy ofof medicine. research that you conducted

and to others posted on april 8, you concluded that quote, based on the data until april 4 for the whole covid-19 fatality season, the risk of dying of a person 65 years old is equivalent to the risk of driving a distance of 9 - 415 miles per hour car by day. i had been saying and then i looked at your research that the numbers thrown around early on models that you're not really made available, the data would comprehend, maybe it's because it wasn't very solid, these huge numbers and millions of americans that would die and hundreds of millions of americans were going to die, i could never find the real basis for these numbers. there was charts on the monitors on the screens, every day, every day, every day, then i read your piece and it

says wait a minute, we don't have reliable data. tell me what was in your mind when you wrotend this piece, and tell me why you were like. >> thank you for the very kind invitation and thank you for giving me an opportunity to try to answer these tough questions. i am a person who is working with data and i'm also check trained in infectious diseases so it was natural when a the pandemic evolved, it became a top priority for me to it understand what was going on. i started looking at what was available and how solid is that evidence that's guiding decisions that have monumental impact on saving lives and also potentially harming lives because of the consequences of some of the measures. it became obvious that some of the evidence we had was utterly unreliable. we had to base our decisions on whatever we had, and i

think that we did the right thing to act decisively and urgently. however many of the numbers were based on how many patients we were seeing with symptoms and how many of those died it was possible there was just a tip of the iceberg that many more could have been infected. they were never documented because they were never tested so the denominators were different. the ones that were circulated by who said three or 4% of those people who will be diagnosed, we give them a label of covid-19 will die of courseof this is astronomical an early mathematical numbers based on these assumptions or tame down but making astronomical assumptions about tens of millions of people

dying around the world, 2.5 million people in the west which of course would be a catastrophe that we have never witnessewitnessed before. however, that's not true. it is completely off, it's just an astronomical air, and over the last several weeks we had 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 they would not even bother to do anything about. the best data we have now suggests that it's not one out of 30 or one out of a hundred people who get infected who will die, it's probably in the range of one and a thousand. we also know that there are some types of people were much higher risk than others. most off the population has

animal risk in the range of dying while you are driving from home to work and back. however, very elderly individuals, people with severe underlying individuals, they are settings with people with very high risk and we need to protect them fiercely and do the best and save lives. however willli be seeing tens of millions of dying individuals. mark:ni i'm nata mathematician, i'm a constitutional lawyer and there's a big gap between the two. you say one and 1000. is that one tenth of 1% of the population that actually has the virus will pass away as a result of the virus and in connection to the virus. >> so this is also an open question because for the data

that we have a little more mature 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. on average they have close to three other reasons to die. on average there 80 years old with other comorbidities as we say and there's quite some debate on whether these people would have died anyhow if not immediately, perhaps in a few days or few weeks or a few monts 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 you're first. first to respond. first to put others' lives before your own. and in an emergency, you need a network that puts you first. that connects you to technology and each other.

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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

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 no matter how we will get there. i don't add up the years. and i don't count the wrinkles. but what i do count on is boost high protein.

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at&t is here. providing support with advanced services for first responders. and connected temporary hospitals, mobile testing sites and emergency management centers. because until their job is done, it is essential that we all have their backs. it's what we've always done. it's what we'll always do.

[♪] mack welcome back. the purpose of tonight's show was to show you, follow the science. but the science isn't always right because it isn't always definitive. other scientists and experts have a different opinion on how we should proceed as a nation. i'm deeply concerned about the technocrats, and the data driving this country into the ground. the president and vice president have been absolutely fabulous. nobody has ever confronted anything like this and they are trying to follow the signs. and they also understand we need to open up our economy. ed the problem is we have certain governors in certain states who are not following the science. if we wait for a vaccine it will be a year or two or three and they will destroy their states.

they like to talk about federalism but they want us to bail out their bad decisions. thank you for joining us. we'll see you next time on "life, liberty & levin." steve: welcome to the next revolution. i'm steve hilton and this is the home of positive populism. joining us from around the country our good friend sara carter, matt gaetz and tammy bruce. this week felt to me like a turning point in the war against the virus. the death toll continues to mount. families across the country ripped apart. but the data is clear. things are getting better. meanwhile the shutdown is getting worse. this week unimaginable numbers out of work with the pain and suffering that goes with it. president t