SGU Episode 775

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SGU Episode 775
May 16 th 2020
(brief caption for the episode icon)
SGU 774                      SGU 776
Skeptical Rogues
S: Steven Novella
Guest
GP: Gerald Posner
Quote of the Week
You might use a simple model and find weird behavior and ignore it. But you shouldn’t ignore it, because that very weirdness is significant.
Dr. Robert May, physicist and ecologist
Links
Download Podcast
Show Notes
Forum Discussion

Introduction

Voiceover: You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello and welcome to the Skeptics' Guide to the Universe. Today is Wednesday, May 13^th, 2020, and this is your host, Steven Novella. Joining me this week are Bob Novella...

B: Hey, everybody!

S: Cara Santa Maria...

C: Howdy.

S: Jay Novella...

J: Uncle Bob!

S: ...and Evan Bernstein.

E: Good evening, folks.

J: So Bob, I got so many emails.

B: Did you?

J: Yeah, so we had a live stream last Friday and my kids come busting into the room and Olivia comes up, my daughter, who's four years old, comes up to the screen and looks and sees everybody on Zoom, right? So she could see everybody and then she does like this weird, funny, adorable dance for Uncle Bob. She's like, Uncle Bob! And she's like moving around, it was awesome.

B: That made my week. Made my week. She's just such a beautiful kid.

E: So if I did that for you, Bob, would that make your week as well?

S: In a very different way, a very different way. All right, guys, let me tell you this story. So before we get into our COVID-19 update. So my older daughter, who's a junior in college, had her first like real skeptical activism experience.

B: Oh, cool.

S: Very good. So I was very proud of her. So she writes to me because she got an email from her university promoting a webinar on energy medicine and Reiki, right? So she's like offended. She's like, oh, this is just total pseudoscience and everything. So she wrote a letter to the powers that be complaining about it and describing why energy medicine is dangerous pseudoscience and that her university is legitimizing pseudoscience, et cetera, et cetera. Very good. So she sent it to me for edits. I didn't edit it because I could have tweaked the hell out of it. I'm like, no, it's good enough. It's best that it's in your voice. It was great. It was fantastic. You did a great job. And then she gets a response. And the response is totally predictable boilerplate BS, right? You know what's in there. It's like we let people decide for themselves. This is in the spirit of discussion. And this is in the tradition of liberal arts blah, blah, blah. And we're not endorsing it. And she's not going to be selling, hawking her services during the webinar. It's like, all right. That's first of all, everything you just said is complete bullshit that it's I don't know if it's naive or they're just trying to cover their ass. But and we have gotten that response, how many times? It's boilerplate.

E: They're saying to her, get away, kid. You're bothering me.

S: You're bothering me. So she yeah, so she's now she's she's I'm helping her craft her response to the response. But so it's like, well, welcome to the skeptical universe.

E: That's right.

S: This is a good job. But this is the response that you get.

E: First arrow or sling.

S: First of all, it's absolutely an endorsement 100 percent it's endorsing it. If you are putting the imprimatur of your college on that person with that person is talking about. It's not framed as a debate or a discussion or whatever. It's them promoting their services. The idea that this is not promotion. Totally naive. One hundred percent. When people do this, they use their affiliation with the university to promote their nonsense.

E: [inaudible charge for the public good. Of course, it's promotion.

S: Yeah. Yeah. So it's like insulting. It's insultingly naive to the point where I don't even think they believe it is just totally like covering their ass because somebody noticed that they completely failed their job.

C: So the real question is, like, how did this happen to begin with? Like who was petitioned? Who reached out to whom and talked to whom to get this listed? Because that's where you're going to find your motivation right there.

S: Right. It might have been that she reached out to them. I think she's an alum of the university. And we haven't dug down to that that that deep, but we're just dealing with the claims themselves. But, yeah, so frustrating.

E: And clearly the powers that be don't really know.

S: Well, this is one person so far, this is one person so far. So the question is going to be how far does she want to push it? You know, so we'll see. I'm not going to push her. We'll see how far she wants to go. It's like the next stop is the board of trustees because they get very antsy about the reputation of their university and explaining to them why this is a not response. This is a non responsive. This is B.S. That response is it's worse. The response is worse than the act itself. You know, typical nonsense. So anyway, I'll keep you updated on how that goes. But I have to say, yeah, I read her initial letter. I was very proud as a skeptical dad. She totally gets it. I haven't really pushed like pushed skeptical activism on my kid. Of course, it's there. You know, just the worldview is embedded in our lives. But it's not like I push them to do stuff like this.

C: She's been involved too, which is cool. Like with the SGU. She's like she comes to different shows and she like helps us out with stuff. So it's yeah, it's a big part of her life.

S: Yeah, absolutely.

B: Julia's awesome. But when she sees me, she does not say, Uncle Bob!

S: Not since she was two. Yeah. All right.

COVID-19 Update (5:29)

S: COVID-19. It continues. You know.

B: It didn't miraculously disappear yet?

'S: Nope. Did not miraculously disappear.

C: Much as a lot of states would wish that were the case.

S: So let's run the numbers, over 4 million cases now, almost to 300,000 deaths worldwide. In the U.S. as of right now, we're at 83,000 deaths. If you chart it out it's plateaued, but it's trending down a little bit. But I think that is because of the early New York peak, as we said before. If you factor New York state out of those numbers, it's going up, you know. All things considered it's still chugging along. It's not, I don't think we could say this is going to go away anytime, anytime soon. So now we're really starting to get, we're really starting to get into the clash of worldviews where you have the scientists and the experts on one side basically saying, we're probably going to have a second wave. One of the things that I learned recently when I was writing about this, every single respiratory pandemic out of the last 14 had a second wave. Every single one. It may just be a generic feature of pandemics that they come in waves, you know.

B: Or human psychology.

C: Like we get tired of doing preventive stuff?

S: That is part of pandemics, right? How people in the aggregate respond to it is part of it. And so, yeah, so maybe that then leads to the question, well, can we prevent a second wave? It's like, well, we never have before, but this may be the first time. But I think with that...

E: I doubt it.

S: You know, if we're being realistic, I think we have to make, we have to plan on there being a second wave.

C: Well, I think it's, I mean, I think it's almost inevitable given the data that we have right now about the lockdown fatigue and about the actual, the political motivation to undo preventive measures.

E: But the society has never been tested in modern times like this.

C: True.

E: I mean, this is, this is, this is a first.

C: But the sad and scary thing is that poll after poll show that the majority of people don't think we've been in lockdown long enough. Like they don't want to end lockdown. It's a small minority of people who are loud and who are aggressive that are actually affecting policy. And that's really scary.

E: And you know what that tells you is that there's going to be some people who've just voluntarily choose to remain quarantined or whatever isolated from, from the rest of what else will be going on. Well, yeah, a lot of people who are vulnerable. But obviously there'll be millions of people who will not be doing that at the same time.

C: And the truth is that's only a choice for privileged people. Like, you can only just choose not to go to work if you're in a financial position to do that.

S: Absolutely. Which is another reason why and the data on this now is absolutely clear that if you're poor and if you're a minority, you are being hit a lot harder by this pandemic.

C: Hell yeah.

E: Once again, right?

S: It's not creating the, the weaknesses and vulnerabilities and inequities in the system, but it is exposing them massively.

J: You know, when I asked listeners to write in and tell me their stories and I want to hear some of the interesting things that they've stumbled on because of the pandemic, I'm getting several different kinds of emails from people that all revolve around a very similar theme. And that's that they're seeing a lot, a lot of people simply not protecting themselves when they're in public.

C: Yep.

J: The biggest one that hit me was someone that works for the airlines and that works on an airplane was saying that they're seeing, they're juggling people around trying to distance people from each other. Seeing that there are a lot of people, especially people in the older generation probably like 60 and above just straight up not wearing any masks or any kind of protection like that and very seemingly not taking it seriously. And that's the part that's very troubling because there are those of us who are in absolute lockdown as best as we can, depending on our individual situations. Like even if you're going, I have friends right now that are, that have already returned to work 50% time in the office as an example. But they're still practicing very serious protocols to protect themselves and everybody else. But then there are, there's a whole layer of people out there that are simply living life as usual. I had a guy come over my house, this, this blew my mind. I had a workman come over to my house because I have really bad erosion in my backyard and I need a professional to tell me what to do to fix the problem, right? I'm keeping my distance and he's breaking protocol left and right. And I said, how how you doing? Are you you seeing any sick people? And he goes, oh no, there's no, I'm not seeing anybody sick out there. He goes, let me tell you something, the whole workforce, everything, all the people that are doing my kind of work and everything, it's business as usual. And of course I'm like, well, what do you mean? He's like, it's, everybody's working. Everybody's back to work. Anybody that owns their own business is back to work and I, I'm fine. Everything's fine. Nothing to worry about. I'm just literally like, damn.

C: And let's be clear.

E: It's the attitude they're taking.

C: But let's be clear. Like there, yes, there's a human nature component to this. There is lockdown fatigue, there's a socially prescribed independence. You know, it's my right to make a choice about my body and my movements. But the vast majority of this kind of mentality is not passive. This is orchestrated. It's like climate denial. People don't just naturally deny that climate change is existing. There's a small percentage of people who do, but this is orchestrated. These people are listening to messages.

S: To a narrative that's crafted for them.

C: Yes. Yes.

E: Well, one that they align with usually.

C: Oh, absolutely.

E: There's political divide here. I think they said like majority of Democrats, I believe, are more likely to follow the regulations put forward and Republicans less likely.

C: Yeah. But there's still a huge percentage probably of people on the right. Because again, something like 70 to 80% of Americans don't want to lift these restrictions early. That can't just be Democrats.

S: No, it's not. Yeah. So it's a majority of Republicans. But the numbers are different.

C: Absolutely. Absolutely. But that's what I'm saying. Like these are conspiratorial. There are, we've seen it, there are conspiracy theories flying all over the internet. There's messaging coming from people in very strong positions of power saying it's not as bad as they're making it out to be. I mean, early on Trump's message was that it was a hoax. Like come on.

J: Wait till you hear my news item tonight.

S: We're going to get to the news items because we do have a few that the first few do have an angle, a COVID-19 angle to them.

News Items

Do Facemasks Work? (12:21)

• Neuorlogica: Do Facemasks Work?

S: So starting with me, I'm going to talk about a question that we've been getting quite a bit recently. And that is, do the face masks actually work? This is something that I talked about actually last fall before the pandemic because we were in Australia and New Zealand and there was this large Asian population there and they were all wearing masks. And I wanted to know first of all, why? And second of all, does it actually work? So I'm going to update that data a little bit because now we have more data and specifically data with COVID-19, although not as much as we would like because it hasn't been that long.

C: Oh, right. Because there's a big difference between just wearing them in life and wearing them during a respiratory pandemic.

S: Absolutely. Absolutely. So there's you can't even ask the question, do face masks work? You have to ask which face mask, worn by whom, in what setting, and for what reason. Worn by the person who's sick, worn by a person who's around other people who's not sick, worn by somebody out in the public, not necessarily being exposed to people who are sick, et cetera. And does it prevent the the spread or does it prevent getting it, et cetera. And so the other thing is there's, and then the final thing, the final thing is the intention to treat. So you could look at saying, does the mask filter out the virus? You know, does it physically work? And does telling people to wear masks work? Which is a very different question.

C: Oh, you're right.

S: Because if you tell people to wear masks, what are they going to do? Jay, I had a workman over at my house this week too. And the guy comes in with, we, again, doing all the social distance and everything. But he comes in with an N95 mask, which is the high end sort of breather mask. And he took it off five times during his visit.

J: Oh my God.

E: That's useless then.

S: So yeah, he rendered it useless because he just couldn't keep it on his face. And that's basically what I, I've been observing people. So first of all, I'm treating patients still. And I've just, I have to go out when I go to work and whenever I'm doing any kind of essential thing where I'm, I have the opportunity to view the public, I pay very close attention to how people are wearing their masks and their protocol. And it's terrible. It is-

C: Are your patients wearing masks?

S: Yep. Every one of them. I've had to tell a few patients, you need to pull that over your nose. Because below the nose is not it doesn't do anything. Plus-

C: You might as well wear it on your wrist.

S: But also just the number of people and the number of times people are fidgeting with their mask, or removing it to do just completely removing their mask.

C: Well, the amazing thing is when they take it off to talk, people do that all the time.

B: Now the best is when there's that person who cut a hole over the mouth so she could breathe better. That was the best.

E: Oh, no.

J: Steve, did you hear that the government put out a message talking about the way you're supposed to wear your mask?

S: Is that right?

J: Yeah. Listen to this. You put it on your face. You make sure the nose, the nose part is snug to help it stay up and everything nice. And you don't touch it until you get out of the danger zone.

C: Yeah. If you're in the danger zone, that's true.

S: And then you wash your hands before you you take it off and you wash it.

C: I've been wearing my mask when I run and it sucks. And so my protocol for that, and maybe it's fair and maybe it's not, is that when I'm passing people, like if I'm 10, 20 feet away from people, I put my mask back on as I run by them. And then when I'm in open road with nobody around, I put it back on.

S: That's fair.

C: Yeah. Because I can't. It's horrible.

S: All right. So let's go over some of the data. So the CDC recommends basically that everyone wear masks when they are out in the public, right? The World Health Organization, however, says this, if you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19. So that's the one difference between the WHO and the CDC. Otherwise they're pretty much agree with each other.

C: But that's a big difference.

S: Yeah. But part of that is sort of like reserving masks for the healthcare workers who actually need it. But it's also what does the evidence say? Does the evidence say that it actually works? The evidence, quite honestly, is... So this is in line with what I just discussed last fall. If you are sick, it absolutely helps prevent you from spreading your virus-laden droplets elsewhere, right? So if you're sick, definitely you should be wearing a mask. If you are...

E: If you're sick, stay home.

S: Yeah, well, that's true. But whatever, you have to go into the office, whatever, you have to go somewhere or around family or whatever. If something's happening, you should wear a mask. If you are around people you know to be sick, absolutely there's evidence that it works. There isn't evidence that it works, however, out in the general public. But we don't really have... We don't really know if it works during this particular pandemic. So that's different. During a respiratory pandemic, it may work. So that's kind of where the gray zone is.

C: Yeah. Especially one where people can be asymptomatic. So they can be sick without being sick.

S: Yeah. So, okay, so there was a systematic review of 19 trials that they sort of did a rapid review of to get the information out there. And they concluded that the study suggests that community mask use, so this is just out in the wild, right? By well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic. So that's the thing. You may be sick and you don't know it. The studies of masks as source control also suggest a benefit that may be important during the COVID-19 pandemic in universal community face mask use, as well as in healthcare settings. But we need more trials to drill down on the details. However, there are some other studies. There was one interesting study, which I think doesn't really generalize very much, but this is what they did. They had people who were sick with COVID-19, had confirmed COVID-19. I think they had four people do this. They had them cough without a mask, with a surgical mask, with a cloth mask, with a N95 mask, and then again without a mask, so five different times. And then they held a Petri dish like four feet away. And then they just...

B: Ah, nice.

S: With viral culture on it. And then they just see how much can we grow, you know? And it didn't didn't really work very much. So...

B: What?

C: Well, yeah, I wouldn't be surprised about that.

S: But that only tells us that it doesn't protect against coughing at short distance. They didn't test it at distance, so maybe with the face mask, your safe distance is a lot closer. Like maybe you could get like 10 feet versus 20 feet. They didn't test that, so we don't know.

C: And they also should have put a mask on the Petri dish, because then that would have really in some ways shown what it's like in a hospital where all the healthcare workers are also wearing masks.

S: They also swabbed the inside and outside of the masks and found something that surprised them was that there was more virus on the outside than the inside of the mask. But it was very consistent. It was a very strong... It was, again, only four subjects, but it was like in every one. So they said, well, maybe it's just the way the air is flowing around the mask. And if you have to wear a mask for a long time, like I do, especially if you also wear glasses, you'll know that when you breathe through that mask, the air that you're breathing out is going outside. It's going out the mask, right? So it's shooting to the side. And it's shooting up. So it instantly fogs your glasses. You have to wear your glasses on the edge of your nose so that they don't instantly fog up. So you could see how, yeah, when you're breathing with that mask, you could see how a virus would just get outside of it. They also had to... They speculated about maybe the virus is being pushed through to the outside of the mask. They don't know.

C: So it could be that that's where it's catching the viral particles.

S: That's where they get caught. Yeah. Yeah. All right. So if we look at all the evidence that there is so far, what does that tell us? I think that the recommendation to just wear a mask whenever you're going to be around other people is a reasonable one, even though we're not... We can't be absolutely sure that it's helping in the situation of a well person in the public, not known to be around somebody who's sick. At this point, again, act as if you're sick, act as if everybody else is sick. That would mean wear a mask. Everyone should be wearing a mask. But here's the two caveats. So one is my anecdotal observation is, and also there's research to back this up, that, a lot of people are not using it properly. And if you don't use it properly, all of the benefits are gone, right? Basically what modest benefit may be there in terms of wearing it in the public is completely gone if you're taking it off to speak or to do whatever, you know? So you...

B: Just don't bother wearing it if you're not going to do it right.

S: Yeah. Well, then it's...

E: Yeah, there's that.

S: I think a lot of people are wearing it just because it's expected and they don't want to get the dirty looks for not wearing it, but then they think it's okay to just totally break protocol.

C: Well, I think it's also there's just a lack of education around it.

S: Yeah.

C: You know, this is very new for people.

E: Yeah. We need to instruct people.

S: Yeah. That's what I was going to say. We need a lot more public service announcement type education about how to wear the mask. The other thing is I... What I'm concerned about...

E: Yeah. Give me those banner ads and pop-up ads.

S: No. Absolutely.

E: Commercials on TV and bombard me with that... Those reminders, please. I don't need another thing for weight loss program.

S: Here's my big concern. And that is that wearing a mask improperly is giving people a false sense of security and they're relaxing their social distancing because they figure, I got a mask on, right?

C: Yeah. And that's especially true of gloves. We're seeing that a lot with people who are like out in public in gloves, but then they touch things the same way they would with their hands and they don't sterilize.

B: Sterilize.

J: Sterilize.

C: I have a question.

S: Yeah. Go ahead.

E: Quick before it happens.

C: I wonder if there's a counterpoint to that because I know that you've long been concerned about the idea that people are living more recklessly because they think that they're wearing PPE appropriately. Is there also something in it, like in my neighborhood, I have to say my psychological reaction when I pass people who are wearing masks is more positive than when I pass people who aren't. And so is there sort of almost like a social cue that we're giving people that says, I'm in the same storm as you and I understand the importance of this?

E: Yeah. Thanks for doing your part.

C: Exactly. I think that people trust me a little bit more or like for whatever the case may be, like we're part of the same community. There's something that I like about that when I do have to go out in public and I see people staying on the line six feet apart or having the hand sanitizer in their pocket or being careful with their masks. I'm kind of like, oh, thank goodness. Like I feel safer.

E: Yeah, courteous.

S: Well, yeah. It's like if you're driving on the road and someone's tailgating you, you know? It's like their behavior is affecting your safety and it's annoying and somebody's keeping their appropriate distance. You appreciate it.

C: Yeah. Like I don't know if that has an actual health outcome, but it has a psychological outcome.

S: The studies show that both effects are in play and it's always hard to know which one is dominant, you know? Is it the false sense of security or is it a reminder that you are engaging in social distancing and other rules? So that's why I say it's a concern. I don't know that this is correct, but certainly my anecdotal observation gives me great caution because I see a lot of people violating the six foot rule, violating the mask rule, touching things when they shouldn't be. I think we need a lot more education on that. People need to be taking it a lot more seriously.

C: Yeah, and I guess the question is, is their behavior different or would they be just as violating without the mask?

S: Yeah, we don't know. So my bottom line recommendation is do what the CDC tells you to do. Wear the mask, wear it properly, but act as if you're not wearing a mask, right? Just like act as if you're not wearing gloves, but sure, wear gloves. But don't do that instead of washing your hands, not touching your face, keeping a good physical distance.

C: Steve, how do you not touch your face with the glasses? I'm trying so hard, but like when they fog up, when they start to fall down.

E: I can't.

S: I touch my glasses, but then the glasses become part of what I'm constantly washing, right? So I wash my glasses and my hands. I incorporate that into my routine.

C: Okay.

Carbon Dioxide and the Pandemic (25:10)

• The Verge: Even with people staying in, carbon dioxide is breaking records

S: Okay, Cara, this is a question that's been sort of hovering around in the background for a while. How is the pandemic affecting global warming and our release of carbon dioxide?

C: Yeah, right? Finally, some time for some good—no, never mind. This is all shit.

S: Time has passed.

C: Nope, yep. So I'm kind of glad that I'm going earlier in the show because this is a depressing news item and hopefully somebody's going to like bring the fun later on.

B: I'll bring it.

C: Thank you. Good. Looking forward to that.

B: Black hole fun.

C: All right. So I'm going to try and keep this short and sweet. Here's the thing. Carbon dioxide in the atmosphere is at an all-time high. And even though our changes, our behavioral changes due to COVID-19 is reducing our carbon emissions right now, the percentage is small, the percentage reduction is small, and it doesn't think—in the grand scheme of things, it's probably not going to really help that much.

S: It's insignificant.

C: That's the bottom line. So here's the detail. Mauna Loa Observatory, where we've been measuring since I think the 50s atmospheric CO2—yeah, since 1958, Charles David Keeling, who started making these measurements. When we first started in 1958, we were at 318 parts per million of carbon dioxide in our atmosphere. We have peaked as of this April, and the number is now 418.12. That's very high.

S: So from 318 to 418.

C: 318 to 418. And I know that like that many parts per million, what does that even mean? But basically, the bottom line is that we would have to completely cut our emissions, like no fossil fuels by 2050, is the only way that we're not going to have catastrophic damage. And unfortunately, I mean, the scary thing is, it's probably not going to happen. The truth is, there is no way at this point that individual consumer changes could affect this curve dramatically. We would have to see massive governmental and corporate action.

S: Yeah, we need industrial changes.

C: Yeah. It's just there's no way. So what we've found so far is that based on the data of carbon emissions from people not driving, from people making behavioral changes during the pandemic is that we're seeing an 8% reduction in carbon emissions, probably mostly from driving. The problem is, people are ordering more stuff online, a lot of people still are driving as part of their daily routine. And so it's even though it seems like, oh, my gosh, nobody's leaving their house, there must be a dramatic effect on the environment. It's an 8% drop. And in the grand scheme of things, I think one of the researchers uses the analogy of like you've been filling up your bathtub or let's say your swimming pool with a big hose. And at one point, you decide to turn it down 8%.

S: Yeah, right.

C: Like it's still filling up pretty fast. Yeah. It's not really going to affect how full the pool is ultimately. The reason I think this is an important conversation to have is because it also in many ways relates to the conversation about ecological damage, right, because all the same stuff is happening with regard to carbon emissions going off and affecting the atmosphere and global warming, but also deforestation and climate change affecting habitat and pollution affecting, ecological niches, different animals, blah, blah, blah. And I think one of the narratives that we often come across with all the just excessive COVID-19 coverage in the media right now, is that, look, the birds are chirping, and they're rebounding, and the frogs are happy again, and the turtles are fine. And the truth of the matter is, that's true to some extent. It's not true to a large extent. And it's not what we want, you guys. It's not a win that because we're staying home, we're seeing a moderate, not even moderate, mild increase in ecological productivity, because we didn't choose to do this. This was not a strategy. This was not a choice that we all banded together to say, hey, let's all stay home for the environment. We're only doing this because we don't want to get sick.

S: But the question is, especially with pollution, so even though, yes, it's a modest decrease temporarily of CO2, but in cities blackened and grayed with pollution that are now clear, will this have an effect on public perception, public pressure? Will people in Indy go, you know what? We forgot what it was like to have clear air, and we don't want to go back to the gray. But I don't know. I'm pessimistic. I got to tell you. I think that it's going to go right back to the way it was, and people will what are they going to do about it?

C: And I'm pessimistic, and not just pessimistic, but I don't want to use... It's actually the opposite of cynicism. I think it really is realistic for the human condition, which is that, yes, it's great that the air is clear, but also people have to go back to work, and they have to do the things that they've been doing and utilize the industrial tools that they've been given in order to thrive as a society. So it's really lofty in many ways to sit around and go, oh, isn't this great? Let's just live like this forever. It's like, okay, look at where the economy is. Like the unfortunate thing is that if we want to live like this forever, we have to make systemic changes. And they have to be at the industrial, governmental, and corporate level. It's not just, oh, I just won't go to work, or I'll just ride my bike instead. It's not enough. And I think that for so long, the onus has been put on individual decision making. There's a great, I think it's Frontline, I always talk about Frontline, it might be American Experience, about plastic pollution, where they really dig deep into the Plastics Council's push towards adding a recycle image on the bottom, using the triangle image, saying that things that have never been recyclable are, talking about how we can recycle everything when only a very small percentage of what we utilize has the ability to go through a recycling plant. And ultimately, it's this intentional shift towards putting the burden on the consumer away from the burden being on the manufacturer. And that's been detrimental. And I think that we really, really have to see change affected in that way. Because otherwise, people are going to do what they have to do to survive.

S: Yeah, definitely. All right. Thanks, Cara.

C: Rant over.

S: Yeah. No, that's the way it is.

Distrust of Expertise Online (31:43)

• Newswise: New Map Reveals Distrust in Health Expertise Is Winning Hearts and Minds Online

S: So Jay, the anti-vaxxers are already gearing up to oppose a COVID-19 vaccine that doesn't even exist yet.

J: This is like the one-two punch, Cara. I feel like I'm the second shoe dropping over here. So this one's going to really piss you off. So it turns out that groups and communities on Facebook that are known to not trust the information we get from health experts or institutions like the CDC, they're more effective than government health agencies and any other trusted health resource at finding and engaging with people who are considered undecided in what they believe about public health. So this is coming from a study that was published in the journal Nature. And here are the details. So if you're like me, you should be fuming after what I just said. Because in essence, what I'm about to tell you is that pseudoscience, or at least the people that are behind it and believe in it, they're essentially winning. They're reaching more people than the resources that we want to. So a group of researchers at George Washington University developed a unique map that tracks people talking about vaccines on Facebook. The map is the physical result that you could look at, but of course they have reams of data that they collect and that they analyze. So they studied 100 million Facebook users, and these are people that were discussing vaccines during the 2019 measles outbreak, during the peak of that outbreak. So the map that their software produces is a visualization of what kind of conversations people are having about vaccines. And it turns out that distrust in what we would consider to be trusted health information sources spreads and then dominates these online conversations. Professor Neil Johnson at George Washington University's research, their research team said there is a new world war online surrounding trust and health expertise in science, particularly with misinformation about COVID-19, but also distrust and big pharmaceuticals and governments. Nobody knew what the field of battle would look like though, so we set to find out. So they wanted to figure out how people are communicating online about this specific topic and what is the exchange and interaction that these people are having. So the software was able to examine the back and forth conversations across many cities, countries, continents and languages, and keeping in mind that this is a tangled web of individuals and communities and groups all communicating with each other, and the software was able to make sense of all of this, which is fascinating. The research team was able to identify three separate communities, and I think this is really obvious. There's pro-vaccine, there's anti-vaccine, and then there's people who are undecided about which camp that they belong in. The software was able to see how these separate groups interacted with each other. That on the surface is amazing, but it's not just seeing it. It's able to track it and make it understandable. Their map showed that there were fewer individuals who were considered to be anti-vaccine on Facebook than those who were considered to be pro-vaccine, but there were three times the number of anti-vaccine communities on Facebook than pro-vaccine communities. Now that makes sense because they're a very vocal minority. The anti-vaccination communities became highly entangled with the undecided groups or individuals. Yikes. That's a big yikes.

C: Yeah, that's bad.

J: At the same time, the pro-vaccination communities remain mostly in the periphery of the undecided groups. They did not figure out how to penetrate or maybe... I don't know. I'm speculating, but I'm sure that these pro-vaccination groups are trying to do outreach, but they're just nowhere near as effective, and I'll tell you why. This is really going to make sense once I say it. The anti-vaccination groups had many more narratives to tell that were related specifically to people's concerns, right?

C: Yeah, they appeal to fear.

J: Of course they do. They can tell us. They could say, oh, are you looking for information about your kids? Are you looking for information about the elderly people in your life? They can write a narrative. They can concoct a narrative out of whole cloth that completely tells the story that they want to tell, where the pro-vaccine people, they don't have anything that sexy to say. They're basically saying, let's toe the line. Let's talk about the mundane repeat answer of all people should be vaccinated. It's the most effective medical intervention that man has ever created. Nobody is telling a story there. It's not cool. It doesn't have any flesh.

C: It's not even that they're not telling a story. I think there's also this thing of like, I'm not going to play that game. I have facts on my side. I have data on my side. And the ethical thing for me to do is show people the truth, whereas ethics are not part of the conversation on an anti-vax agenda. So it's like they're playing a different game. They're hitting below the belt on purpose because they're like, well, I'm just going to scare the crap out of you and hope that that prevents you from vaccinating your children.

J: We have to take these things very seriously. If you look up this article and read about what this study did and you see the graph, man, it's scary. It's really powerful stuff.

S: We may have inadvertently created a platform which gives an edge to misinformation.

C: True. Yeah. It might be being elevated because of the nature of the platform.

S: Inadvertently. It's an unintended consequence. And so we have to think about how it's functioning. And you don't necessarily even need to censor information, just make it function differently so that high quality information has an advantage as opposed to sensational poor quality information.

C: Or just go back to like losing, I mean, they'd never do this because of ad revenue, but like get rid of these algorithms altogether. Just the first thing that's posted goes to the top, but then it's like, how do you remove this stuff from the bots? Yeah. It's more like the Reddit model where it's just people upvote or they downvote and it is what it is. And how do you get rid of bots basically is a huge problem.

S: Yeah. Yeah.

E: Oh boy. That's a whole other conversation.

S: All right. Thanks, Jay.

Closest Black Hole to Earth (37:45)

• Universe Today: Closest Black Hole Found, Just 1,000 Light-Years From Earth

S: All right, Bob, you're going to take us off of the COVID-19, the world is going to end news and talk about something fun like black holes.

C: Yay.

J: Yes. Black hole Bob. Black hole Bob.

B: But yeah, the closest black hole to the earth ever was recently discovered. And the discovery of that black hole may actually help us find ones that are even closer in the future, which is pretty cool. So this comes from a team of astronomers led by the European Southern Observatory, ESO. And if you want to read more detail, that's very difficult to understand. You could read their entry in the journal, Astronomy and Astrophysics. So this all started with a simple survey of binary stars. And they were looking at the constellation called Telescopium, known as HR 6819. Yes. Telescopium. Really? Look, I found a new bacterium. I think I'll call it Microscopium. What is that? I actually had to look this up because it was like, wait, why would anyone in their right mind name a constellation Telescopium? So what happened here is that it was a European astronomer sailed south, because you can only see it in the Southern Hemisphere. And he just used, he just named things after mundane objects, like microscopes, actually telescopes, pendulums or pendula. So it's like, okay, there you go. That's it. This guy had no creativity or imagination and whatever. So anywho, so what they did when they saw this binary system, what they thought was a binary system, they saw the two main sequence stars and they were behaving very oddly. Some sites were reporting that one star was moving too fast, one was moving a little slow and their rotations were kind of weird as well. They looked more closely and they saw that one star orbited the gravitational center, I guess, the barycenter of this system every 40 days. And the other star wasn't even involved. It was orbiting very far away. So this interior star was orbiting something that had to be, if you looked at it gravitationally, it had to be over four solar masses, but it was not visible. What could it possibly be? Of course, there's really only one answer. Something that's got a stellar mass that you can't see. It's a stellar mass black hole, obviously. So this led to what I call two immediate yippies. The most obvious one was, holy crap, this telescopium system is only a thousand light years away. We have just found the closest black hole to earth. Let's get drunk. I mean, well, that's what I would say. So after they sobered up, they had their second yippie and that was like, hey, this is a very rare silent black hole. Now if you look at them, if you look at them Milky Way, we've only discovered say a couple dozen or so stellar mass black holes. And of course that means like those are black holes within a mass range of like, say, you know what, two and a half to five or six solar masses a solar mass being our sun. We haven't found a lot of those. And if you look at-

C: So that's like opposed to super massive black holes?

B: Yeah. There's intermediate size, there's super massive, but we haven't found a lot of black holes that are within a range of the mass of our sun. We just haven't found a lot of them, only a couple dozen. And if you look at almost every one without fail, they interact with their environment in a way that is very easy to detect. For example, often you will have a black hole that sucks gas from a binary companion that they're orbiting each other, sucking the gas and that gas swirls around the accretion disk drain of the black hole. And as it gets closer and closer to the black hole and there's more rotation and more compression, it heats up and it heats up so much that it sends screaming x-rays towards the earth. And we could detect those very easily. When that kind of interaction is not there, if the black hole is not interacting with the space around it, really in any way, astronomers call them silent or invisible black holes, which obviously aren't truly invisible, only mostly invisible. And that's because of gravity, right? Because of gravity. There's no cloaking gravity really. And if you look for how the gravity would affect other nearby bodies or light, it would reveal itself. And that's exactly what they did. They did their calculations and they said, there's something invisible here that is causing this. I think the other star in the interior was like five to seven solar masses. Something is causing that to orbit in such a way. It's got to be like a four solar mass invisible object, which is the black hole. That's what they did. They discovered the black hole and it's only a thousand light years away. Very, very close. The closest one was like three or four times more distant. So this is the closest. And this star, get this, this is really cool. This star system is actually naked eye visible in the Southern hemisphere. If it's a good clear night, you can see these stars and you can look at those points of light and say, without a telescope, without binoculars, you can point to these stars and say, there's a black hole orbiting them right now.

C: Even though it's called telescopium, you don't need a telescope?

B: Right. You don't need a telescope. Right. That's another reason why the name sucks.

E: Totally false advertising.

C: It should be called binocularopium.

B: Naked eye-um.

C: Eye-ballium.

B: So the cool thing is that because we have discovered this and we know the characteristics of these stars that are in a silent black hole, the activity, how the stars are orbiting it are interacting with a little bit more detail. Now we know, potentially, maybe we'll find other black holes in the future that are a lot closer. Imagine if they found a black hole that was like, say, 10 light years away. I think that's probably not going to happen because I think we probably would have already by now being that close. But it's fascinating to think what it would be like to have a black hole in your neighborhood. Imagine if Alpha Centauri had a black hole. That would be so cool. I mean, eventually, we'd have telescopes with such sophistication that we could really imagine looking at a black hole that close. I mean, remember the black hole last year that they imaged with the clarity that we've never done?

E: Oh, yeah. They got the ring.

B: That black hole was 55 million light years away. Imagine our view of the black hole using that technique if it were only 10 to 50 light years away. Or how about this black hole? It's only 1,000 light years away. What kind of view could we get of that? So really cool story. I really enjoyed reading up on it. I just love the idea of having a black hole really close. But not too close.

J: I don't like that at all.

S: What would be too close, Bob?

J: Too close would be within the Oort cloud, within a light year. That would be kind of scary.

S: Oh, yeah.

B: But the thing, yeah, people are like, oh, I don't want a black hole near me. No. If you replaced the sun with a black hole of the same mass, yes, it would be dark after 8.3 minutes. But we would not go hurtling towards the black hole. We would stay in orbit. No problem. It doesn't reach out and suck you in. You got to get it. It's just gravity. If you get really close, yeah, you're in deep shit. But if you're not that close, you're totally fine.

J: Like how he nonchalantly says, it's just gravity, you know?

C: Yeah, it's just gravity, guys.

S: All right. Yeah, I think several light years is good.

E: Just to be safe. Hey, social distancing, you know? Black hole distancing.

S: Astronomical distancing. Absolutely.

Who's That Noisy? (45:29)

• Answer to last week’s Noisy: John Cleese, talking about David Dunning's theory

S: OK, Jay, it's who's that noisy time.

J: All right. Before I start, I have a minor correction. So apparently, I accidentally said that last week's animal was hippos when it's rhinos.

C: Yeah, you did say... You mixed up hippos and rhinos? That is not a minor correction, Jay.

E: Well, they both end in O.

S: Hippos, rhinos.

C: Yeah, but we talked about their behavior for like five minutes.

J: Yeah, we did. You and I talked about hippo behavior. Yes, we did.

C: Yes, we did.

J: You're correct.

C: So you were talking about hippo behavior. You weren't talking about rhino behavior, but using the name hippo.

E: Jay, you know what that makes you.

J: Yeah, I mean, look, at some point in my head, the two got mixed up with each other.

'C: Because I was talking about them being in the water, and that's why I'd never heard the noisiest thing.

J: Yeah, I mean, look, I made a mistake, and I can get past this if you can.

E: Jay, Jay.

C: I love you, Jay.

E: I can't let this go. I can't let this go.

C: I love you so much.

E: You know what it makes you? A hypocrite.

J: All right. So listen. All right. That was good, Evan. That one was right above the waterline. So a listener named Brandon Hildreth emailed me very politely. The way he did it was kind of funny, because I'm fairly certain that that was this clip from... I wrote him back, and I wrote, shit.

E: Like Clay Davis.

J: All right. So anyway, so that's my correction. Here is the noisy from last week. [plays Noisy] Okay. You heard it last week. So there's the person. I think I'm correct in saying that this may be both the most responded noisy I've ever done, and the most correctly responded noisy I've ever done. It is apparent that whoever this person is, is extraordinarily loved by many, many, many people. So here are some guesses. The first one I got, Brandon Ayers said, hey, Jay, long time listener, first time guest for Who's That Noisy was this week's noise, Stephen Fay. I think he meant Stephen Fry.

C: That's probably a typo.

S: That's a good wrong guess, but no.

J: Yes. That's incorrect, but thank you for emailing me. Andrew Gertz said, Jay, first time, long time. The Who's That Noisy this week has to be Justin Kruger of the famed Dunning-Kruger effect, but then again, I don't know what I don't know, so maybe not.

C: I love that.

J: That's incorrect. And then there is a million people who wrote in and said really funny, personalized, correct answers with extreme detail about how well they know this particular person. So let me just get to the answer. The winner of last week was David Blythe, and David said that has got to be John Cleese, either him or his dead parent. So that was John Cleese. My God is the man loved. He is, the emails I got, the funny things that people wrote where they were like, exposing their information that they have about all the bits that he did and everything. It was really like, really amazing. I wish that, I'm sure that John Cleese knows that he's loved, but it would have been really to hear his reaction to all these emails that we got from just playing a snippet of him talking. So anyway, the great John Cleese, if you don't know who he is, he's from Monty Python and the man has made several films and has just been one of those comedians, like Robin Williams, who kind of became a part of our culture. And I think he's fantastic. I absolutely adore him as a person. I think he's a great guy, but his comedy is one of those things that him and his friends have created something that I think will never be touched again. It was just that good. Anyway, so thank you all for who wrote in.

New Noisy (49:30)

J: I have a new noisy for this week.

[Cackling animal has taken someone's phone]

All right. Another cute situation going on here. I thought it was the right time to pull this one out. What is it and what's happening? You can email me your answers, your guesses. You can email me any cool noises you heard at WTN@theskepticsguide.org.

S: All right. Thanks Jay.

Questions/Emails/Corrections/Follow-ups

Email #1: R-Naught (50:23)

Dear Steve, Bob-1, Bob-2, Evan, and Cara, [Insert standard I love the show and all of you text here.] There has been a lot of talk about R-Naught these days, and I'm still confused. I've watched multiple videos and read multiple articles, and I still can't wrap my head around the subtleties. Wikipedia, for example, says R0 is the expected number of cases directly generated by one case in a population where all individuals are susceptible to infection in the absence of "any deliberate intervention in disease." That part makes sense. But then it says R0 is not a biological constant for a pathogen, as it is also affected by other factors such as environmental conditions and the behavior of the infected population, which seems to me to contradict the previous statement. Does it include interventions or not? I also hear talk of getting R0 below 1 to stop the spread, which also seems to go against the idea of "in absence of interventions" part of the definition. Is the R0 of measles 18 or less than 1 because we are mostly vaccinated? If R0 can change based on population behavior, wouldn't you have to list the assumptions for the number to be meaningful? Anyway, I think you get what I'm getting at. Love all of you and stay healthy! Best, Bryan Schiffner, Colorado

S: We're going to do one email. This is a good question. That is again relevant to the current situation. This comes from Brian Shifter from Colorado. And he writes, dear Steve, Bob one, Bob two, Evan and Cara.

J: It's not dying. I'm getting so many freaking. You know, everybody is like sending me who's that noisy emails and it like sending pictures of Bob with themselves pretending it's me. You know what I mean? Here's a picture of us. Yeah, thanks.

S: All right. So Brian writes, there has been a lot of talk about R0 these days and I'm still confused. I've watched multiple videos and read multiple articles and I still can't wrap my head around the subtleties. He then goes into him trying to understand it. But let me just skip that and go right to what is it? Cara, how would you define the R0?

C: The R0 from the best that I understand is the number of people that one person, so one generation of infection would affect. So for example, like if measles has an R0 of 12 to 18, that means that one person who has measles would on average infect 12 to 18 other people. And then you obviously calculate generation from there.

S: Yeah, close. So that's where…

C: The basic reproduction number.

S: Yeah, yeah. But I think there's a subtle difference in there. So this is what was confusing Brian. That is you said like measles R0. But the R0 is not an intrinsic property of a specific pathogen. So you can't really say that like this is measles R0. You had to give a range, right? 12 to 18. And why is that? Because it's a combination of the pathogen and the environment. That's the key.

C: Yeah, that's true. So the R0 is going to change based on the outbreak. So when I say the R0 of measles, I'm talking historical. So it's 12 to 18. But the R0 of an active pandemic, you could probably give a single number if you have enough data. But it would need to be updated maybe the following season.

S: Yeah, so you calculate it by saying like how… What's the probability of an infected person who's encountering a non-infected person passing it on? How many people are encountering each other and over what time, right? So you calculate all that out and that's what gives you the R0. It depends both not only like the environment, like the temperature, but also people's behavior.

B: But isn't it really a reflection of the shedding and how symptomatic you are?

S: That's one factor.

B: But it's a big factor. I mean that's kind of like a big chunk.

S: Yeah, but it's not the only one. It also takes into consideration things like people's movements. Are they flying around? Are they washing their hands or whatever? Just in any given situation including all of those variables, just what would the number of infected people be? So it's a way of modeling an infection. But again, it's different based upon the pathogen but also people's behavior and the environment.

C: So you're saying that like Ebola's R0 would be completely different if we had an Ebola outbreak in the U.S. for example.

S: Yeah, totally. So it's not intrinsic. Ebola doesn't have one R0 there's an R0 in a situation. Okay, but it doesn't include steps that are deliberately taken to treat an epidemic or a pandemic. It's only like just out there in the natural environment, whatever that is.

C: So lockdown doesn't affect it, the R0?

S: Yeah, that's right. So the thing is that's a different number. That's the R. It's not the R0. So there's just two numbers that people kind of use interchangeably and sometimes they're talking about one, sometimes they're talking about the other. The R0 is just the pathogen and the environment in which it is, the situation. And then the R is the actual infection rate that's actually happening at any time. You know, the number of people who are infecting. How many people is an average infected person infecting in turn? All right. So if you think about things like the vaccination. So vaccines, for example, do not change the R0 because by definition, because you don't consider the vaccine. And so you don't ask the question, what is the effect of a vaccine on the R0? You say, given the R0, how many people would need to be vaccinated in order to prevent spread, to achieve herd immunity?

C: R0's used to, yeah, to figure out what herd immunity is going to be.

S: Yes, exactly. What penetration do you need for the vaccine in order to achieve herd immunity given an R0 of whatever?

C: So R0 does account for what you would call previous immunity, though. Because not all infectious diseases are novel. So there is previous immunity that's established for a lot of diseases in communities.

S: The next COVID-19 outbreak may have a different R0 because of a different susceptibility of the population. Absolutely. So that's just a subtle difference. And it is true that the R0 of one is sort of the critical point, right? If it's greater than one, then it's spreading in the population. And if it's less than one, then it's decreasing in the population. But that's really the R, right? Not the R0 that you're talking about. Because the R is the actual spreading that's happening in the community. So, guys, we have a fantastic interview coming up with Gerald Posner about his latest book, Pharma. Should be interesting. So let's go to that interview now.

Interview with Gerald Posner (56:28)

• Pharma: Greed, Lies, and the Poisoning of America

S: We are joined now by Gerald Posner. Gerald, welcome back to The Skeptic's Guide.

GP: Great to be back. I'm glad to join you.

S: Always fun to talk to you. So we're bringing you on now to talk about your latest book, Pharma. Greed, Lies and the Poisoning of America, which is just coming out this March. This is one of of your books that we've been talking about. This is one of of your books that does a really deep dive on a complex and nuanced topic. We first became aware of your work with Case Closed because it's a giant conspiracy theory about the assassination of JFK. I think that's why I really came to appreciate your work. But you've applied that same kind of diligence to many topics. So tell us, give us an overview of what this book is about.

GP: Well, what it's about, I think, what it was intended to be was sort of a history of the modern American pharmaceutical industry. And I thought that would be World War II to the current time. You know, I made that mistake before on books. When I did the last book on the Vatican and finances, I thought it was going to be World War II to the current day. And then I kept rolling back a little bit to the Lateran treaties. And then I'd roll back a little bit more to the unification of Italy. And then I'd roll back to the Middle Ages. So in this case, it went from World War II at the time. What fascinated me was this idea that at the start of World War II, half of the world's drug sales came from German pharmaceutical companies. And at the end of World War II, 15 American firms had about 80% of the market. So the German industry was decimated. The American firms had moved forward. And I thought, there's the starting point. It turns out that I ended up bringing it all the way back to patent drugs. And when there was cocaine, morphine, and heroin were the biggest remedies in the legal drug market and no prescription in the 1800s. And so it's really the story of the American drug business from sort of the Civil War up through the current day in the opioid crisis.

S: Going back to 1900, what did you find? Because probably I know a lot of this because of being a skeptical physician. I'm always curious like what the lay public thinks about like the pharmaceutical industry and its history. So what was most surprising for you that you discovered in this process?

GP: I think what was most surprising was the idea that not only was there little understanding of what caused many diseases. You know, tuberculosis was thought to be hereditary or things like this. There was no national licensing for physicians like you until 1900. But the idea that there were so many patent remedies, these remedies that literally could promise to be cure-alls. There was no control over advertising efficacy, whether they were therapeutic or what the ingredients were. And the primary ingredients, the top five ingredients used in thousands of these drugs at the time was essentially morphine, cocaine, cannabis, variations of opioids, and heroin, which is a brand name put out by Bayer. And I guess the surprise to me was to find out before we had the 1906 Pure Food and Drugs Act, there was no federal regulation. Bayer had a research team that in 1897 discovered acetaminophen the basis of Tylenol. The next year discovered aspirin, truly a wonder drug. They misnamed it for the wrong saint. And then two years later, come up with heroin, which is German for heroic. And then in 1903, they come up with barbiturates, phenobarbital is their big product. Of those four drugs discovered in Bayer labs, they only didn't put one out to the public because they thought it was too toxic in their lab tests. And that was acetaminophen. So it's pretty remarkable to think, you know. So there were lots of things that raised the eyebrows. And it wasn't regulation that turned the business around. It was the 1914 Harrison Act that made all narcotic drugs illegal. And then we go into the prohibition experiment with no alcohol. So all of the ingredients used in these drugs disappear. Sears and Roebuck, the biggest catalog in America, is selling for $1.50 a vial of cocaine and a hypodermic needle. That's gone. And the drug industry then is literally hundreds of small companies. The biggest one has no more than 3% of the market. And it's an industry looking for a product. Insulin comes up in 1922. But it's really penicillin, one of the great wonder discoveries of all time, that becomes a secret project funded by federal government in World War II that remakes the industry. And sort of sets what we think of as the basis for the modern American drug industry.

S: It is amazing the different attitudes towards those kinds, what we think of now as recreational drugs. But they were pharmaceuticals back then. The thing is though, they all work in that they have pretty clear pharmacological effects. They're not – I wouldn't consider them to be panaceas or safe how they were used. But they were strong drugs. They actually did something.

GP: Well, you're right. But what's interesting is the way that they were packaged was interesting. So this is an era, as you well know, until 1938, no prescriptions needed for anything. So even until then, it was pretty much the Wild West. You were over 18 years of age. You could walk in and buy anything over the counter that was packaged in. And one of the biggest sellers was a thing called – it's a COPS baby sooner. And it was sold to mothers. The marketing on it was interesting. They would look through the newspapers to see sort of a congratulation notices of new births. And then they would send the marketing material to the new mothers saying this is the way to keep your baby quiet. It was true. It was 30% to 40% opium. After it killed a few dozen babies, that was bad. And I talk about it in the book how they are putting out heroin marketed originally as a cure for morphine addiction. Well, it is.

S: Yeah, sort of.

GP: Sort of. You're right. They're strong. It was easy to mask a lot of ailments with the strong medications of alcohol and the tinctures being used. But it was sort of a shotgun and random approach.

S: Yeah, yeah. While we're on this theme, did you come across – I was a little surprised when I first learned this not too long ago. That during World War II, Germany – they heavily marketed a numerical drug which was basically methamphetamine.

E: Methamphetamine. I heard that too.

S: It was over the counter without a prescription and – I didn't know this. The Blitzkrieg where they basically conquered France, the Nazi soldiers were able to stay up for three days because they were all on methamphetamine.

E: They were all high.

B: Wow.

J: I mean, Steve, if you think about it, in the short term, it is a freaking miracle drug in the short term. It's just –

S: Well, it was literally a super soldier drug, right?

J: Sure.

C: Yeah.

S: You get to stay up for days and you kind of lose your inhibition about doing things like killing other people.

GP: It's interesting because I talk about the fact that the Nazis were – Okay. So part of this – you'll all like this. It's easy for me to say you will all like it and then you'll tell me you don't like it. But there's a part of it I talk about in here in which in the middle of the war almost, in 1943, the war production board has sort of these two consuming priorities. Number one is the Manhattan Project developing the atomic bomb. And the second, the secret project is mass producing penicillin. They knew they needed to make it on this industrial scale. And they were really focusing on the same time, not only penicillin, but they wanted to focus on developing antimalarials to slash the death rate for American troops fighting the Japanese in the Far East. And they had research going for these corticosteroids fueled by false reports initially that the Nazis were using them and had enabled them for super pilots. These are the FBI and NSA. So the early versions of intelligence files that came in. They had reports that the Nazis had been able to come up with effective drugs for super pilots to fight altitudes over 40,000 feet. And that – the Air Force spent millions on SmithKline's Benzedrine pills here in the U.S., distributed them to bomber and fighter pilots in the U.S. Air Force. And the Army stocked up on barbiturates, which dispense widely to soldiers to alleviate pain. The corticosteroids didn't go anywhere, but we did come up with a few antimalarials. But we were trying here too to figure out how to take advantage of that.

S: Oh, yeah. So I think that's pretty fair to characterize the pharmaceutical industry prior to modern regulations prior to World War II as the Wild West. You know, the patent medicine era where they would put either nothing or just what we would think of now as like powerful, addictive, dangerous drugs into their products and market them for everyday use. But now you said let's go to the more modern era, like from World War II to more recently with FDA, at least in the U.S. FDA regulations. So how has the industry behaved under that regime?

GP: So like any industry, there are some wonderful tales and not so wonderful tales. And because this industry, as you well know, is at the intersection of public health and many people take drugs and we think about high drug prices and that, we tend to be a little bit more concerned when the behavior is bad, especially if it's not maybe revealing side effects at a certain time until they're disclosed years later in a Senate investigation. And look, the 1950s becomes, this is broad overstatements, but they fit to a degree. There are many exceptions, but the 50s really is the decade of antibiotics. They are the top selling drugs for the industry and the penicillin, they're not making any money on after World War II because there's no patent on it. They all have the same medicine. So they're all looking for variations of that big breakthrough is these broad spectrum antibiotics like streptomycin and that. And then come the so-called Me Too drugs. They literally will come up with one patent, one atom difference to come up with a new version like teramycin or aromycin. And once the companies start to do that, it sets the framework for what will happen on other drugs once they get into benzodiazepines in the 60s. You also see in the 50s the upsurge of what I call the mind drugs. Thorazine comes out and it helps to relinquish half of the population of mental asylums across the country are let out as sort of a medicinal lobotomy. But 90% of that drug is prescribed by psychiatrists. The next drug that comes is a mild tranquilizer called Miltown. It was a big hit in the 50s and 70% of the prescribers are general practitioners. So you could see as it moves along how the business changes. And by the time you get to the 60s, it's really not until 62. As you know, when you have these Estes Coffoffer hearings, Coffoffer having made his fame a decade earlier on the mafia, he's investigating the drug industry and he thinks there's price fixing. He wants to cut the amount of time they have for a patent and some negotiations on prices. And they successfully rebuffed that. But the linomite disaster, the almost disaster where babies are being born with horrible deformities because mothers are taking a over-the-counter pill in Europe that calms you and doesn't cause morning sickness. It gets blocked here in the US by a doctor in the FDA, Frances Kelsey, and she's becomes a hero overnight. But the result of that is that the legislation that's passed in 62 really is focused on safety. It's what builds in all the clinical trials for safety. So for the first time, hard to imagine, in 1962 forward, drugs have to be tested not just for their accuracy that they're giving you what they say, but that they actually are effective at doing what the drug companies claim they do. Before that, they didn't have to prove efficacy. So after 62, it's a new ballgame. I always get the sense reading about prior to the 1960s that it's just all so naive. You know, they're just not used to dealing with powerful drugs. And they didn't have respect for how dangerous they could be. And also, the combination of typical industry marketing in a, as you say, a critical health sector doesn't quite jive. You need someone looking over their shoulder to make sure that they're doing what they're supposed to be doing.

GP: You know, it's interesting you say that because there's a moment in the book in which I talk in the early 50s. The George Merck, the great-grandson of the original founder of the German Merck, is running the American Merck. And he says to a graduating class of medical students, put the patients first. We are a for-profit business, but if we concentrate on the patients and the cures, the profits will follow. A lot of people in the drug industry thought he was an old-fashioned guy whose time had passed. Pfizer was run by a hard-charging executive called Jack McKean. He came up with his own antibiotic, teramycin, and he chose a fellow who had a small ad business, Arthur Sackler, the oldest of three psychiatrist brothers, to sort of come up with a campaign for that. They spent $10 million on it in the late 50s, which was then a record. And it was Sackler who came up with the idea for detail men. Then they were all men, salesmen who go out and visit the doctors, free samples, the idea of color advertisements, and really made what the equivalent was of what I call a modern advertising and promotion machinery that he later refined. So in 1963, it's Arthur Sackler and his ad firm that makes Hoffman and LaRoche's Valium, the first $100 million seller in the drug industry history, and a few years later makes it the first billion-dollar drug. So we see in this period that the advertisement and promotion come in heavily, and the odd part of it is that for many of your listeners, you'll realize this, and I know it by working on this book, but it's an odd business because the companies making the product, the drugs, and selling them are not selling them directly to the end user, in this case, the patients. They have to go through these middle people, like you, Steve, doctors, because you need to have a prescription dispensed. So the marketing, until the late 90s when they approved direct-to-consumer advertising, we can talk about later, but the advertising and all the efforts are to the doctors to get them to write the prescriptions, and the doctors, for the most part, you may prove an exception to this, but for the most part, don't know the prices the patients are paying. Even if a doctor happens to know the list price for a prescription that he or she is writing, they don't know what that patient's drug insurance plan may pay for, if they have Medicare, what their particular drug plan may pay for. They don't know what the copay is. So you're encouraging doctors to write prescriptions, to stay loyal to the brand, and at the same time, price is not a factor in it. So it's a very unusual business in which the promotion plays out.

S: That's totally true. It's often you don't know what price, ultimately, your patient's going to be paying for a drug because there's so many variables. It's basically what is their insurance company going to be making them pay for, and it's a moving target and there's so many variables. However, I have seen this change in the last 20 years, 20 or so years. So even back in the 90s, during my training, we were encouraged to consider price in the prescribing decision-making process and to ask patients about their resources and their ability to pay for medication because you can come up with the optimal treatment plan for a patient, but if there are practical reasons why they can't do it, it doesn't make any difference. Also, with the advent of electronic medical record systems, now the prices come up right when I look at the medication that I'm about to prescribe. So it's a lot easier to know at the point of making the prescription at least the range in the market that you're in, what medications cost. It's an eye-opener for some. Sometimes it's amazing. It's like, really? Holy shit, that's $100 a pill? Forget that. There's no who can afford that. But the thing is, you get to the point where you have to ask every patient, do you have insurance to cover prescriptions? Because if you don't, I've got to come up with a completely different plan based upon how good your insurance is.

GP: Right. And this is a footnote. I like to write with footnotes, but one of the footnotes in the book is that, for instance, on Medicaid, if you're a Medicaid patient, the U.S. has an unusual rule that once a drug is FDA approved, it's automatically on the formulary for Medicaid. So if you're suffering from an unusual genetic disease and that drug is $300,000 a year, you will get covered because the government cannot refuse to pay for an FDA approved drug. Now, no other country does that. Other countries control their formularies, their final list. We allow these middle companies, pharmacy benefit managers, big companies, multi-billion dollar companies like Caremark and PCS and others to make up the formularies. But on Medicaid, everything's covered. And so the taxpayer ends up paying for drugs that are remarkably expensive and if you're actually dispensing to a Medicaid patient, you can choose the best medication for them even if it happens to be one that makes your eyes roll up when you happen to see the figure. So it's an unusual system, one that has its peculiarities to say the least.

E: Gerald, in this model where the manufacturers were basically marketing directly to the doctors, were there a lot of cases of things like payoffs and kickbacks and bribes, direct payments to these doctors to help push their particular drug that they were trying to get sold?

GP: No, surprisingly not. And I know that may surprise a lot of listeners who are looking for meat but here's what did happen. Over time, companies that were very successful would develop speaker's bureaus. This happened years later with Purdue and it's opiod painkiller Oxicontin, you'd be part of that speaker's bureau if you were a high-dispensing doctor on that particular drug. Whether it was Capitan for hypertension, you might be able to go to medical clinics and talk to other physicians about it. There'd be some pharmaceutical swag, as I call it, like at the Academy Awards, giving out gifts and things like that but nothing that's going to make a doctor prescribe. There'd be a few conferences that would be held in Bermuda in the middle of winter so you could get away from New Jersey or New York but what did happen is that they got better. They, meaning the pharmaceutical companies, got better at pinpointing the high-prescribing doctors on a particular drug and when a new brand came out in that very same field particularly when it came to the drugs that were more likely to be abused and that includes barbiturates in the 50s, the benzodiazepines, Valium and Librium and all that in the 60s and the 70s and also in the 60s, amphetamines. There were 8 billion amphetamine pills being churned out a year. Diet clinics popped up everywhere. They were the equivalent of pill mills later on opioids. Doctors would pay $71 at these diet centers for 100,000 10 mg amphetamines and they would charge $12,000 on average on churning them out so you would get doctors 5% of the doctors on amphetamines were prescribing 60% of all amphetamine prescriptions on Oxycontin in the 2000s, a time in Florida around 2011 3-4% of doctors were prescribing about 2 thirds of all opioids. So what happens is it's not that they're being bribed they are abusing the system themselves sometimes on those addictive products or the ones that are easy, they're diverting it to the black market, they're making a fortunein the pill mills. They're sort of the second part of the conspiracy for a drug company that's gone and lost in it's way if that makes sense.

C: Wait, so they weren't just prescribing but they were also acting as the pharmacy?

GP: In Florida that's exactly what happened so they've changed that law, that's why we had pill mills in Broward County. So you were able to dispense as well and this is really remarkable to me and I talked about this in a chapter, you are a doctor, so Steve you can do this in Florida. You're a doctor and you fill in your form, you renew your license and there's a little box at the end that says do you want to be a dispenser. You check that box and you get $10 more. So for $10 you're now a dispenser. So the clinics were set up and as long as they did not accept insurance they didn't have to go through a state system that reported the sales. You went into the clinic, you were then diagnosed by a physician who said ok your back pain is really terrible, you need palliative care and would prescribe you the maximum amount available for oxycontin. And then you would pay cash for that visit and cash for the oxycontin that was then given to you at the clinic and you never went through a normal pharmacy. You didn't go through a CVS or Walgreens or whatever else. So that was part of what was really amazing. Same thing with the diet centers in the 60s. By the way as a sidelight, we tend to repeat the same error so to the extent we had amphetamines and diet pills and diet centers in the 60s and then there's a big crisis all of a sudden everybody loves them and they realize they're being abused. There are Senate hearings and press turns against them. That happens with benzodiazepine, everybody loves Valum, they think it's fantastic and there's songs written about it the Rolling Stones and then all of a sudden in 75 the New York Times, everybody turns against them and Senator Gaylord Nelson has hearings. Oxycontin in the beginning is a new way to treat pain we're going to treat all types of pain with it/ And then 20 years later there are Senate investigations and calls for everybody's head on. So we get into these things where people embrace something as a new wonder drug of sorts, it becomes abused, it gets diverted to the black market and then the reports come out about the abuses and then when it turns against it, it creates the marketing opportunity for the new drug to come in, if that makes sense.

S: I've been doing this long enough to see that whole cycle I've been doing this for 25 years or so, where we're under treating pain, we need all these new drugs and then there always seems to be this minority of abusers, we call them Dr. Feelgood. The people who will just write prescriptions for anything. But again, I've also seen the regulations being slowly tightened up over the last 20 years. For example, the biggest probably sea change during my career was in the 90s pharmaceutical representatives were just part of the background. They were there, they were providing lunch, they were swag all over the place. Now, totally gone, they are completely gone. So I think that was a very positive change. So let me ask you this question, this is sort of the big question I wanted to ask you. Because I have kind of a love-hate relationship with the pharmaceutical industry I think just like a lot of people, it does a lot of good things but it needs to be carefully regulated. And it's always kind of looking for ways to push the limits. So after doing this book, after doing all your research, what's your bottom line? What do you think about, just big picture about the pharmaceutical industry. Are they more good or more bad? How wouold you summarize your view?

GP: It's both, notwithstanding my subtitle, Poisoning of America, which would tend to make you think it's all bad. It is the yin and the yang. there are some heroes in this book. There's Jonas Salk with the first polio vaccine being asked by Edward R. Murrow on CBS radio who owns this? You have the patent? Does the drug company have the patent on this? It's a chapter title, could you patent the sun? He thought it was publicly available.Everybody should have it. There's work on, when you see the synthetic insulin that Genentech puts out, they make a lot of money on it but it turns around people's lives with diabetes. And there are cancer treatments that come up from our DNA work that's absolutely critical. There are researchers and scientists toiling away in the labs for little payback in the end. And there's also tremendous greed sometimes inside the boardrooms and those are the cases that we think of that tarnish and tarn-feather the industry and it's a shame, but it's both ends of the spectrum. And certainly on the opioid crisis, so many Americans have died. More Americans have died on that than died during the Civil War, so there we're talking about something lethal, not just greed. It's the last chapter that deals with opioids as well in the Sackler family. So maybe the final taste you have from the book is somewhat bitter but I have mixed feelings about it, I see the great things that happen in pharma and I see the terrible things I write about them as well.

S: And here's the sort of related follow-up question, were you left with a sense that there was anything significant that is broken about the industry, including its regulation that you think we need to fix?

GP: Oh yeah. I'm not the type of writer, I don't editorialize in my books. Just sort of drag it, just the facts. But I think it's clear where I think the holes are. There are things that could be done by an executive order, by any president. People say to me, who's more to blame, Democrats or Republicans. I'm an equal, I am a castigator of both sides of the aisle. There are instances in this book in which you'll see Democrats were to blame for not getting something done and other instances in which Republicans were. The pharma lobby is very clever, it doesn't have to have every member of Congress on its side. It just needs to have the key members to be able to vote or to get a filibuster going. But there are some things that could be changed overnight. So for instance, there's a chapter on orphan drugs and a lot of listeners may say, orphan what? They are a law created in the early 1980s, as you've seen many times with good intent. Which was to get drug companies to focus on underserved populations of 200,000 people or less with rare genetic disorders. Huntington disease and other diseases like that. And since then the companies have learned how to game it very well. So if you take the top 10 most expensive drugs in the world today, 8 of them are orphans, half of all the drugs approved in the last 5 years are orphan drugs. When Gilead recently announced it was going to get Remdesivir approved for early treatment on COVID-19, it applied for orphan status even though it would eventually be treating billions of people. There was a protest from people who understood it and five days later have reversed that patters, but you could stop the way that orphan process is gamed pretty easily. And it's not being done. The tougher question is, we are the only country on the planet... We're one of two countries on the planet, with New Zealand that allow direct-to-consumer advertising, that's a different issue. But we're the only country on the planet that allows drug companies unfeatherd power to set their own prices. And in a wonderfull worlds that's fantastic to think they have that power. But what happens is we are paying on average, a 2014 study showed all the drugs available here and abroad were paying at least, smallest difference was 3 times more than what they were paying in Great Britain. Up to 16 times more, the cheapest country on the list was India but on average between 4 and 6 times more for the same drug in the US. Even Oxycontin was 2 to 3 times more expensive in the US than it was aborad. And the reason is because the other countries, as I talk about this, negotiate a price and the companies know that since they have unlimited pricing power in the US, if they get driven down on the price of the UK, France or Germany, they can ratchet up that price a little bit in the US and make up for it. And we become the extra part of the profit margin. I just hate being in that role. I don't know what we want to do about it because in the past whenever it's been mentioned even LBJ byt the way, just so you know this, they tried to put into Medicare. I write this a reasonable cost, the pharma industry went crazy on that and it never got through. Then there was a suggestion that Medicare should have a drug prescription plan in 65 but by generic zoning. That got knocked out. I'm not a believer that you have to be Bernie Sanders here, come and nationalize the drug industry, but I do think that there's a point at which you can say if every other country is negotiating prices with you we buy to two. We missed that opportunity in 2006 when Bush put through the prescription drug plan on Medicare. They were talking about that but in the end they didn't include it.

S: We're subsidizing drug therapy around the world.

GP: That's right. And Steve, not only are we subsidizing drug therapy but companies say and they're very good at saying this, they have good PR. They say we need these high prices for research and development. We're coming up with a life-saving drug. You want a cure for cancer? We're looking for it. The hundreds of millions and billions they spend on drugs and how expensive it is. It's true but the key is and hammered them at one point in the book on this, and that is, you go through their own budgets. These are public companies for the most part. A few are private companies like Purdue with Oxicontin, but he public companies are big ones, they're the conglomerates. And they spend more on promotion and advertising, the top 10 companies, than they do on research and development. When you throw in stock buybacks it's nearly 2 to 1. So I get it, but there's a lot of room for play here.

S: Yeah, absolutely. Gerald this was fascinating. I look forward to reading the book. Tell us how people can get this and your other works.

GP: I always like to say, I'm so used to having 13 books. And Tricia, by wife's on 2, so we've got 15 books. And I usually say it's available everywhere fine books are sold. Except it's not true now, the pandemic, since fine books aren't sold at bookstores since they are shuttered. Even on Amazon you might have to wait a week or so to get a hardcover versus if you're not looking for a Kindle. It is available digitally online everywhere, including Barns&Noble. Apple picked it as its book of the month. I didn't know Apple had a book of the month. It's available and it's around. The best feedback I get are from doctors. I'm not writing for doctors but I love it when a doctor writes a note to me and says, I thought I knew all this. I kew a lot of this, but that part was really interesting. Or this part really got me or that's really interesting. That's always the part that's interesting you're writing to a profession and sometimes even the profession, you're doing it and you say now I understand why they were doing it that way.

S: Awesome. Well, thanks again. It's always a pleasure.

GP: Thank you very much. I'll talk to you guys in 5 years on the next book. Thanks you.

Science or Fiction (1:26:42)

Answer	Item
Fiction	Multitasking
Science	Random leaders
Science	Gamer addiction

Host	Result
'

Rogue	Guess

Voiceover: It's time for Science or Fiction.

Item #1: Researchers find that multitasking in the office leads to greater satisfaction and decreased depression.
Item #2: A new study finds that choosing leaders partly at random reduces abuse of power.
Item #3: A study of teen video gamers finds that 10% display pathological video game addiction.

S: Each week I come up with 3 science news items or facts, 2 real and 1 fake. And then I challenge my panel of skeptics to tell me which one is the fake. Are you guys ready for 3 random news items this week?

C: Yes, sir.

S: No theme. Here we go. Item number 1, researchers find that multitasking in the office leads to greater satisfaction and decreased depression. Item number 2, a new study finds that choosing leaders partly at random reduces abuse of power. And item number 3, a study of teen video gamers finds that 10% display pathological video game addiction. Jay go first.

Jay's Response

J: This first item here about the researchers finding that multitasking in the office leads to greater satisfaction and decreased depression. I'm a little confused about that just because I would think it's the exact opposite. I would think that having to focus on too many things would become very frustrating and stressful. And that's just it. I know that multitasking is innately a stressful thing and that we're not really wired for it. So that one is on the absolute maybe list for me. Second one here a new study defines that choosing leaders partly at random reduces abuse of power. What do you mean partly at random?

S: So you, it's good that you asked that question becasue I was going to clarify. You choose a pool of people and then you randomly choose from within that pool. So you use some other method to get to your pool like meritocracy or whatever. And then once you're down to those 20 people you choose one of those 20 at random is the actual leader.

J: So there must be some component here. If this is true there may be a component that might psychologically affect the people that were in that pool. I just find that fascinating if that's true that that would have some type of an effect. Or maybe the people that were more motivated to get elected or something might be more likely to abuse the power. I'm not sure. I'm really not but there's something in there that's interesting. And the last one a study of teen video gamers finds that 10% display pathological video game addiction. I think that's true. I would suspect that it could be even more I don't think it's 1% which would be where I think Steve were going. And I'm sure it's not 100%. I think that makes sense. I think that there's a healthy dose of people out there that have video game addiction. I'm going to go and say that the multitasking one is the fake.

S: OK, Bob?

Bob's Response

B: I'll start from 3. 10% seemed a little high but yeah I agree that there could be a good chunk of them that are pathologically addicted. It seems a little high. It's funny Jay you think it maigh be even higher than that. But I kind of agree with that one. The partly a random thing reduces abusive power. I don't know. I don't even feel like thinking about that one.

E: I like your honesty.

B: This one just pulled me in. Anecdotally, absolutely. I hate multitasking at work. I'm pretty immune to stress but one of the things that gets me stressed at work is like holy crap, I have four things that needs to be done and they are all urgent. Holy crap. And switching from one to the other just annoys the crap out of me. Oh man, you make a little progress. Then you have to jump to the other task and I think we've actually talked about it. It does slow you down because you need to shift gears a bit to get acclimated to the second task. And it's not an efficient way to get the stuff done. So that one just presses to many of my buttons so I'll say that one's the fiction as well.

S: OK, Cara?

Cara's Response

C: OK, so I feel like there are operative very important details in each of these and I want to explore quickly. So it's a study of teen video gamers that finds that 10% of them have pathological video game addiction. That seems realistic to me because we're not talking about all teenagers. WWe're just talking about self-defined gamers. And so yeah, sure, I could see that 10% of gamers would have a pathological addiction. Also, the choosing leaders partly at random reduces abusive power. This one seems really nuanced because it really comes down to that question does absolute power corrupt absolutely. What comes first, the power-hungry person or does being in power corrupt them? Something tells me that this study is a laboratory study. And if so, it's a simulation. And if so, it's not longitudinal or long-term. Which I think would very quickly change things. Multitasking in the office, this one I have a massive question on. When you say multitasking, do you mean having multiple tasks that yoiu need to get done in the day you do you mean having to do multiple things at the exact same time? Like being on the phone while you're writing an email?

S: The second thing. The multitasking does involve an element of interrupting one task to do another.

C: Interesting. That one sticks out to me as being the fiction for that reason. If it was having multiple tasks to do like variability in your career I think that would definitely lead to greater satisfaction. It's more interesting to be at work if you're not doing monotonous labor. But if you're having the added stress of having to jump around I don't know if you would be more satisfied at the end of the day. OK, I'm going to go with the guys on this and just hope that I was right about the abuse of power thing that it depends on the length of the study. I'm going to go with the guys and say it's the multitasking things that's the fiction.

S: OK, Evan.

Evan's Response

E: Cara, why did you do that?

C: I'm sorry, don't you love it when I go before you?

E: Well, most of the time, not this time. You're killing me with this one. It's the challenge of going last.

B: Don't think about it.

E: So here are my initial thoughts. Multitasking, we've talked about it being the illusion of multitasking. In a lot of cases, an illusion is so much more satysfing than reality. In a sense, I can see that could be in play here. You may think you're getting more done. You're not really being more productive though. There's nothing about productivity here. And then this other one about choosing the leaders at random, reducing abuse of power. Cara, thank you, is's a really good question you thought about timeframe. That probably does have some impact, how long are you choosing this leader for? A day, a month, a year, or 10 years? So there's a lot of wiggle room there. There's not a lot of information to go on here which is why I think this one could lend itself to be the fiction. And that's why always thoght you were going with.

C: almost did!

E: Fine, I'll eat the bullet. I will take the leaders at random. I'll say that one's the fiction.

C: Oh no. When Evan goes on his own he usually wins.

E: Oh gosh, you know?

Steve Explains Item #3

S: Well, let's start with number three since that's what you guys all agree on. A study of teen video gamers finds that 10% display pathological video game addiction. You guys all think that is science and that one is science. It's funny how all the reporting was like it's only 10%.

C: That's a lot.

S: That's a lot. This is published in Developmental Psychology. They said, they broke down a lot of the gamer stereotypes and found that they're not really true. And they did say 10% is a minority but it is a significant minority is a lot of people. How do they define that? 90% of gamers play in a way that does not cause any harmful or negative long-term consequences. However 10% play to such an extent it interfered with their ability to socialize, to be productive, to do their schoolwork, etc. So it actually had negative consequences for their life. They also found that it correlated with a couple of things. First of all, being male, not a surprise. And second of all, having pro-social behavior. Those 10% were disproportionately boys who lack pro-social behaviour to begin with. So it may be an interaction between personality type and excessive video gaming that is causing the problem. Just one slice of a very complicated question but that's what this study showed.

Steve Explains Item #2

S: All right, let's go on to number two. A new study finds that choosing leaders partly at random reduces abusive power. Evan, you think this one is the fiction. Everyone else thinks this one is science. Although Cara almost went for this one.

C: Evan, will you admit that I might have loosen this jar for you?

E: Maybe.

S: This one is science. Sorry Evan.

C: Never mind.

S: This was a combination, actually, that why I didn't want to answer about the timing. First of all, they looked at historical examples like in classical Athens and medieval Venice that actually used this. They used some kind of lottery system among a pre-selected group in order to determine who would be the leader of a party or whatever. And then they did a laboratory experiment where they did compare groups one selected through a process, a competitive process and the other partly at random. What they found was that the leaders chosen partly at random were more humble. And they engaged in less behaviour that would be considered corrupt. The thinking is that this is the thought behind all this, that leaders, generally speaking are overconfident. Someone who seeks out a position of power is starting from a baseline of overconfidence. If you then go on to win a competitive selection method that reinforces and confirms your overconfidence. And that pushes them to the point for some of them, they think that they actually deserve the position that they're in. And that they're entitled to use it to enrich themselves, for example. Whereas if the final selection method was random they don't get that confirmation of their overconfidence. They're more humbled by the process because they know that they were the beneficiaries of luck. They engage in less corrupt or self-serving behavior. They actually went as far as to suggest, this is not just for government but also for companies that you don't just use a system of determining who rises to the top of the hierarchy that's entirely competitive because that does, while it may promote skills and certain abilities, it also promotes certain personality traits that may be not desirable in those positions.

C: Definitely.

S: I think we may be living through that right now.

Steve Explains Item #1

S: Let's go to number one. Researchers find that multitasking in the office leads to greater satisfaction and decreased depression. So Cara, you were sort of flirting there with exactly the interpretation I was hoping that you were going to go for which is that having multiple things to do is actually better than a boring single task. But you asked the question so I answered it honestly. The test, the study looked at people who were engaged in one task versus people who were engaged in the same task but were frequently interrupted by having to do another task. So you're checking your email and you get a phone call. And the people who were getting interrupted by another task, Jay and Bob is correct, it had an opposite effect, they showed more stress, more depression. So it had a tremendous negative effect. But you could argue it's really the interruption component of it.

C: Yeah, like if you're multitasking on your own terms that's probably a little bit more satisfying. Like I'm going to do this and then I'm going to answer this while I'm doing it. And the lower attention requiring jobs can have something else going on. If somebody else is dictating how you have to multitask that's difficult.

S: Yeah, so this is just they were answering emails and then they would get interrupted. And the other group would not get interrupted. Which I agree I find extremely disconcerting as well. Sometimes I'm charting, for example and then I get asked a question while I'm in the middle of charting and I have to break away from the groove that I was in. Then I have to come back to where was I. It takes a lot of cognitive work to make sure I don't forget to do anything. And then I have to almost reproduce all of that cognitive work, just because I was briefly interrupted. You know what I mean? Yeah, multitasking is bad. We're not good at it. It does reduce our efficiency. You should just not do it. And apparently it takes an emotional toll as well. At least in this research paradigm. As Cara likes to point out a lot of this psychological studies are a one-offs but it seems like a reasonable reasource design.

Skeptical Quote of the Week (1:40:23)

You might use a simple model and find weird behavior and ignore it. But you shouldn’t ignore it, because that very weirdness is significant.
– Dr. Robert May, physicist and ecologist (1936-2020)

S: All right, Evan, give us a quote.

E: This quote was suggested by one of our listeners. Rod H. from Boston, Massachusetts. Thanks, Rod. "You might use a simple model to find weird behavior and ignore it. But you shouldn't ignore it because that very weirdness is significant." And that was said by Dr. Robert May, who I believe is someone we've maybe never spoken about on the show before. But this guy is pretty amazing. Robert McCready May, Baron May of Oxford. Here's all his titles. Order of Merit, Order of Australia, Fellowship of the Royal Society, Fellowship of the Australian Academy of Science, Fellows of the Australian Academy of Technology and Engineering, Royal Society of New South Wales, the Australian Institute of Building among other things. That's his short list. He was into so many different things. He's basically just a giant thinker. He's trained in physics. That's his teachings. But really he spanned into biology and into politics and economic theory.

S: He'a a polymath?

E: Yeah, he put his brain to so many big problems, metaproblems and megaproblems and his work has been cited by so many groups and institutions as being very, very important. A true giant among scientists. And I'm surprised we've never really had a chance to talk about him on the show before. That he hasn't come up in some level of discussions.

S: I like that quote. I often say that's not an exception, that's data. Becasue there's a bias to look at something that doesn't fit your model as an exception. But that's really just a way of dismissing data. And so it's kind of another way to say what he's saying here.

C: Yeah, like you just need to iterate your model, my friend.

E: We brought him up because he passed away just last month.

S: Too bad.

E: Died at age 84. But should be celebrated for great contributions in his life.

S: 84, awesome. Alright, well we survived another week. And we are continuing to do our Friday streaming. So Friday at 5pm eastern time.

E: And where can they watch us, Steve?

S: They can watch us on Facebook and YouTube, Jay?

J: Yep, that's right. They can go to theskepticsguide.org and they'll see a link on our homepage that says live. And that'll take you to where we're broadcasting.

E: And we go live at 5pm eastern time in the US.

S: And for this week, by the time this show goes up we will have done the streaming episode with George Hrab. But I point that even though it's too late, I point that out because who knows? Maybe in the future we'll have other surprise guests. Check in to the stream. It's been a lot of fun and we've gotten really good feedback. More content that we're putting out there, we're a little bit more off the rails, it's a lot of fun. Take a listen. Hopefully George had some fun stuff in store for us. And we may be joined by other surprise guests as well. So take a listen. Alright guys, thanks for joining me this week.

B: Sure man.

C: Thanks Steve.

E: Thanks you Steve.

Signoff

S: —and until next week, this is your Skeptics' Guide to the Universe.

S: Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to info@theskepticsguide.org. And, if you would like to support the show and all the work that we do, go to patreon.com/SkepticsGuide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.

Today I Learned

• Fact/Description, possibly with an article reference
• Fact/Description
• Fact/Description

References

Vocabulary