YouSaid · the spoken record

Michael Mina

lines on the record: 159
first: 2020-12-19
most recent: 2020-12-19
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“It has to pair with an iPhone. And so it's good as a, I think that this is going to become, there's a lot of use for this from a medical perspective, you know, where you want good reporting. This can, because of pairs with an iPhone, it can immediately send the report to a Department of Health, whereas these paper strip tests, they're just paper. They don't report anything unless you want to report it. So I'm going to just pick it apart. And so you can see is there's like fluorescent readers and little lasers and LEDs and stuff in there. You can actually see the lights going off.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“So then there's this test here, which is another, you know, it's funny. Let me just open this up and show you. This is a really nice test. It's another antigen test. Works the exact same way as this, essentially. But what you can see is it's got like lights in it and a power button and stuff. This is called an alum test, which is fine. And it's a really nice test, to be honest, but...”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“That's right. Yep, it says wait 15 minutes to see both lines. But in general, if somebody's really going to be positive, that line starts showing up within a minute or two. So you want to keep the whole, we'll keep watching it for the whole 15 minutes as it's sitting there. But I would say you're knowing that you've had PCR tests recently and all that”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Gold standard or confirmatory test for any of these antigen tests. So one of the recommendations that I've had, especially if people start using antigen tests before you get onto a plane or as what I call entrance screening, if somebody's positive, you don't immediately tell them you're positive, go isolate for 10 days. You tell them, let's confirm on one of these, on a detect test, that is because it's completely orthogonal, it's looking for the RNA instead of the antigen. There's no reason, no biological reason, that both of these should be falsely positive. So if one's falsely positive and the other one is negative, especially because this one's more sensitive, then I would trust this as a confirmatory test. If this one's negative, then the antigen test would be considered falsely positive.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Would mean that you're likely contagious or you likely have infectious virus in you? What we can do, because one of the things that my plan calls for is because sometimes these tests can get false positive results. It's rare. Maybe 1% or in the case of this BINEX now, this Abbott test, 0.1%, so 1 in 1,000, 1 in 500, something like that can be falsely positive. What I recommend is that when somebody is positive on one of these, you turn around and you immediately test on a different test. You could either do it on the same, but for as good measure, you want to use a separate test that is somewhat orthogonal, meaning that it shouldn't turn falsely positive for the same reason. This particular test here, this detect test, because it is looking for the RNA and not the antigen, this is”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“That's perfect. That's what you want to be seeing. You want to see that so right now you essentially want to see that blue line turns pink or purpley color. There's a blue line that's already there printed. It should turn sort of a purple pink color. And ideally there will be no additional line. For the sample”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Now, what we will see is we will see a line form. What's happening now is the buffer that you put in there. Is now moving up onto the paper strip test. And it has the material from the swab in there. And so what we'll see is a line will form. And that's going to be the control line. And then we'll also see ideally we'll see no line for the actual test line. And that's because you should be negative. So one line will be positive and two lines will be negative.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Hold it parallel to the test. So put the test down on the table. Yep. And then go into that bottom hole. Yep, and push forward so that you can start to see it in the other hole. There you go. Now turn. If it's, once it hits up against the top, just turn it three times, one, two, three, and sort of, yep. And now... You just close to pull off that adhesive sticker there. And now you just close the whole thing.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“And now you're going to take that swab, open it up And now just wipe it around inside into the front of your nose, do a few circles on each nostril That looks good.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“That's correct. That's the swab from the ABA test. So, what I'm going to do to start is I'm going to take this buffer here, which is just the buffer that goes onto this test. So this is a brand new one. I just opened this test out. I'm going to just take six drops of this buffer and put it right onto this test here.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“That's still the main, yeah. There are some saliva tests coming about And these can all work potentially with saliva. They just have to be recalibrated. But these swabs are really not bad. This isn't the deep swab that goes way back. Into your nose or anything. This is just a swab that you do yourself, like right in the front of your nose. So if you want to do it.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. So I talked about PCR tests, and those are done in the lab, or they're done essentially with a rapid test like this, the detect. And we can even try this in a moment. It goes into a little heater, so you might have one of these in a household or one of these in a nursing home or something like that, or in an airport. Or you could have one that has 100 different outlets. This is just to heat the tube up. These are the rapid tests. They are super simple. No frills. You just swab your nose and you put the swab into a buffer and you put the buffer on the test. So we can use these right now if you want. We can try it out”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“No longer infectious because you might only be infectious for five days, but then you'll remain PCR positive for three or four or five weeks. And so when you go and just evaluate these tests and you say, okay, this person's PCR positive does the rapid antigen test detect that, more often than not, it's no. But that's because those people don't need isolation. They're post-infectious. And this is become much more of a problem than I think even the FDA themselves is recognizing because they are unwilling at this point to... Look at this as a public health problem requireing public health tools.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“And unfortunately, our regulatory landscape fails to apply that knowledge to evaluate these tests as public health tools. They're only evaluating the tests as medical tools. And therefore, we get all kinds of complaints that say this test, which detects 99 plus, you know, 99.8% of current infectious people. By the FDA's rubric, they'll say, no, no, it's only 50% sensitive. And that's because when you go out into the world and you just compare this against PCR positivity, most people who are PCR positive in the world right now at any given time are post-infectious.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Health, we need to only look forward. We don't want to go back and say, well, was this person? Are there symptoms because they had an infection two weeks ago? In public health, we just want to stop the virus from spreading to the next person. And so that's where we don't care if somebody was infected two weeks ago. We only care about finding the people who are infectious today.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“And if I have a patient who comes to me and wants to know if their symptoms are a result of them having COVID, then I want every shred of evidence that I can get to see, does this person currently or did they recently have this infection inside of them? And so in that sense, the PCR test is the perfect test. It's really sensitive. It will find the RNA if it's there at all so that I could say, you know, yeah, you have a low amount of RNA left. You might have been, you said your symptoms started two weeks ago. You probably were infectious two weeks ago and you have lingering symptoms from it. But that's a medical diagnosis. It's kind of like a detective recreating a crime scene. They want to go back there and recreate the pieces so that they can assign blame or whatever might be. But that's not public health.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. It all mixes back with this whole idea of the medical industrial complex. In this country and in most countries, we have almost entirely defunded and devalued public health, period. We just have. And what that means is that we don't have a language for it. We don't have a lexicon for it. We don't have a regulatory landscape for it. And so the only window we have to look at a test today is as a medical diagnostic test. And that becomes very problematic when we're trying to tackle a public health threat and a public health emergency by definition. This is a public health emergency that we're in. And yet we keep evaluating tests as though the diagnostic benchmark is the gold standard, where if I'm Physician, I am a physician, so I'll put on that physician hat for a moment.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“They call it a case stemmic. They say, oh, PCR It's detecting people who are. False positive. They're not false positives. They're late positives, no longer transmissible.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Because of that, you've had trillions and trillions of viruses go to zero, essentially. But the RNA is still there. It's these remnants in the same way that if you go to a crime scene and blood was sort of spread all over the crime scene, you're going to find a lot of DNA. There's tons of DNA. There's no people anymore. But there's a lot of DNA there. Same thing happens here. And so what's happening with PCR testing is when people go and use these exceedingly high sensitivity PCR tests, people will stay positive for weeks or months after their infection has subsided, which has caused a lot of problems in my opinion. It's problems that the CDC and the FDA and doctors don't want to deal with. But I've tried to publish on it. I've tried to suggest that this is an issue both to New York Times and others. And now it's unfortunately kind of taken on a life of its own, of conspiracy theorists thinking that no.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, I would say that there is a greater accuracy. There's also a downfall, though, of PCR and tests that look for RNA, they can sometimes detect somebody who is no longer infectious. So you have the RNA test and then you have these antigen tests. The antigen tests look for structures, but they're generally only going to turn positive if people have actively replicating virus in them. And so what happens after an infection dissipates, you've just gone from having sort of a spike. So if you get infected maybe three days later, the virus gets into exponential growth. And it can replicate to trillions of viruses inside the body. Your immune system then kind of tackles it and beats it down to nothing. But what ends up in the wake of that, you just had a battle, you had this massive battle that just took place inside your upper respiratory tract.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“So you're either looking for a sequence or you're looking for a structure. The PCR test that a lot of people have gotten now and they're done in labs usually are looking for the sequence of the virus, which is RNA. This test here by a company called Detect, this is one of Jonathan Rothberg's companies. He's the guy who helped create modern-day sequencing and all kinds of other things. So this detect device, that's the name of the company. This is actually a rapid RNA detection device. So it's almost, it's like a PCR-like test, and we could even do it here. It's really a beautiful test, in my opinion. It works exceedingly well. It's going to be a little bit more expensive, so I think it could confirm, could be used as a confirmatory test for these.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“There's two ways to look for the virus. You can either look for the genetic code of the virus, like the RNA, just like the DNA of somebody's human cells. Or you can look for the proteins themselves, the antigens of the virus. So I like to differentiate them. If you were a PCR test that looks for RNA in, let's say if we made it against humans, it would be looking for the DNA inside of our cells. That would be actually looking for our genetic code, the equivalent to an antigen test is sort of a test that actually is looking for our eyes or our nose or physical features of our body that would delineate, okay, this is Michael, for example.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“So, the testing landscape is a little bit complicated, but I'll break it down. There's really just three major classes of tests. We'll start with the first two. The first two tests are just looking for the virus or looking for antibodies against the virus. So we've heard about serology tests, or maybe some people have heard about it. Those are a different kind of test. They're looking to see has somebody in the past, does somebody have an immune response against the virus, which would indicate that they were infected or exposed to it? So we're not talking about the antibody test. So I'll just leave it at that. They actually can look very similar to this or they can be done in a laboratory. Those are usually done from blood. And they're looking for an immune response. So that's one. Everything I'm talking about here is looking for the virus itself, not the immune response to the virus. And so you...”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“This is how they're packaged and they don't have to, you know, these are coming in individual packages, again, because they're really considered individual medical devices. You could package them in a bigger packets and stuff. You want to be careful with humidity so they all have a little one of those humidity removing things and oxygen removing things. So this is one class, these antigen tests.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Yep, yeah, this Abbott one here is in this case, instead of being put in a plastic sheath, it's just put in a cardboard thing and literally glued on. I mean, it looks like nothing. You know, it's just It looks like a simplest thing you can.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Tests. It's the technology this particular one from Abbott. This has been used for other infectious diseases like malaria and actually a number of these companies have made malaria tests that do the exact same thing. So they just co-opted the same form factor and just changed the antibody so it picks up SARS-CoV-2 instead of other infections.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“A Kepler action through this nitrocellulose membrane. And there's little antibodies on there, these little proteins that are very specific, in this case for antigens are proteins of the virus. So these are antibodies similar to the antibodies that our body makes from our immune system, but they're just printed on these lateral flow tests, and they're printed just like a little line. So then you slice these all up into individual ones. And if there's any virus on that buffer as it flows across, the antibodies grab that virus and it creates a little reaction with some colloids in here that cause it to turn dark, just like a pregnancy test. One line means negative. It means a control strip worked, and two lines mean positive, means if you get two lines, it just means you have a virus there. You're very, very likely to have virus there. And so they're super simple. It is the exact same technology as pregnancy.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“These are just injection molded, I think. They can build them at high numbers, but then they have to place them in there appropriately and all this stuff. So it is a bottleneck or somewhat of a bottleneck in manufacturing. The actual bottleneck, which the government, I think, should use the Defense Productions Act to build up, is there's a nitrocellulose membrane, a laminated membrane on this, that allows the material, the buffer with a swab mixture to flow across it. So the way these work, they're called lateral flow tests. And you take a swab, you swab the front of your nose, you dunk that swab into some buffer, and then you put a couple drops of that buffer onto the lateral flow. And just like paper, if you dip a piece of paper into a cup of water, the paper will pull the water up through capillary action. This actually works very similarly. It flows through somewhere.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“So I'd rather not see this kind of waste be out there. And there's a few companies, Quidell, is making a test called the QuickView, which is just this. They've gotten rid of all the plastic.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. So there's a few different classes of tests that I just have here, and there's more tests, there's many more different tests out in the world too. These are one class of tests. These are rapid antigen tests that are just the most bare bones paper strip tests. These are, this is the type that I want to see produced in the tens of millions every day. It's so simple. You don't even need the plastic cartridge. You can just make the paper strip and you could have a little tube like this that you just dunk the paper strip into. You don't actually need the plastic, which I'd actually prefer because if we start making tens of millions of these, this becomes a lot of waste.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Oh, yeah, this, I mean, just here I have three different companies. They all look similar. Well, this one's closed, but these are three different companies right here. This is a fourth Abbott. This is a fifth. This is a sixth. These two are a little bit different.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“So, there's ways to get the efficiency gains much better. But let's say I think that the optimal number right now that matches sort of what we can produce more or less today if we want it is 20 million a day. Right now, one company that I don't have their test here, but one company is already producing 5 million tests themselves and shipping them overseas. It's an American company based in California called Inova, and they are giving 5 million tests to the UK every day Not to the, you know, and this is just because there's no government hasn't authorized these tests.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“In the United States. So we could do it. There's other ways you can have two people in a household swab each other swab themselves rather and then mix, you know, put the swabs into the same tube and onto one test. So you can pool. So you can get a 2 or 3x gain in efficiency through pooling in the household. You could do that in schools or offices too, where everyone just uses a swab you have a there's two people like i mean even if it's just standing in line At a public testing site or something, you know, you could just say, okay, these two are the last people to test or swab themselves. They go into one thing. And if it comes back positive, then you just do each person. And it's rapid. So you can just say to the people, one of you is positive, let's test you again.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“So if we want to slow this virus and actually stop it from transmitting, achieve what I call herd effects, like vaccine herd immunity, herd effects are when you get that R value below one through preventing onward transmission. If we want to do that with these tests, we need about 20 million to 40 million of them every day. Which is not a lot.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Know all of these tests that they should be buying 20 million a day and getting them out to people's homes. This virus has cost trillions of dollars to the American people. It's closed down restaurants and stores and obviously the main streets across America have shuddered. It's killing people. It's killing our economy. It's killing lifestyles and why. This is an obvious obvious.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Why would I ever as a, you know, in our capitalistic economy and sort of infrastructure, why would I ever not sell this for $30 when insurance will pay for it or $100? It might only cost me 50 cents to make, but by pushing all of these tests through a medical pathway at the FDA, what extrudes out the other side is an expensive medical device that's erroneously expensive. It doesn't need to be inflated in cost, but the companies say, well, I'd rather make fewer of them and just sell them all for $30 apiece than make tens of millions of them, which I could do. It's a problem with our whole medical industry that we see tests only as medical devices. And what I would like to see is for the government in the same way that they bought 150 million of these from Abbott, they should be buying”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Expensive. We have the proof is right here. This one at its, you know, Abbott did not lose money on this deal. They got $750 million for selling $150 million of these at five bucks apiece. All of these tests can do the same. So anyone who says that these should be, you know, unfortunately what's happening though is the FDA is only authorizing all of these tests as medical devices. So what happens when you If I'm a medical company if I'm a test production company and I want to make this test and I go through and the FDA at the end of my authorization the FDA says okay you know you now have a medical device not a public health tool but a medical device and that affords you the ability to charge insurance companies for it”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“This is a slightly more complicated one, but you can see it's just got the exact same paper strip inside. This is really, it doesn't look like much, but it's kind of the cream of the crop in terms of these rapid tests. This is the one that the U.S. government bought, and it is doing an amazing job. It has a 99.9% sensitivity and specificity. So it's really good. And so essentially the way it works is you just use a swab. You kind of use a swab on yourself, you put the swab into these little holes here. You put some buffer on it and you close it, and a line will show up if it's positive and a line won't show up. If it's negative, it takes five, ten minutes. This whole thing, this can be made so cheap that the US government was able to buy them by $150 million of them from Abbott for $5 apiece. So anyone who says that these are...”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I mean, it's criminal. Absolutely, we can get costs. This thing right here costs less than a dollar to make with everything combined plus the swabs, maybe it costs $1.50. Could be sold for, frankly, it could be sold for $3 and still make a profit if they want to sell it for five. This one here.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“From the people in charge. And that's what's really grading on, I think, public health officials who say, no, we need the data. So they're effectively saying, if I can't have the data, I don't want the individuals. I don't want the public to have their own data either. Which is a terrible approach to a pandemic where we can't solve a public health crisis without actively engaging the public. It just doesn't work. And that's what we're trying to do right now, which is a terrible approach”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“I completely think so. And there's a lot of people who don't want to get a test today. And that's because it gets sent to a lab. It gets reported It has all this stuff. And we're a country which teaches people from the time they're babies, you know, to keep their medical data close to them. We have HIPAA, we have all these, we have immense rules and regulations to ensure the privacy of people's medical data. And then a pandemic comes around and we just assume that the average person is going to wipe all of that away and say, oh, no, I'm happy giving out not just my own medical data, but also to tell the authority as everyone who I've spent my time with so that they all get a call and are pissed at me for giving up their names. You know, so people aren't getting tested and they're definitely not giving up their contacts when it comes to contact tracing. And so for so many reasons, that approach is failing, not to even mention the delays in testing and things like that. And so this is a whole different approach, but it's an approach that empowers people and takes the power a bit away.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“I'm just so fucking pissed that these tests don't exist. Meanwhile, and everyone says, Know, oh, we couldn't make these, that we could never do it. That would be such a hard, a difficult problem. Meanwhile, the vaccine gets, we have at the same time that we could have gotten these stupid little paper strip tests out to every household. We have developed a brand new vaccine. We've gone through phase one, phase two, phase three trials, we've scaled up its production, and now we have UPS and FedEx and all the logistics in the world getting freezers out to where they need to be. We have this immense, we see when it comes to sort of medicine, you know, something you're injecting into somebody, then all of a sudden people say, oh, yes, we can. But you say, oh no, that's too simple a solution, too cheap a solution. No way could we possibly do that. It's this faulty thinking in our country, which frankly is driven by big money, big, you know, the only time when we actually think that we can do something that's maybe a”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Ivory Tower academics who want data, you know, they want to see perfection. And we have this issue of letting perfection get in the way of actually doing something at all, doing something effective. And so we keep comparing these tests, for example, to the laboratory-based PCR test. And sure, this isn't a PCR test, but this doesn't cost $100 and it doesn't take five days to get back, which means in every single scenario, this is the more effective test. And we have unfortunately a system that's not about public health. Entirely eroded any ideals of public health in our country for the biomedical complex, you know, this medical industrial complex, which overrides everything. And that's why, you know, I'm just. Can I swear on this podcast?”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“That's exactly right. I mean, it's just empowerment. But, you know, this is a problem. We have not put these into action in large part because we have a medical industry that doesn't want to see them be used. We have a political and a regulatory industry that doesn't want to see them be used. That sounds crazy. Why wouldn't they want them to be used? We have a very paternalistic approach to everything in this country. Despite this country kind of being founded on this individualistic ideal, pull yourself up from your bootstraps, all that stuff. When it comes to public health, we have a bunch of”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“All we have to do is remove, say, 30, 40% of new infections from continuing their spread. And then instead of exponential growth, you have exponential decay. So this doesn't need to be perfect. We don't have to go from 100 to zero. We just have to go and have those 100 people infect 90 and those 90 people infect 82, whatever it might be. And you do that for a few weeks, and boom, you have now gone instead of 100 to 500, you've gone from 100 to 20. Not very hard. And so the way to do that is to let people know. They're infectious. I mean, we're a perfect example right now. This morning I used these tests to make sure that I wasn't infectious. Is it perfect? No, but it reduced my odds 99%. I already was at extremely low odds because I spent my life quarantining these days.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Little paper strip tests. And if we do that and we get these into people's homes so that they can use them twice a week, then we can know if we're infectious. Is it perfect? Absolutely not. But is it near perfect? Absolutely. And so if we can say, hey, the transmission of this is for every hundred people that get infected right now, they go on to infect maybe 130 additional people. And that's exponential growth. So 100 becomes 130. A couple days later, that 130 becomes another 165 people have now been infected. And, you know, go over three weeks and 100 people become 500 people infected. Now, it doesn't take much to have those 100 people not infect 130, but infect 90.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“Credit to their loved ones and their friends and neighbors and whoever else. We could have done this. We still can. Today we could start. We have millions of these tests. These tests are simple paper strip tests. They are inside of this thing is just a little piece of paper. And I can actually open it up here. There we go. So this is how we do it right here. We have this little paper strip test. This is enough to let you know if you're infectious. With somewhere around the order of 99% sensitivity 99% specificity, you can know if you have infectious virus in you. If we can get these out to everyone's homes, build these, make ten million, 20 million, 30 million of them a day. You know, we make more bottles of Dasani water every day. We can make these”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“We use tests like these. So the only reason the virus continues spreading is because people spread it to each other. This isn't magic. And so there's a few ways to stop the virus from spreading to each other. And that is you either can vaccinate everyone and vaccinating everyone is a way to, Immunologically prevent the virus from growing inside of somebody and therefore spreading. We don't know yet, actually, if this vaccine, if any of these vaccines are going to prevent onward transmission. So that may or may not serve to be one opportunity. Certainly, I think it will decrease transmission. But the other idea that we have at our disposal now, we had it in May, we had it in June, July, August, September, October, November, and now it's December. We still have it, we still choose not to use it in this country and in much of the world. That's rapid testing. That is giving, it's empowering people to know that they are infected and giving them the opportunity to not spread.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“It takes one in the whole world, you know, and we have to not forget that this particular virus was one. It was one opportunity and it has spread across the globe and there's no reason that can't happen tomorrow anew. It's scary”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source
“You get a lot of viruses out there. And if you start applying pressure ecological pressure to this virus, that when it's that abundant, God, the opportunity for a virus to sneak around immunity, especially when all the vaccines are identical, essentially.”
2020-12-19 · Lex Fridman Podcast · #146 – Michael Mina: Rapid Testing, Viruses, and the Engineering Mindset · IDENTIFIED FROM THE TRANSCRIPT · source