Transcript Eric (00:00):Okay. Hello, this is Eric Topol and this is a rare privilege for me to interview my favorite epidemiologist, Dr. Michael Osterholm. He is the Regents Professor of the University of Minnesota. He's director of CIDRAP, which is certainly one of the leading entities around the world for public health. And, we've been friends for the last few years, which we'll we'll talk about. So, welcome Michael. Such a great privilege to have you today.Michael (00:31):Well, thank you, the honor, really is mine. As I have shared with you and others know very well--you have been a real mentor to me and many others during this pandemic. And, I could never repay you adequately for all that you've helped teach me throughout these last three years. It's been immeasurable.Eric (00:49):No, if you're too kind, I think it's much different. The opposite way. I've learned so much from you because this isn't my area, as you well know. I thought we'd start with, of course, right now things are relatively good for the pandemic in the United States and mostly around the world, with relatively less cases, less hospitalizations and deaths. But obviously still people are getting infected. And maybe you can tell us about the recent case that you went through that would be enlightening.End of the Pandemic?Michael (01:28):Yeah, I think we're all trying to understand when the pandemic ends. And, as we've discussed many times before, we'll probably know that about a year after it ends, then we'll say, yep, that was the end of it. Don’t for a moment think that at the end means that there won't be cases. You know, for every infectious agent that we think of when causing a pandemic, they still come back, whether it be influenza, or potentially coronaviruses. They will, they will continue to circulate. It's a matter of how many cases occur, how many people die. And I think that's an important point. There isn't really a definition for when a pandemic ends. It's, I guess it's just when you feel like it's over. And clearly the world has come to that conclusion already. You don't need a, an epidemiologist or a politician to tell 'em that the pandemic's over that they feel that we're still seeing about 165 deaths a day in this country from Covid.(02:24):So it's hardly gone away completely. But we do have to acknowledge it. Most of those deaths are older individuals, people who have not been vaccinated recently with bivalent boosters. And in that regard, we could surely even reduce the illnesses further. I don't have any faith right now in the surveillance systems that have been set up to look at cases around the world. We've pretty much dismantled that. We are not testing people that we results in reports being made to public health agencies, whether in this country or anywhere else in the world. So I really look at two other things. One is deaths. And even they're realizing that still is a challenge in terms of how complete death reporting is due to covid. But then the other thing we're looking at, which has been really, you might say, public health revolution during the pandemic, and I say revolution cause it's really changed things.(03:19):And that is the issue of wastewater surveillance. And we've been able to ascertain in many areas of the world, in fact, with using wastewater surveillance, a much better sense of how much virus is in the community. And so, just in following with your very thoughtful comment about case numbers dropping, that's exactly what we're seeing in most locations in this country too. We, for example, here in the Minneapolis St. Paul area, have seen a dramatic decrease in wastewater activity in the last two months. So I think we're in a place right now where I can hope it'll only get better. On the other hand, you know, I have a lot of respect for this virus, and frankly, we all ought to have a lot of humility. We don't know if another variant will emerge that with, given how much immunity we have in our population will some