Corey Dion Lewis (00:00.817)
Hello everybody. Thank you for listening to the Healthy Project podcast. I am your host, Corey DeAnne Lewis. Today I have no stranger to the Healthy Project podcast, someone that I've just been admiring all the work he'd been doing in this area. Really, really great information online and just some great, just great work in general.

I have Dr. John White, Chief Medical Officer of WebMD. Dr. White, thank you so much for being with me today. I really appreciate it.

John (00:31.978)
Thank you, Cori. As I said before we started, I was excited to get the invitation from you. So it's a mutual admiration society. I admire all the work that you've been doing in this space as well.

Corey Dion Lewis (00:42.337)
Awesome. I appreciate that. So, you know, I really wanted to talk to you because, you in the beginning, you know, 2020, you had a great video series. I don't know if it was just a video series or if it was a podcast as well. I remember seeing it as a video series with coronavirus in context. Am I saying that correctly?

John (00:57.994)
Yes, that's right.

John (01:03.786)
That's exactly right. Interviewed over 400 guests over almost a two year period. And the first like 250 were year one.

Corey Dion Lewis (01:08.593)
Jeez.

Corey Dion Lewis (01:13.041)
Yeah, and it was just some really good information because a lot of people didn't know what was going on. And it was a great resource to kind of understand what was going on at that time. And then I had you want to talk about how to manage that during the holidays. But now it's been some time since then. And I'm sure you maybe kind of feel this people are kind of like COVID. What's COVID? What happened? Like what? Like it just kind of went.

John (01:19.132)
Yeah.

John (01:28.49)
Yeah. Mm -hmm.

Corey Dion Lewis (01:41.841)
kind of back to normal, I guess, in a lot of people's minds. So, you know, I would love to get your thoughts on, you know, kind of where in your mind, where COVID, where the coronavirus, where that is now in 2024.

John (01:43.474)
Mm -hmm.

John (01:54.952)
Mm -hmm.

John (01:59.306)
You're exactly right. And somehow I feel there was kind of this shift in people's thinking. We're early on. And that's why we were doing four or five interviews a day, just trying to get people the best information that we had at that time. Now, what we've learned is sometimes that information was not as accurate as we might have liked, right? Science changes. It was a rapidly evolving science. And some people got it wrong.

upset about, oh, first you said, don't wear masks. Then you said, do wear.

you know, how much safety is there in terms of data around the vaccine. So people started to lose trust in some.

she was very well respected. And then by the end, people were questioning what his motivations were. So that's...

Corey Dion Lewis (02:52.079)
Mm -hmm.

John (03:02.794)
Now, the good news is that people often aren't as serious in terms of the infection, that they don't have to be hospitalized. We still see some of that, particularly with elderly population and immunocompromised, but it's still no walk in the park. People don't feel great. It can have an impact on your lives. And it's still something that people have to be aware of.

Corey Dion Lewis (03:03.025)
Wow.

John (03:29.802)
And I think we're recognizing the change. The CDC revised their guidelines about the quarantine period because we do kind of have this baseline immunity now in the community, which people have to remember we did not have four years ago. We didn't. And people were dying. Sometimes people forget about that. The number of deaths that we were seeing on a daily basis was frightening. And many of the steps that we took then really helped alleviate.

Corey Dion Lewis (03:44.559)
Right.

John (03:59.85)
the burden in terms of the number of people that had to come to the ER and be treated.

Corey Dion Lewis (04:06.033)
Yeah, time, you almost forget, you do, you forget how it was. And like you said, you're still seeing people that are being affected by this. Are there any other significant changes or updates around COVID -19 that the public should be aware of?

John (04:27.498)
And I've heard people say it's like COVID time. It seems like one year seems like it was four years ago. But I think the biggest change is...

Corey Dion Lewis (04:30.513)
Yeah

Corey Dion Lewis (04:35.025)
Oh, okay.

John (04:42.026)
after you get infected and when you start to feel better.

John (04:48.106)
are symptom -free and fever -free, or at least symptoms are improving, and you're not on fever -lowering medications. But the other recognition is the impact.

people's health, that's not something that we knew about early on and there's still people suffering from that. It's still the impact on immunocompromised individuals. But, you know, I would argue is it's been a success story in terms of science responding to an emergency and the public health officials really stepping up to the plate and being heroes and have doctors.

Corey Dion Lewis (05:22.169)
Mmm.

John (05:29.322)
Remember, it does seem so long ago. Doctors and nurses went in to the hospital every day at a time when we didn't have vaccine, we didn't have Paxilovid, we didn't have treatments, we didn't have masks, and then in the quantity that we needed in terms of protective devices. So there's many aspects to celebrate from what we've learned from COVID. But people should still be aware of it, not scared, but be aware.

Corey Dion Lewis (05:36.177)
BAM.

Corey Dion Lewis (05:57.329)
Right. Right. Are there, how has your approach changed to the treatment around COVID -19?

John (06:08.586)
I find there is good dialogue with patients. So early on, there was a small subset of population that you really had to convince to get vaccinated. But in general, they didn't typically come to the doctor's office to talk about things if they didn't want to get vaccinated. And if they were already having COVID, they're not going to get vaccinated at that time. I think now what we've seen is in terms of the recent COVID vaccine and previously the boosters, there's not much uptake. People are not as concerned about it.

They're not sure about continuing to get more and more shots. And it's really a discussion with patients that I welcome of what's the risk and benefit for them. And that's a great opportunity to talk about your personal risk. But then when it talks to respiratory viruses, it's great to talk about who's around you. Do you take care of young children? A lot of people live with elderly parents.

Corey Dion Lewis (07:03.601)
Mm.

John (07:08.498)
who are the people around you that you still have to be mindful of in terms of your decisions could impact someone else. So it's great to have those discussions with patients. And we're always pressed for time, but I welcome those conversations. And we have to have those conversations. It's really becoming a little bit like flu vaccine, whether or not you get vaccinated.

Corey Dion Lewis (07:17.369)
Right.

Corey Dion Lewis (07:28.209)
Right. And you brought up children, which I know within my circles, that's a hot debate around getting the topic of vaccination for COVID -19 and children. What is the current stance of medical professionals on this when it comes to children and vaccination for COVID?

John (07:35.338)
Mm -hmm.

John (07:48.394)
Yeah. Right. And I'm not a pediatrician. I'm an internist. I only treat adults, but I do have children. And I think early on, a lot of parents certainly did that first series of two shots. Remember, that's what we used to talk about, to be considered fully vaccinated. But then recognizing that COVID doesn't impact as many children as other age groups in terms of that these

Corey Dion Lewis (08:05.135)
Mm -hmm.

John (08:18.41)
were new mechanisms of vaccination, the MRA vaccines, although it wasn't a new technology, and that parents had concerns, rightfully so, and had to make individual decisions based on their family, whether or not they wanted to continue to vaccinate their children. And I think that's still the discussion now. I mean, certainly, if kids are immunocompromised, that's a different story. That's for lots of diseases, not just.

for COVID. But I also think, Corey, what we've seen is, think about what happened a year ago with RSV. We're not talking COVID, just other viruses. Think about those years where we've had bad flu seasons. So the principles that we have to talk about as it relates to COVID impacts other respiratory viruses as well.

Corey Dion Lewis (09:00.207)
Right.

Corey Dion Lewis (09:12.177)
Right. No, that makes a lot of sense. Something that I kind of saw when I was looking before we had our conversation today was the vaccine accessibility and cost. That kind of came up in some of my research around that. And that's something where I have the privilege to not really worry about. I have great insurance. When I get the email, hey, it's time for your vaccine. I just go, copay, boom, done.

But do you feel like there is a lot of concern for people out there and what are some of your thoughts around the accessibility and maybe the affordability of the vaccine?

John (09:54.442)
I think it's a real issue. Remember, early on, we said the government would cover it. Absolutely. Then it became, well, your insurance should cover it. And then government insurance would kick in if you could. And then they could charge an administration fee if they needed to. So luckily that today, still with COVID vaccination, it's covered by insurance, almost all of them. And then,

Corey Dion Lewis (10:07.599)
Right.

John (10:23.882)
if you're not sure there's mechanisms to cover it. But it shouldn't be this hard, Corey. And I'm not sure if that's going to persist over time. I mean, luckily, in terms of vaccinations in general for school -aged kids, there's lots of opportunities at schools to qualify, even if you can't afford them the opportunity. Because we know that we should be protecting our children.

on. So affordability as it relates to vaccinations can be a challenge.

Corey Dion Lewis (10:55.985)
Absolutely. I want to kind of go back a little bit because, and I would love to understand your thoughts or hear your thoughts on this. Whenever I have conversations or again, researching about COVID, some of the same, I would say talking points come up from back in 2020, 2021. And it's like, well, you said it very clear. We have...

John (11:03.53)
Yeah.

Corey Dion Lewis (11:23.217)
We have all the research. Yes, there were some times where as you're going through research, things change, right? That stuff kind of happens. Are you still hearing some of the same kind of misconceptions around COVID -19 now that you were hearing back in 2020?

John (11:44.004)
Honestly, Corey, I'm glad you bring this up because I think many of these misconceptions are starting to reemerge. So let's look at even several months ago where we start to see some instances of young athletes having a heart issue. You could not look on social media and not see someone saying something, oh, I wonder if he had been vaccinated for COVID.

thinking that it's the COVID vaccine, because there was an incidence of myocarditis, completely different medical condition than what some of these athletes were experiencing. And if you actually look at the data, we see decrease in instances of heart issues in young athletes. But people didn't want to be bothered by the data. I kid you not, a friend of mine not in the medical field said to me two weeks ago, he's like, I heard.

Corey Dion Lewis (12:10.543)
Yep.

John (12:38.236)
There's a lot more heart issues nowadays going on from the COVID vaccine. And I had written a book on heart disease, and it recently came out. So he asked me if that was in the book. And I said to him, no, that's not what we're seeing. There's no data. And he meant it like, oh, like, you know, I was like, no, that's not what we're seeing. And then a lot of discussion of people are saying, well, you were wrong about masks. You were wrong about this. And part of the challenge is, remember, back at that time,

Corey Dion Lewis (12:49.649)
Hehehehehe

You

John (13:08.062)
we were trying to keep people safe. And some of the assessment of science in terms of early on has changed. And that doesn't mean that people had mal intent. That just means based on the evidence that they had at the time, they made the best decision. And that's often what we see with science. And unfortunately, I think it's led to still a lot of

conspiracy theories that are out there, the concern that, you know, COVID vaccine causes COVID or these other issues. So it remains a challenge and it goes to the broader concept query where we really now have a distrust of science, a distrust of CDC, a distrust of FDA, which I would argue in some ways has grown.

not decreased. And that's where there was this change at some point during the pandemic that I think people were tired of it and wanted to be enough's enough. And it's just some of the decisions may not have been the best when we look in hindsight, but remember what we were dealing with at the time.

Corey Dion Lewis (14:25.041)
Right. And I feel like too, and this is just my own personal opinion, but there have been so many things that were done right. But unfortunately, those aren't the things that we see on social media.

John (14:28.298)
Mm -hmm.

John (14:41.866)
and the way they're communicated. Corey, look at what we're seeing in terms of measles and how we're having a resurgence of measles. And we're having outbreak of measles. There was just an article recently about how other people were infected from an unvaccinated child that came into the emergency room. So you're exposing other people to harm. And to think that somehow the vaccines for measles don't work, we have an extensive.

Corey Dion Lewis (14:43.821)
Yes.

John (15:11.12)
extensive body of evidence to support that. And I wish we had better dialogue. Sometimes, Corey, I think doctors talk down to patients. And we saw that during the pandemic, that somehow if you don't get vaccinated, you're not educated, you're not smart, or you're being ridiculous. And that was the wrong way to approach it. It was to talk about their concerns, to understand their concerns. And maybe that's why

Corey Dion Lewis (15:11.217)
Right.

John (15:40.298)
is the decision that they made that day, but maybe you could revisit it later. And everyone was rushed for time and everything and still in the doctor's office. And sometimes I think if people don't agree with us, then it's automatically confrontation on either side. And we really have to say, well, let's look at some of this information. For me,

Corey Dion Lewis (15:56.593)
Hmm.

John (16:02.25)
I worked at FDA. As you know, I looked at the advisory committee. It was all online. I looked at the data. Not that I necessarily understood all of it, but I was willing to look at the numbers. I was willing to look at the outcomes. And I wish more people did that rather than listen to some influencers who didn't have all the details. But there really is kind of this under thing like, oh, I wonder if that was from COVID.

Corey Dion Lewis (16:24.217)
Mmm.

John (16:28.362)
Or people are saying there's more cancer cases. I wonder if that's from COVID. Yes, because people didn't go get screened. That was the reason. And any increase I find in cancer rates or other diseases, people are like, that's because of COVID. Someone said to me the other day, a patient, he said that he was having more gas. And he was, I have young children, so I'll say tooting a lot. And I kid you not, he said to me, maybe that's from COVID.

Corey Dion Lewis (16:35.057)
Right.

Corey Dion Lewis (16:52.913)
Hehehehehe

Oh my god.

John (16:57.34)
the vaccine. And I'm like, okay, first of all, you were vaccinated a while back. Like, I don't think that's it. Like, I think it could be your diet. I think it could be other things. But that's what we're seeing, Corey, more and more of that. And he probably read it somewhere. But everything is attributed now, you know, to the vaccine, instead of thinking that it has kept many people alive.

Corey Dion Lewis (17:02.065)
I'm

Corey Dion Lewis (17:15.375)
Oh my gosh.

Corey Dion Lewis (17:20.753)
Right, right. And that's where I was going that there was so many things that were great and there were so many lives that were saved. But unfortunately, if you were to go onto TikTok or insert social media platform, you weren't seeing a lot of those stories of like how it was helpful, how it helped a family or whatever the story may be.

John (17:32.234)
Yeah.

John (17:37.994)
now.

John (17:44.97)
And remember, at the beginning, people were clamoring for it. Remember, at first, we only did health care officials. And there were stories about people impersonating health care officials to get vaccinated. And people had to wait in long lines. And think about how many of those people did well because of the vaccine. And we can't forget that. I think, unfortunately, sometimes,

our government agencies, our scientific agencies, public health agencies, aren't always the best communicators because they want to parse everything so carefully, use a parlance, a language that most people don't use or understand and then think, well, they're just going to do it because CDC said it or FDA said it. That's not how it is anymore. You really have to have that

Corey Dion Lewis (18:27.569)
Hmm.

John (18:39.786)
effective communication that is culturally sensitive, that addresses the concerns of people and not to be dismissive of it. And then also to be out there promoting the right messaging rather than letting the conspiracy theorists dominate the airwaves and social platforms.

Corey Dion Lewis (18:50.129)
No.

Corey Dion Lewis (19:01.169)
Yeah, you make a very good point, Dr. White. I think people more now today, they want to be advocates for their health care, and they're just not going to automatically take what the provider says as Bible. You know what mean? They're going to ask questions, and they're going to do some of that. And if they don't understand it, sometimes, not all times, but sometimes they may take that as, oh, I don't believe them, because they don't even know what the doctors are really trying to say.

John (19:08.234)
Yes.

John (19:14.792)
Mm -hmm.

John (19:21.258)
Mm -hmm.

John (19:25.546)
Yeah, that's right. And the challenge now of the social algorithms are it's going to feed you up what you've already been getting. So that's the problem. Because then when you look on your social feeds, it's going to be other people that also might have those conspiracy theories or also that are searching all these deaths are relating from the COVID vaccine. And that's the challenge with some of these algorithms.

Corey Dion Lewis (19:55.089)
Exactly. I can't say anymore. That's the truth. I want to be mindful of your time, Dr. White. But what I want to finish with is, you know, it's been a little over four years. Where do you see, what's the future regarding COVID -19? Is it going to be where people see it just as the flu? Are there any promising developments? What's your opinion on that?

John (20:00.906)
Sure.

John (20:20.97)
I think we're going to see it kind of lumped together with respiratory viruses in general. And I think that's what we see with the current recommendations about quarantine. So how you manage COVID is going to be the same in some ways as influenza or RSV or other respiratory virus. So I think we're still going to be talking about the importance of hand washing. I think there is a baseline endemic.

amount of COVID in the community, so there is some baseline protection, but I think variants are going to continue to change. So I do think we'll still see this probably annual booster or flu or booster vaccine as we do with the flu vaccine. It might not be a booster because technically the booster refers to a certain way that it's formulated as opposed to addressing the new variants. So I think COVID is going to be around for a while.

but it's not going to have the scourge on society that it had for many years, and that's a good thing. But we're still going to be talking about it, and people are still going to get it and be aware of it, but they're not going to be scared of it. It's not going to be treated as an outlier. It's going to be treated as these other respiratory viruses. And I actually think that can be a good thing, Cory. So it's not being, you know,

it out, right? So there's people that don't like to get the flu vaccine, that don't believe in the flu vaccine, that have misconceptions about the flu vaccine. I think it's going to be the same as COVID, but what we're trying to do is minimize deaths from flu and people die from flu, particularly the elderly. We're going to try to minimize deaths from COVID in the future. And I think the issue will be, how do we continue to get effective therapies? There's plus and minus on Paxlovid as it relates to rebound.

And I think we have to continue to explore how do we treat COVID and other respiratory viruses. And I think the longer discussion, no pun intended, is going to be around long COVID and what we're seeing from there.

John (22:33.802)
you know.

Corey Dion Lewis (22:36.785)
Yeah, can you, I know that was my last question, but long COVID, what, um, what are some of the things that people are experiencing from long COVID? And I personally know one person who has experienced that or they hadn't been able to taste for almost a year.

John (22:39.434)
Sure.

John (22:51.79)
Yeah, you know, there's the aspect of taste and hopefully for most people that taste will come back. But as your friend probably told you, it really is a horrible feeling and it impacts their quality of life not to be able to taste. Someone said they knew they were getting better when they could smell coffee again. So I thought that was a good sign too. But part of it is breathing. A lot of people who never had problems breathing might have a persistent

Corey Dion Lewis (23:02.769)
Yeah.

Corey Dion Lewis (23:10.193)
Yeah.

John (23:19.914)
they continuously get short of breath and they don't have asthma, they don't have COPD, but they have some damage to their lungs that's making it harder for them to have their normal breathing and their right oxygenation. But it's also this brain fog that people talk about, how it's impacting their cognition, impacting their ability to be in the moment. You know, one patient said to me, it's kind of like a menopause.

and their body and they're continuing to...

John (23:58.794)
biomarkers, that's kind of the common thing that we look for nowadays in labs and you know we don't necessarily have the best treatments yet so NIH is...

and hopefully we'll be able to provide people with some relief soon.

Corey Dion Lewis (24:14.161)
Right. That's great. So there is kind of light at the end of the tunnel, maybe, like for some people. Awesome. Well, again, Dr. White, thank you so much for your time and for your insights on this. For those that are listening or watching that want to connect with you and see all the things that you're doing, where can they connect with you at?

John (24:19.562)
I hope. Sure.

John (24:37.342)
Sure, they can always find me at WebMD and all my social handles are my name, Dr. John White.

Corey Dion Lewis (24:46.193)
Awesome. Again, Dr. White, thank you so much for being here and everybody. Thank you for listening to the Healthy Project podcast. I'll holler you next time.