More COVID Disruptions, Government Internet Carve-Ups, and Friend of Pivot, Dr. Vivek Murthy

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Hi, everyone.

This is Pivot from the Vox Media Podcast Network.

I'm Kara Swisher.

And I'm Scott Galloway.

Oh, you're so calm this morning.

What's going on?

I'm feeling mellow.

What?

I'm feeling mellow.

I took a sleeping pill last night.

I took Lunesto, which is, I used to take Ambien, which is like being hit by a sledgehammer.

Yeah.

I used to, when

my mom, I used to talk to my mom every Sunday nights.

And when I say talk to her, I was mostly getting talked out.

Yeah.

So I would put on headphones and I would take an ambien and I'd wake up nine hours later and I would look at my phone and see that we had talked for a good hour and a half.

And she wouldn't even notice that I'd been asleep for 87 hours.

Oh my God, that is a sad story.

And then once, you know what?

It made her happy.

As long as she just knew that I was on the other end, that's all she needed.

Okay.

And then once I was going from London to New York, and I took an ambient to, I'm sorry, New York to London overnight.

I took an ambient because I'm like, okay, I got to get some sleep.

It's a red eye.

I got to hit the ground running.

And they said, all right, I take it and like, planes, you know, we're boarding in five minutes.

So I pop the ambient and then I'm like, okay, plane.

We're going to have to delay this boarding for 30 minutes.

And I woke up five hours later in the terminal and no one was there.

And I'd missed my plane.

So I was.

She went to Lucky once.

Not the same thing.

She was on the plane.

Yeah, she was on the plane.

She took an ambient and then they had to carry her out essentially.

So I downgraded to Lunesta, which is like Diet Coke.

It just kind of pushes me over the edge.

Anyways, but I feel a little, I feel a little slow this morning.

And contemplative.

Yes.

Oh, really?

You just came back from South by Southwest, correct?

Yeah, South by Southwest.

S by SW 2022 NFT.

I thought it was a naming party for Elon's new child.

A lot of numbers.

A lot of acronyms.

Putin, did you see his tweet?

He's going to beat up Putin.

Yeah.

Yeah, that's helpful.

No, that's a productive tweet.

That's helpful.

That's not a function of narcissism.

No,

that's a helpful diplomatic communication from a thoughtful leader who commands the space he occupies.

What if Putin took him up on it?

Oh, God.

I don't know.

Pay-per-view goes crazy.

I mean, that's literally the world we're headed towards.

Yeah.

Yeah.

I don't know.

Where there's battle bots, things like that.

But how is Texas?

How was how is that?

This This is the first year it's back.

Remember when we were going to go that year, the first 2020, and then we didn't.

We were going to have our whole grand entrance thing.

Big thing.

Yeah.

Yeah.

It was really nice.

I like the people by South by.

I got to know them a little bit.

And it's a hopeful event.

And it's a little bit, I love Austin.

You know, it's sort of, you know, I enjoy Texas.

I always have a great time.

The people are super friendly.

And my talk went well.

I had about 2,000 people show up, which was exciting.

It It was probably the fourth or fifth talk I've done live in two years.

It felt great to be in the company of other people.

And

CNN Plus had a big house there.

That was fun.

I was,

every time I go to Texas, I have a great time, and especially Austin.

There are laws against gays and trans women.

But okay, go ahead.

There's that.

But the

barbecue is amazing.

I'm going to say, as someone who's from South Florida, I think Austin is a very very progressive, wonderful city.

I love it.

100%.

Did you have barbecue?

I pushed, you know, one of your compatriots at CNN, Poppy Harlow, I told her where to go to get barbecue.

Poppy.

Poppy.

Did you see her?

Did you see Poppy?

Yeah, Poppy.

Good.

Well, I'm glad you had a good time.

I can't believe I missed it.

As you know, as I've told you, I have a Hall of Fame pass that gets me into everything.

Well, of course you do.

I do, I'm a family.

I have a Hall of Fame.

We'll smell you.

Wow.

A Hall of Fame pass.

I do.

I have it.

It's very heavy.

It's very heavy.

I was put into the South by Southwest Hall of Fame by the previous owners.

They have new owners now.

I'm sure they're going to try to reneg on their things.

But

I was given a badge that is very heavy and I can wear it.

It gets me into everything.

Well, I reach level five on Zelda.

Okay.

All right, Lunesta.

And my youngest son, for my birthday, named me General Consulate of Australia because I always joke about it.

So I have a big banner.

No, really?

That's very nice.

Very nice.

Well, I'm sorry I wasn't there, but not really.

They have new owners of South by Southwest, by the way.

Anyway, today we'll talk about China, Russia, the U.S.

carving up the internet.

We'll also see what China's new lockdowns mean for global supply chain.

And we'll speak to Surgeon General Dr.

Vivek Murthy about misinformation and loneliness.

But first, another Disney update from Florida CEO Bob Chapik, Bob II, as I like to call him, said the company would pause all political donations in the state.

This, of course, comes after the company faced criticism, including from its own employees, for not initially speaking out about the don't say gay bill.

Chapic now says the company will increase donations to advocacy groups.

The Republicans are saying Disney's are making hay of the idea that Disney's trying to push them around, which, of course, Disney does push them around constantly.

Too little, too late.

What do you think?

Yeah, I think it's become a bit of a meme.

I think he screwed up.

I think he recognized he screwed up and is trying to do the right thing.

I think he should be commended from that.

Commended for that.

Also, we have a tendency, this stuff makes for good headlines, but no one's going to decide they're not going to Disneyland.

I don't think.

People talk a big game, but at the end of the day,

if they want to go to Miami Beach or they want to go to Disneyland, they're not going to not go because of this.

And they're not going to not go to Disneyland because Bob kind of got it wrong for a couple weeks.

So

I'd say yes on the second one, no on the first one.

I don't care.

Well, you're evidence of that as evidenced by the fact that the mayor of Miami is now writing letters back to you saying, please come back to Miami, please, baby, come back.

I mean, literally, all these people are like, we miss you.

That was a lovely letter by Mayor Cava, but go ahead.

In some, he screwed up.

He apologized.

He got it right.

Now, next.

I don't know.

Next.

Yeah.

Yeah.

He said quite a few, though.

I think he's got to really think hard before he does things in a lot of ways.

I know he's trying to carve out his own image from Bob One, Bob Iger, but, you know, the Scarlet Joe Hansen thing wasn't great.

That sticks in your craw.

You like like Scarlett.

It does.

I love Scarlet.

Not just that.

It's like Halent is the only thing that matters for that company.

I'm sorry.

It's not their fantastic technology.

It's nothing else.

I think it's what's the, what was the point of that?

And I usually don't take Hollywood's side.

When they were all complaining about streaming, I was go, I was like, suck it up, people.

But in that case, it seemed kind of like silly to do.

Let's talk about happy people.

Pete Davidson is having the year of his life.

He's going to fly into space with Blue Origin.

He's been dating Kim Kardashian.

Of course, he's dated a lot of very lovely ladies.

And he's going to go into space.

And of course, Kanye is trying to kill him, but, or seems allegedly.

But really kind of interesting to put him up into space.

And he's funny.

And he's fun.

It's great.

Whatever.

I couldn't even read this thing.

I'm like, this is not one of these things.

It's like how we're descending into hell.

You talk about Pete Davidson.

I think he's funny.

I hope he's happy dating Kim Kardashian.

Yeah.

Anyways, what's going on there?

He's going into space.

Great.

He's dating a lot of people.

Oh, my God.

The Lunesta is taking.

All right, let me try this one.

Dolly Parton told the Rock and Roll Hall of Fame that she's not worthy.

She removed herself for inclusion in the Hall of Fame, saying she's worried she would split the votes.

How about that?

Will that make you feel better?

You know what?

I think Dolly,

there are just some people who keep getting it right and who embody America.

Incredible talent.

You know, a coal miner's daughter.

Wait, that was the other one.

The other Timmy.

Yeah, that's Loretta Lynn.

Nonetheless, from, she's from Tennessee.

Fairly humble beginnings.

Beginnings, yes.

Just incredibly talented.

I just, and oh, by the way, played a role in developing the vaccines because she's very, very philanthropic.

And she's always, she's never, I don't think she's ever made a personal attack in her life.

She's never been caught up in any of this Hollywood bullshit.

I just, yeah.

Dolly Parton is,

you know, if there's, you have a list of sort of a couple dozen Americans that you'd like to say to aliens, you know, this is kind of what we, this is how we roll.

You'd want Dolly Parton out in front.

I think she's a really impressive and

she always says the right thing.

That's correct.

A lot of people could take their cue, everybody, including Elon tweeting about this thing.

It's funny in any other situation, except for these people dying, these continual stories.

It's such a ha-ha, jackass culture.

It really does feel wrong.

I mean, there are thousands of U.S.

diplomats who are working behind the scenes.

There are thousands of charities actually trying to get people food and, you know, toys.

I even saw this wonderful video of this guy in Poland who dressed up as a dinosaur and was passing out crayon books.

There are so many millions of points of light on a little, on a small level.

And then you have people who decide to create a sideshow, the wealthiest man in the world, saying, I challenge him to combat.

And by the way, I actually don't think, I think that's hurtful.

I think these guys are such fucking macho narcissist weirdos.

I think it makes likely Putin less likely to want to.

that's just not going to help, Elon.

And by the way, I want to acknowledge creating an infrastructure around his brilliant technology and brilliant mind around hooking up Starlink, that does help.

That does help.

But then you do something like this.

Yeah, this is typical.

This is, it seems typical to me.

It doesn't help.

And I especially,

I usually am like, oh, whatever on this.

But when I read about that, there was a picture of a woman who's pregnant who was bleeding on a stretcher

pulling out of that hospital.

She has died and so has her baby.

And you don't want to like bum the whole world out, but it's serious.

It's serious what's happening there and around lots of conflict zones.

And I don't want you to like wallow in feeling bad, but at some point, it's like, it's not funny.

Not funny.

Not funny.

Yeah,

this is serious shit.

And it's at some point, and I've said this over and over, your inner child has to grow an outer man.

Yeah.

And, you know, just because you can and you can say something and it feels good doesn't mean you should.

Yeah.

Yeah.

Anyways, Anyways.

There is an ugliness to the humor.

There really is an ugliness to the humor.

Ian Bremer, who I'm just an enormous fan of, kind of summarized it.

He said, world's wealthiest dude pretends he can't help being an asshole because it comes so naturally.

That just sort of sums it up, in my view.

Yeah.

Anyways, the great Ian Bremer.

It's tasteless is what it is.

Anyway, let's go to our first big story.

Governments continue to carve up the global internet.

TikTok will reportedly store American user data with Oracle and keep it out of the hands of the Chinese parent government, ByteDance.

Oracle was, of course, involved in possibly

buying the company at one point during the Trump administration.

But China seems worried about its own data security.

Last week, it denied the rideshare app Didi permission to list on the Hong Kong Stock Exchange.

The Chinese regulators said Didi wasn't doing enough to protect user data.

Didi's stock dropped 44% on Friday after the news broke.

This bite dance issue has not been paid attention to.

Obviously, China's a big global player

from a digital point of view, and people have been focusing on Russia and Russia misinformation, etc.

And so Byte Dance TikTok's a very popular app.

I just recently interviewed Ann Neuberger, who's one of the big cybersecurity officials in the Biden administration.

And I think worries about China are very high,

even though the focus right now is on Russia.

So, you know,

it's going to be an interesting situation.

What think you of the Chinese threat?

Well, I interviewed Francis Halligan for my CNN Plus show yesterday, and we were talking about how the algorithms are trained to basically try and capture people's attention.

And sometimes the algorithms take the content that's most novel, and oftentimes very novel content is misinformation, and give it more oxygen than it deserves.

And that's bad.

What would be worse is if we find out there's anything resembling a tweak to the algorithm on TikTok that perhaps made it easy for American teen youth to not trust their government as much.

The moment that happens, TikTok is over, any evidence of it.

So what TikTok is doing right now is smart.

And that is the difference between TikTok being a great tech company that never was and one of the five most valuable companies in the world

is their ability to erect I won't call it a Chinese wall, but a Western wall that says this is a company with large Chinese shareholders.

But be clear, the data and the algorithm are totally impenetrable, are totally off limits from Chinese, from the CCP.

If they can erect that

wall, that Western wall, this will be one of the five most valuable companies in the world.

Yeah, it leads it up to IPO.

I mean,

that sent them up.

You know, they're talking with the Committee on Foreign Investment in the United States.

This did start during the Trump administration.

There were all kinds of ideas of Oracle.

Trump had the right-leaning thing to do here, but of course he was talking about a VIG and he screwed with Oracle and Microsoft, et cetera.

And so they've been in longgoing talks with

the Committee on Foreign Investment, which does vet all this stuff.

And so this would not allow the Chinese owners to access it.

And data sovereignty is a really important issue, especially around this kind of data.

President Trump had an executive order where he

would have banned TikTok.

That didn't, it just fell away essentially.

But this is trying to come to a deal.

It was going to do a deal with Oracle and Walmart.

Then it was going to be Microsoft.

So here, this is sort of an ending to this.

And let me read from Dan Primack.

If the agreement with the Committee on Foreign Investment is indeed reached, TikTok would then need to transfer physical control of its U.S.

data to Oracle's clouds.

There would need to be a system created whereby Oracle could provide national security assurances to government agencies.

Once completed, all this could set up TikTok for an IPO.

Very successful company.

I think they have to do this if they want that to happen.

The question is whether the Chinese government will allow it.

Yeah,

this is the difference between a company that might produce a lot of cash flow, but never recognizes tens of billions and a company that could be worth half a trillion dollars.

So I would also, I would go one step further.

I would hire a very credible Western leader to lead the company that has, that has there is one leading the U.S.

company, Vanessa Papas.

I'm saying someone to run the entire thing that comes across as almost sort of bulletproof in terms of American values and someone you can trust.

Although it's a Chinese company.

It's not really yeah, but it's Chinese shareholders.

And what we're finding out is that money is an addictive substance.

And I think that the, I mean, this is where I think the tension is.

I think the Chinese shareholders are totally down with the CCP CCP not being involved in any way because they see an opportunity to become billionaires and then move the fuck out of China.

We find that Western democracies and ideals in super cool, fun restaurants where you can dance on tables or Italian shipyards and make beautiful yachts or when you can go to Nobo in London or you can party like a rock star in Las Vegas.

That billionaires really like this was just your last month's schedule, but go ahead.

Keep going.

You want to roll with a dog in Vegas.

I have so much fun with you.

I don't.

No, I do not.

Not at all.

I'd like to just watch TV at home, but go ahead.

The creative class and freedom attracts money from everywhere.

And these countries where they basically, I don't want to say soak the middle class, but they have incredible infrastructures.

They develop economies.

Russia, not as much.

It's mostly around natural resource, but China's manufacturing economy and innovation is just remarkable.

And then the people that are able to aggregate the most wealth, the first thing they want to do is get the fuck out.

Yeah.

So so I would bet the people who own TikTok are like, you know, I really like the idea of having a fat pad in Soho and partying in St.

Bart's and the way I get there.

And if the CCP doesn't have the ability to manipulate these algorithms, I'm down with that.

Yeah.

So we'll see.

We'll see if the government, I've been told the government is quite firm.

But speaking of it more serious situation, actually, this will probably be sorted out in some way.

Russia has now banned Instagram in addition to Facebook.

There's a story about all the Instagram influencers in Russia putting up their final final goodbyes to people.

This is actually a big deal within Russia because it's so popular there.

Russian legislators reportedly angry with Facebook policy change that allowed Ukrainian users to wish death upon Russians only in a figuratively.

I will add in a story by Kurt Wagner, who used to work for me, actually, works for Bloomberg now.

His Facebook parent Meta Platforms clarified on Sunday that it is against the company's users' rules to share a post that, quote, calls for the death of a head of state, likely a reference to Russian President Vladimir Putin.

I think that's probably reasonable.

Meanwhile, YouTube has banned banned all Russian state-backed media and is removing videos.

This is a big deal.

They've sort of been declared terrorists, I think, Facebook, under these new rules.

And it's a very fine line.

I got to say, Nick Clegg is going out on a limb, which he should be out on, but

what he's doing is correct.

President Zelensky praised Meta over the weekend saying they stand side by side with Ukrainians, with the Ukrainians.

Facebook also reviews its policy to allow praise of a controversial Ukrainian battalion.

But it seems to be going straight at Russia and Russia is going straight at Facebook.

And there was an amazing story in the New York Times this weekend about how executives at Apple and I think it was Facebook were detained.

And

they have a lot of employees in these countries.

So tough geopolitical situation for Facebook here and also users of Instagram across Russia.

I think, and let's call them Facebook, not Meta.

I think they've done the right thing here, and that is they finally acknowledged they're a media company, and they have to make editorial calls.

And they made an editorial call here.

They kept content on the platform that said, you know, someone might say Putin should be taken out or something like that.

And they said, we're going to let people continue to do that.

And they chose an editorial bias against Russia and toward the Ukraine.

And because they believe that the Ukraine is behaving as a better corporate global citizen than Russia.

And that's the same call every media company makes or doesn't make.

Or in the case of Fox, they make the call, we're going to rub the shoulders of Putin and then a week later pretend that we don't like him.

They make an editorial call and they switch that editorial call.

But

Facebook effectively has made an editorial call here and that's what they need to be.

That's what they should be doing.

It's going to be tough going.

This is a really, they have got employees.

They've got all kinds of geopolitical things.

And probably Nick Clegg is the right person to deal with this.

He's probably right at the dead center of this.

Anyway, we'll see what happens, but it's going to get worse, I think, over time.

But we'll see how the Russians take to not having Instagram.

They really do like it as opposed to Facebook itself.

It is a very popular app there.

All right, Scott, let's go on a quick break.

We come back.

COVID takes another bite out of Apple, and we'll speak with friend of Pivot, Surgeon General, Dr.

Vivek Murthy.

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Scott, we're back.

COVID's not done disrupting the global supply chain.

Today, more than 50 million people are locked down in Shanghai and Shenzhen, China, home to some of the world's largest ports.

Shenzhen had 66 new cases of COVID on Sunday, and that prompted a lockdown.

Now, Apple's supplier, Foxconn, shut down its operations at two of its largest factories in Shenzhen.

There's issues all over Hong Kong, everywhere else.

Will the supply chain disruptions like this speed up the adoption of robotics in manufacturing?

I don't know.

What goes on?

Does Apple need to develop more ways to deal with this?

Obviously, the network of global supply chains still continues to have its price.

Well, the most important, the most profitable product in the history of modern economy is the iPhone.

It has the margins of a Ferrari with the production volumes of a Toyota.

We've never seen that.

We've never seen the high-priced product be the market share leader.

And that is, to a certain extent, a joint venture of the Americans and the Chinese.

And while we garner the majority of that shareholder value, China's played a huge role on it.

There are more employees of Apple in China than there are in the United States.

The most important product, I believe, of the last 50 years, as it relates to geopolitical influence, are the vaccines.

And specifically, we make better vaccines.

And they're so complicated and intricate, and the supply chain has to be cold storage.

That when Russia comes out with a shitty vaccine and Argentina says, okay, we're taking your vaccine, and then a bunch of people still end up in the hospital.

And the Chinese vaccine also isn't as good, it says something very powerful around the world: that America, despite all our problems, is still the most innovative nation, still has the best quality standards, still has the brightest minds.

When shit gets real and you need something very important, you can trust Americans in America to make the best product.

And this directly impacts what's happening in China because

the right approach early in the pandemic was a severe lockdown.

And because of notions around personal freedom or misinformation or willingness, a lack of willingness to sacrifice, we didn't adopt that.

And I think China got it right initially.

It was harsh, it was brutal, but within a few months, people were spending time with their grandparents and going to concerts and going on dates.

This is entirely the wrong strategy right now.

And they can't adopt the same strategy as us because it is still a much bigger risk to them.

If this thing goes, you could still have

more people could die from COVID-19 in China from this point forward because their vaccine is not as effective.

And unfortunately, as we've seen, there is a real cost economically and psychologically, especially for older and younger people.

It's sort of like this vaccine.

The thing I've noticed about this virus is everybody gets their turn at the woodshed here.

And to a certain extent, China hasn't.

And I wonder if that's coming for China.

But

this is a big deal.

And as it relates to supply chain, for the last two years, every company I'm involved in has been thinking about a more heterogeneous supply chain.

Let's move some stuff out of China and Shenzhen.

Hard, though, with this, in this case, you know,

we make all our phones come from there.

Like it's, it's sort of, they have concentrated in one place, and making that shift is expensive.

It's difficult.

It might not be possible like very quickly.

So I think that's the problem is they've put all their faith in a global supply chain, really, pretty much, and especially a China-based one for all our technology.

Well, not even global, a Chinese supply chain.

Chinese supply chain, yeah.

I mean,

I was on the board of a retailer, and we woke up one day and realized like 97% of our tops came from not just China, but one region in China.

And when it got shut down, we had no jobs.

I think the big beneficiary, just going out to a second-order effect, I think the big beneficiary here is going to be Mexico because my colleague at NYU has done Ponkach Gemoat, has just done some great research.

And as global as we are, trade is still a function of proximity.

Typically, your biggest trading partner is the one that's on your border.

Our biggest trading partners are Canada and Mexico.

And I think a lot of companies are going to decide to pay a little bit more and have a more approximate supply chain out of Mexico, which has lower costs, has a

decent technology infrastructure.

Mexico City is a fantastic city.

The universities of Monterey produce fantastic technologists.

They attract capital.

It's a stable society.

It's a democratic society.

They are no threat to us.

We like them.

They have been sending their human capital to us, despite the fact we demonize them.

We have a great deal of people.

Yeah, former President Trump's not going to like that.

He wants to build a wall, I hear.

Well, he wants to build a wall to keep people in the world.

He's going to pay for it.

To keep people in here.

Yeah, that's true.

I think it's something that they've got.

I would love to be in a meeting at Apple about what they're going to do going forward,

how they're going to create things.

Anyway, it's a very big issue.

We'll see where it goes.

We're watching it very carefully.

And that sort of leads us into our friend of Pivot.

As Surgeon General of the United States, Dr.

Vivek Murthy has focused on youth mental health.

online misinformation and COVID-19.

This month, he's called on tech companies to turn over data about COVID misinformation on their platforms.

Welcome, Surgeon General.

Well, thanks so much.

It's good to be with you today.

Thanks for doing this.

You know, I think I'd just actually like to start.

I want to talk about the data and everything else, but sort of give us an update of where we are.

Obviously, people are focused on Ukraine and COVID has sort of taken a backseat in terms of news.

Not that it's not still here, but give us sort of an update of where the country is.

I know numbers are lower and things are getting better, but there's still concerns.

Yes, Carol.

Well, you know, it turns out we are in a much better place, thankfully, than we were a month and certainly two months ago.

Cases, hospitalizations, and deaths have all come down.

We are still having tens of thousands of people get infected each day and losing far too many people each day to this disease, but we are trending in the right direction.

The good news also is that we've got more tools now to help address COVID if and when future waves do come our way.

And that's vaccines, boosters.

therapeutics that are now increasingly available.

And we have also now freely available masks and tests as well, which should help us.

So we've got to be vigilant.

We've got to keep preparing for the future.

We've got to keep investing in making sure these tools are there for everyone and they get better in terms of especially vaccines and therapeutics.

But we are in a better place now than we were.

Though it hasn't gone away, I mean, just this morning I woke up and former President Barack Obama has coronavirus, correct?

How do you have people still have the awareness as news just does move on?

I mean, obviously overwhelmed with a very important issue in Ukraine, but how do you keep going?

Because, you know, this sort of happens every day now.

And of course, course, I think it's 9,000 deaths a day at this point.

So we're probably on the average of around 1,000 deaths a day

at this point.

But certainly that's a large number, though, right?

And far more than we want.

But hopefully that will continue to come down.

You're asking the right question, though, which is: look,

there's a lot happening in the world right now, in addition to COVID.

And

we know COVID's not going to go away.

My hope is that what we can do with COVID is make it something that's easy for people to actually address in their day-to-day lives.

If we can make things like, for example, getting vaccinated and boosted just easy and part of your routine, the way flu shots are for many people, and the way doctors have the ease of just doing it and giving it to you when you go in to see them, that would be good.

If we make therapeutics increasingly available, the way we're doing now with the test-to-treat program that the president announced in the State of the Union, that's another way to just weave it in to the fabric of our day-to-day lives.

So people don't have to be thinking about it all the time.

There is an element, though, of precautions that we'll just need to continue to reinforce to people.

If cases and hospitalizations do trend back up, it's a time where we need people to pull out their masks again and use them to use tests, perhaps

before they gather, especially if you're in a higher risk category.

So we want people to be armed with these tools.

It's going to require a lot of consistent, thoughtful messaging, not just from the government, but in particular from healthcare providers over the coming months.

But people have a fatigue of it.

You can feel it everywhere, you know, not just because it's spring across most of the United United States.

It's still cold in places, but I feel like the fatigue is really significant, even among people who've done their best.

And I'm leaving out the other group that just doesn't, has been hostile to the whole idea before that.

So, how do you get people to think about that if there's another variant or anything else?

Well, this is, this fatigue is real that you're talking about.

I think, and all of us feel it, even those of us who, and I include myself in this category, like we've all gotten, it's been an exhausting couple of years, right?

And we've had to worry about not just ourselves, but our loved ones, uh you know friends family members many of whom in my case and many other people's cases have gotten sick and some cases have passed away so this is not easy and it's been tiring but i think part of the way that we help people through this is number one we've got to acknowledge that that there's been a mental health toll of this pandemic as well uh and i think the second thing is we've got to make sure that when they need support it's there for them and that's a key part of ensuring that people have again freely available tests masks vaccines boosters therapeutics and finally we've got to empower the people who they see and trust on a regular basis-doctors, nurses in their communities, educators-to be able to provide them with information.

That's one of the reasons we actually built the COVID-19 Community Corps back in the spring of 2021 because we recognize that to really reach people on an ongoing basis, you need more than just a few messengers.

You need people in communities all across America who can help bring trust and information to people when they need it.

So it feels as if we go into this steady state or endemic, endemic, or at least psychologically, we've decided this thing is going endemic.

We go in with somewhere between 65 and 70 percent of our population vaccinated versus 90 plus in other wealthy nations.

So

the virus has enough uninfected hosts to continue to spread, but there's enough people who've been vaccinated for the virus to learn.

Haven't we set up the perfect storm for a really ugly variant?

It's a really important question, Scott.

And you're right.

We ideally would have more people fully protected from the virus in the country than we do now.

If you take some combination of the people who have been vaccinated, you know, and who have had prior infection in our country, that does accrue to be the vast majority of people in our country.

But we're a big country.

So even a small minority is millions and millions of people who don't have protection.

What we've also seen, Scott, which I know you're alluding to, is that the protection of the vaccine doesn't last forever, right?

We know that there is, after you get two doses, that there's a waning and then you need a booster dose.

And we saw that was a particularly important during Omicron.

And this is actually very typical of other vaccines.

You know, boosters are very common with other vaccines, but it means that it's not just one shot, two shots, you're done.

So yes, we are at risk certainly of other variants popping up.

And we've seen this playbook before.

The good news, though, is that thankfully with the the variants that we've seen to date,

they have been responsive by and large to our vaccinations when it comes to the most important outcomes.

And those are preventing people from dying and keeping them out of the hospital.

Are they perfect?

No.

But do they give you a high degree of protection against those outcomes?

Yes.

We can't bank on that always being the case, Scott, which is why we've got to continue our work on building the next generation of vaccines, making sure that they get better and better.

It's why the investments, for example, that the administration is calling for from Congress are so important because you've got to continue that work.

The work and the job is not done yet.

But, you know, no doubt that the more people we vaccinate, the lower the risk, you know, of us developing more variants of seeing community spread.

And that includes not just the U.S., but vaccinating people around the world, which is why it's been so important that we get out there, invest in getting vaccines to the world, but not just getting

vaccines to them, making sure we're training people to deliver those vaccinations into arms, that we're supporting them in public education campaigns.

Those are also important parts of the process because we know all around the world countries are dealing with health misinformation, which is a big threat to the vaccination effort.

Just to follow up on that,

the highest per capita mortality rate of any wealthy nation here in the U.S., despite having invented the vaccines, having the supply chain, spending more on health care.

And the only two signals from the noise that I can discern that are just

too correlated to ignore are one, that vaccination rate, which is lower than a lot of wealthy nations, and two,

our nation's obesity rate.

And

we've seen a lot of very robust discussion at government level and a lot, I think, leaders trying to demonstrate leadership around the importance of

getting the right information to people.

What I haven't seen is I feel like a lot of our leadership is afraid to take on the obesity issue for fear that they'll be perceived as body shaming.

Your thoughts?

Well, I think you're raising a critical point.

And,

you know, pandemics like this, health crises often reveal the challenges that we've had even before the pandemic began in this case what we saw is that we had a public health infrastructure was not nearly as strong as it needed to be in terms of getting the information out pulling data in being equipped with the people and technology to get vaccines and therapeutics out as quickly as possible but what we've also seen scott to your point are the failures in public health and medicine and policy over the last several decades that have actually allowed for the increase in obesity and chronic disease across the board.

Part of the reason that that's true, Scott, is it's multifactorial.

It has to do in part with the nature of our food supply, the fact that it's far easier to get cheap, unhealthy food that increases your risk of obesity than it is to actually eat a healthy diet.

We also know that in this day and age, getting physical activity is not as easy as perhaps it was 30, 40 years ago.

You have to actually go out and make it a point to do it.

And you have schools across the board canceling physical education classes and outdoor time.

That puts you at increased risk for health issues with kids, which is why in kids as well, we see very high rates of obesity and overweight.

And so, yes, there are significant public health challenges related to our high level of chronic disease in this country that we've absolutely got to address.

And that means, and that's not easy.

Everyone wants to deal with a problem that has one simple cure in the form of a pill.

That's not what obesity is, right?

Obesity is a problem that has to do with multifactorial

inputs, including our food supply.

And unless we address that, we're not going to be able to protect our country in the way that we need to.

You're asking companies to turn over data about COVID misinformation, tech companies.

Now, I know you've been back and forth with them a couple of times on this issue.

Can you talk about where the relationship is right now, or they're complying with you?

When it comes to COVID misinformation, is free speech in conflict with public health?

Well, I don't think it has to be.

I think the problem is, as I see it, is that we've got to take responsibility for our speech.

And if we're platforms, we have to take some responsibility for the information that's being shared on our platform, especially when it's harmful to the public's health.

You know, I think it's easy, I think, Kara Scott, and you know this because you both know this topic and this space so well,

but it's easy to get sucked into a narrow conversation about censorship.

To me, this isn't about censorship.

You know,

our country values free speech.

It's one of the bedrock values of our country.

It's one of the values that brought my family as immigrants and many other immigrant families to this country.

But we also live in a society.

We're not just 330 million people who happen to be out there on our own.

What we say, what we do has an impact on others.

This is why we have speed limits.

And it's why we have guardrails

around things

where our actions may cause harm to others and when it comes to to speech and and to what's being disseminated on the platforms you know i i think we have too often seen in the face of this explosion in misinformation uh platforms step back and say this is somebody else's problem rather than step up which is what do you want to do for them so what do you need to get from them and what aren't they giving you or are giving you well so i'll tell you this when we started our work on health misinformation uh at the very beginning of my tenure as surgeon general we started by listening and talking to people in the community and this is what we heard we heard researchers tell us that they have been trying for years to get information from the technology platforms about the extent to which this misinformation is spreading on those platforms who is being targeted uh if there are groups that are disproportionately being impacted and what solutions they are implementing that actually work And they kept saying that they are having a hard time getting that information.

We also kept hearing from nurses and from doctors who were saying that they are battling COVID in the hospitals during the day, and then they're coming home and battling COVID misinformation at night, trying to call patients, talk to family and friends who have bought into myths that they have unfortunately commonly seen on social media about COVID and about the vaccines.

What we need the tech companies to do is to transparently share the data which they have about, again, who is being impacted, what kind of misinformation is spreading.

Are there solutions which they talk about often?

Are they actually working and to what extent to reduce misinformation?

So we've requested this information.

This is the request for information that we put out recently, the formal RFI, is the first time that this full set of questions is being formally issued as a request to all of the companies.

And it's not just to the companies, by the way, it's the broader public.

So we now have healthcare workers, educators, and others who and policymakers who are sharing their experiences with health misinformation, which will help us develop a better strategy for how we address it.

And their cooperation is what is so far.

Well, we're still waiting.

You know, the RFI just went out recently, so they still have a little more time to submit information.

I'm hopeful they will.

I'm also hopeful that they recognize the following: that parents and people around the country are increasingly frustrated at the misinformation that they are seeing online, and especially the harm it may be doing to them and to their families.

I hope they also recognize that healthcare workers themselves, nurses and doctors, are extraordinarily frustrated.

They are trying to put their own families and their own health at risk trying to address COVID.

Meanwhile, the countries are washed in health misinformation.

They don't see the platforms stepping up to help.

And finally, legislators.

You know, we talk to lawmakers all the time, and I can't tell you how many of them are extraordinarily frustrated.

What they see is the reluctance of these platforms to actually step up and address this issue.

Do you think it was a mistake?

Initially, you were quite aggressive, and President Biden went so far as to say they're killing people, although he stepped that back.

Was that effective to having done that?

Because you still don't have the information from these companies.

Well, you know in the beginning in july of 2021 when i issued the surgeon general's advisory on health misinformation my goal was to to call attention to a critical health issue and to be honest and transparent about the extent of the problem and that involves like who is contributing to the problem and so I do not regret being honest and transparent about that.

And I've continued to do that.

What we've seen, and we're giving companies the opportunity one more time here to actually openly share what they've got.

And some have been good actors, don't get me wrong.

Others have been less transparent.

But look, this is a process that we've got to keep on because while it would be easier to step back and to pull back,

what I think about are the stories I hear every day of the people who tell me their family members were misled by information online, that they didn't get vaccinated, and now they're in the hospital, or God forbid, they passed away from COVID-19.

I heard so many of those stories, Kara.

And what pains me about them is those personalities.

These platforms are still essentially killing people.

Is still the assertion of the government?

Well, I mean, what we're saying is that health misinformation, absolutely, has an adverse impact on people's health and contributes to deaths.

Absolutely.

And all of us have a choice, including the tech platforms, to decide: are we going to step up and play a role in helping to reduce the spread of health misinformation?

I'd like to see these

companies do a lot more than they have.

And I'm not talking about legal responsibility here, I'm talking about moral responsibility.

We should be doing more, in my belief, than the bare minimum.

We should be in the midst of a crisis like this, doing everything we can to help keep people healthy and safe.

So can I just ask you one more question?

Who is the worst and best?

You said some are better than others.

Can you give us specific names?

Well, I don't want to go into specific names of the company.

I know you don't want to, but I'd like you to.

And well, you know, I'll tell you this.

You had mentioned Facebook previously.

That's why.

Yeah, so I'll tell you this.

You know, we have said.

that we were going to make, you know, the information that's submitted to us after we go through it.

We're going to make a lot of that publicly available.

Public will be able to see which companies have actually been forthcoming with data on health misinformation and which are not.

We've obviously been very focused on the health crisis from the pandemic.

Another huge crisis, and you've spoken to it, is the emerging mental health crisis among teens.

And again, looking for signals, it appears that once social media went on mobile, specifically Instagram, specifically when Facebook acquired Instagram and began scaling it, we saw a dramatic increase in not self-reported, but actual hospital admissions from young girls around self-harm.

Do you agree, and would you consider advocating for age-gating social media?

Yeah, well, so Scott, I appreciate the question.

And I think I am deeply concerned about the impact on our kids.

And I do think that many kids at young ages, when their brains are still developing, when their sense of identity and self is still developing,

they're immersed in these platforms.

And in some cases, these platforms are having very negative effects on body image sense of self.

As a parent, and I say this not as a doctor, not a surgeon gentleman, but as a parent, I am worried about my kids using social media too early.

My kids are four and five.

They're not using social media, thankfully.

But I'd like to wait until as long as possible.

Part of the challenge we have, though, Scott, and you're getting at the heart of it with your question, is that we actually need data to understand the impact on children, right?

We have some data.

We have alarming rates of depression and anxiety that have increased in our kids.

We have clear evidence, in fact, that the suicide rate has increased significantly in the 10 years prior to the pandemic in young people.

We have record numbers of young people who are saying they feel persistent feelings of hopelessness and sadness.

We know that things are getting worse for our kids.

But what we also need in this case is for the companies to share the information that they have right now about the impact of their platforms on children.

In some ways, what's happening now is we're conducting this national experiment on our children with social media.

We don't know the results yet, and yet we continue to plow forward.

And, you know, when hearing about some of these platforms developing, you know, versions, you know, of their product for younger, younger children, to me, that is incredibly disturbing.

It also strikes me as irresponsible to do without having data on how this is impacting our children.

And lastly, I'll just say this.

If I told both of you that we were going to push a drug out for use in the country, the clinical trials were still ongoing.

I couldn't quite tell you what they're going to say.

I don't know where they'll end up.

And you can't actually see the data, but go ahead and use the medication.

Most people would balk and say, that seems ridiculous.

You know, why don't you tell me what the results are?

And then I'll decide whether that's safe for me and my family.

Parents in particular deserve the same, you know, I think transparency and honesty when it comes to the impact these platforms are having on their children.

The companies actually have not done enough to actually step up and share that data.

We hear the same thing from researchers in this space as well, that they're only getting tidbits of data, the ones that seem to be favorable.

That's no way to approach the mental health challenges that we're seeing in our kids.

With all that said, look,

I'm a fan of technology.

I'm a supporter.

I spent years building a technology company in my past.

I'm a believer tech can make our lives better.

And I think when it comes to social media as well, there are some benefits.

It can bring people together.

It can help people find community where they need it.

But we have to be more thoughtful about how we use technology, the boundaries we draw around it, what age we get our kids introduced to technology.

And that requires data to understand the impact on the mental health of our kids.

But you want data.

Data, data, data is what you want.

I agree.

I agree.

We can't know anything until we know.

The doctor has written a book right before the pandemic came out.

It was called Together, the Healing Power of Human Connection in a Sometimes Lonely World.

So

it's an area you and Scott share talking about a lot.

This point about human connection in this moment, I think, is so incredibly important.

It's why we have to not just snap back to 2019 as we make our way through this pandemic, but we have to ask ourselves the question, what have we learned in this last two years about what really matters in life, what really matters in terms of pandemic preparedness and public health.

And one of the things that has struck me again and again is that it is our relationships that are such an important backbone of our individual health and well-being and also the health and well-being of our communities.

Many of us missed those connections in the early part of the pandemic when we couldn't see people.

But we've also seen the product of not being connected, what happens when communities are fragmented, when the social fabric is thin and when it frays, which is that during times of crisis, we can't come together, we can't do hard things.

And so whether we're thinking about the next pandemic, whether we're thinking about economic equality, climate change, or other big challenges that are at our doorstep, It is our connections that we build between each other, the community that we support.

That's what's going to help us get through it.

That's where I hope we will invest as individuals and more broadly as a society.

Well, can I ask you then, what did you learn?

And excluding something you think you should have done differently or the government should have been done differently because there seems to be such a distaste for the government by a lot of people.

What could it have done better?

Or what could you as Surgeon General have done better?

Well, how much time do you have?

There's a lot of things I could have done better.

Yeah.

You know, I'm sure.

And this has been a learning process for all of us.

You know, I'll tell you, you know, from my standpoint, you know, one of the things that certainly I wish if I could do this all over again, I would have done a lot more of is I would have taken some of the listening sessions that we were doing with community members, and I would have really amped those up even more because I think you get so much out of listening.

It's not just what you learn, it's also a message you send to people that you respect them, that their views matter.

And I would have done even more of those in communities across the country, including in partnership with faith organizations.

And I think the other thing that I would have wanted to do really early on is make sure that we messaged just with much more emphasis to people what the goal of a vaccination was.

It became sort of, I think, understood early on that a vaccine should prevent any infection period.

And we were in some ways spoiled because the early trials of vaccines showed that they had a very high success rate at preventing any symptomatic infection.

But in reality, the most important goal of a vaccine is to save your life or keep you out of the hospital.

And the vaccines by and large have done an amazing job of that.

But because there have been breakthrough infections, many people have felt, oh, gosh, does this mean the vaccines have failed, that they don't work?

So that's a place where I think we could have been even more clear and I think emphatic in our messaging about the primary goal of vaccines.

Dr.

Vivek Murthy, Surgeon General of the United States, thank you so much for coming.

We really appreciate it.

Thank you so much.

It was good to talk to you both.

Take care.

Thank you, Doctor.

All right, Scott, wasn't he impressive?

I like him a lot.

I think he's doing a great job so far.

So, one more quick break.

We'll be back for wins and fails.

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Okay, Scott, wins and fails.

Can I just do one win?

My win is Mitt Romney, who is talking, Tulsi Gabbard's been spewing a lot of

nonsense about bio labs and things like that.

And Mitt Romney just said it flat out.

Tulsi Gabbard is parenting false Russian propaganda.

Her treasonous lies may well cost lives.

I thought, well, okay, that's what what he's saying about that.

Yeah, she

responded.

She'll clap back.

She served.

She did.

She did.

She said, you called me a treasonous liar for stating the fact that there are 25 plus U.S.-funded biolabs.

Anyway,

good for Mitt Romney.

I just have to say good for Mitt Romney.

We love Mitt.

Who would have been using

social media?

It's interesting how quickly people, in this case, I usually don't like the clapbacks, but

I thought this was

a good use of Twitter in this regard.

So anyway, so I felt like that was interesting from my perspective.

What do you think?

Fails?

My fails are, I think it's going to be very interesting.

If you think about what's going on in London, you know, what they're calling London Grad,

back in the 80s, so I've been going to London since I was a kid.

And what has happened to London in the last 20, 30 years is just remarkable.

It's been a multi-trillion dollar facelift.

It is the most opulent, well-groomed, cosmopolitan city in the world.

And you think, okay, there's been other cities that have incurred that type of uplift.

You know, you think about the Bay Area just looks amazing because of this massive

prosperity around

the microchip and the internet.

New York has incredible financial services and alternative investments and publishing.

London, you think, well, okay, what does London do?

They make Range Rovers, they have tourism.

But you wouldn't look at it and go, it's a safe haven.

It is a jumping off point, like a Singapore finance.

But still, it doesn't, you think, it still doesn't kind of justify or explain the massive apparent prosperity.

And what does explain it is that basically the biggest money washing

in history has taken place in London.

And that is private property laws are very strong in London, which is Latin for regardless of how you made your money.

If you bring it here, we'll create a shield around you.

No one will be able to get it.

We won't out you.

So a few years ago, I don't remember if you remember these transparency laws passed in New York, and we found out that a bunch of mid-level bureaucrats in Brazil and China owned $11 million condos.

And it was clear that these were ill-gotten gains or gains through corruption.

London has done none of that until recently.

And now it is coming out that all of these individuals that own tens of billions of dollars in real estate, own football teams, own the most popular restaurants, have been made lords because they bought two newspapers and then started speaking well of Boris Johnson.

London has a reckoning right now.

I would not have expected this, Scott.

It's very interesting.

I hadn't thought of it that way.

Well,

we have to,

again, it comes down to to what extent do we want to promote and actually have the music match the words around democratic values.

And there's just some amazing stats.

Do you realize there is more Russian wealth held outside of Russia than inside of Russia?

Oh, I'm not surprised.

I mean, all the rich rich people are in London.

If you used to, a couple of years ago, there was all the Saudis there running around in Dubai.

And it was so, it was when you went to any of Mayfair or any of the nicer areas, and I was like, oh, they're all living over here

from their wealth over there.

It was, it was an interesting.

But when you think about Russia, when you think about the Russian people, they buy coal, they buy their electricity, they buy their cars,

they take their hard-earned money, and then there's incredible wealth generated.

And then an oligarch decides how to dole out that wealth which is bad and what's even worse is the oligarchs then take that wealth and they spend it somewhere else they don't spend it in russian russia

to keep people down yeah

they don't spend it on russian real estate tail as old as time as they say they don't spend it on russian russian uh companies they don't they don't start vc funds and start start backing local local internet companies in st.

Petersburg name an internet company that's that's gone global out of Russia and this is a this is a community that has incredible appreciation for science, despite how mad we are at them.

They have fantastic science.

They have very intelligent, educated workforce.

But anyone with capital does one thing.

They leave and they start spending their capital elsewhere.

And London is going to have some real soul searching around the fact that they have let so much dirty money come into their country.

All right, that's good.

All right.

What's your positive?

My win is I'm just inspired by

all of these small charities that have shown up and been really agile.

Avi Schiffman, a student from Harvard, get this care, started a site to help Ukrainian refugees to find housing.

It's called ukraintakeshelter.com.

Again, that's ukrainetakeshelter.com.

He sort of took the Airbnb idea and scaled it.

I mean, just a young, really impressive young man who understands technology and said, I'm not going to wait around.

I'm not going to pontificate.

I'm not going to challenge.

I'm not going to challenge Putin to a fight.

I'm just going to try and find people homes using technology, refugees.

But really impressive.

And then there's a small organization that I've been involved with for a little bit.

It's a company called Lifting Hands International, and they do refugee work, among other things.

And what do they do?

It's a bunch of BYU grads.

And most recently, they bought it.

They raised like 10 or 30 grand, and they bought a bus in Ukraine and are shuttling refugees out.

That's literally what they do.

They're like, we want to do something.

So they raise money, they buy a bus, they find a driver, they go to a border, and they start getting people out of Ukraine.

I mean, that's it's so simple, it's so non-technological, and it's so inspiring that a bunch of BYU grads, I know the woman who runs it, and she's this incredibly impressive young woman in her 20s who could be working at Bridgewater or Google, and instead she's like, no, I'm just going to figure out creative ways to help people.

But all these small, nimble grassworks

organizations reaching where bigger entities don't get to.

And if anyone wants to join me in supporting it, it's a company called LiftingHands International.org.

Again, that's liftinghandsinternational.org.

They were doing things like getting goats to Syrian refugees.

But the thing I love about them is they're just small, super nimble, and basically 99 cents on the dollar gets to a refugee or to a Syrian

individual whose goat can change their lives.

But there are literally thousands of these little, nimble organizations run by inspiring people who are like, you know what?

I'm sick of complaining.

I don't need to turn to Twitter to Virtue Signal.

I'm going to buy a fucking bus and start getting refugees out of the Ukraine.

Anyways, my win is all these wonderful little organizations.

I like it.

And a fail, it would have to be Elon and the joke.

It's not funny right now.

It's not.

I know, you know, you can call me like a scold, but boy, is that not the best?

He tweeted at me this weekend again.

Oh, what did he say?

He's my new troll.

My trolls are getting more impressive, which is exciting.

They are.

What did he say?

I just put out what I thought was a harmless tweet.

I said, I'm doubling down on the greatest payment technology and store of value in history, the U.S.

dollar, and out a picture of an eagle.

And of course, the crypto Taliban weighed in about what a fucking idiot I am, including Elon.

That I actually like the dollar.

The majority of my assets are held in the USD.

I do trigger these guys, but I'm triggering more important people, which is very rewarding.

Yes.

You know, it's interesting.

I yell at many of them behind the scenes.

I'm like, lay off Scott.

I do.

Go on.

I'm not going to.

I just, I threaten them quite a bit.

I'm like, what is the problem?

First of all, I'm like, you're a bunch of creepy people.

It's creepy.

Go find worthy people to really go after.

Do you know

I've had a VC who shall remain nameless who has tweeted about me 424 times in the last 24 months?

I have spoken.

I mean, literally, the guy's going to show up at a conference and profess his love for Jodi Foster and pull a piece on me.

It is getting very strange.

He's been on a diet.

He's been dieting, so I'm thinking he's just lost.

That's his excuse.

He's been dieting.

I don't know.

He talks about dieting.

He's now tweeting about dieting, which I'm very

guy who claims he's the representative for Silicon Valley, and he tweets about me three or four times a day.

But nonetheless, I have spoken to him that I am not happy about this.

I find it creepy.

I want to say that.

Oh, you think?

I find it creepy some of them.

They can dislike you and they can argue with you online.

I get that in my own house.

I'm down with it.

Exactly.

It reaches creepy proportions in any case that is a fail fail elon i'm sorry it's just not funny it's just not funny i'm sorry anyway and you have an impact so oh my god and you did such a good thing with darling like what are you doing like what are you doing anyway that is the show i hope you feel a little livelier and the lunest is wearing off uh we'll be back friday for more can you read us out Today's show was produced by Lara Naiman, Evan Angle, and Taylor Griffin.

Ernie Andretod engineered this episode.

Thanks also to Drew Burrows and Mili Silverio.

Make sure you're subscribed to the show wherever you listen to podcasts.

Thanks for listening to Pivot from New York Magazine and Vox Media.

We'll be back later this week for another breakdown of all things tech and business, liftinghandsinternational.org.