NOTeD Interviews Dr. Monica Gandhi about the COVID Vaccine

Tom Rifai, MD, FACP
Our guest for this episode of NOTeD is Dr. Monica Gandhi, an infectious disease specialist at the University of California San Francisco. We also welcome a special guest co-host today, Dr. David L. Katz, founder of The True Health Initiative and CEO of DietID Inc.

Dr. Gandhi was recently interviewed on ZDoggMD’s podcast, a great “prequel” to this NOTeD episode!

In our conversation, we cover a wide range of COVID vaccine topics such as how to regain trust in public health messaging, natural versus vaccine immunity, and possible long term cardiovascular benefits of COVID vaccines.

We begin our conversation discussing the concept of hybrid immunity and touch on the lack of communication from U.S. officials that people who have contracted COVID-19 have a significant degree of naturally-acquired (notably, many contend a better-than vaccine acquired) immunity. We also discuss the role of the general public’s trust in public health officials.

COVID Vaccine: Boosters or Distribution?

We turn our attention to the ethical ramifications of the current U.S. COVID vaccine rollout versus a distribution of vaccines worldwide. We discuss that for public health professionals, there were some hard questions, including either providing vaccine boosters (or single shots/jabs in those who’ve already achieved natural immunity), or vaccines to the Global South, where pre-infection vaccine distribution has been challenging. Dr. Gandhi shares her thoughts on these COVID vaccine concerns.

“Feet, Forks and Fingers:” How Cardiometabolic Health Affects COVID Risk

Our interview also touches on how high-risk factors for COVID infection are also factors that affect risk of severe infection pre-vaccine as well as severe breakthrough infection after immunization. We discuss how chronic lifestyle-driven diseases – including heart disease, stroke, dementia, many cancers and excess weight – contribute to these risks.

Lack of physical activity (“feet”) along with high-risk, calorie laden, low nutrient foods (“forks”) and continued smoking (“fingers”) are a big part of the problem. Not only do “feet, forks and fingers” account for 80% of preventable early death in the United States, but prior disease accounts for an estimated 63.5% of the total COVID casualties in the U.S., according to a Dariush Mozaffarian, et. al. study in the Journal of the American Heart Association.

COVID Response Compared to the 1918 Spanish Flu Pandemic

Dr. Gandhi provides some historical context around pandemics, including discussion of the 1918 Spanish Flu pandemic. Dr. Gandhi’s research led her to understand that fetal stress during the 1918 pandemic led to poor cardiovascular outcomes. We discuss other data indicating long term health complications and early death for children because of the shutdowns in 1918.

As a result of the modern-day COVID response, we are seeing history begin to repeat itself, including weight gain and mental health consequences in children. People have turned even further away from focusing on overall health promotion and this has led to poorer COVID outcomes. As Dr. Gandhi puts it, postponing healthy lifestyle throughout the pandemic and saying “we’ll deal with that later…was actually fundamentally integral to what happened in this country with COVID outcomes, And then the poor cardiovascular health that has resulted from the COVID response” is essentially pouring salt on a wound, if not gas on an open flame.

You’ll find in this interview a RARE focus on LIFESTYLE as medicine for COVID “prophylaxis,” (as president-elect of the American College of Lifestyle Medicine and Harvard professor, Dr. Beth Frates, and I wrote about last summer in the American Journal of Health Promotion).

I believe that this is one of the most insightful interviews you will see on the current state of COVID in the United States. So grab your earbuds, head out for a brisk walk and enjoy the wisdom of Dr. Monica Gandhi!

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